Investigating the Moral Sensitivity of Medical Students in the Preclinical and Late Clinical Courses Shabnam Bazmi (original) (raw)
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BMC medical ethics, 2004
Most medical schools in Japan have incorporated mandatory courses on medical ethics. To this date, however, there is no established means of evaluating medical ethics education in Japan. This study looks 1) To develop a brief, objective method of evaluation for moral sensitivity and reasoning; 2) To conduct a test battery for the PIT and the DIT on medical students who are either currently in school or who have recently graduated (residents); 3) To investigate changes in moral sensitivity and reasoning between school years among medical students and residents. Questionnaire survey: Two questionnaires were employed, the Problem Identification Test (PIT) for evaluation of moral sensitivity and a portion of the Defining Issues Test (DIT) for moral reasoning. Subjects consisted of 559 medical school students and 272 residents who recently graduated from the same medical school located in an urban area of Japan. PIT results showed an increase in moral sensitivity in 4th and 5th year stud...
Measuring the ethical sensitivity of medical students: a study at the University of Toronto
Journal of Medical Ethics, 1992
An instrument to assess 'ethical sensitivity' has been developed. The instrument presents four clinical vignettes and the respondent is asked to list the ethical issues related to each vignette. The responses are classified, post hoc, into the domains ofautonomy, beneficence andjustice. This instrument was used in 1990 to assess the ethical sensitivity ofstudents in allfour medical classes at the University of Toronto. Ethical sensitivity, as measured by this instrument, is not related to age or grade-point average. Sensitivity increases between the Ist and 2ndyear and then decreases throughout the rest of undergraduate medical training, such that the 4th-year students identify fewer issues than those entering medical school. Students expressing a career choice offamily medicine identify more issues than theirpeers. Several problems with the use ofthe instrument and the interpretation ofthe data were found. Nonetheless, these findings, ifreproducible, are important and their meaning needs further discussion.
The Predictors of Moral Sensitivity Among Physicians
International Journal of General Medicine
The continually advancing nature of health care has improved the quality of care provided to patients. However, it has also resulted in complex ethical issues healthcare providers face in Saudi Arabia. Literature concerning healthcare workers' moral sensitivity in Saudi Arabia is limited. This study aims to estimate moral sensitivity among physicians and determine the factors that influence it. Participants and Methods: A descriptive cross-sectional study was carried out among physicians working at a tertiary hospital. The Moral Sensitivity Questionnaire (MSQ) developed by Kim Lützén was used. The lowest score that can be obtained from the MSQ is 30, and the highest score is 210. Low scores demonstrate high ethical sensitivity, and high scores indicate low ethical sensitivity. Results: A total of 253 physicians participated in the study. The mean score of moral sensitivity was 90.6±19.6. There is a significant difference in the overall moral sensitivity in relation to age (P = 0.049). There are significant differences in the Moral conflict dimension according to age (P = 0.002), parental status (P = 0.011), being a member of an ethical committee (P = 0.025), years of experience (P = 0.002), clinical ranking (P < 0.001), and previous training in bioethics (P = 0.029). There were significant differences in the Relational orientation dimension with the clinical ranking (P = 0.038) and specialty (P = 0.038). Membership of an ethical committee is a significant variable in the Benefit dimension (P = 0.028). Correlation coefficients between the overall moral sensitivity score and its dimensions were Autonomy (r = 0.68), Practice (r = 0.69), and Holistic approach (r = 0.69). Physicians who previously had training in bioethics (β 2.37, P = 0.022) and physicians who worked with clinical ethics committee (β 2.66, P = 0.008) were more likely to score better in Moral conflict dimension. Conclusion: Implementing ethical training for medical students and physicians will help raise their moral sensitivity levels, thereby enhancing how they deal with ethical dilemmas.
Medical Education, 1993
Medicine endorses a code of ethics and encourages a high moral character among doctors. This study examines the influence of medical education on the moral reasoning and development of medical students. Kohlberg's Moral Judgment Interview was given to a sample of 20 medical students (41.7% of students in that class). The students were tested at the beginning and at the end of their medical course to determine whether their moral reasoning scores had increased to the same extent as other people who extend their formal education. It was found that normally expected increases in moral reasoning scores did not occur over the 4 years of medical education for these students, suggesting that their educational experience somehow inhibited their moral reasoning ability rather than facilitating it. With a range of moral reasoning scores between 315 and 482, the finding of a mean increase from first year to fourth year of 18.5 points was not statistically significant at the P 6 0.05 level. Statistical analysis revealed no significant correlations at the P < 0.05 level between the moral reasoning scores and age, gender, Medical College Admission Test scores, or grade point average scores. Along with a brief description of Kohlberg's cognitive moral development theory, some interpretations and explanations are given for the findings of the study.
