SAEM Ethics Curriculum Intro July 2012 Final

Intro: 1

2012 SAEM ETHICS CURRICULUM Introduction Review date: June 2012 Appendix: ACGME New Accreditation system

The purpose of this manual is to provide an aid to residency directors and others responsible for teaching ethics to emergency medicine residents. Our goal is to facilitate education of EM residents by offering tools to develop the skills required for ethical professional conduct..

The manual is divided into teaching modules relevant to emergency medicine residents throughout their training. Each module includes objectives, illustrative cases, trigger questions, a discussion to help educators and students, and a brief recent bibliography. The objectives define basic material a resident would be expected to master after each session. The study questions can be used to focus discussion and stimulate thought. Like all of medicine, biomedical ethics is continually changing. This curriculum is not comprehensive, but rather offers core ethics topics that are part of the Model Curriculum in EM and the ACGME core competencies in a format that is easy to teach.

These case-based modules use concrete situations to help professionals recognize the existence of ethical dilemmas, develop a process for working through ethical choices, and demonstrate how to manipulate universally applicable standards. When true ethical dilemmas exist, people of good faith and sincere motives may disagree, but should be ready to defend their choice of action based on ethical values and principles. Our goal in providing these teaching modules is that emergency medicine practitioners become more intentional about recognizing and making choices that are based on values that they can articulate and that support the best ethical principles of our profession. Case-based discussions, narrative writing based on patients who trigger recognition of the need for making ethical choices, and small group debates help make residents recognize and commit to their own values, both professional and professional.

The Society for Academic Emergency Medicine Ethics Committees over the years has developed and updated an ethics curriculum. The first manuscript was published in 1994 and the text was updated and posted on line at the SAEM website last in 2005. The 2010-2011 and 2011-2012 Ethics Committees have leaned heavily on the thoughtful contributions of our predecessors in creating this current version. The primary effort of this update is to make the ethics curriculum more accessible as a teaching tool by dividing it into topical modules that derive from the Model Curriculum and the most recent program requirements in Emergency Medicine. In 2012 the newest version of “Emergency Medicine Milestones� has been developed from the Next Accreditation System (ACGME-NAS). Each module is indexed to the Milestone competencies that it

Intro: 2 targets. In this current Ethics Curriculum, the format has been changed, cases have been added and the bibliography has been both updated and thinned to focus on a few core recent articles that may help in teaching. However, the current authors acknowledge, with deep gratitude, the prior “editions” of our colleagues from 1994 and 2005 -- for cases and, in some places, the text.

SAEM Ethics Committee Curriculum Subcommittee, 2010 – 2011, and 2011-2012: Jean Abbott, Coordinator; Shellie L Asher Darren M Beam Mark Clark Stephanie Cooper Christian Jacobus Scott Kurpiel Sangeeta Lamba Joel Moll Edward Otten Ryan Paterson Caitlin Schaninger and Jeremy Simon, Chair, SAEM Ethics Committee 2010-2011 and 2011-2012.

The authors would like to especially thank the members of the 2004-2005 SAEM Ethics Committee who worked on the most recent revision of the curriculum: Terri A Schmidt (Chair), Andrew Beckman, Richard Bradley, Natalie DiGioia, Jennifer Girod, Stephanie Hollingsworth, Jason A Hughes, Jayne MacLaughlin, Catherine A Marco, Brian D McBeth, Katie B McClure, Tammie E Quest, Rachel M Schears, Drew Waters.

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Table: ACGME General Competencies for Emergency Medicine Relevant to an Ethics Curriculum for Residents

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Patient Care and Procedural Skills § Value of patient-focused care § Accurate communication § Cost-effective evaluations § Obtaining informed consent § Identifying and respecting patient preferences § Management of difficult or uncooperative patients Medical Knowledge § Understand basic ethical theory as it applies to the practicing physician Professionalism § Respect for others § Prioritization of patient interests above own § Accountability to society, profession § Respect for patient autonomy, privacy, confidentiality § Responsiveness to diverse patient populations § Attitude of caring that is derived from humanistic and professional values § Awareness of risk-benefit and cost in relation to patient and population-based care § Accountability for wellness of self and colleagues.

Practice-based Learning and Improvement § Self-awareness of strengths, deficiencies, limits § Recognition and disclosure of errors § Responsible use of technology (social media, testing, and avoiding industry influence) Patient Centered and Team Communication Skills § Effective communication with patients, families across broad range of socioeconomic and cultural backgrounds. § Communication with other health team members and consultants. § Communication of sensitive issues or unexpected outcomes, including delivery of bad news, end-of-life issues and death notification, and medical errors § Supervision of trainees

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Available on-line; posted May, 2012 at: http://www.saem.org/emergency-medicinemilestones, accessed 6.20.12. Â