Clarifying ethics and law in the curriculum
Practice points for clarifying ethics and law in the curriculum: Address the cognitive, affective, and psychomotor domains of learning in your course design.
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Anticipate that your students and colleagues will have many different ideas of ethics in medicine.
Approach ethics in terms of practical reason. Maintain the linkage between ethics and law.
If the overall goal of ethico-legal education is to promote the development of students’ practice in becoming ethical doctors, from the outset it will be essential to know what the proximate goals or objectives are of your curriculum in ethics and law so that the programme you design may be fit for the purpose you have in mind.
This need not be a purely linear process. As Prideaux (2003) explains, a ‘prescriptive curriculum’ specifies desired student outcomes in advance, leading to decisions on planned content that in turn pre-determine the learning experiences programmed for students, out of which assessment and course evaluation are constructed. However, where such arrangements are already in place, a ‘situational curriculum’ may begin at any stage in the process and adjust the other elements as appropriate. In either case, there will be core learning in ethics and law that you intend all students to acquire.
Box 7 relates Bloom’s cognitive, affective, and psychomotor domains to some examples of generalised curriculum outcomes in ethico-legal learning that may then be further specified according to course content. In practice this can be difficult, however. As Rees (2004) notes, “these descriptors are not sensitive to the needs of different disciplines”. There are also theoretical difficulties with this tripartite model that have particular significance for ethico-legal education (Bebeau et al., 1999), and these will be taken up when turning to assessment in the final chapter. Nevertheless, there are necessarily cognitive, affective, and psychomotor dimensions to our students’ learning, and it is a requirement of our course design to address these.
BOX 7 Some generalised outcomes according to learning domain and level
Cognitive (at an advanced level) Affective (at an intermediate level) Psychomotor (at an elementary level)
Critically weigh concepts of justice, autonomy, beneficence, and non-maleficence in real cases.
Demonstrate verbally some identification with ethical values of patient care.
Follow basic protocols relating to safety in healthcare when present in clinical settings.
...it will be essential to know what the proximate goals or objectives are of your curriculum in ethics and law so that the programme you design may be fit for the purpose you have in mind.
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Guide 53: Ethics and Law in the Medical Curriculum
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