JMU offers model for teaching health care ethics

Medical colleges across the country can now incorporate lessons on ethics developed by a team at James Madison University.

In 2012, JMU professors led by Emily Akerson, associate director of the Institute for Innovation in Health and Human Services, responded to a call for proposals from the Association of American Medical Colleges to create an interprofessional curriculum for the association’s online health education resources hub, MedEdPortal.

“There were a limited number of grants available, so we knew the process would be competitive,” Akerson said. But she and her colleagues also knew that JMU, despite not having a medical school, could make a valuable contribution to the site with its innovative approach to teaching health care ethics.

Their proposal, one of 16 nationwide to be awarded funding from AAMC for development, was based on JMU’s interdisciplinary course Ethical Decision-Making in Healthcare: An Interprofessional Approach. Over the past decade, more than 1,500 students at Madison, including future doctors, nurses, therapists, dietitians, social workers, psychologists and health care administrators, have benefited from its team-building approach to tackling real-world ethical dilemmas encountered in practice.

Ethical Decision-Making in Healthcare offers pre-professional health students a unique learning experience, one that is aligned with the World Health Organization’s goal of interprofessional collaborative practice. This holistic approach has been shown to result in better medical outcomes and higher patient satisfaction as well as increased efficiencies and lower costs.

“We’re on the crest of the wave,” Akerson said. “We’ve been doing this for 10 years. Our students have opportunities to understand things and explore interprofessional collaborative practice. These are big goals, and we’ve been working on them.”

“[Health] problems don’t happen in isolation and neither do solutions,” added professor of graduate psychology Dr. Anne Stewart, who has helped teach the ethics course at JMU since its inception in 2003. “Effective solutions can be achieved through this process of learning from one another and finding a creative way forward. As health and human services professionals, we’re going to be working together. Why not educate together?”

One of the case studies used in the course involves Ricky, a 17-year-old on life support following a motorcycle accident. As the case unfolds, the students, working in interdisciplinary teams, must consider not only issues related to his care, but also the ethical dimensions of end-of-life decisions, the mental health needs of surviving family members and any long-term financial assistance.

Throughout the semester, students in the course are encouraged to reflect on their own personal code of ethics as well as that of their chosen field and how it relates to other health professions. “We want them to notice the differences and respect them, but also to see the incredible commonalities that exist,” Stewart said.

“They find how much they need each other as well as how to provide whole-person health care, whole-family health care and whole-community health care,” Akerson said.

JMU’s first training module for MedEdPortal, “Got Ethics? Exploring the Value of Interprofessional Collaboration Through a Comparison of Discipline-Specific Codes of Ethics,” was published Jan 30. Developed by the team of Akerson, Stewart, assistant professor of social work Dr. Joshua Baldwin, professor of social work Dr. B.J. Bryson, professor of health sciences Dr. Janet Gloeckner and associate professor of health sciences Dr. David Cockley, it consists of a series of lesson plans that medical colleges can use as an introductory session or at any time in a course sequence.

The team used the grant money from AAMC to create a video module based on the Ricky case study for submission to MedEdPortal at a later date. Additional modules are also planned.

In addition, efforts are under way to tie Ethical Decision-Making in Healthcare to The Madison Collaborative: Ethical Reasoning in Action, the university’s bold new effort to teach ethical reasoning skills to the entire student body.

“The goal is for our students to go out and to be leaders and innovators in their respective fields,” Stewart said. 

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By Jim Heffernan (’96), JMU Public Affairs