610 - Developing, Implementing, and Assessing an Ethics and Professionalism Curriculum for Neonatal Clinicians Utilizing Flipped Classroom Technology: An International Pilot Study

Poster Number: 610
Publication Number: 610.306

Gina Geis, Albany Medical College, Glenmont, NY, United States; Christy L. Cummings, CHILDREN'S HOSPITAL BOSTON, DIVISION OF NEWBORN MEDICINE, BOSTON, MA, United States; David N. Williams, boston childrens hospital / harvard medical school, Boston, MA, United States

Background: Clinicians in the NICU face ethical dilemmas daily in their care of sick newborns and their families. Despite requirements to establish trainee competency in ethics and professionalism, there is little evidence to suggest whether current attempts advance knowledge and skills or alter attitudes and behaviors or if these competencies are assessed across interprofessional members of the healthcare team. In an attempt to close this gap, our regional pilot data demonstrated efficacy and feasibility of this curriculum across various academic health systems, demonstrated by knowledge acquisition and improved confidence among neonatal-perinatal medicine fellows.

Objective: 1. To implement a digitally innovative curriculum in ethics and professionalism in neonatology on an international level;
2. To evaluate the effects of the curriculum on clinician knowledge and confidence during an international pilot.

Design/Methods: We made our previously developed 12 module curriculum in neonatal ethics available to healthcare clinicians around the world via an online platform. Data collection began in July 2017 and is ongoing.  Multi-media content was constructed by experts in neonatal ethics, peer-reviewed, and uploaded onto a digital platform. Participants reviewed content online and then participated in live sessions at their home institutions to further solidify knowledge and skills. We contrasted paired pre-and post-test scores for each lesson to date to assess knowledge acquisition.  The Wilcoxon signed-rank test for paired data was used.

Results: We developed a process map to illustrate the development and implementation of our curriculum (Figure 1). Preliminary data were obtained for 789 participants in the international pilot. Pre/post comparisons of median differences in test scores were significant < .001 in all modules (Table 1).  Conclusion(s): Our curriculum has been supported by the Organization of Neonatal-Perinatal Medicine Training Program Directors of the American Academy of Pediatrics as the standard curriculum for neonatal ethics and successfully implemented internationally on an online platform. Preliminary data demonstrates that for each lesson, participants’ knowledge levels of approaching ethical challenges significantly improved. Ongoing steps include assessing the effects of this curriculum on overall knowledge and confidence levels across various educational levels as well as utilizing an ethics behavioral assessment tool to better quantify clinician performance when leading clinical discussions.
Figure 1: Educational Process Map.TEK-Neo= Test of Ethics Knowledge for Neonatal-Perinatal Physicians; BCH=Boston Children’s Hospital; TMC=Tufts Medical Center; AMC = Albany Medical Center; AAP = American Academy of Pediatrics

References:
1. Cummings, CL, Geis, GM, Kesselheim, JC, and Sayeed, S. “Ethics and Professionalism Education During Neonatal-Perinatal Fellowship Training in the United States”. Journal of Perinatology. 2015, Oct.; 35 (10):875-879. PMID: 26110498
2. Cummings, CL, Geis, GM, Feldman, HA, Berson, ER, Kesselheim, JC. “Assessing Ethics Knowledge: Development of a Test of Ethics Knowledge in Neonatology”. Journal of Pediatrics. 2018, Aug.: 199: 57-64. PMID: 29754867
3. Geis, G, Cumming, C. “Ethics and Professionalism in Neonatology Year 1 Curriculum”. 2017, July. Online curriculum. OPENPediatrics TM.
4. Geis, G, Cumming, C. “Ethics and Professionalism in Neonatology Year 2 Curriculum”. 2018, Aug. Online curriculum. OPENPediatrics TM.
5. Geis, G, Cumming, C. “Ethics and Professionalism in Neonatology Year 3 Curriculum". 2019, Oct. Online curriculum. OPENPediatrics TM.
6. Geis, GM, Feldman, HA, Berson, ER, Cummings, CL. “Developing a Digitally Innovative Ethics and Professionalism Curriculum for Neonatal-Perinatal Medicine Fellows: a 3-Year Multicenter Pilot Study”. Journal of Perinatology. 2021, Sept. PMID: 34504300.
Table 1:Median difference in pre-/post-test score by lesson.