Medical Studentsʼ Experiences of Moral Distress: Development of a Web-Based Survey

Wiggleton, Catherine; Petrusa, Emil; Loomis, Kim; Tarpley, John L.; Tarpley, Margaret J.; O'Gorman, Mary Lou; Miller, Bonnie M.

doi:10.1097/acm.0b013e3181c4782b

Cited by 109 publications

(102 citation statements)

References 17 publications

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“…The main purpose behind this comparison was to appraise whether these student cohorts engaged in different types of academic dishonesty and to consider attitudes to ethical dilemmas between professional contexts of learning. No articles were found that compared the extent of academic dishonesty between these two cohorts, even though considerable research has examined the extent of the problems within the disciplines (Ng et al 2003;Papadakis et al 2004;Bilic-Zulle et al 2005;Whitley & Starr 2010;Wiggleton et al 2010).…”

Section: Practice Pointsmentioning

confidence: 99%

Academic dishonesty and ethical reasoning: Pharmacy and medical school students in New Zealand

et al. 2012

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Background: There is ample evidence to suggest that academic dishonesty remains an area of concern and interest for academic and professional bodies. There is also burgeoning research in the area of moral reasoning and its relevance to the teaching of pharmacy and medicine. Aims: To explore the associations between self-reported incidence of academic dishonesty and ethical reasoning in a professional student body. Methods: Responses were elicited from 433 pharmacy and medicine students. A questionnaire eliciting responses about academic dishonesty (copying, cheating, and collusion) and their decisions regarding an ethical dilemma was distributed. Multivariate analysis procedures were conducted. Results: The findings suggested that copying and collusion may be linked to the way students make ethical decisions. Students more likely to suggest unlawful solutions to the ethical dilemma were more likely to disclose engagement in copying information and colluding with other students. Conclusions: These findings imply that students engaging in academic dishonesty may be using different ethical frameworks. Therefore, employing ethical dilemmas would likely create a useful learning framework for identifying students employing dishonest strategies when coping with their studies. Increasing understanding through dialog about engagement in academic honesty will likely construct positive learning outcomes in the university with implications for future practice.

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Section: Practice Pointsmentioning

confidence: 99%

Academic dishonesty and ethical reasoning: Pharmacy and medical school students in New Zealand

et al. 2012

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“…For similar reasons, moral distress is also prevalent among house staff. [4][5][6][7] Situations that often produce moral distress include aggressive treatment of dying patients, witnessing or participating in substandard care, and involvement in the withholding of information from patients. 6 Clinicians' levels of moral distress often crescendo around a crisis and then fall after the precipitating incident has resolved.…”

Section: Moral Distressmentioning

confidence: 99%

Moral Distress in Medical Education and Training

Berger

2013

J GEN INTERN MED

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Moral distress is the experience of cognitive-emotional dissonance that arises when one feels compelled to act contrary to one's moral requirements. Moral distress is common, but under-recognized in medical education and training, and this relative inattention may undermine educators' efforts to promote empathy, ethical practice, and professionalism. Moral distress should be recognized as a feature of the clinical landscape, and addressed in conjunction with the related concerns of negative role modeling and the goals and efficacy of medical ethics curricula.

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“…Wiggleton et al [32] found that female medical students reported witnessing distressing dilemmas significantly more frequently than male medical students, although males tended to report experiencing greater distress than females with each dilemma they encountered [32]. In our questionnaire study of 2,397 medical students in the United Kingdom (UK), we found that males typically classified themselves as experiencing no distress, whereas females typically categorized themselves as experiencing distress [2].…”

Section: Moral Distress and Its Correlatesmentioning

confidence: 63%

Antecedents and Consequences of Medical Students' Moral Decision Making during Professionalism Dilemmas

Monrouxe

Shaw

Rees

2017

AMA Journal of Ethics

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Medical students often experience professionalism dilemmas (which differ from ethical dilemmas) wherein students sometimes witness and/or participate in patient safety, dignity, and consent lapses. When faced with such dilemmas, students make moral decisions. If students' action (or inaction) runs counter to their perceived moral values-often due to organizational constraints or power hierarchies-they can suffer moral distress, burnout, or a desire to leave the profession. If moral transgressions are rationalized as being for the greater good, moral distress can decrease as dilemmas are experienced more frequently (habituation); if no learner benefit is seen, distress can increase with greater exposure to dilemmas (disturbance). We suggest how medical educators can support students' understandings of ethical dilemmas and facilitate their habits of enacting professionalism: by modeling appropriate resistance behaviors. IntroductionFor many, medical school is a time of great stress. Indeed, a systematic review of research examining psychological distress in medical students suggests they suffer a high degree of depression and anxiety and greater psychological distress than the general population [1]. In this article, we consider medical students' distress, focusing on moral distress, i.e., emotional distress arising from the dissonance between one's ethical/moral beliefs and one's behavior, which occurs when one's actions are perceived as being limited by institutional constraints or unequal power relations [2][3][4]. By highlighting the concepts of professionalism dilemmas and moral decision making, we examine various types of dilemmas encountered by students, how they respond to those dilemmas, and any resultant moral distress they experience. Finally, we offer suggestions for how medical educators, working at the student, faculty, and organizational levels, can reduce or prevent students' professionalism lapses in the face of ethical dilemmas, thereby reducing their moral distress.

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Medical Studentsʼ Experiences of Moral Distress: Development of a Web-Based Survey

Cited by 109 publications

References 17 publications

Academic dishonesty and ethical reasoning: Pharmacy and medical school students in New Zealand

Academic dishonesty and ethical reasoning: Pharmacy and medical school students in New Zealand

Moral Distress in Medical Education and Training

Antecedents and Consequences of Medical Students' Moral Decision Making during Professionalism Dilemmas

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