Abstract
Background
In the domain of orthopedics, ethical practice significantly influences professionalism and the quality of patient care delivered by postgraduate students. This narrative review aimed to investigate the implementation and impact of an ethics-centric curriculum tailored for orthopedic postgraduate students.
Methods
The proposed curriculum incorporates methodologies such as case-based learning, interactive discussions, and dedicated mentoring sessions, focusing on the unique ethical challenges encountered in orthopedics.
Results
Introducing the curriculum provided postgraduate students with a robust foundation in ethical principles, enhancing effective communication, and fostering better doctor-patient relationships. Consequently, the students displayed an increased aptitude in navigating intricate ethical dilemmas in their clinical practice.
Conclusion
There is a crucial need for continuous ethics education in orthopedics. Creating a supportive learning environment is essential to cultivate professionalism and promote patient-centered care. This study underscores the transformative potential of ethics training in molding orthopedic professionals who are both competent and deeply committed to maintaining the highest ethical standards.
Keywords: Orthopedics training, Orthopedic residency, Moral values, Attitudes, Doctor–patient relationship, Effective communication
Introduction
Ethics serves as the moral compass that guides the practice of medicine, and its significance is particularly pronounced for postgraduate students pursuing a career in orthopedics. As these students embark on their journey to become proficient orthopedic surgeons, they must cultivate a strong ethical foundation that will shape their professional conduct, decision-making processes, and interactions with patients and colleagues. Ethical practice is not only essential for upholding the integrity and reputation of the medical community but also for ensuring the provision of high-quality, patient-centered care [1, 2].
Orthopedic residency programs equip postgraduate students with the knowledge and skills necessary to excel in the field of orthopedic surgery. While technical expertise is paramount, the development of ethical competence is equally critical to prepare these students for the ethical dilemmas they will encounter throughout their careers. Ethical practice encompasses a range of principles, including informed consent, confidentiality, integrity, and the promotion of equity in healthcare delivery [3–5].
This article will delve into the significance of ethics in orthopedic residency and explore key ethical principles that guide the behavior and decision-making process of postgraduate students. Furthermore, real-world examples will be provided to highlight the practical application of ethics in orthopedic settings, underscoring the impact it has on patient outcomes and the overall reputation of the medical community.
Informed Consent and Shared Decision-Making
Ethical practice in informed consent and shared decision-making is vital for orthopedic residents as they navigate complex treatment options and empower patients to participate in their healthcare decisions [6–12]. Let’s explore what orthopedic residents must do ethically in this regard, along with suitable examples:
Provide Comprehensive and Understandable Information
Orthopedic residents should ensure that patients have a clear understanding of their condition, treatment options, risks, and benefits. For example, when discussing a surgical procedure such as joint replacement, residents should explain the expected outcomes (pain relief, improved range of motion and ability to perform daily activities), potential complications (infection, deep vein thrombosis, neurovascular injuries, fracture, dislocation etc.) and rehabilitation process (physical therapy, continuous passive motion etc.) in a way that patients can easily grasp. They should use layman’s terms (i.e., for DVT, use the term “blood clot”, visual aids, and provide sufficient time for patients to ask questions and seek clarification [6–9].
Respect Patient Autonomy
Orthopedic residents must respect patients’ rights to make decisions about their own healthcare. They should present the available treatment options neutrally, without undue influence, and respect the patient’s final decision. For instance, if a patient with chronic knee pain is considering either non-surgical management or knee arthroscopy, the resident should provide unbiased information about the risks, benefits, and expected outcomes of both options, allowing the patient to make an informed choice based on their values and preferences [9–12].
Assess Decision-Making Capacity
The residents need to assess whether patients have the capacity to make informed decisions. This is particularly important when dealing with patients with cognitive impairments, mental health issues, or language barriers. For instance, if a patient has difficulty understanding complex medical information due to a language barrier, the resident should ensure the availability of a qualified interpreter to facilitate effective communication and support the patient’s decision-making process [10–15].
