Gregory Moore

Innovative Holistic Teaching in a Canadian Neonatal Perinatal Residency Program

Ethically complex and challenging cases confront health care professionals in neonatal-perinatal medicine more often than in most other subspecialties in medicine. Neonatologists regularly encounter situations where crucial life-or-death decisions need to be made in the best interest of an infant and its family. While physicians and their professional societies seem to dictate this best interest standard by weighing the risk of mortality and morbidities, parents may have other perspectives to be considered. Our review of programs for teaching ethics in Canadian neonatal-perinatal residency programs has revealed that 90 percent of them incorporated formal and informal medical ethics education, meeting the Royal College of Physician and Surgeons of Canada requirements, but that the teaching strategies, topics covered, and time devoted to teaching ethics are not standardized. Lectures and case presentations—the pedagogic strategy used by most programs—are not ideal for teaching communication skills. We propose, therefore, a holistic approach to teaching and training that imparts (1) a traditional understanding of ethical theory and reasoning, (2) advanced skills in communication and counseling, and (3) a disposition to engage in self-reflection and to be aware of the emotional and spiritual dimensions of neonatal-perinatal medicine.

The birth of scenario‐oriented learning in ethics

research component of CHEF despite monetary incentives (enrolment was optional: one could participate in the seminar without participating in the research). With hindsight, we instead would have worked with our institutional review board to further streamline the consent process. In addition, we realise after reflection that our experimental design should have employed a waitlist control group, which would have greatly added to our ability to capture the impact of the intervention. We plan to scale up in subsequent semesters to fully evaluate the effects of CHEF and welcome collaboration with other institutions on this critical issue in medical education.

Comparison of two ventilator circuits for Dräger Babylog high-frequency ventilation

Aim:  The Dräger Babylog 8000plus ventilator (Dräger Medical Systems, Lübeck, Germany) can provide both conventional and high‐frequency ventilation (HFV). Dräger recommends specific circuits for each of these modes. We investigated the performance of the Babylog ventilator in HFV mode when used with the recommended circuits for both conventional and HFV.

Developing a Knowledge Test for a Neonatal Ethics Teaching Program

Objective The innovative Neonatal-Perinatal Medicine (NPM) Ethics Teaching Program at the University of Ottawa provides NPM trainees with vital foundational knowledge required to manage ethically contentious clinical scenarios frequently encountered in practice. In this study, our aim was to develop a knowledge test to assess the impact of the NPM Ethics Teaching Program on trainees’ knowledge about ethics. Study design Using an iterative four-step process, we developed a test for assessing pre- and post-training knowledge of NPM ethics. We first created a blueprint of the test, identifying its purpose, length, and format. We then weighted the learning outcomes of the NPM Ethics Teaching Program sessions to determine the number of questions that would be asked to assess to each learning outcome. Next, we populated the question bank and constructed a draft test. We obtained feedback from content experts on the draft test and piloted the draft test with former trainees from the NPM Ethics Teaching Program. Results We developed a pre- and post-knowledge test in NPM ethics consisting of 44 multiple choice questions (MCQs), each with five response options. The test takes approximately 60 minutes to complete. It took roughly 15 months to design and pilot the NPM ethics test. Conclusions This test can aid in the assessment of the amount of NPM ethics gained by trainees and contribute to the identification of areas for improvement in teaching and in the overall ethics program. Further iterations of the test will allow for additional assessment of its validity and the efficacy of the teaching program. Given the lack of structured evaluative ethics teaching programs in NPM nationally, this project will act as another step towards the introduction of our NPM Ethics Teaching Program to other Canadian NPM residencies.