Greetings from St. Louis and WashU. For my ‘Surgical Ethics Education Resources -- #13’ communication, I am sharing (see below) an adaptation of a values assessment tool the first draft of which I created about twenty years ago while working as part of the leadership team for a community health center serving a truly rural and impoverished patient population in East TN/KY. Rather than simply state/post a claimed set of values, we created a values assessment tool to use in surveys, interviews, and focus groups with all staff members (i.e., physicians, nurses, and administrative staff) as well as with a cross-section of the communities/families we served. By soliciting their feedback re four criteria (i.e., a ‘core’ value is clearly explained, significantly influences decisions and actions, is expected throughout the organization, and is encouraged/incentivized), we dared to ask if our community health center’s stated/claimed values were in fact true and experienced, realizing that we were inviting the staff and the communities/families to expect us to address barriers to prioritizing/strengthening any value/s in question.
I was prompted to recall this exercise in taking values seriously when I recently came across a copy of our department’s 2017 annual report in which eight ‘core values’ are highlighted. I have inserted below an adaptation of our community health center’s values assessment tool and plan to suggest we use some such tool for measuring the breadth and depth of the eight values presented as ‘core’ within our department.
Values and ethics are strongly linked. Each individual forms a personal sense as to what is of ultimate value and what is of lesser value. These ultimate (i.e., core) values serve as a filter through which information is interpreted before being applied to life’s decisions. Certain relationships, experiences, circumstances, and objects are thus regarded to be of such importance to us that we are prepared to suffer great loss rather than to violate them.
Judgments about what ought or ought not to be done can usually be acted upon safely without much conflict. However, some situations – certainly in the education and the practice of medicine -- require a collective judgment from a number of individuals with competing values or divergent viewpoints. In such situations, a reflective approach to decision-making -- i.e., ethics -- is necessary. Ethics then has to do with the determination of what ought to be done in a given situation, all core values considered.
I suggest that one way we can encourage surgical ethics education in our respective departments is to introduce creative ways to identify and assess the values that shape the experience of staff and patients. Please feel free to make any use of this values assessment tool that you think might be helpful. I welcome your feedback.
Doug
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Values – Assessment Tool
The following ‘core’ values are highlighted in our department’s 2017 annual report. A clarifying definition from the report is added for each value. Please rate (1-5 scale, ‘1’ meaning ‘definitely yes’ and ‘5’ meaning ‘definitely no’) each value using the four criteria re how central/essential (i.e., ‘core’) you have found each value to be in the decision-making and conduct of our department. Your assessment is to be descriptive – i.e., is there evidence that these values are in fact true of and pivotal within our department?
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This value is clearly explained
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This value clearly influences decisions and actions
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This value is expected throughout the dept
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This value is encouraged (i.e., there are incentives to honor
and maintain the value)
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Comment/s
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Psychological Safety. We all should feel safe when sharing
ideas, concerns, and mistakes.
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Fostering Leadership. We build successful leaders and
provide leadership opportunities.
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Broad Promotion Criteria. We reward contributions in
education, patient care, research.
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Recruiting Diversity In All Forms. We encourage all to
achieve their best.
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Addressing Disparities. We do so through research and
community engagement. We welcome researchers who are members of
underrepresented minorities.
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Work-Life Balance: We foster work satisfaction by allowing
all staff to contribute on flexible terms.
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Mentorship: We expect strong mentors and provide resources
to develop these skills.
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Serving A Diverse Population: We work hard to address the
complex barriers to minority clinical trial participation.
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