Understanding the clinical dilemmas that shape medical students' ethical development: questionnaire survey and focus group study

Hicks, Lisa K.; Lin, Yulia; Robertson, David W.; Robinson, Deborah; Woodrow, Sarah

doi:10.1136/bmj.322.7288.709

Cited by 160 publications

(138 citation statements)

References 4 publications

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“…Interestingly, some studies report that students rate their tutors' interpersonal skills to be at least as important as their teaching skills 43 , and that the demonstration of patient-care skills is positively related to perceived teaching effectiveness 44,45 . A recent study of medical students has revealed that they are sometimes brought into situations where their medical education seems to conflict with the priorities of patient care, or where they are given responsibility beyond their capacity, or even where they are involved in what they consider to be substandard care 46 . These issues are seldom discussed or resolved.…”

Section: Methods Of Teachingmentioning

confidence: 99%

Professional attitudes: can they be taught and assessed in medical education?

2002

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-The medical profession is under increasing scrutiny with regard to the undesirable attitudes and behaviours of some of its members. Despite the setting of objectives for professional attitudes, it remains unclear how these can be taught and assessed. Having defined 'attitudes' , we consider some of the influences upon the development of professional attitudes within medicine. We then review possible ways of encouraging desirable attitudes and behaviours. Finally, we review and critique the main types of attitude assessment. We conclude that attitudes are complex, that the influence of medical culture is crucial, and that feasible assessment tools have yet to be developed. Key words: assessment, CPD, General MedicalCouncil, medical education, professional attitudes.The performance of doctors has come under increasing scrutiny in both the USA and the UK. This reflects the public's concern over what are perceived to be the inappropriate attitudes and behaviours of some members of the profession, together with an apparent lack of accountability. Sir Donald Irvine, President of the UK's General Medical Council (GMC), has called for a 'new professionalism' and has highlighted the fact that 'the public's unfulfilled expectations of doctors are crucially about attitudes' 1 . Similarly, in the USA, the definition of a profession (attributed to Supreme Court Justice Louis Brandels) stresses altruistic attitudes: 'A profession … cherishes performance … above personal rewards' 2 .How can medical students and doctors be encouraged to develop desirable attitudes? In the UK, medical schools have been revising their curricula in response to the recommendations published by the GMC in Tomorrow's doctors 3 . For the first time, the GMC has presented UK medical schools with a list of 'attitudinal objectives' that students are expected to have acquired and demonstrated by the time they graduate (Table 1). At postgraduate level, the GMC has published Good medical practice 4 , which contains a list of 14 'duties of a doctor' which are similar to, but not exactly the same as, the undergraduate attitudinal objectives ( Table 2). The GMC's approach to attitudes is not new. It mirrors aspects of 'the ideal internist' , a concept first put forward by the American Board of Internal Medicine (ABIM) in the 1970s 5 . More recently, the importance of attitudes has been reiterated in the USA in the form of learning objectives for medical student education. These have been proposed both by the Association of American Medical Colleges (AAMC) 6 and by a collaboration of the Society of General Internal Medicine (SGIM), the Clerkship Directors in Internal Medicine (CDIM) and the Division of Medicine at the US Department of Health and Human Services 7 . How are these objectives to be taught and assessed? At a conference organised by the GMC in 1997 it was acknowledged that 'the teaching and assessment of professional attitudes was proving to be the most difficult element of the new guidance' 8 , and the AAMC concluded that 'universally agre...

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Section: Methods Of Teachingmentioning

confidence: 99%

Professional attitudes: can they be taught and assessed in medical education?

