ETHICS EDUCATION FOR MEDICAL HOUSE OFFICERS - LONG-TERM IMPROVEMENTS IN KNOWLEDGE AND CONFIDENCE

Objective - To examine the long term effects of an innovative curricul um on medical house officers' (HOs') knowledge, confidence, and attitu des regarding medical ethics. Design - Long term cohort study. The two -year curriculum, implemented by a single physician ethicist with assi stance from other faculty, was fully integrated into the programme. It consisted of monthly sessions: ethics morning report alternating with didactic conferences. The content included topics such as ethics voca bulary and principles, withdrawing life support, informed consent, and justice. identical content was offered simultaneously at the largest affiliated community hospital. Setting- A multi-hospital university tr aining programme from July, 1992 to June, 1994. Participants - Thiny-n ine HOs responded in '92. Thirty HOs from the same cohort responded in '94 (response rates = 83% v 71%; P=0.19). Results - The curriculum wa s well received, with 960io of HOs finding the sessions stimulating. P reviously validated scales of knowledge and confidence were administer ed at baseline and at follow-up. The average knowledge score improved 14% (P < 0.001). Confidence also improved, rising from 3.3 to 3.8 on a 5-point Likert scale (P < 0.001). These findings were independent of age, gender, religion, and prior education. The only attitudinal chang e was an increase in the proportion of residents who thought that ethi cs should be a required part of residency training (57% v 80%, P=0.05) . Conclusion - This curriculum appears practical, popular, and effecti ve. It should be readily transferable to other institutions.