The importance of an up-to-date ethics and professionalism curriculum in the era of technology-based practice in healthcare

Background: Increasing use of information and communication technologies in healthcare service delivery influences the way medical students experience and practice ethics and professionalism (EP). Use of these technologies also presents new issues, or complicates perennial problems in EP. While several issues relating to specific technologies or practices have been explored in medical ethics research or addressed in professional guidelines, this remains a marginalized topic in EP curricula, in contrast to quotidian integration of these technologies into the professional and personal lives of students and clinicians. Failure to address technological changes adequately may exacerbate the theory-practice gap which arguably ‘pervades health professional education (1). Methods: Drawing on the example of mobile phone use to record details of documented patient histories when preparing and communicating case summaries, we explored current research investigating this practice and available professional guidance. Ethical risks and benefits of the practice identified through normative analysis were then evaluated in the context of current EP components of medical curricula. Recommendations for curricular changes to address the risks of this practice were developed by an interprofessional group with expertise in e-Health, medical education and medical ethics. Results: Contemporary EP curricula and professional guidelines lag behind technology-based practices. Factors influencing this lag may include lack of awareness of technology-based practices on the part of educators, neglect of these issues in bioethics, and the perception that technology-related issues are a specialized topic rather than a cross-cutting component of EP curricula. Consequently, students may be ill-prepared to manage these issues during their training and in clinical practice. Conclusions: Alignment of EP curriculum with contemporary issues requires rethinking to ensure new clinical practices are routinely incorporated into case-based learning, and novel issues likely to be commonly encountered are explicitly addressed in the core curriculum. This approach may assist in brokering the theory-practice gap but requires a review of content to avoid curriculum overload. Reference 1. Newton, J.M., Billet, S., Jolly, B. and Ockerby, C. (2009) Lost in translation: barriers to learning in health professional clinical education, Learning in Health and Social Care, Vol.8, Issue 4, p.315-327