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Bridging the education–action gap: a near-peer case-based undergraduate ethics teaching programme
  1. Wing May Kong1,
  2. Selena Knight2
  1. 1 Imperial College London and Central Middlesex Hospital LNWH NHS Trust, London, UK
  2. 2 Department of Primary Care and Public Health Sciences, King's College London and Chelsea and Westminster NHS Foundation Trust, London, UK
  1. Correspondence to Dr Wing May Kong, 3rd Floor Reynolds Building, Charing Cross Campus, St Dunstans Road, London W6 8RR, UK; w.kong{at}


Undergraduate ethics teaching has made significant progress in the past decade, with evidence showing that students and trainee doctors feel more confident in identifying and analysing ethical issues. There is general consensus that ethics education should enable students and doctors to take ethically appropriate actions, and nurture moral integrity. However, the literature reports that doctors continue to find it difficult to take action when faced with perceived unethical behaviour. This has been evident in recent healthcare scandals, in which care has fallen below acceptable ethical standards, despite the presence of professional ethical guidelines and competencies. The National Foundation Training Programme forms the first 2 years of training for new UK doctors. We designed a Foundation Doctor (FD)-led teaching programme in which medical students were invited to bring cases and experiences from clinical placements for small group discussion facilitated by FDs. The aim was to enable students to act ethically in practice through developing moral sensitivity and moral identity, together with skills in ethical reasoning and tools to address barriers to taking ethical action. FDs were chosen as facilitators, based on the evidence that near-peer is an effective form of teaching in medicine and may provide positive role models for students. This article reviews the background rationale for the programme and its design. Important themes emerging from the case discussions are explored. Student and FD facilitator feedbacks are evaluated, and practical challenges to the implementation of this type of programme are discussed.

  • Applied and Professional Ethics
  • Clinical Ethics
  • Education
  • Education for Health Care Professionals
  • Education/Programs

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  • Contributors There was equal contribution from both authors.

  • Competing interests None declared.

  • Ethics approval Imperial College School of Medicine Curriculum Advisory Group and the North West Thames Foundation School.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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