LAUSR

In preparing ethicists with specialized expertise in neurological sciences, institutions should recognize the importance of implementing an examination element when drafting pedagogy. Establishing a means of certification through examination is the appropriate step in realizing Moses and Illes’s (2017) vision of improved standardization and transparency in committee recruitment and training. Such an exam would help institutions to (1) objectively evaluate the preparation of committees and individual consultants, (2) assess the efficacy of institutional ethics training, and (3) establish a baseline of what expertise in neuroethics should include. In the last few decades, several institutions have made efforts to develop postgraduate fellowships, certificates, and degree programs in medical ethics (Chidwick et al. 2004; Hill 1994). On one hand, this has led to an array of academically rich and engaging opportunities to develop expertise in ethics. On the other hand, the number of programs churning out graduates calls into question whether or not there should be an accrediting body for such programs. Relatedly, there is growing sentiment for institutions to collectively develop a baseline standardization for ethics curricula (Acres et al. 2012). Professional organizations focusing on neurological sciences can assume a leadership role in establishing such a curriculum by collectively developing a comprehensive credentialing exam in neuroethics. A standardized assessment of content acquisition in bioethics is challenging but not impossible. Though the practice of ethics is, in many ways, contextual, there is potential for measuring general mastery in the field. Program directors and faculty at Emory University acknowledged this in developing a comprehensive exam for their master’s of bioethics program. In particular, they cited two benefits worth noting in implementing a comprehensive exam: (1) the ability for students to demonstrate general mastery in bioethics rather than narrow depth through thesis work, and (2) the ability for faculty members to assess the efficacy of their curriculum through a common metric of exam scores (Schonfeld, Stoddard, and Labrecque 2014). Another example of “standardization with examination” is demonstrated by the Collaborative Institutional Training Initiative—or CITI Training—for research ethics. Launched in 2000, the CITI program has been used by more than 600,000 people at more than 715 institutions (Braunschweiger and Goodman 2007). CITI Training is now a requirement at most institutions for those conducting human subjects research, providing participants with a baseline understanding of research ethics and human subjects protection. The content is not meant to be exhaustive, but there remains an exam after each short educational module, allowing participants to evaluate mastery before moving onward in their training. Combining the merits of both aforementioned examples can help to achieve the level of standardization and transparency that Moses and Illes envision. A collective of representatives from academic institutions and organizations that focus on neurological sciences can work to develop an exam that serves as a means for credentialing potential ethicists. Unlike CITI Training, this exam would take place at the end of any formal training in ethics (i.e., a graduate or certificate program, a postgraduate fellowship). This serves two benefits. First, it allows for professionals in neurological sciences to reach consensus on a baseline of what expertise in neuroethics should include. It also implies that an examination alone is not enough in credentialing clinical ethicists, but is rather a standardized piece that can be added to existing portfolio-based models (Fins et al. 2016). This acknowledges the role of formal training in developing consult skills and broader ethics expertise while simultaneously providing a standardized assessment specifically tailored to neurological sciences. Not only does such an exam improve standardization for credentialing, it can also be used for transparency purposes as an institutional assessment tool for preparation and quality. Currently, ethics committees lack a means to