Document the Consent Process
Orthopedic residents should maintain accurate and detailed documentation of the informed consent process. Documentation should include the discussions held, the information provided, the patient’s questions and concerns, and the final decision reached [9–12]. For example, a resident may document the patient’s decision to undergo a specific surgical procedure after discussing the risks and benefits in detail and obtaining their informed consent.
Consider Cultural and Personal Values
Orthopedic residents should be culturally sensitive and considerate of the personal values that may impact a patient’s decision-making process. They should recognize that different cultures and individuals may have distinct beliefs and preferences. For instance, if a patient’s cultural or religious beliefs influence their acceptance or refusal of a particular treatment option, the resident should respect those beliefs and work collaboratively to find an alternative solution that aligns with the patient’s values [13–15].
Ongoing Communication and Reassessment
The residents should maintain open and ongoing communication with patients to address any concerns, provide updates, and reassess treatment decisions as necessary. They should encourage patients to ask questions and express their preferences throughout the treatment journey. For instance, if a patient initially consents to a surgical procedure but later expresses doubts or concerns, the resident should engage in a further discussion, reevaluate the decision, and address the patient’s reservations.
By adhering to these ethical principles, orthopedic residents demonstrate their commitment to patient autonomy, shared decision-making and patient-centered care. These practices contribute to building trust, ensuring informed consent, and fostering collaborative relationships between residents and their patients.
Confidentiality and Privacy
Confidentiality and privacy are crucial aspects of ethical practice in healthcare, and orthopedic residents play a significant role in ensuring the protection of patient information. Upholding confidentiality and privacy rights not only maintains trust between patients and healthcare providers but also safeguards sensitive medical data [10–12]. Let’s explore the role of orthopedic residents in confidentiality and privacy, along with suitable examples:
Maintaining Strict Confidentiality
The residents must adhere to strict confidentiality guidelines to protect patient information. This involves keeping patient records, test results, and discussions confidential, both in electronic and physical formats. Residents should exercise caution when discussing patient cases in public areas or using personal electronic devices. Respecting confidentiality builds trust and fosters a safe environment for open communication between patients and healthcare providers [9–15].
Example: An orthopedic resident encounters a professional athlete with a career-threatening injury. The resident must exercise utmost discretion to prevent unauthorized disclosure of the patient’s condition, respecting their privacy rights. Additionally, residents should ensure that patient records and discussions are conducted in secure environments, maintaining confidentiality and fostering trust between the patient and the medical team.
Safeguarding Electronic Medical Records
With the increasing use of electronic medical records (EMRs), postgraduate students must be diligent in maintaining the privacy and security of patient data. They should use secure computer systems, employ strong passwords, and follow institutional protocols for accessing and transmitting patient information. Additionally, students should be aware of potential cyber-security threats and remain vigilant to protect patient records from unauthorized access.
Example: An orthopedic resident is responsible for entering a patient’s surgical notes into the hospital’s EMR system. To ensure confidentiality, the resident logs in with their unique credentials, double-checks the patient’s identity, and takes necessary precautions to prevent accidental exposure of patient information to other individuals accessing the system.
Communication with Colleagues
Orthopedic residents often collaborate with other healthcare professionals, including attending physicians, fellow residents, and nurses. They must be mindful of patient privacy when discussing cases or seeking advice from colleagues. Residents should ensure that conversations related to patient care occur in private settings, limiting the disclosure of patient information to those directly involved in the patient’s treatment [12–15].
Example: During a multidisciplinary team meeting, an orthopedic resident presents a complex case involving a professional dancer/celebrity with a career-ending injury. The resident ensures that the discussion takes place in a designated meeting room with only authorized healthcare professionals present. They refrain from mentioning the patient’s name or any identifiable details that could compromise the patient’s privacy.
Consent for Sharing Information
The residents should obtain appropriate consent from patients before sharing their medical information with other healthcare providers or entities involved in the patient’s care. This includes obtaining consent for consultation with other specialists, sharing records with primary care physicians, or participating in research studies. Residents should explain the purpose, scope, and potential risks involved in sharing the information, allowing patients to make informed decisions [11–15].
