RT Journal Article
SR Electronic
T1 Evaluation of medical ethics competencies in rheumatology: local experience during national accreditation process
JF Journal of Medical Ethics
JO J Med Ethics
FD BMJ Publishing Group Ltd and Institute of Medical Ethics
SP 839
OP 842
DO 10.1136/medethics-2019-105717
VO 45
IS 12
A1 Virginia Pascual-Ramos
A1 Irazú Contreras-Yáñez
A1 Cesar Alejandro Arce Salinas
A1 Miguel Angel Saavedra Salinas
A1 Mónica Vázquez del Mercado Del Mercado
A1 Judith López Zepeda
A1 Sandra Muñoz López
A1 Janitzia Vázquez-Mellado
A1 Luis Manuel Amezcua Guerra
A1 Hilda Esther Fragoso Loyo
A1 Miguel Angel Villarreal Alarcón
A1 Mario Pérez Cristobal
A1 Eugenia Nadina Rubio Pérez
A1 Alfonso Ragnar Torres Jiménez
A1 María del Rocio Maldonado
A1 Everardo Álvarez-Hernández
A1 ,
YR 2019
UL http://jme.bmj.com/content/45/12/839.abstract
AB Introduction Rheumatologists are the primary healthcare professionals responsible for patients with rheumatic diseases and should acquire medical ethical competencies, such as the informed consent process (ICP). The objective clinical structured examination is a valuable tool for assessing clinical competencies. We report the performance of 90 rheumatologist trainees participating in a station designed to evaluate the ICP during the 2018 and 2019 national accreditations.Methods The station was validated and represented a medical encounter in which the rheumatologist informed a patient with systemic lupus erythematosus with clinically active nephritis about renal biopsy. A trained patient–actor and an evaluator were instructed to assess ICP skills (with a focus on kidney biopsy benefits, how the biopsy is done and potential complications) in obtaining formal informed consent, delivering bad news and overall communication with patients. The evaluator used a tailored checklist and form.Results Candidate performance varied with ICP content and was superior for potential benefit information (achieved by 98.9% of the candidates) but significantly reduced for potential complications (37.8%) and biopsy description (42.2%). Only 17.8% of the candidates mentioned the legal perspective of ICP. Death (as a potential complication) was omitted by the majority of the candidates (93.3%); after the patient–actor challenged candidates, only 57.1% of them gave a clear and positive answer. Evaluators frequently rated candidate communications skills as superior (≥80%), but ≥1 negative aspect was identified in 69% of the candidates.Conclusions Ethical competencies are mandatory for professional rheumatologists. It seems necessary to include an ethics competency framework in the curriculum throughout the rheumatology residency.