Professional & Medical Ethics: Internet Resources

Earlier this week I was asked to compile a list of resources on professional ethics. Now I am sharing it with you. Below is a selection of Internet resources in three broad categories. All are free online, but full text of retrieved resources usually requires subscriptions. For best searching results, read the search tips and use advanced search screens where available. (I always do this, but then I am a librarian and I can’t help myself.)

A. Selected Literature Databases

PubMed: Use the MeSH Database (Medical Subject Headings) to find appropriate subject terms [see the left sidebar on the PubMed site].  Search here for MeSH terms such as:
     Ethics, Professional; Ethics, Medical; Ethical Theory; Bioethics
CAM on PubMed [National Center for Complementary and Alternative Medicine (NCCAM) and NLM]
     Search CAM to limit searches in PubMed to CAM journals.
CHID: Combined Health Information Database [U.S. National Institutes of Health]
RDRB: Research & Development Resource Base [University of Toronto Faculty of Medicine, Office of Continuing Education]  Search the medical education literature, particularly continuing health education.
Index to Chiropractic Literature [Chiropractic Library Consortium]

B. General Search Engines

Google Advanced Scholar Search      Google Advanced Book Search 

C. Selected Web Sites

Librarians’ Internet Index (LII)          LII Ethics section 
Codes of Ethics Online [Center for the Study of Ethics in the Professions, Illinois Institute of Technology]
     Health Care section 
ProfessionalEthics.ca: The Canadian Resource for Professional Ethics
EthicsWeb.ca: Canadian Ethics Institutes
American Medical Association: Medical ethics
BioethicsWeb: The guide to Internet resources for biomedical ethics [Wellcome Trust, U.K.]

Cluster randomized controlled trial of the effectiveness of audit and feedback and educational outreach on improving nursing practice and patient outcomes

 From the June 2006 issue of Medical Care: [full text by subscription]

Cheater FM, Baker R, Reddish S, Spiers N, Wailoo A, Gillies C, Robertson N, Cawood C. Cluster randomized controlled trial of the effectiveness of audit and feedback and educational outreach on improving nursing practice and patient outcomes. Med Care 2006;44:542-551.
 
 BACKGROUND: Current understanding of implementation methods is limited, and research has focused on changing doctors’ behaviors. AIM: Our aim was to evaluate the impact of audit and feedback and educational outreach in improving nursing practice and patient outcomes.
 METHODS: Using a factorial design, cluster randomized controlled trial, we evaluated 194 community nurses in 157 family practices and 1078 patients with diagnosis of urinary incontinence (UI) for nurses compliance with evidence-linked review criteria for the assessment and management of UI and impact on psychologic and social well-being and symptoms. In the outreach arms, nurses’ self-reported barriers informed development of tailored strategies.
 RESULTS: In comparison with educational materials alone, the implementation methods tested did not improve care at 6 months follow-up. Moderate rates of improvement (10-17% of patients) in performance for the assessment of UI and greater rates of improvement (20-30% of patients) for the management of care were found but effects were similar across arms. Improvement in patient outcomes was more consistently positive for educational outreach than for audit and feedback but differences were not significant. Adjustment for caseload size, severity or duration of UI and patients’ age did not alter results.
 CONCLUSIONS: Printed educational materials alone may be as effective as audit and feedback and educational outreach in improving nurses’ performance and outcomes of care for people with UI. Greater understanding of the underlying processes in improving performance within multidisciplinary teams through further, theory-driven studies with “no intervention” control groups and longer follow-up are needed.
 PubMed AbstractPlus

Interprofessional education: articles from the Journal of Interprofessional Care

 From the June 2006 issue of the Journal of Interprofessional Care: [full text by subscription]

Stone N. Evaluating interprofessional education: The tautological need for interdisciplinary approaches. J Interprof Care 2006;20:260-275.

Abstract: This paper explores some issues associated with evaluating interprofessional education (IPE) programs. It proposes options that harness the synergy made possible through interdisciplinary and multi-method approaches. Both qualitative and quantitative research approaches are suggested. It is argued that traditional, control group experimental designs may not be adequate, appropriate or reasonable as the sole means of evaluating interprofessional education. The example of the four-year Rural IPE (RIPE) project, from southeastern Australia, is provided to suggest ways to identify indicators and implement features of successful IPE programs. It offers an interdisciplinary approach to measuring the effectiveness of IP programs. A particular focus is the use of self-assessment to both monitor and promote structured reflective learning and practice. Sample triangulatory data are presented from a range of evaluation methods collected from the RIPE project. The results suggest evidence of some significant educational gains as a result of this intervention. The data, the methods and the analyses may be useful for others interested in implementing or strengthening interprofessional education. The paper suggests a judicious, customized and balanced blend of methods and methodologies may offer more useful ways forward than relying on single method controlled studies which are, in any case, rarely feasible.
PubMed AbstractPlus   

Kwan D, Barker KK, Austin Z, Chatalalsingh C, Grdisa V, Langlois S, Meuser J, Moaveni A, Power R, Rennie S, Richardson D, Sinclair L, Wagner SJ, Oandasan I. Effectiveness of a faculty development program on interprofessional education: A randomized controlled trial. J Interprof Care 2006;20:314-316.

Excerpt: Evidence of the effectiveness of interprofessional education (IPE) is largely untested. In particular, assessing the best model for educating clinical faculty about IPE and whether it impacts their teaching remains a challenge. The IPE literature recognizes that skilled, knowledgeable, interprofessional faculty facilitators are integral for the successful implementation of IPE interventions. For collaborative practice (CP), however, there are gaps in our educational knowledge base. First, the literature falls short in outlining how faculty should learn how to teach interprofessional collaborative practice. Second, the literature offers little in the way of empirical accounts of the effectiveness of these sparse descriptions for faculty development.  The goal of this study is to assess the effectiveness of education in IPE for clinical faculty who teach and practice in clinical settings. The primary objective is to measure the effectiveness of a Faculty Development Program on Interprofessional Education (FDP-IPE) on the faculty’s knowledge, skills, attitudes (KSA) related to teaching IPE for collaborative practice.
PubMed AbstractPlus