Example: An orthopedic resident is considering consulting with a radiologist to obtain a second opinion on a challenging imaging study. Before sharing the patient’s records, the resident seeks the patient’s informed consent, explaining the rationale for seeking additional input and ensuring the patient understands the potential implications.
Ethical Handling of Personal Devices
The residents should exercise caution when using personal electronic devices (such as smartphones or tablets) in clinical settings. Personal devices may contain patient-related information, and residents must ensure appropriate security measures are in place, such as password protection and encryption. Personal devices should not be used to store patient information unless compliant with institutional guidelines.
Example: A resident receives an urgent message on their personal smartphone regarding a patient’s MRI appointment time. The resident ensures that their smartphone is password-protected, and after confirming the patient’s identity, they securely delete the message from the device to prevent accidental exposure of the patient’s information.
Reporting and Addressing Privacy Breaches
Orthopedic residents must be vigilant and proactive in identifying and reporting any breaches of patient privacy. If they become aware of a privacy breach, such as unauthorized access to patient records, they have a professional and ethical obligation to promptly report the incident to the appropriate authorities within their institution. Residents should also actively participate in privacy training programs to stay informed about privacy regulations and best practices.
Example: An orthopedic resident notices that a colleague accessed a patient’s medical record without a legitimate reason. Recognizing the breach, the resident promptly reports the incident to their supervising attending physician, the hospital’s privacy officer, or the designated individual responsible for addressing privacy breaches.
The orthopedic residents have a vital role in upholding confidentiality and privacy in healthcare and must follow the Health Insurance Portability and Accountability Act (HIPAA). By maintaining strict confidentiality, safeguarding electronic medical records, communicating with colleagues while preserving patient privacy, obtaining appropriate consent, handling personal devices ethically, and reporting privacy breaches, residents contribute to building and maintaining patient trust. These ethical practices ensure that patients’ sensitive information remains confidential and protected, fostering a safe and respectful healthcare environment.
Integrity and Professional Conduct
Integrity and professional conduct are fundamental pillars of ethical practice for orthopedic postgraduate students. These students serve as future leaders in the field of orthopedics, and their commitment to upholding high ethical standards is essential for building trust with patients, colleagues, and the broader healthcare community. Let’s explore the role of orthopedic postgraduate students in integrity and professional conduct, along with suitable examples [9–15]:
Honesty and Transparency
Orthopedic postgraduate students must embody honesty and transparency in their interactions with patients, colleagues, and healthcare providers. They should provide accurate and truthful information about diagnoses, treatment options, and expected outcomes. For example, when discussing the risks and benefits of a surgical procedure with a patient, the student should present the information objectively and avoid exaggeration or omission of relevant details.
Accountability for Mistakes
Integrity involves acknowledging and taking responsibility for mistakes or errors. Orthopedic postgraduate students should demonstrate accountability for their actions and openly address any adverse events or complications that may occur during patient care. They should work collaboratively with the healthcare team to rectify the situation, learn from the experience, and prevent similar incidents in the future.
Example: If a postgraduate student inadvertently performs a wrong-site surgery, it is their ethical obligation to promptly report the incident, inform the patient and their family, and take appropriate steps to rectify the error. The student should actively engage in the hospital’s quality improvement process and work with mentors and senior colleagues to prevent such occurrences in the future.
Advocacy for Patient Safety
Orthopedic postgraduate students have a responsibility to prioritize patient safety and advocate for best practices in their clinical settings. They should actively identify and address potential risks or hazards that could compromise patient well-being. This may involve speaking up about unsafe practices, participating in quality improvement initiatives, and adhering to evidence-based guidelines to promote patient safety.
Example: If a postgraduate student observes inadequate infection control measures in the orthopedic ward, they should raise concerns with the appropriate authorities, such as the infection control committee or their supervising attending physician. By advocating for improved infection prevention protocols, the student plays a crucial role in protecting patients from avoidable harm.
