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Integrating Technology and Context into Research Ethics Education in ACME

Chihhung Jason Wang

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National Institutes of Health (NIH)
The goal of this initiative is to develop research ethics leaders in Southeast Asia to meet the emerging research and health system evaluation demands of societies undergoing rapid transition. Ethical behavior in healthcare-related research is a worldwide issue and concern. Currently, there remains no regional capacity to train emerging leaders to identify problems, analyze possible solutions, and apply ethical principles to meet their countries' challenges in research and evaluation. We propose the creation of Centers of Excellence in Research Ethics Training (Centers) in the Asia Collaborative for Medical Education (ACME), a consortium of leading medical schools and healthcare institutions. These Centers will be based at (1) Stanford University (USA), and regionally at (2) the Koo Foundation Sun Yat-Sen Cancer Center (KF-SYSCC)/National Yang Ming University (NYMU) in Taiwan. The Centers will operate as hubs for training, research, and innovation for Asian health and research professionals. The proposed research will capitalize on several organizational and curricular innovations, including the use of technology in the delivery of a 2-year Masters level curriculum, and a focus on research ethics in health services research, which are likely to be most relevant to developing countries as many are conducting program evaluation to assess the impact of different health delivery interventions. We will focus our efforts in developing countries in Southeast Asia, starting with Thailand and Vietnam, and expanding our efforts to Nepal, Burma and Bhutan in future award periods. The curricular innovations include: (1) The use of the IDEO design method, a human-centered, design-based approach that uncovers "latent needs, behaviors and desires", to help scholars develop culturally appropriate curriculum with regards to local contexts. (2) Trainees will be paired with core faculty members from Stanford and KF- SYSCC/NYMU for mentorship on research ethics practicum, which will then be developed into a training curriculum appropriate for their home institutions. (3) Application of the Institute for Healthcare Improvement's Improvement Collaboratives, where scholars from different countries are invited to participate in a Research Ethics Improvement Network (REIN). The model includes both face-to-face learning sessions (story boards, role plays, simulations, didactics), a web-based support component (didactics materials, cases discussions, video/audio teleconferences for problem solving, etc.), and the use of plan-do-study-act (PDSA) iterative cycles of curricular improvement. (4) The Collaboratives model also has a dissemination component where scholars are encouraged to build networks and to engage policy makers and community leaders to publicize the importance of research ethics in their academic and local communities. Our partnership-fellowship proposal will likely extend the US research network overseas, build local human capital capacity, and garner support for initiatives by researchers from the US and from the region. We believe that the basic training and innovation mechanisms developed by our initiative will be relevant to other parts of the world facing similar demands.

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