Incoming Medical Students’ Evaluations Regarding Medical Ethics Issues and Medical Ethics Education

Abstract

Background: The study’s aim is to investigate future doctors’, who are at the beginning of their medical education, perceptions on the field of medical ethics and expectations for the medical ethics education. Methods: A questionnaire was applied to the first-year students, prior to the first professional values and ethics lecture, which included questions about demographic characteristics, students’ perceptions on ethics and moral concepts, the prior education they received in ethics, their opinions on the presence of ethical issues in health care area and the necessity of medical ethics education in these particular issues, medical ethics education’s necessity in medical education and on the ethics education they will be receiving. The data were evaluated by using descriptive analysis. Results: 63.8% of students stated that they know ethics concept, 53.5% stated that there is a difference between ethics and morals, 87.7% stated that they had no prior teaching on ethics, 90% stated that medical ethics education was necessary in medical education, 91.5% stated that there are ethical issues in the health care area. Most preferred teaching methods were video/movies, small group studies, inclusion of ethics components in PBL scenarios, lectures, respectively; 82.3% stated that there is no need for exams in ethics education. Conclusion: Although the majority of the students stated that they were not previously trained in issues related to ethics, they pointed out to the presence of ethical problems in health care in our country and emphasized the necessity of ethics teaching in medical education pertaining to this area. The findings have contributed to the improvement of the professional values and ethics program in school; educational methods like small group studies, video/movies have been increased, assignments related to novels, movies and ethical issues have been added.

Keywords

• Medical education, medical ethics education, medical students, ethical issue

TIP FAKÜLTESİNE YENİ BAŞLAYAN ÖĞRENCİLERİN TIBBİ ETİK KONULARINA VE EĞİTİMİNE İLİŞKİN DEĞERLENDİRMELERİ

Abstract

Amaç: Çalışmanın amacı tıp eğitimlerinin başlangıcında olan hekim adaylarının, tıbbi etik alanına ilişkin algılarının ve eğitime yönelik beklentilerinin değerlendirilmesidir. Gereç ve Yöntem: Birinci sınıf öğrencilerine, ilk Mesleksel Değerler ve Etik dersinde, demografik özellikleri, etik ve ahlak kavramına ilişkin algıları, bugüne dek etik ile ilgili aldıkları eğitim, sağlık alanındaki etik konulardaki sorunlar ve bu konulardaki eğitim gereksinimi, tıp eğitimi kapsamında tıbbi etik eğitiminin gerekliliği ve verilecek etik eğitimine ilişkin görüşleri ile ilgili soruları içeren bir anket uygulanmıştır. Verilerin değerlendirilmesinde tanımlayıcı istatistiksel analizler kullanılmıştır. Bulgular: Öğrencilerin %63.8’i etik kavramını bildiğini, %53.5’i “etik ile ahlak” kavramları arasında fark olduğunu, %87.7’si bugüne dek etik konusunda herhangi bir eğitim almadığını, %90.0’ı tıp eğitimi kapsamında tıbbi etik eğitiminin gerekli olduğunu, %91.5’i sağlık alanında etik sorunlar olduğunu düşündüklerini belirtmişlerdir. Öğrenciler etik eğitiminde yöntem olarak sırasıyla video/film gösterimi, küçük grup çalışması, PDÖ senaryoları kapsamında etik öğelerin yer almasını ve sunumu tercih etmişler, % 82.3’ü tıbbi etik eğitiminde sınava gerek olmadığını belirtmiştir. Sonuç: Öğrencilerin çoğunluğu bugüne dek etik konulara ilişkin eğitim almadıklarını ifade etmelerine karşın, ülkemizde sağlık hizmetleri alanında etik sorunların varlığına işaret etmiş ve tıp eğitimi kapsamında bu alanlarda etik eğitiminin verilmesi gerektiğini belirtmişlerdir. Elde edilen veriler Fakülte’deki Mesleksel Değerler ve Etik eğitiminin geliştirilmesine katkıda bulunmuş; eğitim sürecinde küçük grup çalışmaları, video/film gösterimleri gibi uygulamaların ağırlığı artırılmış, kitaplar, filmler ve etik konularla ilgili ödevler eklenmiştir.