Respect for Patient Confidentiality
Orthopedic postgraduate students must uphold patient confidentiality and respect the privacy of personal health information. They should adhere to institutional policies and legal requirements governing the handling and sharing of patient data. Confidentiality is especially crucial when discussing patient cases or participating in educational activities, such as case presentations or research.
Example: When presenting a case during a departmental conference, an orthopedic postgraduate student should ensure that patient identifiers, such as names and medical record numbers, are not disclosed. The student should use de-identified or anonymized data to protect patient privacy while still providing valuable educational insights.
Collaboration and Collegiality
Orthopedic postgraduate students should foster a collaborative and collegial environment by respecting the expertise and contributions of their colleagues and multidisciplinary team members. They should actively engage in effective communication, teamwork, and shared decision-making to ensure optimal patient care. By treating colleagues with respect and professionalism, they contribute to a positive work environment.
Example: When working as part of a surgical team, an orthopedic postgraduate student should actively communicate with nurses, anesthesiologists, and other team members to ensure smooth coordination and exchange of critical information (follow WHO safety checklist). Respectful and effective collaboration among healthcare professionals enhances patient safety and outcomes.
Professionalism in Conduct and Appearance
Orthopedic postgraduate students should maintain a professional demeanor, both in their conduct and appearance. This includes adhering to dress codes, displaying appropriate bedside manners, and demonstrating punctuality and reliability. They should also demonstrate cultural sensitivity and respect for diversity in patient populations.
Example: An orthopedic postgraduate student should arrive on time for scheduled clinical rounds, be attentive during patient interactions, and address patients and colleagues respectfully. By presenting themselves professionally, students cultivate an atmosphere of trust and demonstrate their commitment to the highest standards of ethical and professional behavior.
Integrity and professional conduct are vital elements of ethical practice. Orthopedic residents must display honesty, transparency, and accountability in their interactions with patients, colleagues, and the broader healthcare community.
Example: Suppose an orthopedic resident discovers a surgical error made by a senior surgeon during a procedure. Upholding professional ethics, the resident should address the issue with the responsible individual or intimate to the concerned individuals through appropriate channels. By prioritizing patient safety and the integrity of the profession over personal or professional relationships, the resident demonstrates their commitment to ethical practice.
Equity and Access to Care
Orthopedic postgraduate students play a vital role in promoting equity and ensuring access to quality care for all patients. They have the opportunity to address disparities and contribute to a more equitable healthcare system. Let’s explore the role of orthopedic postgraduate students in equity and access to care, highlighting key responsibilities and suitable examples [9–16]:
Awareness of Health Disparities
Orthopedic postgraduate students should be knowledgeable about health disparities that exist within their patient population. They should familiarize themselves with socioeconomic, cultural, and geographic factors that contribute to inequities in healthcare access and outcomes. This awareness enables students to identify and address disparities in their practice.
Example: An orthopedic postgraduate student working in a rural community may observe that patients from lower socioeconomic backgrounds face challenges in accessing specialized orthopedic care due to limited resources and transportation options. Recognizing this disparity, the student can advocate for improved outreach programs, telemedicine initiatives, or local partnerships to enhance access for underserved populations.
Cultural Sensitivity and Linguistic Competence
The students should demonstrate cultural sensitivity and linguistic competence to effectively communicate and provide care to diverse patient populations. They should strive to understand and respect different cultural beliefs, values, and practices. Students should also ensure that language barriers do not hinder patients’ understanding or access to appropriate care.
Example: when encountering a patient from a different cultural background, an orthopedic postgraduate student should make an effort to learn about cultural norms and beliefs that may influence the patient’s perception of their orthopedic condition and treatment options. The student can engage professional interpreters, cultural liaisons, or utilize translation services to ensure accurate communication and facilitate informed decision-making.
Advocacy for Underserved Populations
The students have a responsibility to advocate for equitable access to care, particularly for underserved populations. They can contribute to initiatives that address healthcare disparities, such as volunteering in community clinics, participating in research on disparities, or engaging in policy advocacy to promote fair resource allocation and improved access to orthopedic services.
