Promoting networks between evidence-based medicine and values-based medicine in continuing medical education

Myriam M. Altamirano-Bustamante, Nelly F. Altamirano-Bustamante, Alberto Lifshitz, Ignacio Mora-Magaña, Adalberto de Hoyos, María T. Ávila-Osorio, Silvia Quintana-Vargas, Jorge A. Aguirre, Jorge Méndez, Chiharu Murata, Rodrigo Nava-Diosdado, Oscar Martínez-González, Elisa Calleja, Raúl Vargas, Juan M. Mejía-Arangure, Araceli Cortez-Domínguez, Fernand Vedrenne-Gutiérrez, Perla Sueiras, Juan Garduño, Sergio Islas-AndradeFabio Salamanca, Jesús Kumate-Rodríguez, Alejandro Reyes-Fuentes

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

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 3rdposition (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. © 2013 Altamirano-Bustamante et al; licensee BioMed Central Ltd.
Original languageAmerican English
JournalBMC Medicine
DOIs
StatePublished - 15 Feb 2013
Externally publishedYes

Fingerprint

Continuing Medical Education
Evidence-Based Medicine
Medicine
Delivery of Health Care
Clinical Ethics
Beneficence
Value of Life
Ego
Medical Education
Mexico
Prospective Studies
Interviews

Cite this

Altamirano-Bustamante, M. M., Altamirano-Bustamante, N. F., Lifshitz, A., Mora-Magaña, I., de Hoyos, A., Ávila-Osorio, M. T., ... Reyes-Fuentes, A. (2013). Promoting networks between evidence-based medicine and values-based medicine in continuing medical education. BMC Medicine. https://doi.org/10.1186/1741-7015-11-39
Altamirano-Bustamante, Myriam M. ; Altamirano-Bustamante, Nelly F. ; Lifshitz, Alberto ; Mora-Magaña, Ignacio ; de Hoyos, Adalberto ; Ávila-Osorio, María T. ; Quintana-Vargas, Silvia ; Aguirre, Jorge A. ; Méndez, Jorge ; Murata, Chiharu ; Nava-Diosdado, Rodrigo ; Martínez-González, Oscar ; Calleja, Elisa ; Vargas, Raúl ; Mejía-Arangure, Juan M. ; Cortez-Domínguez, Araceli ; Vedrenne-Gutiérrez, Fernand ; Sueiras, Perla ; Garduño, Juan ; Islas-Andrade, Sergio ; Salamanca, Fabio ; Kumate-Rodríguez, Jesús ; Reyes-Fuentes, Alejandro. / Promoting networks between evidence-based medicine and values-based medicine in continuing medical education. In: BMC Medicine. 2013.
@article{ae38a3f3cda245d191d098dc5e797cd2,
title = "Promoting networks between evidence-based medicine and values-based medicine in continuing medical education",
abstract = "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 3rdposition (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. {\circledC} 2013 Altamirano-Bustamante et al; licensee BioMed Central Ltd.",
author = "Altamirano-Bustamante, {Myriam M.} and Altamirano-Bustamante, {Nelly F.} and Alberto Lifshitz and Ignacio Mora-Maga{\~n}a and {de Hoyos}, Adalberto and {\'A}vila-Osorio, {Mar{\'i}a T.} and Silvia Quintana-Vargas and Aguirre, {Jorge A.} and Jorge M{\'e}ndez and Chiharu Murata and Rodrigo Nava-Diosdado and Oscar Mart{\'i}nez-Gonz{\'a}lez and Elisa Calleja and Ra{\'u}l Vargas and Mej{\'i}a-Arangure, {Juan M.} and Araceli Cortez-Dom{\'i}nguez and Fernand Vedrenne-Guti{\'e}rrez and Perla Sueiras and Juan Gardu{\~n}o and Sergio Islas-Andrade and Fabio Salamanca and Jes{\'u}s Kumate-Rodr{\'i}guez and Alejandro Reyes-Fuentes",
year = "2013",
month = "2",
day = "15",
doi = "10.1186/1741-7015-11-39",
language = "American English",
journal = "BMC Medicine",
issn = "1741-7015",
publisher = "BioMed Central Ltd.",

}

Altamirano-Bustamante, MM, Altamirano-Bustamante, NF, Lifshitz, A, Mora-Magaña, I, de Hoyos, A, Ávila-Osorio, MT, Quintana-Vargas, S, Aguirre, JA, Méndez, J, Murata, C, Nava-Diosdado, R, Martínez-González, O, Calleja, E, Vargas, R, Mejía-Arangure, JM, Cortez-Domínguez, A, Vedrenne-Gutiérrez, F, Sueiras, P, Garduño, J, Islas-Andrade, S, Salamanca, F, Kumate-Rodríguez, J & Reyes-Fuentes, A 2013, 'Promoting networks between evidence-based medicine and values-based medicine in continuing medical education', BMC Medicine. https://doi.org/10.1186/1741-7015-11-39

Promoting networks between evidence-based medicine and values-based medicine in continuing medical education. / Altamirano-Bustamante, Myriam M.; Altamirano-Bustamante, Nelly F.; Lifshitz, Alberto; Mora-Magaña, Ignacio; de Hoyos, Adalberto; Ávila-Osorio, María T.; Quintana-Vargas, Silvia; Aguirre, Jorge A.; Méndez, Jorge; Murata, Chiharu; Nava-Diosdado, Rodrigo; Martínez-González, Oscar; Calleja, Elisa; Vargas, Raúl; Mejía-Arangure, Juan M.; Cortez-Domínguez, Araceli; Vedrenne-Gutiérrez, Fernand; Sueiras, Perla; Garduño, Juan; Islas-Andrade, Sergio; Salamanca, Fabio; Kumate-Rodríguez, Jesús; Reyes-Fuentes, Alejandro.

In: BMC Medicine, 15.02.2013.

Research output: Contribution to journalArticle

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

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 3rdposition (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. © 2013 Altamirano-Bustamante et al; licensee BioMed Central Ltd.

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 3rdposition (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. © 2013 Altamirano-Bustamante et al; licensee BioMed Central Ltd.

U2 - 10.1186/1741-7015-11-39

DO - 10.1186/1741-7015-11-39

M3 - Article

C2 - 23414220

JO - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

ER -

Altamirano-Bustamante MM, Altamirano-Bustamante NF, Lifshitz A, Mora-Magaña I, de Hoyos A, Ávila-Osorio MT et al. Promoting networks between evidence-based medicine and values-based medicine in continuing medical education. BMC Medicine. 2013 Feb 15. https://doi.org/10.1186/1741-7015-11-39