A hybrid approach to improving learning outcomes in medical ethics 

Dr Sarah Bailey: s.g.bailey@surrey.ac.uk 

In my final year Genetics module, we devote a chunk of learning to develop a more complex understanding of whether treatments given to extremely ill patients are ethically feasible using four main ethical principles [Beauchamp and Childress]. I use real-life cases like that of Charlie Gard, which rely on the input of multiple teams of experts, striking a balance of cost, medical and societal benefit, and scientific capability. The module incorporates group work, autonomous learning, and debate. I was motivated to use a hybrid approach with three aims; to support a geographically disparate cohort, enable student choice, and facilitate digital group and project management skills.  

Driven by a need to enable students to access content from across the globe as the Covid-19 pandemic hit, I embedded a BBC documentary using box of broadcasts about genome editing into SurreyLearn. Next, students used uploaded resources such as scientific articles, websites, podcasts, videos and fact-sheets to decide which of five groups to join. Here, SurreyLearn enabled student group choice without the associated administrative load. Once signed up, students could access a dropbox and discussion board within their groups with the brief plus resources aimed towards exploring the topic and bringing ethics content into their discussion.  

A face-to-face session enabled me to talk to all groups about the debate’s aim: to apply their knowledge to the scenario and try to persuade me. A great aid to starting discussion in this in-person (socially distanced) session was encouraging groups to communicate in real-time using the Zoom breakout-room chat function. 

Next, students shared their thoughts using the discussion board on applying the ethical principles to the documentary and their chosen group stance, and the focus of their “argument” in the debate. They uploaded their resources, and some groups organised sessions to discuss their thoughts. I monitored posts on the discussion boards, facilitating dialogue and encouraging those less focused on the task to stay on track.  

Students had a short time in their group in the debate session to finalise strategies, then moved to breakout rooms containing one person from each of the five groups, where an initial statement was provided. This organic approach to ethics enabled the students to utilise higher-order thinking skills than traditional methods could have achieved alone. In a post-debate questionnaire, students reported enjoying the experience – enabling them to integrate this with other module content areas, including discussing ethics with friends and family. 


Beauchamp TL and Childreess JF. Principles of Biomedical Ethics,  7th Edition (2013) Oxford University Press, Oxford, UK.