- Bioethics Education in Training of Medical and Pharmaceutical Specialists in Kyrgyzstan
Successful reform of healthcare is not possible without reforming medical and pharmaceutical education under conditions of intensive development of legal and ethics regulation of relations between a patient and a doctor. In this regard, the teaching of bioethics and medical law is conditioned by the necessity of social and normative regulation in healthcare, given the interaction between moral norms and law.
In our opinion, a bioethics course serves to mould a future professional doctor, providing him with not only clinical but also bioethics thinking and culture. Bioethics culture and law have become indispensable with the development of modern medical science and practice, and the ever-changing models of relations between a doctor and a patient.
The Kyrgyz State Medical Academy (KSMA) is the leader in medical education in the Kyrgyz Republic and most of the fast-developing institutes of higher education in Central Asia. At KSMA, there are more than 4,500 students from Kyrgyzstan, the Commonwealth of Independent States countries and 17 other countries. Recognising the importance of bioethics education for future medical and pharmaceutical specialists, an interdisciplinary, undergraduate-level course on bioethics was introduced in KSMA in 2009. In 2010, KSMA and UNESCO signed a Memorandum of Understanding and Implementation of the Core Curriculum of UNESCO on Bioethics.
The volume of this curriculum was 46 hours, with 18 hours devoted to lectures and practical lessons and 10 hours to independent work. With the introduction of the new national standard of training for three generations in the 2014–15 academic year, the number of credits was increased to two. This [End Page 454] increased the possibility of independent work and discussions, with greater emphasis on cultural-ethnic issues, international instruments, the choice of optimal tactics, and the behaviour of future doctors and pharmacy specialists. The curricula have been designed for students of different specialties and include: general medicine, pediatrics, public health, dentistry, advanced nursing and pharmaceutics. In each programme, special attention is paid to the priority issues of that specialty.
The world community recognises bioethics as one of the highest priorities and highlights issues of legal protection of fundamental human rights. The moral culture and responsibility of medical and pharmaceutical employees is a necessary component in the formation of the global outlook of a specialist. Education in bioethics, the development of skills and the ability to apply them in real life is a necessary condition for the formation of professionally competent strategies of healing, as doctors and pharmacists meet new challenges, conflicts and dilemmas.
The forms of teaching include: debates, discussions, role games, and exploration of organisation and situational problems, ethical dilemmas and conflicts. Independent work is carried out in the clinics. The wishes of the students and their proposals were considered in changes to the curricula. Questionnaires have been used to obtain feedback from students. To assess the content of curricula, anonymous surveys of students were carried out during all four years of teaching. Students were asked four questions:
1. Is the subject “Bioethics” needed?
2. In which year of study should the bioethics course be introduced?
3. Are lecture hours sufficient?
4. Is enough time devoted to skill-building sessions?
5. Should an interdisciplinary approach to teaching bioethics be adopted?
Average results obtained over four years were:
1. “Yes”—95.4%, “No”—2.0%, “Do not know”—2.6%.
2. Most of the students would like to study bioethics after one to two and then five to six years of education.
3. “Yes”—66.4%, “No”—33.4% (the number of hours of lectures should be increased).
4. “Yes”—32.8%, “No”—33.4% (the number of hours of skill-building sessions should be increased).
5. “Yes”—84.0%, “No”—16.0% (the reason: it is difficult to go to different clinics in the city). [End Page 455]
We can conclude that bioethics is still a new subject and that the curricula are still being improved and updated. We also feel that after four years of teaching bioetics, the decision to introduce this subject was done in time. We are proposing to introduce this subject on a post-graduate level too.