Keywords

• Tıp eğitimi, tıbbi etik eğitimi, tıp öğrencileri, etik sorunlar

References

1. Miles SH, Lane LW, Bickel J, Walker RM, Cassel CK. Medical ethics education: Coming of age. Academic Medicine 1989; 64: 705–714.
2. Huijer M, Van Leeuwen E, Boenink A, Kimsma G. Medical students’ cases as an empirical basis for teaching clinical ethics. Academic Medicine 2000; 75: 834–839.
3. Williams JR. Dünya Hekimler Birliği, Tıp Etiği Elkitabı. Türk Tabipleri Birliği Yayınları. http://www.ttb.org.tr/kutuphane/tip_etigi.pdf adresinden 15 Haziran 2011 tarihinde ulaşılmıştır.
4. General Medical Council, Tomorrow’s Doctors. Recommendations on Undergraduate Medical Education. (http://www.gmc-uk.org/Tomorrows_Doctors_1993.pdf_25397206.pdf adresinden 15 Haziran 2011 tarihinde ulaşılmıştır)
5. Martinez SA. Currents in contemporary ethics. The Journal of Law, Medicine & Ethics 2002; 30: 452–
6. DuBois JM, Burkemper J. Ethics education in U.S. medical schools: A Study of Syllabi. Academic Medicine 2002; 77: 432–437.
7. Goldie J, Schwartz L, Morrison J. A process evaluation of medical ethics education in the first year of a new medical curriculum. Medical Education 2000 ; 34: 468–473.
8. Musick DW. Teaching medical ethics: A review of the literature from North American medical schools with emphasis on education. Medicine, Health Care and Philosophy 1999; 2: 239–254.

9. Eckles RE, Meslin EM, Gaffney M, Helft PR. Medical ethics education: Where are we? Where should we be going? A review. Academic Medicine 2005; 80: 1143–1152.
10. Louhiala P. Philosophy for medical students-why, what, and how. Journal of Medical Ethics; Medical Humanities 2003; 29: 87–88.
11. Civaner M, Okuyan ZA, Şemin S. Dokuz Eylül Üniversitesi Tıp Fakültesi’nde Mesleksel Değerler ve Etik Eğitimi: Üç yıllık deneyim, sorunlar ve öneriler. Tıp Fakültesi Dergisi, Özel Aktif Eğitim 2001; 57–61.
12. Ozan S, Timbil S, Semin S, Musal B. Interns' perceptions on medical ethics and ethical issues at the Dokuz Eylul University School of Medicine in Turkey. Education for Health 2010; 23(3): 1–11.
13. Roff S, Preece P. Helping medical students to find their moral compasses: ethics teaching for second and third year undergraduates. Journal of Medical Ethics 2004; 30:487–489.
14. Boon K, Turner J. Ethical and professional conduct of medical students: Review of current assessment measures and controversies. Journal of Medical Ethics 2004; 30:221–226.
15. Mattick K, Bligh J. Teaching and assessing medical ethics: where are we now? Journal of Medical Ethics ; 32: 181–185. Fard NN, Asghari F, Mirzazadeh A. Ethical issues confronted by medical students during clinical rotations. Medical Education 2010: 44: 723–730.
16. Piccoli GB, Mezza E, Soragna G, Burdese M, Bermond F, Grassi G, Jeantet A, Segoloni GP. What do Italian medical students read? A call for a library of good books on physicians for physicians. Journal of Medical Ethics: Medical Humanities 2003; 29: 54–56.
17. Johnston C, Haughton P. Medical students’ perceptions of their ethics teaching. Journal of Medical Ethics ; 33: 418–422. Bissonette R, O’Shea RM, Horwitz M, Route CF. A data-generated basis for medical ethics education: categorizing issues experienced by students during clinical training. Academic Medicine 1995; 70: 1035–
18. Feudtner C, Christakis DA, Christakis NA. Do clinical clerk suffer ethical erosion? Students’ perceptions of their ethical environment and personal development. Academic Medicine 1994; 69: 670–679.
19. Patenaude J, Niyonsenga T, Fafard D. Changes in students’ moral development during medical school: a cohort study. Canadian Medical Association Journal 2003; 168: 840–844.
20. Hafferty FW, Franks R. The hidden curriculum, ethics teaching and the structure of medical education. Academic Medicine 1994; 69: 861–871.
21. Savulescu J, Crisp R, Fulford KWM, Hope T. Evaluating ethics competence in medical education. Journal of Medical Ethics 1999; 25: 367–374.
22. Wong J, Cheung E. Ethics assessment in medical students. Medical Teacher 2003; 25 (1): 5–8.
23. Shumway JM, Harden RM. AMEE Guide No 25: The assessment of learning outcomes for the competent and reflective physician. Medical Teacher 2003; 25: 569–584.