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The Essential Role of Medical Ethics Education in Achieving Professionalism: The Romanell Report

Carrese, Joseph A. MD, MPH; Malek, Janet PhD; Watson, Katie JD; Lehmann, Lisa Soleymani MD, PhD; Green, Michael J. MD, MS; McCullough, Laurence B. PhD; Geller, Gail ScD, MHS; Braddock, Clarence H. III MD, MPH; Doukas, David J. MD

doi: 10.1097/ACM.0000000000000715
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This article—the Romanell Report—offers an analysis of the current state of medical ethics education in the United States, focusing in particular on its essential role in cultivating professionalism among medical learners. Education in ethics has become an integral part of medical education and training over the past three decades and has received particular attention in recent years because of the increasing emphasis placed on professional formation by accrediting bodies such as the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education. Yet, despite the development of standards, milestones, and competencies related to professionalism, there is no consensus about the specific goals of medical ethics education, the essential knowledge and skills expected of learners, the best pedagogical methods and processes for implementation, and optimal strategies for assessment. Moreover, the quality, extent, and focus of medical ethics instruction vary, particularly at the graduate medical education level. Although variation in methods of instruction and assessment may be appropriate, ultimately medical ethics education must address the overarching articulated expectations of the major accrediting organizations. With the aim of aiding medical ethics educators in meeting these expectations, the Romanell Report describes current practices in ethics education and offers guidance in several areas: educational goals and objectives, teaching methods, assessment strategies, and other challenges and opportunities (including course structure and faculty development). The report concludes by proposing an agenda for future research.

J.A. Carrese is professor, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, and core faculty, Johns Hopkins Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.

J. Malek is associate professor, Department of Bioethics and Interdisciplinary Studies, Brody School of Medicine, East Carolina University, Greenville, North Carolina.

K. Watson is assistant professor, Medical Humanities and Bioethics Program, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

L.S. Lehmann is associate professor, Center for Bioethics, Brigham and Women’s Hospital, and Division of Medical Ethics, Harvard Medical School, Boston, Massachusetts.

M.J. Green is professor, Department of Humanities and Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania.

L.B. McCullough is professor and Dalton Tomlin Chair in Medical Ethics and Health Policy, Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas.

G. Geller is professor, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, and core faculty, Johns Hopkins Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.

C.H. Braddock III is professor and vice dean for education, David Geffen School of Medicine at UCLA, Los Angeles, California.

D.J. Doukas is William Ray Moore Endowed Chair of Family Medicine and Medical Humanism and director, Division of Medical Humanism and Ethics, Department of Family and Geriatric Medicine, University of Louisville School of Medicine, Louisville, Kentucky.

Funding/Support: The Project to Rebalance and Integrate Medical Education was supported by the Patrick and Edna Romanell Fund for Bioethics Pedagogy of the University of Buffalo.

Other disclosures: J.A. Carrese, D.J. Doukas, M.J. Green, and J. Malek hold leadership roles in the Academy for Professionalism in Health Care (APHC). At the time of writing, C.H. Braddock and L.S. Lehmann also held APHC leadership roles.

Ethical approval: Reported as not applicable.

Disclaimers: The views expressed by the authors reflect their personal perspectives and do not necessarily reflect those of the APHC.

Correspondence should be addressed to Joseph A. Carrese, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, 5200 Eastern Ave., Mason F. Lord Building, Center Tower, Suite 2300, Baltimore, MD 21224; telephone: (410) 550-2247; e-mail: jcarrese@jhmi.edu.

© 2015 by the Association of American Medical Colleges