The Effectiveness of Flipped Teaching for the Ethical Dilemma in Withdrawal Life-Sustaining Treatment

10.6145/jme.201806.0007

Ching-Mei Chang；Hsien-Feng Lin

interdisciplinary ； flipped teaching ； withdrawal life-sustaining treatment

Journal of Medical Education

22卷2期（2018 / 06 / 01）

64 - 74

英文

Background: Withdrawing a life-sustaining treatment, healthcare provider usually feels dilemmas. We aimed to explore the effectiveness of flipping teaching methods for withdrawing life-sustaining treatment by interdisciplinary staff. Methods: This study adopted pretest-posttest experimental design, Convenience sampling was used. It was taught via a simulation-based, flipped classroom approach. Effectiveness analysis was conducted before and after course intervention. Results: In total, 45 participants were recruited. The results of this study showed, only 60% of the participants were clear about the procedures and criteria for withdrawing life support. 62% of the participants knew that when withdrawing life support should be recommended, respectively. 66% of the participants experienced stress in withdrawing a life-sustaining treatment care, 68% previously encountered ethical conflict. In-depth examination of the correlation between age and life-sustaining treatment revealed that in favor of withdrawing life support (p = 0.13; P ≤ .05), younger ethnic groups are more in favor of withdrawing life-sustaining treatment. In addition, the correlation between religious beliefs and ability to assist patients in parting, thanking, and apologizing and possession showed a significant correlation (p = .041; P ≤ .05). In-depth examination of the intervention effectiveness of life-sustaining treatment of flipped teaching increased from 3.1 during pretesting to 4.3 during post-testing and improvement rate was 24.1%. A p-value of 0.000 was obtained for paired sample test, and this demonstrated significant correlation. Conclusion and Relevance to clinical practice: The results showed that a flipped teaching of withdrawing life-sustaining treatment is effective for improving clinical staff' self-perception and decrease ethical dilemmas toward death. In the view of these findings, flipped teaching education can be used to decrease the stress faced by interdisciplinary staff in withdrawing life-sustaining treatment care and dilemmas.

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