TY - JOUR
T1 - Promoting networks between evidence-based medicine and values-based medicine in continuing medical education
AU - Altamirano-Bustamante, Myriam M.
AU - Altamirano-Bustamante, Nelly F.
AU - Lifshitz, Alberto
AU - Mora-Magaña, Ignacio
AU - de Hoyos, Adalberto
AU - Ávila-Osorio, María T.
AU - Quintana-Vargas, Silvia
AU - Aguirre, Jorge A.
AU - Méndez, Jorge
AU - Murata, Chiharu
AU - Nava-Diosdado, Rodrigo
AU - Martínez-González, Oscar
AU - Calleja, Elisa
AU - Vargas, Raúl
AU - Mejía-Arangure, Juan M.
AU - Cortez-Domínguez, Araceli
AU - Vedrenne-Gutiérrez, Fernand
AU - Sueiras, Perla
AU - Garduño, Juan
AU - Islas-Andrade, Sergio
AU - Salamanca, Fabio
AU - Kumate-Rodríguez, Jesús
AU - Reyes-Fuentes, Alejandro
N1 - Funding Information:
We are indebted to all of the professors and participants who were involved in the on-line clinical ethics course. We are also grateful to the staff of the Direction of Innovation and Technology of the IMSS and ISAPEG for helping us to reach our goal. We greatly appreciate the work of Ana Serrano, Carlos Macías, Uria Guevara and Sandra Lizarraga for their help in data coding and for their participation in fruitful discussions. We appreciate the help of Juan Jimenez in designing the Figures for this paper. Adalberto de Hoyos would like to acknowledge the support provided by the postdoctoral fellowship program at UNAM. The authors are also indebted to the healthcare personnel who generously shared their experiences in the interviews. We also wish to thank Dr. Israel Grijalva Otero for his support. We want to thank Isaac Fernández, our computer guru, for all his support. Funding for this study was provided by Mexico’s Council of Science and Technology (CONACYT) 068673 and the General Direction of Academic Personnel Affairs of UNAM (DGAPA) for the Papiit project ID 400112.
PY - 2013/2/15
Y1 - 2013/2/15
N2 - Background: In recent years, medical practice has followed two different paradigms: evidence-based medicine (EBM) and values-based medicine (VBM). There is an urgent need to promote medical education that strengthens the relationship between these two paradigms. This work is designed to establish the foundations for a continuing medical education (CME) program aimed at encouraging the dialogue between EBM and VBM by determining the values relevant to everyday medical activities.Methods: A quasi-experimental, observational, comparative, prospective and qualitative study was conducted by analyzing through a concurrent triangulation strategy the correlation between healthcare personnel-patient relationship, healthcare personnel's life history, and ethical judgments regarding dilemmas that arise in daily clinical practice.In 2009, healthcare personnel working in Mexico were invited to participate in a free, online clinical ethics course. Each participant responded to a set of online survey instruments before and after the CME program. Face-to-face semi-structured interviews were conducted with healthcare personnel, focusing on their views and representations of clinical practice.Results: The healthcare personnel's core values were honesty and respect. There were significant differences in the clinical practice axiology before and after the course (P <0.001); notably, autonomy climbed from the 10th (order mean (OM) = 8.00) to the 3rd position (OM = 5.86). In ethical discernment, the CME program had an impact on autonomy (P ≤0.0001). Utilitarian autonomy was reinforced in the participants (P ≤0.0001). Regarding work values, significant differences due to the CME intervention were found in openness to change (OC) (P <0.000), self-transcendence (ST) (P <0.001), and self-enhancement (SE) (P <0.019). Predominant values in life history, ethical discernment and healthcare personnel-patient relation were beneficence, respect and compassion, respectively.Conclusions: The healthcare personnel participating in a CME intervention in clinical ethics improved high-order values: Openness to change (OC) and Self Transcendence (ST), which are essential to fulfilling the healing ends of medicine. The CME intervention strengthened the role of educators and advisors with respect to healthcare personnel. The ethical values developed by healthcare professionals arise from their life history and their professional formation.
AB - Background: In recent years, medical practice has followed two different paradigms: evidence-based medicine (EBM) and values-based medicine (VBM). There is an urgent need to promote medical education that strengthens the relationship between these two paradigms. This work is designed to establish the foundations for a continuing medical education (CME) program aimed at encouraging the dialogue between EBM and VBM by determining the values relevant to everyday medical activities.Methods: A quasi-experimental, observational, comparative, prospective and qualitative study was conducted by analyzing through a concurrent triangulation strategy the correlation between healthcare personnel-patient relationship, healthcare personnel's life history, and ethical judgments regarding dilemmas that arise in daily clinical practice.In 2009, healthcare personnel working in Mexico were invited to participate in a free, online clinical ethics course. Each participant responded to a set of online survey instruments before and after the CME program. Face-to-face semi-structured interviews were conducted with healthcare personnel, focusing on their views and representations of clinical practice.Results: The healthcare personnel's core values were honesty and respect. There were significant differences in the clinical practice axiology before and after the course (P <0.001); notably, autonomy climbed from the 10th (order mean (OM) = 8.00) to the 3rd position (OM = 5.86). In ethical discernment, the CME program had an impact on autonomy (P ≤0.0001). Utilitarian autonomy was reinforced in the participants (P ≤0.0001). Regarding work values, significant differences due to the CME intervention were found in openness to change (OC) (P <0.000), self-transcendence (ST) (P <0.001), and self-enhancement (SE) (P <0.019). Predominant values in life history, ethical discernment and healthcare personnel-patient relation were beneficence, respect and compassion, respectively.Conclusions: The healthcare personnel participating in a CME intervention in clinical ethics improved high-order values: Openness to change (OC) and Self Transcendence (ST), which are essential to fulfilling the healing ends of medicine. The CME intervention strengthened the role of educators and advisors with respect to healthcare personnel. The ethical values developed by healthcare professionals arise from their life history and their professional formation.
KW - axiology
KW - clinical ethics
KW - concurrent triangulation strategy
KW - continuing medical education
KW - values
UR - http://www.scopus.com/inward/record.url?scp=84873719963&partnerID=8YFLogxK
U2 - 10.1186/1741-7015-11-39
DO - 10.1186/1741-7015-11-39
M3 - Artículo
C2 - 23414220
SN - 1741-7015
VL - 11
JO - BMC Medicine
JF - BMC Medicine
IS - 1
M1 - 39
ER -