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Introduction to the Project on Bioethics for Informed Choices - page 15 / 115

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Bioethics Education545

Clinical Anthropology, a PBL Method for Education of Humanity and Ethics

- Shin'ichi Shoji, M.D. .

Department of Neurology, Institute of Clinical Medicine, University of Tsukuba,

1-1-1 Tennodai, Tsukuba, 305-8575, JAPAN

Email: sshoji@md.tsukuba.ac.jp

Clinical anthropology has been considered as a method for humanities and ethics education. The most effective and attractive method for learners should be a small group discussion type of education.  Problem-based learning is conducted as follows, 1) presentation of a concrete clinical case or scenario requiring decisions relating to birth, aging, illness or death, 2) presentation of essential information for discussion, 3) presentation of typical opinions about the theme, 4) questions and answers, 5) free discussion in small groups with or without tutor(s), 6) presentation of abstract of small group discussion, 7) general discussion, 8) presentation of tutors’ private opinions, 9) describing learners own opinion.

General instructional objective of this type of education is that learners will be able to consider humans through birth, aging, illness, or death. Specific behavioral objectives of this type of education is as follows, 1) extract problems from information, 2) speak one's own opinion clearly in plain language, 3) listen intently to other’s opinion, 4) play as a chairperson of small group discussion, 5) record abstract of discussion, 6) present abstract of small group discussion, 7) write sentences on one's own opinion. Evaluation of learners is done by percentage of attendance and report. Evaluation of class is done through learner questionnaires.

In the School of Medicine, University of Tsukuba, the reform of curriculum is going to start from  April 2004.  From first-year student to third-year students, the curriculum of medical education is going to use mainly this problem-based learning.  One lecture a day and two tutorials a week and two half-day practices a week are the standard plan of the curriculum. From fourth-year student to fifth-year student, a strict clinical clerkship will be done in the university hospital and related institutions.  In the final school year, the sixth-year, is planned to use as an elective course for student. Students can choose any laboratory or institute of basic medicine, clinical medicine, or social medicine of inside and outside of the university,  and inside and outside of Japan.

Discussion

Miller: I realize that you attempt to teach some basic rules of argument but because of the limited time and because of the fact that you go to specific questions very early; do you not think that you risk indoctrination rather than teaching people how to reason and to answer for themselves?

Shoji: It’s a matter of the amount of knowledge. Within the 6 years of medical education, students already have a lot of material in their regular classes that they have to master to become medical professionals. So in this course, we give them the freedom to choose what they want to learn, what they want to read. In this paper, I only gave the example of medical students; but actually we also give this class to others.  We can see that there is a change in the way students look at the course once they start taking it.  If students are given the chance to choose what they learn, they become more passionate about the topic.  It is not important what we teach, but rather, it is important to give students the chance to learn by themselves. They can study by themselves. We just introduce them to a lot of journals and texts.

Xiao Wei: I am also teaching bioethics in university. You use a lot of case studies and discussion in your class. Do you also teach fundamental ethics and philosophy to your students since they don’t have a lot of ethical and philosophical background? Another question is what do your students choose to learn? I wonder what can influential in this choice; for example since Japan is an Asian culture, perhaps Confucian ethics is important?

. pp. 545-546 in Macer, DRJ., ed., "Challenges for Bioethics from Asia" (Eubios Ethics Institute, 2004).

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