Example: An orthopedic postgraduate student may recognize that patients from marginalized communities face barriers in obtaining necessary assistive devices, such as wheelchairs or braces, due to financial constraints. The student can collaborate with social workers, non-profit organizations, or advocacy groups to develop programs that provide affordable or subsidized assistive devices for those in need.
Education and Health Literacy
The students can play a crucial role in improving health literacy among patients, particularly those from underserved communities. They should ensure that information about orthopedic conditions, treatment options, and preventive measures is communicated in a clear and understandable manner. Students should also actively engage in patient education initiatives to empower individuals to make informed decisions about their care.
Example: An orthopedic postgraduate student may participate in community health fairs or educational workshops where they provide information about common orthopedic conditions, injury prevention, and rehabilitation exercises. By disseminating knowledge in an accessible manner, the student helps to bridge the gap in health literacy and empowers patients to actively participate in their orthopedic care.
Collaboration with Interdisciplinary Teams
Orthopedic postgraduate students should collaborate with interdisciplinary healthcare teams to address complex health issues and ensure comprehensive care. By actively participating in team-based discussions and care planning, students contribute to holistic and patient-centered approaches that consider the unique needs of each individual.
Example: An orthopedic postgraduate student working with a team caring for patients with chronic conditions, such as osteoarthritis, may collaborate with physical therapists, occupational therapists, and pain specialists to develop personalized care plans that incorporate non-surgical interventions and lifestyle modifications. This collaborative approach ensures that patients receive comprehensive care that goes beyond just surgical interventions and considers the broader impact of the condition on their quality of life.
Orthopedic postgraduate students have a significant role to play in promoting equity and access to care. By raising awareness of health disparities, demonstrating cultural sensitivity, advocating for underserved populations, improving health literacy, and collaborating with interdisciplinary teams, these students contribute to a more equitable healthcare system. Their efforts can help ensure that all patients, regardless of their background, have equal opportunities to receive high-quality orthopedic care and achieve optimal health outcomes.
Rejecting Corruption and Financial Influences
Orthopedic postgraduate students have a professional obligation to avoid corruption, bribery, and any unethical financial practices involving pharmaceutical and implant companies. Maintaining integrity and ensuring that patient care remains the top priority are essential principles that postgraduate students must uphold. Let’s explore why it is crucial for orthopedic postgraduate students to avoid corruption and unethical financial relationships [9–15]:
Patient Welfare
The primary responsibility of the students is to provide the best possible care for their patients. Corruption and bribery compromise this responsibility by introducing financial motives that may influence medical decision-making. By avoiding such practices, postgraduate students ensure that their patients receive unbiased and appropriate treatment options based solely on their medical needs.
Professional Ethics
Orthopedic postgraduate students are expected to adhere to high ethical standards throughout their training and practice. Engaging in corrupt practices, such as accepting money or gifts from pharmaceutical or implant companies in exchange for using their products, undermines the integrity of the profession and erodes trust between healthcare providers and patients.
Conflict of Interest
Maintaining independence and objectivity is crucial in the medical field. Financial relationships with pharmaceutical and implant companies can create conflicts of interest, where personal gain may influence medical decisions, compromise patient safety, or favor certain products over others. Postgraduate students must be mindful of these conflicts and take proactive steps to mitigate them.
Impartial Decision-Making
Postgraduate students must base their treatment decisions on scientific evidence, clinical guidelines, and the best interest of their patients. Accepting financial incentives from pharmaceutical or implant companies can bias decision-making, leading to the use of products that may not be the most suitable for a patient’s condition. By avoiding corrupt practices, postgraduate students can ensure that their decisions are impartial and patient-centered.
Professional Reputation
Engaging in corrupt practices can tarnish the professional reputation of orthopedic postgraduate students and damage the reputation of the entire healthcare system. Transparency, integrity, and trust are crucial for establishing a positive professional reputation that benefits both patients and colleagues. By maintaining ethical conduct, postgraduate students contribute to the credibility and respectability of the orthopedic profession.
