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Developing a digitally innovative ethics and professionalism curriculum for neonatal-perinatal medicine fellows: a 3-year multicenter pilot study

Journal of Perinatology volume 42, pages 476–482 (2022)Cite this article

Subjects

Abstract

Objectives

The purpose of this study was to develop and regionally pilot a digitally innovative curriculum in ethics and professionalism in neonatology and study the effects on trainee knowledge and confidence.

Study design

We developed 13 modules in ethics for neonatology fellows and piloted them at three academic institutions utilizing a flipped-classroom approach. Baseline surveys in ethics knowledge and confidence in approaching ethical dilemmas were compared with repeat surveys after curriculum completion. Pre- and post-tests were also administered for all 13 modules.

Results

Forty-four of 49 eligible fellows participated (90% response rate). Pre/post comparisons demonstrated significant improvements in overall knowledge and in 8/13 modules, as well as improvement in overall confidence and individually when navigating 16/22 ethical dilemmas.

Conclusions

After completing this curriculum, participants’ knowledge scores and reported confidence in approaching ethical challenges significantly improved. Future steps include assessing the effects of this innovative curriculum via an ongoing international pilot.

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Fig. 1: Assessment of knowledge.
Fig. 2: Assessment of confidence in approaching ethical challenges.
Fig. 3: Assessment in confidence overall and by domain.
Fig. 4: Assessment of learning methods.

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Acknowledgements

We would like to thank the neonatal-perinatal fellowship program directors at the three institutions for their support of the curriculum at the time, including immediate past directors Helen Cristou, MD at Boston Children’s Hospital and Christiane Dammann, MD at Tufts Medical Center and current program director Joaquim Pinheiro, MD, MPH at Albany Medical Center, as well as the participating fellows. In addition, we are extremely grateful for the contributions of our content experts, without whom this curriculum would not be possible. Our content experts are as follows: Mark Mercurio, MD, MA; Christy Cummings, MD, Gina Geis, MD, MS; Theophil Stokes, MD; Annie Janvier, MD, PhD; Barbara Farlow, MBA; Ahmed Moussa, MD, MSc; Bonnie Arzuaga, MD; C. Lydia Wraight, MD; William Meadow, MD, PhD; Zeynep Salih, MD, MA; Renee Boss, MD; Sadath Sayeed, MD, JD; Adam DeTora, MD; Ian Holzman, MD; Lilly Frank, PhD; Mona Khattab, MD; Gautham Suresh, MD; Benjamin Wilfond, MD; and Elliott Weiss, MD, MSME. We thank Dara Brodsky, MD, Med for her expert advice and thoughtful review of many of the modules. We are also grateful for the support of Erin Ward, MA a NICU family faculty advisor at Boston Children’s Hospital who reviewed all educational content to ensure the family perspective was incorporated throughout the curriculum. Furthermore, we are grateful to Robert Truog, MD, MA who first wisely advised that we make this curriculum accessible online. This work has been generously supported by grants from the Arnold P. Gold Foundation (PI Cummings), Boston Children’s Hospital (PI Cummings), the American Academy of Pediatrics Section on Neonatal-Perinatal Medicine (PI Geis), and Albany Medical College (PI Geis). In addition, Dr. Cummings is currently supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health under award number RO1HD094794 (PI Cummings).

Author information

Authors and Affiliations

  1. Division of Neonatology, Associate Professor Department of Pediatrics and Center for Bioethics, Education and Research; Albany Medical College, 43 New Scotland Ave., Mail Code 101, Albany, NY, 12208, USA

    G. M. Geis

  2. Principal Biostatistician, Boston Children’s Hospital, Institutional Centers for Clinical and Translational Research, 300 Longwood Ave., Mail Stop 3200, Boston, MA, 02115, USA

    H. A. Feldman

  3. Yale University Medical Student, 200 College Street, Apt. 426, New Haven, CT, 06510, USA

    E. R. Berson

  4. Division of Newborn Medicine Boston Children’s Hospital, Assistant Professor of Pediatrics Harvard Medical School, 300 Longwood Avenue, Hunnewell 437, Boston, MA, 02115, USA

    C. L. Cummings

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  1. G. M. Geis
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  3. E. R. Berson
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  4. C. L. Cummings
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Contributions

All authors (G.G., H.F., E.B., and C.C.) 1. conceived and/or designed the work that led to the submission, acquired data, and/or played an important role in interpreting the results; 2. drafted or revised the manuscript; 3. approved the final version, and 4. agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to G. M. Geis.

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Conflict of interest

The authors declare no competing financial interests. This study was reviewed and approved by the Institutional Review Boards at all three institutions (Boston Children’s Hospital: IRB-P00013058, Tufts Medical Center: IRB-11305, and Albany Medical Center: IRB-4302) and determined to be exempt from full review under federal regulation 45 CFR 46.101(b)(2), including a waiver of written consent. This study was performed in accordance with the Declaration of Helsinki.

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Geis, G.M., Feldman, H.A., Berson, E.R. et al. Developing a digitally innovative ethics and professionalism curriculum for neonatal-perinatal medicine fellows: a 3-year multicenter pilot study. J Perinatol 42, 476–482 (2022). https://doi.org/10.1038/s41372-021-01203-6

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