Teaching Ethics in a Clinical Setting: Finding Teachable Moments

Teaching ethics in clinical settings or medical schools can be difficult. Medical students and trainees are focused on patient care issues, passing the boards, and getting good evaluations. Ethics can be seen as peripheral to the biomedical core content and skills that young physicians-in-training prioritize.

Because ethical issues arise daily in the practice of medicine, faculty can meet the students where they are with their interest in patient care matters. Faculty can capitalize on teachable moments for ethics in patient care and clinical practice by focusing on communication events that arise frequently for trainees. Certain communication events are challenging for everyone, even the most experienced clinicians. Consider the importance of several of these common, but complex, communication events:

• Acknowledging Uncertainty
• Transitions to Palliative Care
• Informed Decision Making/Consent
• Managing Family Conferences
• Breaking Bad News
• Do Not Resuscitate Orders
• Discussing Medical Errors

Teachable moments can arise during any observed patient encounter, or even during a case presentation or debriefing during a team meeting. You might find yourself at the bedside, in the hallway, in the team meeting room, or in a seminar or lecture hall to discuss these issues. You might set aside a block of time to practice certain skills that are particularly important for the service or residency. These teaching materials are intended to give you a framework for thinking about your teaching in a variety of settings.