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Evaluating assessment tools of the quality of clinical ethics consultations: a systematic scoping review from 1992 to 2019.
BMC Med Ethics. 2020 Jul 01; 21(1):51.BM

Abstract

BACKGROUND

Amidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality of CECons.

METHODS

Guided by Levac et al's (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.

RESULTS

Nine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified - the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.

CONCLUSION

This review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy. To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards.

Authors+Show Affiliations

Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Drive, Singapore, 169610, Singapore. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore.Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Drive, Singapore, 169610, Singapore. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore.Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Drive, Singapore, 169610, Singapore. Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Dr, Experimental Medicine Building, Singapore, 636921, Singapore.Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Drive, Singapore, 169610, Singapore. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore.Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Drive, Singapore, 169610, Singapore. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore.Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Drive, Singapore, 169610, Singapore. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore.Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Drive, Singapore, 169610, Singapore. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore.Medical Library, National University of Singapore Libraries, National University of Singapore, Blk MD6, Centre, 14 Medical Dr, #05-01 for Translational Medicine, Singapore, 117599, Singapore.Department of Family Medicine, National University Health System, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.Division of Cancer Education, National Cancer Centre Singapore, Level 4, 11 Hospital Drive, Singapore, 169610, Singapore.Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK.Division of Supportive and Palliative Care, National Cancer Centre Singapore, Level 4, 11 Hospital Drive, Singapore, 169610, Singapore. Lalit.Radha-Krishna@liverpool.ac.uk. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore. Lalit.Radha-Krishna@liverpool.ac.uk. Division of Cancer Education, National Cancer Centre Singapore, Level 4, 11 Hospital Drive, Singapore, 169610, Singapore. Lalit.Radha-Krishna@liverpool.ac.uk. Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, University of Liverpool, Liverpool, UK. Lalit.Radha-Krishna@liverpool.ac.uk. Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK. Lalit.Radha-Krishna@liverpool.ac.uk. Centre of Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, #02-03, Singapore, 117597, Singapore. Lalit.Radha-Krishna@liverpool.ac.uk. Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore. Lalit.Radha-Krishna@liverpool.ac.uk.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32611436

Citation

Yoon, Nicholas Yue Shuen, et al. "Evaluating Assessment Tools of the Quality of Clinical Ethics Consultations: a Systematic Scoping Review From 1992 to 2019." BMC Medical Ethics, vol. 21, no. 1, 2020, p. 51.
Yoon NYS, Ong YT, Yap HW, et al. Evaluating assessment tools of the quality of clinical ethics consultations: a systematic scoping review from 1992 to 2019. BMC Med Ethics. 2020;21(1):51.
Yoon, N. Y. S., Ong, Y. T., Yap, H. W., Tay, K. T., Lim, E. G., Cheong, C. W. S., Lim, W. Q., Chin, A. M. C., Toh, Y. P., Chiam, M., Mason, S., & Krishna, L. K. R. (2020). Evaluating assessment tools of the quality of clinical ethics consultations: a systematic scoping review from 1992 to 2019. BMC Medical Ethics, 21(1), 51. https://doi.org/10.1186/s12910-020-00492-4
Yoon NYS, et al. Evaluating Assessment Tools of the Quality of Clinical Ethics Consultations: a Systematic Scoping Review From 1992 to 2019. BMC Med Ethics. 2020 Jul 1;21(1):51. PubMed PMID: 32611436.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluating assessment tools of the quality of clinical ethics consultations: a systematic scoping review from 1992 to 2019. AU - Yoon,Nicholas Yue Shuen, AU - Ong,Yun Ting, AU - Yap,Hong Wei, AU - Tay,Kuang Teck, AU - Lim,Elijah Gin, AU - Cheong,Clarissa Wei Shuen, AU - Lim,Wei Qiang, AU - Chin,Annelissa Mien Chew, AU - Toh,Ying Pin, AU - Chiam,Min, AU - Mason,Stephen, AU - Krishna,Lalit Kumar Radha, Y1 - 2020/07/01/ PY - 2020/04/07/received PY - 2020/06/19/accepted PY - 2020/7/3/entrez PY - 2020/7/3/pubmed PY - 2020/7/3/medline KW - CECs KW - Clinical ethics KW - Clinical ethics committees KW - Clinical ethics consultations KW - Medical ethics SP - 51 EP - 51 JF - BMC medical ethics JO - BMC Med Ethics VL - 21 IS - 1 N2 - BACKGROUND: Amidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality of CECons. METHODS: Guided by Levac et al's (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings. RESULTS: Nine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified - the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations. CONCLUSION: This review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy. To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards. SN - 1472-6939 UR - https://www.unboundmedicine.com/medline/citation/32611436/Evaluating_assessment_tools_of_the_quality_of_clinical_ethics_consultations:_a_systematic_scoping_review_from_1992_to_2019 L2 - https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-020-00492-4 DB - PRIME DP - Unbound Medicine ER -
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