Effectiveness of the Course of Medical Ethics for Undergraduate Medical Students
Journal of Medical Ethics …, 2009
Judgment This study was done in order to evaluate the effectiveness of the revisions made in the course of medical ethics for undergraduate medical students. Medical Students of Tehran University of Medical Sciences who took the course of medical ethics in a semester before the implementation of the revision and those who took the course after the implementation of the revision at the beginning and at the end of course responded to two questionnaires (one for evaluating knowledge and the other for assessing their moral judgment). Response rate was between 70 to 93.1 percent. Students' knowledge was significantly higher in the semester after the course revision (mean ± SD: 6.12 ± 1.3) in comparison with the semester before the reform (mean ± SD: 3.63 ± 1.7) (P=0.001). Students' knowledge after taking this course showed an increase of about 60% when compared with their knowledge level before starting the course (P=0.001). There was no significant difference in the level of moral judgment before and after taking the revised course of medical ethics while moral judgment level of students in two semester[before (21.21 ± 4.0) and after 15.25 ± 2.87) reform] were significantly different (P=0.02). The revisions made in the course of medical ethics for medical students were effective in improving students' knowledge but could not improve their moral judgment. This could be due to the short length of this course and also the small sample size in this study. We suggest that this study should be repeated with larger sample size and also with other methods of a course evaluation.
Is medical students' moral orientation changeable after preclinical medical education?
Journal of Medical Ethics, 2011
Purpose Moral orientation can affect ethical decision-making. Very few studies have focused on whether medical education can change the moral orientation of the students. The purpose of the present study was to document the types of moral orientation exhibited by medical students, and to study if their moral orientation was changed after preclinical education. Methods From 2007 to 2009, the Mojac scale was used to measure the moral orientation of Taiwan medical students. The students included 271 first-year and 109 third-year students. They were rated as a communitarian, dual, or libertarian group and followed for 2 years to monitor the changes in their Mojac scores. Results In both first and third-year students, the dual group after 2 years of preclinical medical education did not show any significant change. In the libertarian group, first and third-year students showed a statistically significant increase from a score of 99.4 and 101.3 to 103.0 and 105.7, respectively. In the communitarian group, first and third-year students showed a significant decline from 122.8 and 126.1 to 116.0 and 121.5, respectively. Conclusion During the preclinical medical education years, students with communitarian orientation and libertarian orientation had changed in their moral orientation to become closer to dual orientation. These findings provide valuable hints to medical educators regarding bioethics education and the selection criteria of medical students for admission.
Supporting the moral development of medical students
Journal of General Internal Medicine, 2000
Philosophers who studied moral development have found that individuals normally progress rapidly in early adulthood from a conventional stage in which they base behavior on the norms and values of those around them to a more principled stage where they identify and attempt to live by personal moral values. Available data suggest that many medical students, who should be in this transition, show little change in their moral development. Possibly, this relates to perceived pressures to conform to the informal culture of the medical wards. Many students experience considerable internal dissidence as they struggle to accommodate personal values related to empathy, care, and compassion to their clinical training. Educational interventions that positively influence this process have established regular opportunities for critical reflection by the students in small groups. Other interventions include faculty development to enhance role modeling and feedback by clinical faculty. The author espouses more widespread adoption of these educational interventions.
Relationship of Moral Sensitivity and Distress Among Physicians
Trauma Monthly, 2015
Background: Providing health services is described as an important moral measure, since its major aim is to ensure the welfare of the people who need treatment and care. Moral sensitivity is the ability to identify the existing moral problem and understand the moral consequences of the decisions made on the patient's part. Physicians are always exposed to moral distress due to various circumstances. Objectives: In this survey, we evaluated moral sensitivity and moral distress among physicians and the relationship of these ethical factors on them. Hence, we assessed y relationship between moral sensitivity and moral distress in physicians will facilitate their sound management so as to provide high-quality and safe health services. Moreover it will confirm proposed theories regarding this subject. Materials and Methods: This cross-sectional descriptive-analytic study aimed at investigating the relationship between moral sensitivity and moral distress among 321 specialist physicians working in hospitals affiliated to Tehran Medical Universities in Tehran. The samples were selected through two-stage random cluster sampling method. A three-partite questionnaire comprising of demographic characteristics, moral distress, and moral sensitivity was used for collecting data which then were analyzed using SPSS-20. Results: There was a negative significant relationship between moral sensitivity and moral distress frequency; there was a positive significant relationship between moral sensitivity and moral distress intensity. Participating in medical ethics courses increased moral sensitivity and decreased the frequency of moral distress. Conclusions: Participating in medical ethics courses increased moral sensitivity and decreased the frequency of moral distress.
Medical students′ evaluation of their exposure to the teaching of ethics
Journal of Family and Community Medicine, 2010
Background: The subject of Biomedical Ethics has become recognized as an essential integral component in the undergraduate curriculum of medical students. Objectives: (1) To review the current Biomedical Ethics Course offered at the College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences (KSAU-HS). (2) To explore the perception of medical students on the different components of the course. Materials and Methods: The medical students were requested to participate in the study at the end of the course by filling in a pre-designed questionnaire. A qualitative approach was used also to examine their perceptions about certain components of the course. Results: Forty-one medical students participated in this study. All students expressed their strong agreement on the importance of their learning biomedical ethics. Their views about the role of Biomedical Ethics were also considered. These include professional development, assessment of ethical competencies, and the timing of the teaching of ethics. Conclusion: The students provided valuable comments that were supported by the literature reviews. Medical Students' views of the teaching of the various components of biomedical ethics are important and should be sought in the planning of a curriculum..