Document Detail


Increasing bioethics education in preclinical medical curricula: what ethical dilemmas do clinical clerks experience?
MedLine Citation:
PMID:  19318789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The increase in bioethics education in preclinical curricula enables medical students to recognize ethical issues and determine right action. The authors sought to explore the ethical dilemmas medical students experience during clinical clerkships. METHOD: Following an e-mail invitation, 100 of 104 graduating medical students allowed their final ethics assignment, a written description of an ethical dilemma experienced during clinical clerkship, to be analyzed. After all identifiers were removed, the narratives underwent qualitative analysis and were then reanalyzed using Jameton's determinants of moral action. RESULTS: Four themes emerged: the clinical service rotation, target, source, and nature of the ethical dilemma. For many clinical clerks, the ethical dilemma arose because they recognized an ethical issue but neither brought it to their supervisors nor resolved it themselves for fear of incurring disfavor. The source of the ethical dilemma was most frequently the student's supervisor (46%), which may explain why, although all narratives demonstrated the Jameton criteria of "moral sensitivity" and 76% demonstrated "moral judgment," only 24% indicated "moral motivation" and only 4% suggested "moral courage." Patients were the most frequent target (76%), followed by students (14%). Students reported informed consent (18%) and inadequate care (17%) as the most common types of dilemmas under the nature theme. CONCLUSIONS: Clinical clerks' experiences of ethical dilemmas might be mitigated if residency education and professional development mirrored the increase in preclinical ethics education, if ethics training included encouraging students to discuss ethical issues as they arise, and if educators developed innovative models of student evaluation.
Authors:
Emily Kelly; Jeff Nisker
Related Documents :
21531909 - Sterilization for individuals with mental disabilities: the other half of the equation.
10277399 - Thinking about ethical dilemmas in pharmacy.
11823849 - Dinosaur locomotion from a new trackway.
4078929 - Ethical dilemmas in office practice: physician response and rationale.
9301139 - Doing the right thing: relief agencies, moral dilemmas and responsibility in political ...
14570019 - Dilemmas in military medical ethics since 9/11.
16578859 - New members and foreign associates elected to the national academy of sciences on may 1...
8759229 - Euthanasia and the law.
10171029 - Smoking in the workplace: a management perspective.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  84     ISSN:  1938-808X     ISO Abbreviation:  Acad Med     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-25     Completed Date:  2009-04-23     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  498-504     Citation Subset:  AIM; IM    
Affiliation:
Family Medicine, The Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Attitude of Health Personnel
Bioethics / education*
Clinical Clerkship*
Curriculum
Education, Medical, Undergraduate
Humans
Informed Consent / ethics
Medicine
Ontario
Patient Care / ethics
Resuscitation Orders / ethics
Specialization
Students, Medical / psychology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Prepublication review of medical ethics research: cause for concern.
Next Document:  Scientific writing training for academic physicians of diverse language backgrounds.