探索道德能力回归:医学生医学伦理教育的叙事方法。

IF 3 1区 哲学 Q1 ETHICS BMC Medical Ethics Pub Date : 2024-06-21 DOI:10.1186/s12910-024-01073-5
Martin Zielina, Jaromír Škoda, Kateřina Ivanová, Daniel Dostál, Lubica Juríčková, David Anthony Procházka, Barbora Straka, Adam Doležal
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引用次数: 0

摘要

背景:来自不同国家的研究报告称,医学生的道德能力在第一年和最后一年之间出现了停滞或倒退,各种教育干预措施的价值仍不确定:方法:我们使用道德能力测验(MCT)来测量道德能力的C-分数,以确定2022/2023学年捷克共和国两所医学院的一年级和五年级医学生之间MCT C-分数的变化,并分析与C-分数相关的因素(观察性研究)。此外,对于一年级学生,我们还比较了医学伦理课程干预前后的 MCT 结果(干预性研究)。在观察性研究中,我们采用了横断面和描述性设计。学生们完成了由两个道德困境(工人困境和医生困境)组成的 MCT,其结果由代表道德能力的 C 分数来衡量:共有 685 名学生参加了观察研究。目标 1:根据对 C 评分的分析,我们观察到一年级和五年级医学生的道德能力有所下降(p 结论:医学生的道德能力有所下降:医学生在医学教育期间的道德能力出现了倒退;与一年级医学生相比,五年级医学生的道德能力较低,且不受性别或自评宗教信仰的影响。虽然由多种医学伦理教学工具(PBL、CBL、KMDD 和 StorED)组成的教育干预并未导致道德能力的提高,但这种干预的纵向效果仍有待观察。
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Exploring moral competence regression: a narrative approach in medical ethics education for medical students.

Background: Studies from different countries report a stagnation or regression of moral competence in medical students between the first and the last year of their studies, and the value of various educational interventions remains uncertain.

Methods: We used Moral Competence Test (MCT) to measure C-scores of moral competence to determine the change in the MCT C-scores between the first- and the fifth-year medical students from two medical schools in the Czech Republic in the academic year 2022/2023 and to analyze factors associated with the C-scores (observational study). In addition, for the first-year students, we compared the results of the MCT before and after an intervention in medical ethics curriculum (interventional study). We used a cross-sectional and descriptive design for the observational study. Students completed the MCT, consisting of two moral dilemmas (Worker´s Dilemma and Doctor´s Dilemma), the results measured by the C-score, which represents moral competence.

Results: In total, 685 students participated in the observational study. Objective 1: based on the analysis of the C-score, we observed a decrease in moral competence between the first and the fifth-year medical students (p < .001). Objective 2: we did not observe a statistically significant effect of gender (p = .278), or self-rated religiosity (p = .163). Objective 3: in the interventional study, 440 students participated in the pretest and 422 students participated in the posttest. The test of statistical significance found no improvement in students' moral competence after the intervention (p = .253).

Conclusion: Medical students show a regression in moral competence during medical education; it was lower in medical students in their fifth year, compared to the first-year medical students without the effect of gender, or self-rated religiosity. Although educational intervention consisting of multiple tools of medical ethics teaching (PBL, CBL, KMDD and StorED) did not lead to increase in moral competence, the longitudinal effect of such intervention remains to be seen.

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来源期刊
BMC Medical Ethics
BMC Medical Ethics MEDICAL ETHICS-
CiteScore
5.20
自引率
7.40%
发文量
108
审稿时长
>12 weeks
期刊介绍: BMC Medical Ethics is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies.
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