2002

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“…1 Understanding this gap helped improve undergraduate medical ethics education. We undertook our study to provide the basis for improving the surgical component of the postgraduate ethics education program at the University of Toronto.…”

Section: The Case: It Is July and David Junior Is A First-year Residmentioning

confidence: 99%

“…4,8 None of these studies have dealt with surgical specialties. Hafferty and Franks 9 and Hundert et al 10 developed a taxonomy of ethics curricula that describes 3 overlapping spheres: (1) formal curricula: what is taught in the classroom; (2)informal curricula: unscripted ,adhoc interpersonal lessons about values and attitudes, learned from role-models and peers outside the classroom as a subset of the hidden curricula; and (3) hidden curricula: the sum of all the socializing influences imbedded in the organizational and institutional culture including tacit knowledge, or task-specific experiences that cannot easily be articulated or stored in documents.…”

Section: The Case: It Is July and David Junior Is A First-year Residmentioning

confidence: 99%

The formal and informal surgical ethics curriculum: views of resident and staff surgeons in Toronto

Howard

McKneally

Upshur

et al. 2012

The American Journal of Surgery

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“…Las respuestas debían ser sostenidas mediante argumentos y los estudiantes tenían que haber leído previamente el artículo titulado: "Understanding the clinical dilemmas that shape medical students' ethical development: questionnaire survey and focus group study" (2) El taller fue desarrollado por la totalidad de estudiantes del curso (30) en el plazo de una semana. Posteriormente, se revisaron todas las respuestas y se extrajo de cada una la idea clínica y en los temas desarrollados durante el curso de Bioética Clínica.…”

Section: Materiales Y Métodosunclassified

La Formación Ética De Los Estudiantes De Medicina: La Brecha Entre El Currículo Formal Y El Currículo Oculto

Süárez-Obando

Amado

2007

Acta bioeth.

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Resumen: Tomar decisiones acertadas desde el punto de vista ético-moral en medicina es un asunto complejo y aprender a hacerlo debe constituir uno de los objetivos del entrenamiento médico. Una forma de contribuir a lograrlo es integrar una completa formación teórica en Ética Médica y Bioética con una verdadera correlación frente a lo vivido en la práctica clínica. Tener en cuenta lo que sienten y piensan los estudiantes al respecto es un buen referente para comenzar. En el presente artículo se presentan los resultados de un taller sobre el tema, llevado a cabo con estudiantes de medicina en Palabras clave: dilemas éticos, práctica clínica, currículo, educación médica ETHICS TRAINING OF MEDICAL STUDENTS: THE GAP BETWEEN THE FORMAL CURRICULUM AND THE HIDDEN CURRICULUMAbstract: To take right decisions in medicine from an ethical-moral point of view is a complex matter and to learn to do it must constitute one of the goals of medical training. A way to contribute to achieve this is to integrate a complete theoretical training in Medical Ethics and Bioethics with a true correlation in clinical practice experience. To take into account what students think and feel about the issue is a good reference to start. In the present paper the results on a raise in the workshop development. Key words: ethical dilemmas, clinical practice, curriculum, medical education A FORMAÇÃO ÉTICA DOS ESTUDANTES DE MEDICINA: A DISTÂNCIA ENTRE O CURRÍCULO FORMAL E O CURRÍCULO OCULTOResumo: Tomar decisões acertadas do ponto de vista ético-moral em Medicina é uma questão complexa e aprender a fazê-las constitui-se em um dos objetivos da formação médica. Uma forma de contribuir a esta questão é integrar uma ampla formação teórica de Ética Médica e Bioética relacionando-a à vivência na prática clínica. Levar em conta o que sentem e pensam os estudantes a respeito desta questão é um bom referencial inicial. O presente artigo apresenta os Palavras chave: dilemas éticos, prática clínica, currículo, educação médica

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Understanding the clinical dilemmas that shape medical students' ethical development: questionnaire survey and focus group study

Cited by 160 publications

References 4 publications

Professional attitudes: can they be taught and assessed in medical education?

Professional attitudes: can they be taught and assessed in medical education?

The formal and informal surgical ethics curriculum: views of resident and staff surgeons in Toronto

La Formación Ética De Los Estudiantes De Medicina: La Brecha Entre El Currículo Formal Y El Currículo Oculto

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