Bridging the Gap: Enhancing First-Year Education Through the Surgical Ethics and Application for Medical Students Program

Abstract

Ethical decision-making is fundamental to surgical education, yet formal ethics training remains underrepresented in medical curricula. To address this gap, we developed the Baylor College of Medicine (BCM) Surgical Ethics and Application for Medical Students (SEAMS) program, an elective hybrid course combining 45-minute didactic lectures with interactive role-playing led by faculty experts in ethics, transplant medicine, and surgical oncology. Thirty-two first-year medical students participated in SEAMS and completed pre- and post-program surveys assessing their understanding, confidence, and preferred learning styles related to surgical ethics. While students' perceptions of the importance of surgical ethics discussions remained unchanged, their knowledge and confidence in discussing surgical futility significantly improved (p<0.01). Confidence in initiating and conducting difficult conversations also increased (p<0.01). Following the program, students exhibited a greater preference for lecture-based education on ethics and surgical indications. SEAMS effectively prepared medical students for ethical challenges in clinical practice by integrating structured lectures and role-playing exercises. To enhance efficiency, the authors recommend a flipped classroom model, allowing students to engage with foundational content before in-person sessions. These findings highlight the need for more structured ethics education in surgical training. Moreover, our techniques may aid the communication and ethical decision-making of experienced physicians caring for challenging patients. Future studies should explore the longitudinal impact of such programs on medical students' ethical preparedness.

Keywords: ethics education; preclinical curricula; role-playing; simulation; surgical education.