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Prepared for practice? UK Foundation doctors’ confidence in dealing with ethical issues in the workplace
  1. Lorraine Corfield1,
  2. Richard Alun Williams2,
  3. Claire Lavelle3,
  4. Natalie Latcham4,
  5. Khojasta Talash5,
  6. Laura Machin6
  1. 1Keele Medical School, Keele University, Keele, Staffordshire, UK
  2. 2Management School, Lancaster University, Lancaster, Lancashire, UK
  3. 3GP Trainee, Wirral GP Specialty Training Scheme, Birkenhead, UK
  4. 4Department of Medicine, Morecambe Bay Hospitals NHS Trust, Kendal, Cumbria, UK
  5. 5Academic Foundation Doctor, Morecambe Bay Hospitals NHS Trust, Kendal, Cumbria, UK
  6. 6School of Health and Medicine, Lancaster University, Lancaster, Lancashire, UK
  1. Correspondence to Lorraine Corfield, Keele University Faculty of Health, Newcastle ST5 5BG, UK; lcorfield{at}doctors.org.uk

Abstract

This paper investigates the medical law and ethics (MEL) learning needs of Foundation doctors (FYs) by means of a national survey developed in association with key stakeholders including the General Medical Council and Health Education England. Four hundred sevnty-nine doctors completed the survey. The average self-reported level of preparation in MEL was 63%. When asked to rate how confident they felt in approaching three cases of increasing ethical complexity, more FYs were fully confident in the more complex cases than in the more standard case. There was no apparent relationship with confidence and reported teaching at medical school. The less confident doctors were no more likely to ask for further teaching on the topic than the confident doctors. This suggests that FYs can be vulnerable when facing ethical decisions by being underprepared, not recognising their lack of ability to make a reasoned decision or by being overconfident. Educators need to be aware of this and provide practical MEL training based on trainee experiences and real-world ethics and challenge learners’ views. Given the complexities of many ethical decisions, preparedness should not be seen as the ability to make a difficult decision but rather a recognition that such cases are difficult, that doubt is permissible and the solution may well be beyond the relatively inexperienced doctor. Educators and supervisors should therefore be ensuring that this is clear to their trainees. This necessitates an environment in which questions can be asked and uncertainty raised with the expectation of a supportive response.

  • clinical ethics
  • decision-making
  • education for health care professionals
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Footnotes

  • Contributors LC, LM, NL and CL were all involved in study design and undertaking the research. RAW performed data analysis. All listed authors contributed to writing and/or editing the article prior to submission.

  • Funding Thos study was funded by Institute of Medical Ethics.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was undertaken with ethics approval from the University of Lancaster Research Ethics Committee and from Health Education England.

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

  • Data availability statement All data relevant to the study are included in the article

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