Doctors Can Step Into the ‘Rough Ground’ with Confidence: Confirmed Route to Cultivate Practical Wisdom in Ethical Decision-Making for the Medical Community

Abstract

Abstract Background It has been argued that phronesis (practical wisdom) has been reduced to following guidelines or a sequential algorithm and there is a call from medical practice to be provided with the means to apply phronesis to their decision-making without yet another set of guidelines. The concept of the phronesis virtue offers a way to navigate the complexity of any given situation through the ‘rough ground’ by drawing on acquired wisdom from self and a practice peer group to make good and wise decisions for the people served by the practice. Our research that informs the work to date involved collecting narratives of doctors’ lived experiences that transmit their ‘collective practical wisdom’ of what it means to make ethical decisions. This second paper provides evidence that phronesis can be cultivated within medical practice by using that ‘collective practical wisdom’ in the form of a film series and app as a unique contemporary moral debating resource. Here we summarise the outcomes and impact of a twelve-month evaluation of the application of those resources to medical and other healthcare practices. Methods Data collected answered two primary questions: 1. Do these resources work in educational or CPD programmes to support practitioners in cultivating practical wisdom in their ethical decision-making practice? 2. What does it mean to education providers and medical practitioners to be using the resources to enhance ethical decision-making? Data were collected through open-ended question and interviews. We used the framework approach to analyse the data. Results The findings are grouped into subthemes which provided answers to two main themes: 1.impact on practice and 2. impact on education. Conclusion The paper evidences that these learning resources make a real difference to practice in terms of improving ethical decision-making for doctors and other healthcare professionals. The implications are that these unique resources can be used by medical educators and practitioners with confidence that they will make a difference to ethical decision-making for patients and their communities. The wider implications are that other professions, globally, can learn to enhance their ethical decision-making whether that be by using these ‘collective practical wisdom’ resources as a starting point or by developing their own bespoke resources.