Influence of Course in Medical Ethics and Law on Career Plans of Medical Students

Abstract

Background: The significant increase in medical disputes and lawsuits in recent years in Taiwan has severely affected behavior and ecology in medical practice. For this reason, we designed integrated courses on ethics and law and conducted a questionnaire-based career plan study to understand whether these issues influence their specialty selection process. Method: We randomly selected sixth-year medical students that rotated to our hospital to take an integrated course on medical ethics, laws and regulations, and problem-based learning. The students completed the same questionnaire before and after the course. We used a five-point Likert scale for agreement. In addition to calculating the proportion of agreement, we used paired t-tests in the question items before and after the course at a 0.05 level of significance. A qualitative analysis was also made. Results: This study included 98 medical students, 65 of whom were male, and 33 were female. In terms of reasons for studying medicine, the question item with the highest agreement proportion was "I chose to study medicine because being a doctor will enable me to lead a stable life"; in terms of career plans, it was "I will choose my specialty based on my personal aspirations and interests". On agreement scale, significant increases were presented in "I will choose my specialty based on my personal aspirations and interests" and "I will choose my specialty based on my sense of accomplishment". However, a significant reduction was found in "I will choose my specialty based on quality-of-life considerations". Qualitative analysis indicated that the students learnt that "acquiring good communication skills and fulfilling the obligation to obtain informed consent are the fundamental means of preventing medical disputes". Conclusion: After completing the course, medical students put greater emphasis on personal aptitude, interests, and sense of accomplishment, and less on quality-of-life in choosing a specialty.

Medical Humanities Education and Its Influence on Students' Outcomes in Taiwan: A Systematic Review

“…In particular, six ( n = 6; 35.30%) ( 26 , 36 – 40 ) used solely the New York University's medical humanities definition. Eight studies ( n = 8; 47,05%) ( 24 , 33 – 35 , 41 – 44 ) applied other Western definitions from one or more of the following countries: USA, UK, Spain, Romania, Australia, or organizations such as World Federation for Medical Education, WHO and EU. A minority of studies ( n = 3; 17.65%) did not clearly specify the definition they used ( 25 , 45 , 46 ).…”

“…Six articles were classified according to an intrinsic rationale ( 35 , 36 , 41 , 42 , 44 , 46 ). Most of these articles explicitly introduced the humanities perspective according to (1) the three principles of primacy of patients' welfare, autonomy and social justice ( 42 ); (2) the relationship between “detachment” and “concern” ( 36 ), facilitating an understanding about the meaning of sickness and death in life ( 35 ), and learning through a “silent mentor” (body donation) to develop positive attitudes toward death ( 41 ).…”

“…Most of these articles explicitly introduced the humanities perspective according to (1) the three principles of primacy of patients' welfare, autonomy and social justice ( 42 ); (2) the relationship between “detachment” and “concern” ( 36 ), facilitating an understanding about the meaning of sickness and death in life ( 35 ), and learning through a “silent mentor” (body donation) to develop positive attitudes toward death ( 41 ). While three other articles emphasize the potential counterbalancing effects of the humanities in the medical curriculum ( 42 , 44 , 46 ), thus aiming to facilitate a more patient-focused student ( 42 ) and greater understanding of the ethical dimension of clinical practice ( 44 , 46 ).…”

“…For articles based on the instrumental rationale, exposure to visual arts ( 24 , 26 ), narrative/storytelling ( 37 , 45 ), reflective writing practice and feedback ( 43 ), exposure to elderly community care practice ( 33 , 40 ), fieldwork ( 39 ) and a course ( 44 ) were employed as interventions. Exposure to elderly community care practice or fieldwork is used by Tsai ( 40 ), Yang et al ( 33 ) and Chen and Chou ( 39 ).…”

“…Within the intrinsic articles, fieldwork ( 42 ), memorial ceremony ( 41 ) and a course ( 35 , 36 , 44 , 46 ) were used as interventions to increase awareness primarily related to ethical issues and participants' own human nature. Specifically, courses here can vary from a series of sessions to a single workshop.…”