may be offset through students being dispersed across locations in primary and secondary care, and by their preoccupation with approaching final examinations.
A further aspect of integration is the extent to which ethics and law are learned together in the course. At an abstract level, their interrelation as disciplines is a complex weave of ideas, which is why they belong together as subject areas. In the realm of curriculum management, however, segmentation of ethics and law is a reality of course organisation and delivery. The task is then to keep the two components side by side, and there are three basic constructions in doing this. Without the one occluding the other in terms of relative importance, the options are either to view law through the lens of ethics, or vice-versa, or to juxtapose them thematically (Box 6).
BOX 6 Ethics and law: side by side
Ethics may be foregrounded over law, or law may be foregrounded over ethics, or the two domains may be figured adjacently on the same ground as each other.
Indispensable to the strategy of programme development, whatever the course design, is a cycle of monitoring and evaluation (Coles & Grant, 1985; Goldie, 2006). Does the course fulfil the purpose for which it is designed? It is one thing to draw up a course, but another thing to implement it, and further still to experience it as a learner. Review of these different areas, their intersections and their complements, and closing the loop by acting upon the information gathered as appropriate, is intrinsic to the assurance and enhancement of educational quality and standards. Routine annual course reporting on process and outcome will typically be nested in a longer cycle with a period of several years, allowing a more comprehensive review for development of course content and modes of delivery. Internally-driven adjustments might be in response to evaluation findings (Goldie, 2006) or to other dynamics of the programme and arrangements in the medical school, while externally-driven course modification could follow from the ever-changing medico-legal framework or requirements set by educational authorities that oversee medical schools.
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Guide 53: Ethics and Law in the Medical Curriculum
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