Report of Presenting at AMEE2012

Introduction
AMEE (the Association for Medical Education in Europe) holds the largest annual conference focusing on medical education, drawing together over 3,000 participants from across the world, to enjoy a huge range of different sessions (including poster presentations, workshops, and series of short presentations, in sessions known as short communications) running in up to 35 concurrent parallel streams. Ethics, and the teaching of ethics are one of the many areas covered, and I submitted an abstract, which was to accepted, to present the work that been undertaken with a number of colleagues, to establish a novel method of discussing and teaching ethical scenarios at King’s College London, known as the Student Clinical Ethics Committee (SCEC).
Our Work: An Introduction to SCEC

Currently in the UK there are 85 clinical ethics committees, which supply ethics support for UK hospital trusts for cases referred. KCL’s Student Clinical Ethics Committee (SCEC) seeks to mirror hospital-based counterparts, however, rather than providing clinical support, it acts as an educational experience, to facilitate engagement with ethical scenarios, and develop understanding and awareness of ethical dilemmas in clinical practice.
The committee meets monthly to discuss a relevant ethical case referred directly from clinical practice as encountered by trainee healthcare professionals. Consent to discuss the case must be attained from the overseeing clinician, and the discussion is kept confidential and anonymous. Meetings are made up of a chair, a referrer, committee members and observers from a range of specialties (e.g. medicine, nursing, pharmacy), all invited to contribute to the discussion. The dialogue adheres to a clear ethical framework seeking to cover all pertinent ethical issues, thus mirroring hospital trust based clinical ethical committees. Cases are then written up and posted on the university intranet/virtual campus, creating an e-learning resource. The committee structures its discussion around a set ethical framework that ensures matters of autonomy, beneficence, non-maleficence and justice are individually and collectively considered as part of the discussion.

Initial feedback suggests that educational outcomes extend beyond the realm of theoretical learning. The SCEC has received extremely positive feedback from participants, observers and referring clinicians, highlighting the benefits of this project as a method of encouraging students to grapple with the complexity of cases experienced in a clinical setting. The use of real clinical scenarios encourages students to immerse themselves in the issues, developing a critical thought process through facilitated discussion. As a result, participants learn and retain a wider range of skills applicable for their future clinical practice, than they might through other forms of didactic teaching.
An Evaluation of SCEC

SCEC is an innovative tool which allows students from all healthcare professions to learn about clinical ethics together, and feel it has the potential to be adopted widely within curricula. The reality of the cases discussed, and the referral by a fellow student emphasises the clinical relevance of ethics and is thus more likely to engage students. The committee offers a well-structured and safe environment in which students of all disciplines can explore challenging cases and sometimes controversial viewpoints, and learn together as a multi-disciplinary team.

SCEC offers a great deal of potential as a tool by which to teach ethics in the mainstream of the curriculum. I have proposed that it would act as an excellent forum for discussion in the later stages of any healthcare professional’s time as a student, complimenting a curriculum which covered basic ethical frameworks and principals in the earlier years. It would well suit the hospital-based nature of students’ courses at this time, highlighting the importance of ethics in clinical practice, and would encourage students to move from the ethical knowledge they had gained in the earlier years, to implementing this. This progression allows students to hone and enhance not only ethical skills, but key transferrable skills; SCEC arguably helps to develop at least four of the ten cited as skills medical students should aim to develop on the NHS Medical Careers website: communication skills, teamwork, empathy and problem-solving.

In the future we hope to develop the remit of SCEC further, engaging a wider number of students, and to develop an e-learning module, covering basic ethical principles, legislation, and terminology, thus providing a foundation upon which all students from different disciplines can build a discussion.

The Presentation Session & Ensuing Discussion

Presenting this work at such a prestigious conference sparked many useful and interesting discussions about the merits of the model, which will hopefully allow us to refine it. I presented alongside my supervisor, and we were the first in a set of six around teaching ethics, in a session of around 60 attendees. The presentation itself went very well wand received a number of positive remarks at the end, along with a recognition that our model was indeed an unusual one. There were also some interesting questions, which sparked a discussion surrounding the extent to which it it is possible to disengage teaching of professionalism and consideration of professionalism from ethical discussion. This arose in the context of questions about how we currently deal with situations in which the practising clinicians have acted in a way which does not meet our recommendations, or in a manner which can be demonstrated to be unprofessional. My response was based around the need to focus on the learning outcomes –what the student would do if they were in that position – rather than upon criticising the clinicians; as SCEC is an educational exercise this falls outside our remit.
Folllowing on from our presentation there were a number of discussions on twitter about our work, which focused around the need to make ethics part of the life-long learning of the model and a discussion of how best to scale SCEC up and integrate it within medical curricula.
Interestingly many of the other speakers in the session drew on similar themes to ours; there was a general agreement within the room that there is a need to develop methods of teaching ethics which are well-integrated into other teaching and clinical life, and which highlight the applicable nature of ethics. In addition many of the attendees concurred that ethics and other ‘soft’ skills provide an excellent opportunity for multi-disciplinary learning.

Conclusion
AMEE2012 was an extremely enjoyable and valuable learning experience for me. It provided me with the opportunity to develop personal skills such as public speaking, and gave me more confidence to submit work for, and engage in more conferences in the future. It was fantastic to have the opportunity to attend a range of other interesting sessions around broader issues of ethics and medical education, which may be useful to me in the future. Additionally, the opportunity to present this work allowed us to share what we have been doing with King’s with other professionals from around the world, and discussions following the presentation have built useful contacts, and allowed us to receive constructive feedback on how to further improve the model. I would like to thank the IME for their support, as without it would not have been possible for me to attend the conference.