Creating an ethics curriculum using a structured framework

While patients and their families often expect their physicians to discuss the options in end-of-life care,1 medical students and residents often feel unprepared to perform this task in clinical practice.2 At times, health care providers may disagree with patients or their families about the direction this end of life care should take. Learners often desire more organized instruction during their medical training to teach them how to elicit their patients’ views and engage patients and families in these end-of-life discussions.3 Thus, it is important to incorporate teaching in this and other medical ethics topics into the medical education curriculum. However, medical educators may find it difficult to develop and implement a curriculum in medical ethics if they lack a structured framework to guide them.4 Roff’s structured learning in clinical ethics, also known as the SLICE model,5 is an example of a structured framework that educators can use to create a medical ethics curriculum. The purpose of this article is to show medical educators how they can use the SLICE framework to develop their own medical ethics curriculum. To demonstrate this, we will illustrate how our respiratory residency program has used this framework to structure our curriculum in the end of life communication and care, which is one of the subjects in our overall medical ethics curriculum.