A RANDOMIZED TRIAL OF ETHICS EDUCATION FOR MEDICAL HOUSE OFFICERS

We report the results of a randomized trial to assess the impact of an innovative ethics curriculum on the knowledge and confidence of 85 me dical house officers in a university hospital programme, as well as th eir responses to a simulated clinical case. Twenty-five per cent of th e house officers received a lecture series (Limited Intervention or LI ), 25 per cent received lectures and case conferences, with an ethicis t in attendance (Extensive Intervention or EI), and 50 per cent served as controls. A post-intervention questionnaire was administered. Know ledge scores did not differ among the groups. Confidence regarding eth ical issues was significantly greater in the aggregate intervention gr oup (3.9 on a 1 to 5 scale) compared to the control group (3.6). Confi dence regarding procedural issues related to ethics was significantly higher for the EI group than for the controls (4.0 v 2.8). Responses t o a simulated case showed that significantly fewer house officers in t he EI group would intubate a patient for whom such therapy would be fu tile (EI = 57 per cent, LI = 87 per cent, Controls = 82 per cent). We conclude that ethics education can have an impact on house officers' c onfidence and their responses to a simulated case, and that the EI was more effective than the LI. Such results have implications regarding the implementation of ethics education during residency.