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Ethics rounds in the ambulance service : a qualitative evaluation

Frank, Catharina ; Rantala, Andreas LU orcid ; Svensson, Anders ; Sterner, Anders ; Green, Jessica ; Bremer, Anders and Holmberg, Bodil (2024) In BMC Medical Ethics 25(1).
Abstract
Background

It is a common ethical challenge for ambulance clinicians to care for patients with impaired decision-making capacities while assessing and determining the degree of decision-making ability and considering ethical values. Ambulance clinicians’ ethical competence seems to be increasingly important in coping with such varied ethical dilemmas. Ethics rounds is a model designed to promote the development of ethical competence among clinicians. While standard in other contexts, to the best of our knowledge, it has not been applied within the ambulance service context. Thus, the aim of this study was to describe ambulance clinicians’ experiences of participating in ethics rounds.
Methods

This was a qualitative... (More)
Background

It is a common ethical challenge for ambulance clinicians to care for patients with impaired decision-making capacities while assessing and determining the degree of decision-making ability and considering ethical values. Ambulance clinicians’ ethical competence seems to be increasingly important in coping with such varied ethical dilemmas. Ethics rounds is a model designed to promote the development of ethical competence among clinicians. While standard in other contexts, to the best of our knowledge, it has not been applied within the ambulance service context. Thus, the aim of this study was to describe ambulance clinicians’ experiences of participating in ethics rounds.
Methods

This was a qualitative descriptive study, evaluating an intervention. Data were collected through sixteen interviews with ambulance clinicians who had participated in an intervention involving ethics rounds. The analysis was performed by use of content analysis.
Results

Two themes describe the participants’ experiences: (1) Reflecting freely within a given framework, and (2) Being surprised by new insights. The following categories form the basis of the themes; 1a) Gentle guidance by the facilitator, 1b) A comprehensible structure, 2a) New awareness in the face of ethical problems, and 2b) Shared learning through dialogue.
Conclusion

Incorporating structured ethics rounds seems to create a continuous development in ethical competence that may improve the quality of care in the ambulance service. Structured guidance and facilitated group reflections offer ambulance clinicians opportunities for both personal and professional development. An important prerequisite for the development of ethical competence is a well-educated facilitator. Consequently, this type of ethics rounds may be considered a useful pedagogical model for the development of ethical competence in the ambulance service. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ambulance clinicians, Ethics rounds, Intervention, Qualitative, Evaluation, Ethical competence, Decisionmaking, Patient autonomy
in
BMC Medical Ethics
volume
25
issue
1
article number
8
pages
10 pages
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85182686416
ISSN
1472-6939
DOI
10.1186/s12910-024-01002-6
language
English
LU publication?
yes
id
8edc4a72-ecca-41a6-b29b-bd3f4a8f6cbd
date added to LUP
2024-01-19 08:29:23
date last changed
2024-04-11 12:39:39
@article{8edc4a72-ecca-41a6-b29b-bd3f4a8f6cbd,
  abstract     = {{Background<br/><br/>It is a common ethical challenge for ambulance clinicians to care for patients with impaired decision-making capacities while assessing and determining the degree of decision-making ability and considering ethical values. Ambulance clinicians’ ethical competence seems to be increasingly important in coping with such varied ethical dilemmas. Ethics rounds is a model designed to promote the development of ethical competence among clinicians. While standard in other contexts, to the best of our knowledge, it has not been applied within the ambulance service context. Thus, the aim of this study was to describe ambulance clinicians’ experiences of participating in ethics rounds.<br/>Methods<br/><br/>This was a qualitative descriptive study, evaluating an intervention. Data were collected through sixteen interviews with ambulance clinicians who had participated in an intervention involving ethics rounds. The analysis was performed by use of content analysis.<br/>Results<br/><br/>Two themes describe the participants’ experiences: (1) Reflecting freely within a given framework, and (2) Being surprised by new insights. The following categories form the basis of the themes; 1a) Gentle guidance by the facilitator, 1b) A comprehensible structure, 2a) New awareness in the face of ethical problems, and 2b) Shared learning through dialogue.<br/>Conclusion<br/><br/>Incorporating structured ethics rounds seems to create a continuous development in ethical competence that may improve the quality of care in the ambulance service. Structured guidance and facilitated group reflections offer ambulance clinicians opportunities for both personal and professional development. An important prerequisite for the development of ethical competence is a well-educated facilitator. Consequently, this type of ethics rounds may be considered a useful pedagogical model for the development of ethical competence in the ambulance service.}},
  author       = {{Frank, Catharina and Rantala, Andreas and Svensson, Anders and Sterner, Anders and Green, Jessica and Bremer, Anders and Holmberg, Bodil}},
  issn         = {{1472-6939}},
  keywords     = {{Ambulance clinicians; Ethics rounds; Intervention; Qualitative; Evaluation; Ethical competence; Decisionmaking; Patient autonomy}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Medical Ethics}},
  title        = {{Ethics rounds in the ambulance service : a qualitative evaluation}},
  url          = {{http://dx.doi.org/10.1186/s12910-024-01002-6}},
  doi          = {{10.1186/s12910-024-01002-6}},
  volume       = {{25}},
  year         = {{2024}},
}