Self-Assessment of Medical Ethics and Professionalism: Comparison Between Preclinical and Clinical Medical Students.

Abstract

Background: Ethics and professionalism are fundamental elements in the practice of medicine consisting of a set of values, behaviors, and relationships that reinforce the trust and respect for the physician in a society. It consists of several key elements that are learnt during their formative years of study. This study aims to compare knowledge and self-reported practice of ethics and professionalism between preclinical and clinical undergraduate medical students.

Methods: We included 427 medical students including males and females of age 18 and above. They were further divided into preclinical and clinical groups. We assessed knowledge and practice of medical professionalism through a validated questionnaire containing 11 core elements (components) of medical professionalism and ethics. The assessment was carried out by comparing median scores assigned to the components of professionalism against each question. Data was analyzed through SPSS v.22 and GraphPad Prism v.8.

Results: Clinical medical students had significantly higher knowledge of medical professionalism as compared to nonclinical students (P = .0016). Moreover, among the components of professionalism, there was a significantly higher score for confidentiality (P = .006), communication skills (P = .001), self-directed learning (P = .011), peer and self-assessment (P = .0011) along with ethics in research and patient care (P = .0042) in clinical students as compared to preclinical medical students. However, no significant difference was found between students of preclinical and clinical years for honesty, accountability, respect, responsibility, compassion, and maturity (P > .05). The findings were comparable across students of different ethnicities in our study cohort (P > .05).

Conclusion: Our findings suggest that knowledge and practice of certain elements of ethics and professionalism are enhanced through clinical exposure, however, few remain consistent across different stages of study. Moreover, lack of significant differences in practice of professionalism based on ethnic differences underscores the potential universal standards in medical education.