Ethical issues in residency education related to the COVID-19 pandemic: a narrative inquiry study (2024)

Ethical issues in residency education related to the COVID-19 pandemic: a narrative inquiry study (1)

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Ethical issues in residency education related to the COVID-19 pandemic: a narrative inquiry study

  1. http://orcid.org/0000-0002-7081-6377Aliya Kassam1,2,
  2. Stacey Page1,
  3. Julie Lauzon3,
  4. Rebecca Hay4,
  5. Marian Coret5,
  6. Ian Mitchell6
  1. 1Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  2. 2Office of Postgraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  3. 3Medical Genetics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  4. 4Pediatric Critical Care Medicine, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada
  5. 5Adolescent Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
  6. 6Pediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  1. Correspondence to Dr. Aliya Kassam, Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Canada; kassama{at}ucalgary.ca

Abstract

Background The COVID-19 pandemic introduced new challenges to provide care and educate junior doctors (resident physicians). We sought to understand the positive and negative experiences of first-year resident physicians and describe potential ethical issues from their stories.

Method We used narrative inquiry (NI) methodology and applied a semistructured interview guide with questions pertaining to ethical principles and both positive and negative aspects of the pandemic. Sampling was purposive. Interviews were audio recorded and transcribed. Three members of the research team coded transcripts in duplicate to elicit themes. Discrepancies were resolved through discussion to attain consensus. A composite story with threads was constructed.

Results 11 residents participated across several programmes. Three main themes emerged from the participants’ stories: (1) complexities in navigating intersecting healthcare and medical education systems, (2) balancing public health and the public good versus the individual and (3) fair health systems planning/healthcare delivery. Within these themes, participants’ journeys through the first wave were elicited through the threads of (1) engage us, (2) because we see the need for the duty to treat and (3) we are all in this together.

Discussion Cases of the ethical issues that took place during the COVID-19 pandemic may serve as a foundation on which ethics teaching and future pandemic planning can take place. Principles of clinical ethics and their limitations, when applied to public health issues, could help in contrasting clinical ethics with public health ethics.

Conclusion Efforts to understand how resident physicians can navigate public health emergencies along with the ethical issues that arise could benefit both residency education and healthcare systems.

  • COVID-19
  • Quality of Health Care
  • Clinical Competence
  • Education
  • Ethics

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    • COVID-19
    • Quality of Health Care
    • Clinical Competence
    • Education
    • Ethics

    Data availability statement

    No data are available.

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    Footnotes

    • X @academialiya

    • Contributors AK is responsible for the overall content as guarantor and accepts full responsibility for the finished work and/or the conduct of the study, had access to the data and controlled the decision to publish. AK designed the study, collected data, analysed data and wrote the manuscript. SP helped to design the study, analyse the data and reviewed/co-wrote the manuscript. JL helped to design the study, analyse the data and reviewed/co-wrote the manuscript. RH helped to design the study, reviewed the interview guide, assisted with data collection and reviewed the manuscript. MC helped to design the study, reviewed the interview guide, assisted with data collection and reviewed the manuscript. IM supervised AK, helped to design the study, reviewed the interview guide, helped to analyse the data and co-wrote and reviewed the manuscript.

    • Funding This study was funded by University of Calgary, Faculty of Graduate Studies (Not Applicable).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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    Ethical issues in residency education related to the COVID-19 pandemic: a narrative inquiry study (2024)
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