Residents' attitudes to training in ethics in Canadian obstetrics and gynecology programs

Abstract

Objective: To determine residents' attitudes toward their current training in ethics, including their preferred learning format, time commitment, and the influences of training and personal background on their views and decision-making process.

Method: All 203 residents from English-speaking Canadian obstetrics and gynecology programs were mailed an 18-question, numerical-response questionnaire in prestamped return envelopes. One hundred thirty-one residents (64.5%) responded (81 to the first mailing and 50 to the second).

Results: The number of hours in the residency program devoted to ethical issues correlated positively with the residents' perception of the residency program in shaping their ethical views (P = .015, r = 0.22). Of the respondents, 44.7% preferred case presentations as their learning format and 30.7% ranked seminars as their first choice. Informal discussions and rounds were less popular, and lectures were considered least appropriate by 69.3%. When asked what most influenced the residents' ethical decision-making process, 34.2% indicated family views, 17.1% undergraduate teaching, 15.4% religious background, 12.8% views of consulting staff, 11.1% residency training, and 9.4% peer attitudes. Sixty-eight percent of residents felt that their training in ethics during their residency program should be increased; this may reflect response bias. A position of conscience conflict during residency training was reported by 28.9% of residents.

Conclusion: Findings from this survey support the benefit of more discussion of ethical issues during residency programs, particularly with the use of case presentations.