Tutorials on Basics of Bioethics: An Experience with Post-Graduate Health Professionals

Abstract

Background

All health professionals are morally bound to recognize and address ethical issues in their daily practice. Understanding basics of bioethics can help professionals promote autonomy and protect the welfare of both patients and research participants. As part of the Fogarty International Center, NIH, USA, funded “Training Program for Psychiatric Genetics in India,” NNM was trained in bioethics at University of Pittsburgh under the mentorship of Lisa S Parker, PhD.

Objectives

The overall goal of this Tutorial project was to translate NNM’s Ethics training for hospital-based Indian health professionals to sensitize them to the ethical issues arising in psychiatric research and practice.

Methodology

After receiving official permission from the medical superintendent of PGIMER-Dr.R.M.L. Hospital, New Delhi, the program was announced. Candidates with a degree in one of the Health Care Sciences were enrolled. Five two-hour interactive sessions were held weekly on five topics. An evaluation of the effectiveness of the interactive tutorial program was conducted.

Results

A total of 16 participants enrolled in these tutorials. The post-program evaluation of satisfaction for all topics of the program by participants indicated high mean score. The main need identified was for continued refreshing of bioethical knowledge and skills through academic activities.

Introduction

Clinical research is increasingly undertaken by medical professionals in developing countries. Bioethics is an integral part of clinical research and day-to-day medical practice, and all health professionals are morally bound to recognize and address ethical issues in their daily practice. But knowledge of bioethics is limited among researchers and clinicians; as.there is little training in bioethics during and after professional degree programs in the developing world. The Indo-US group for Psychiatric Genetics Research at PGIMER-Dr RML Hospital has been conducting research in major mental disorders for the last 20 years and recognizes the need to adhere to ethical guidelines and to impart them to health professionals. As part of the Fogarty International Center, NIH, USA, funded “Training Program for Psychiatric Genetics in India,” the first author (NNM) was trained in bioethics at University of Pittsburgh under the mentorship of bioethicist Lisa S Parker, PhD. The Program of Tutorials on Basics of Bioethics was designed to share his expertise to fill the knowledge and skill gap among health professionals.

Methods

To disseminate knowledge acquired during the NIH-funded training program, a program of tutorials in bioethics for health professionals in India, particularly mental health professionals, was designed. The following activities were undertaken to design, advertise, and evaluate interactive sessions on different bioethics topics:

• ❖Availability of the bioethics tutorial program was advertised on hospital notice boards and Internet groups, and applications for program participants was sought
• ❖Evaluation of the 16 enrolled participants’ perceived needs and (post-session) satisfaction with training
• ❖Weekly two-hour sessions were held on 5 topics: Overview of Bioethics, Informed Consent, Privacy and Confidentiality, Risk and Benefit Analysis Case Study
• ❖Didactic material introducing key ethical concepts or principles and relevant legal and policy guidance
• ❖Interactive components, including question and answer session, role play, and case discussion
• ❖Case Study: Multiple cases were discussed on each topic

Results

• ❖16 participants enrolled in the program were Doctor of Medicine (MD Psychiatry) (n=5) Diplomate National Board (DNB Psychiatry) (n=4) Master of Philosophy (M. Phil, Psychology) (n=5) M.Phil, Psychiatric Social Work (n=1) and Biostatistician (n=1).
• ❖Using a 5-point likert scale (5= excellent to 1=poor) for rating satisfaction for each topic and adding scores to find total score, the mean score 16.78 was computed which suggests that participants rated sessions mostly in the excellent range.
• ❖There is a perceived need for refreshing of bioethical knowledge and skills among health professionals.

Conclusion

• ❖The bioethics tutorial program fills a perceived gap in training and should be implemented as a regular refresher course among health professionals.
• ❖Content and interactive format of the tutorials were highly appreciated, and should be retained in future presentations of the program.

Limitation

Lack of continued funding prevented expanding this tutorial program to a wider range of health professionals; therefore, its effectiveness with a broader audience or a non-self-selecting audience cannot be known.