Phronesis and the Medical Community Follow-on Impact and Engagement Report: Impact Assessment of Phronesis Resources on Ethical Decision Making for Doctors

The original ‘Phronesis (practical wisdom) and the Medical Community’ research (2015-2018) contributed theory of the virtues that the medical community in the UK draw on to make good/wise/ethical decisions for patients and their communities. A research process that draws on humanities (virtue ethics) and arts (film production) helped to convey that theory in a highly accessible film box set and app format. The purpose of the follow-on ‘Impact and Engagement’ project (2018-2019) was to assess the impact of that contribution by evaluating its application in a series of pilots. Those pilots used the box set and app output of the research as a contemporary ‘moral debating resource’ in medical undergraduate, postgraduate and CPD educational programmes. This non-prescriptive debating resource conveyed the current ‘collective practical wisdom’ of the medical community interviewed and observed in order to stimulate reflection and debate on ethical decision-making. A developmental dimension to the project, a formative evaluation, used the feedback from the pilots to update the resources from an ‘alpha’ to a ‘beta’ version. That refining process helped the resources become more understandable and helpful for participants in their practice of making good/wise/ethical decisions for patients and their communities. The main research question of this project was to ask whether applying the research findings in this form contributed to cultivating or growing their phronesis at any stage in medical careers. The answer and central argument made in this report, based on the summative evaluation of the pilots is that the ‘moral debating resource’ output from the original research does support the cultivation of phronesis in ethical decision making at all career stages of medical practice and can be also be used to support ethical decision making in other healthcare practices. Impact areas include the following:

• Enabled medical and related healthcare professionals to cultivate phronesis (practical wisdom) in a way that improves their good/wise/ethical decision making.
• Medical students and trainees gained early phronesis insights related to ethical decision making from using the resources.
• Some medical schools have endorsed the research by including the resources into already very packed curricula as they can see the importance of the contribution.
• Wider wellbeing impact from changes in medical decision-making practices plus a strong interest in the approach and use of the resources from other sectors/ organisations that influence national and international wellbeing.

Both projects were funded by the Arts and Humanities Research Council (AHRC). The importance of inter-professional collaboration to ethical decision-making was raised by the participants in the original research and created a strong call for further research. This combined with the social policy drivers associated with integrated healthcare and the lack of research on inter-professional ethical decision-making has led the research team to submit a subsequent Inter-Professional Phronesis (IPP) research grant application to the AHRC. The aim is to study ethical decision-making in the context of integrated mental healthcare given that according to the British Medical Association poor mental health carries a UK economic and social cost amounting to £123bn a year as well the considerable wellbeing cost to families and communities.