An Interactive Approach to Teaching the Clinical Applications of Autonomy and Justice in the Context of Discharge Decision-Making

INTRODUCTION: Students are taught the basics of medical ethics during their pre-clinical education, but need additional instruction on how to apply these principles to patient situations they may encounter during their clinical rotations. The ethical principles of autonomy and justice become especially pertinent to patient care in the setting of discharge decision-making. Third-year medical students would therefore benefit from an interactive educational activity that allows them to practice applying these principles within the context of discharge decision-making. METHODS: This session was designed for third-year medical students completing their required rotation in neurology. Students participated in a 1-hour, facilitator-led, interactive, small-group, ethics-based activity meant to simulate the typical 4-day post-stroke hospital stay. Learning objectives for the activity were to enhance students' understanding of the principles of autonomy, justice, competence, and capacity. Students were given pretest to gauge prior knowledge of activity learning objectives; their knowledge was again assessed afterwards, and they were surveyed on the usefulness and value of the activity. RESULTS: Twenty-three third-year medical students completed the activity over three sessions. The average improvement between pre- and posttest score was 40%. Lastly, on the qualitative feedback form, a majority of students strongly agreed that the activity was useful and presented new information, with 18 of 23 students giving the activity the highest possible rating of excellent. DISCUSSION: A large majority of the students found the activity to be valuable, and the activity was shown to be effective at improving students' knowledge of a key aspect of successful medical practice.