Table 4 Pedagogy employed

Case-based approach

Case-based approaches may be integrated into many of the approaches below.

An example of how a case-based approach may be utilised is through videotaped consultation or significant event analysis as presented by Chandra et al. (2017 and Oljeski et al. (2004).

Sim et al. (2015) and Goodrich, Irvine, and Boccher-Lattimore (2005) interestingly used narratives in their teaching to showcase the human element at the centre of ethical dilemmas.

Roberts et al. (1996) in describing their work on ethics teaching in psychiatry, mention a six step approach to ethical cases, from defining the case to creating context for reflection and review.

[48, 50, 51, 56, 57, 59, 67, 73, 81, 82, 86, 97, 98]

Online ethics modules

These may be made available for interested learners to utilisel in their own free time.

However, Jain et al. (2011) highlight that the “value of web-based approaches warrants further investigation”.

[50, 85, 89]

Lectures and Seminar Sessions which may be termed as “Grand Rounds”

Such methods are more didactic, with key speakers who might be experts in the field sharing information on ethics principles.

[65–67, 78, 81, 88, 92, 94]

Group Discussions

Such as on key ethical issues or cases, and may serve as a platform for learners to voice their opinions, values and uncertainties. There might be a faculty leader present to guide discussion.

[49, 50, 58, 59, 65, 73, 86, 94, 99]

Research Opportunities

In these, students are given the opportunity to carry out research projects.

[100]

Hands-on Practice

Doctors may be asked to apply their ethical knowledge and practice demonstrating ethical competencies through the use of:

· Simulation

· Role Play

· Practice with Standardized Patients

A case-based approach may be used in conjunction with hands-on practice.

[58, 69, 74, 78, 86, 99]

Reflective Practice

This may be achieved through:

· Writing, editing and publishing deliberation on ethical issues

· Writing and reading poetry and pieces of written work related to doctors and patients

[56, 69, 99]

Observation and Shadowing

Learners may be invited to family meetings, ethics consultation and inpatient rounds where they observe a careful consideration of ethics being integrated into clinical decision-making.

[72, 99]

Role-modelling

Jain et al. (2011)’s survey on ethics teaching on psychiatry residents elucidated that the teaching was more memorable if learners were treated ethically by their teachers.

[50, 70, 97]

Bedside teaching

These are tutorials carried out by tutors by the bedside.

[69, 70]

Master Programs in Medical Ethics or Fellowships

These are formal certification programmes in the field of Medical Ethics.

[62, 70]

Educational Portfolios

Portfolios may be utilised in conjunction with mentorship in order to improve self-reflection.

[63, 69]

Mentoring Programs

These mentoring programs may be informal or formal.

[63, 69, 94]