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Confronting Barriers to Implementation

Douglas S. Diekema, MD, MPH; Richard P. Shugerman, MD

Arch Pediatr Adolesc Med. 1997;151(6):609-614.

Abstract
Background
The 1997 Residency Review Committee requirements in pediatrics mandate a structured curriculum in medical ethics for all accredited pediatric residency programs. To our knowledge, there are no published models for the development of an ethics curriculum for pediatric residents. Several obstacles may confront those attempting to begin an ethics teaching program.

Objective
To describe the successful implementation of a structured ethics curriculum for pediatric residents.

Methods
Our program was designed to overcome the following obstacles: (1) time constraints of faculty and residents, (2) scheduling difficulties and lack of continuity, (3) attitudes of residents toward the material, and (4) inadequate ethics training among faculty. In addition to traditional topics in medical ethics, the curriculum focuses on issues that confront residents primarily during their training, issues that may shape their professional values in important ways.

Results
This ethics curriculum has been successfully implemented in our own program and offers solutions to common barriers faced by those seeking to implement an ethics curriculum for pediatric residents.

Conclusion
We present the ethics curriculum currently in use at our institution as a tool that may be adopted as it stands or as altered by others as they develop their own program's ethics curriculum. We believe the proposed curriculum directly confronts many of the barriers to successful ethics education of pediatric residents.

Arch Pediatr Adolesc Med. 1997;151:609-614

Author Affiliations
From the Departments of Pediatrics (Drs Diekema and Shugerman) and Medical History and Ethics (Dr Diekema), University of Washington School of Medicine, Children's Hospital and Medical Center, Seattle.

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