The Ethics OSCE: Standardized Patient Scenarios for Teaching and Evaluating Bioethics
Standardized Patient Program, University of Toronto, Centre for Research in Education
Fourteen standardized patient scenarios on video are available to teachers of medical ethics. The standardized scenarios may be used to teach medical ethics and to evaluate medical students' understanding of ethical issues and appropriate professional behavior. This program applies "the technology of the objective structured clinical examination (OSCE) using standardized patients to the evaluation of bioethics." (p. 1 manual) The video program and teaching manual were developed by Peter A. Singer, Centre for Bioethics and Department of Medicine, University of Toronto and Anja K. Robb, Department of Family and Community Medicine, University of Toronto. It is distributed by the Standardized Patient Program at the University of Toronto. The program is part of the Ethics OSCE Project which is funded by Educating Future Physicians for Ontario (EFPO). The manual is available online at http://spp.utoronto.ca/images/download/ethics_osce.pdf The video and manual contain the presentation and information about 14 ethics objective structure clinical examination (OSCE) cases: 7 on decisions to forego treatment, 2 on confidentiality, 3 on truth-telling, and 2 on women's health. For each of the fourteen stations, the manual contains 1) a blueprint for the OSCE station, 2) instructions to the candidate, 3) checklist items to help in rating the candidate, 4) instructions to the standardized patient, with a timeline and prompts for the patient. Cases: 1) "Nancy B" - "Susan Potts is requesting the removal of her respirator. She has beeen diagnosed with chronic Guillain-Barre Syndrome. There is no hope for her recovery (10 minutes); 2) "Candura" - "Albert Whiteside has gangrene in his right leg and it is recommended that it be amputated. Mr. Whiteside is refusing to have the operation even though the decision will in all likelihood lead shortly to his death." (10 minutes) 3) "Do Not Intubate Me" - Seventy year old Ms. Stone wants to make it known that she does not want to be intubated again. She was intubated a few days ago when she arrived at the hospital with acute pulmonary edema." (10 minutes) 4) "Do Not Resuscitate (DNR) my Mother" - "Ann Brown is asking for a DNR order to be written on her mother's chart without her mother's knowledge. her mother has chronic congestive heart failure and her health has deteriorated over the past 5 years." (10 minutes) 5) "Cruzan" - Steven Hewitt requests removal of wife's feeding tube. His wife (Rita Hewitt) has been in persistent vegetative state for 6 years." (10 minutes) 6) "Malette" - "Annette Beaulieu wants to speak with the emergency physician about her mother (Mrs. Montecino) who is unconscious and bleeding as a result of a head-on collision. Mrs. Beaulieu and Mrs. Montecino are both Jehovah's Witnesses." (10 minutes) 7) "Brain Death" - Mrs. Pike wants information about her husband Matthew's condition. Matthew suffered a cerebral aneurysm while jogging 4 days ago. He has been declared "brain dead." (10 minutes) 8) "Birth Control Pill" - "Beverley Carter is asking for information about her daughter Linda's visits to the doctor's office. Mrs. Carter suspects that Linda is sexually active and taking the pill." (10 minutes) 9) "HIV Infection" - "David Plant requests results of HIV test which is positive. Mr. Plant does not want his wife to know his HIV status." (10 minutes) 10) "Pancreatic Cancer" - "Gwen Jones does not want her husband (Lloyd) to know about his diagnosis of pancreatic cancer. The cancer is inoperable and Mr. Jones is terminally ill." (10 minutes) 11) "Alzheimer's Disease" - "David Forrester has come to the office for results of neuropsychological and neurological testing. According to the neurologist, Mr. Forrester has a clinical presentation typical of Alzheimer's Disease." (10 minutes) 12) "Doctor's Note" - "Paul Carter, who appears well, is requesting a note saying he is too sick to write an examination tomorrow." (10 minutes) 13) "Battered Woman" - "Jennifer Davis is requesting tranquillizers because she has been on edge, under a lot of stress and has had trouble sleeping." (10 minutes) 14) "Sexual Impropriety" - "Carol Abbott is requesting a referral to a new psychiatrist. 'Things didn't work out' with the one she had been seeing." (10 minutes) (sexual relationship between physician and health professional)
Bioethics; Brain; Brain Death; Birth Control; Cancer; Confidentiality; Death; Diagnosis; Disease; Ethics; Evaluation; Health; Jehovah's Witnesses; Knowledge; Medical Ethics; Medical Students; Medicine; Patients; Persistent Vegetative State; Physicians; Students; Technology; Terminally Ill; Women's Health; Bioethics Education; Education for Health Care Professionals;
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