Orthopedic postgraduate students must strictly avoid corruption, bribery, and unethical financial practices involving pharmaceutical and implant companies. By upholding the principles of patient welfare, professional ethics, conflict of interest management, impartial decision-making, and maintaining a positive professional reputation, these students contribute to the integrity of the healthcare system and ensure that patient care remains the primary focus. Upholding ethical standards is crucial for fostering trust, professionalism, and the overall advancement of orthopedic practice.
Maintaining Ethical Standards in Orthopedic Residency Dissertations
Avoiding plagiarism and maintaining professional integrity are crucial when preparing a dissertation or any academic work during your orthopedic residency. Here are some tips to help the resident maintain ethical standards [11–13, 15]:
Understand plagiarism: The residents must familiarize themselves with what constitutes plagiarism, including direct copying of text, paraphrasing without proper citation, and self-plagiarism (submitting own work without acknowledgment).
Proper citation: Whenever the students use someone else’s ideas, data, or words, they should give appropriate credit through proper citation. Follow the citation style recommended by the institution or program.
Paraphrasing and summarizing: While using someone else’s work, the residents must rephrase the content in their own words while still crediting the original source. Be cautious not to rely too heavily on someone else’s work and make sure to add own analysis and interpretation.
Use reputable sources: When gathering information for the dissertation, use reliable and reputable sources such as peer-reviewed journals, academic books, and reputable websites. This helps ensure the accuracy and credibility of the information that are being included in the work.
Plan and organize: Develop a clear outline for the dissertation to stay organized and avoid inadvertently incorporating someone else’s work without proper attribution. Plan the research and writing process in advance to avoid time pressures that may lead to ethical lapses.
Seek permission: If the residents want to include copyrighted material, such as figures or tables from published papers, seek permission from the copyright holder and provide appropriate acknowledgment.
Review and proofread: Before submitting the dissertation, thoroughly review and proofread the work to ensure proper citation and attribution of all sources. Use plagiarism detection software to double-check for any unintentional plagiarism.
Seek guidance: If there are any doubts or questions regarding proper citation, referencing, or the ethical use of others’ work, consult with your advisor or dissertation committee. They can provide guidance and help the resident navigate ethical challenges.
Be aware of academic integrity policies: The postgraduate students must familiarize themselves with their institution’s policies on academic integrity and misconduct. Understanding the consequences of ethical violations will further motivate them to maintain professional standards.
Maintain integrity in collaborations: If the resident collaborates with others during his/her research, ensure that proper acknowledgment and authorship credits are given to all contributors based on their level of contribution.
By adhering to these guidelines, the residents can uphold academic integrity, avoid plagiarism, and maintain professional conduct throughout orthopedic residency while preparing dissertation.
How to Implement Ethics into Residency Program?
Implementing ethics into an orthopedic residency program is essential to prepare future orthopedic surgeons to handle ethical dilemmas that may arise during their practice. The importance of incorporating ethics in the medical curriculum was recognized in the late twentieth century. The World Medical Association, during its 51st General Assembly in Tel Aviv, Israel, underscored this by passing a resolution that mandates the inclusion of medical ethics and human rights as obligatory courses in all medical school curricula. Since 2019, the Medical Council of India introduced the Attitudes, Ethics, and Communication Module (AETCOM) into the Competence Based Medical Education, aiming for a curriculum attuned to both local relevance and global adaptability. However, Indian medical schools differ in how they deliver ethics education at undergraduate and postgraduate levels, similar to international variations. In the USA, ethics is integrated into both high school and medical school curriculums. Students undergo ethics education and typically take examinations on the subject in many universities. European medical school favored intensive ethics teaching through case reports, discussions, and study group seminars. Similar preferences were seen in past surveys from the Medical College of Georgia and the United Arab Emirates University. Overall, ethics education should be student-centric and incorporate problem-based teaching [18, 19]. Here are some steps to effectively integrate ethics into the orthopedic residency program in India [2, 16, 17]:
Curriculum Development: Design a comprehensive ethics curriculum tailored to orthopedic surgery. This curriculum should cover key ethical principles, communication skills, doctor-patient relationships, end-of-life care, informed consent, and specific ethical issues related to orthopedics. The AETCOM module, incorporated in India’s MBBS curriculum, is structured to enhance communication, ethics, and professional attitude among medical students [Fig. 1]. It includes 27 diverse modules over four years, covering core and supplementary competencies within a 140 h framework. Although it utilizes 16 case studies emphasizing problem-based learning, it lacks focus on primary healthcare [18, 19]. While students are the primary focus, the training needs of faculty members cannot be ignored. It’s essential to adapt and include this curriculum in postgraduate training too.
Ethics training sessions: Incorporate regular ethics training sessions into the residency program. These sessions can take the form of didactic lectures, interactive case discussions, role-playing exercises, and simulation-based learning. The AETCOM modules require consistent teaching and simultaneous training sessions for faculty to ensure effective and up-to-date impartation of knowledge and skills.
Case-based learning: Use real-life case studies to illustrate ethical challenges commonly faced in orthopedics. Encourage residents to analyze and discuss these cases, facilitating ethical decision-making and critical thinking skills.
Ethical review board: Establish an institutional ethics review board or committee to provide guidance and support in resolving ethical dilemmas encountered by residents during their training.
Mentoring and Role Modeling: Appoint faculty members as ethics mentors who can guide residents in navigating ethical issues and serve as positive role models in ethical decision-making.
Professionalism and communication skills: Emphasize the importance of professionalism and effective communication in dealing with patients,
Ethics grand rounds: Organize regular ethics grand rounds where residents present and discuss ethical challenges faced in their clinical experiences, fostering a culture of open dialogue.
Ethical decision-making framework: Introduce a structured ethical decision-making framework that residents can utilize when confronted with complex ethical situations.
Longitudinal ethics education: Ensure ethics education is integrated throughout the residency program, with ongoing discussions and assessments to track residents’ ethical growth.
Multidisciplinary approach: Encourage collaboration with other specialties, such as palliative care and medical ethics teams, to expose residents to diverse perspectives on ethical issues.
Ethical research and quality improvement projects: Encourage residents to undertake research projects exploring ethical aspects of orthopedic care or quality improvement initiatives that address ethical concerns.
Assessment and feedback: Implement regular assessments of residents’ ethical knowledge and skills. Provide constructive feedback to help them improve their ethical decision-making abilities.
Continuous improvement: Regularly review and update the ethics curriculum based on resident feedback, changing ethical challenges, and advancements in medical ethics.
Fig. 1.
Moral values taught to the medical students in India through AETCOM module (implemented by MCI)
By following these steps, the orthopedic residency program can create a supportive and enriching environment for residents to develop strong ethical foundations, preparing them to become compassionate, responsible, and ethically competent orthopedic surgeons.
Conclusion
In conclusion, ethical practice is the foundation of postgraduate training in orthopedics. By embracing ethical principles and behaviors, postgraduate students lay the groundwork for a successful and fulfilling career as orthopedic professionals. Upholding professionalism, patient-centered care, integrity, and equity ensures that postgraduate students make a positive impact on patient outcomes, build trust with their colleagues, and contribute to the advancement of the field.
Funding
None.
Declarations
Conflict of Interest
The authors of this manuscript declare that they have no conflicts of interest to disclose.
Footnotes
Publisher's Note
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Contributor Information
Sujit Kumar Tripathy, Email: ortho_sujit@aiimsbhubaneswar.edu.in, Email: sujitortho@aiimsbhubaneswar.edu.in, Email: sujitortho@yahoo.co.in.
Mantu Jain, Email: ortho_mantu@aiimsbhubaneswar.edu.in.
Ramesh Kumar Sen, Email: senramesh@gmail.com.
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