Is medical students' moral orientation changeable after preclinical medical education?

Lin, Chaou Shune; Yau, Kuo-Inn Tsou; Cho, Shu Ling; Hsieh, Ming‐Hong; Wu, Hsi Chin; Lin, Ching‐Hsuan

doi:10.1136/medethics-2011-100092

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…Inter-disciplinary educational strategies that increase awareness of different moral orientations and of the key factors (including those that are modifiable and those not under the control of clinicians) involved in moral decision-making may be essential for clinicians to express more compassion toward their colleagues’ approach to clinical moral dilemmas. Education regarding moral orientation should be integrated early in healthcare training and continue to be the object of specific educational activities during practice ( 29 , 39 – 41 ). Interventions focused on boosting healthcare professionals’ sense of moral empowerment may also be highly valuable ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

Moral Orientation, Moral Decision-Making, and Moral Distress Among Critical Care Physicians: A Qualitative Study

Piquette

Burns

Carnevale

et al. 2023

Critical Care Explorations

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IMPORTANCE: Moral distress is common among critical care physicians and can impact negatively healthcare individuals and institutions. Better understanding inter-individual variability in moral distress is needed to inform future wellness interventions. OBJECTIVES: To explore when and how critical care physicians experience moral distress in the workplace and its consequences, how physicians’ professional interactions with colleagues affected their perceived level of moral distress, and in which circumstances professional rewards were experienced and mitigated moral distress. DESIGN: Interview-based qualitative study using inductive thematic analysis. SETTING AND PARTICIPANTS: Twenty critical care physicians practicing in Canadian ICUs who expressed interest in participating in a semi-structured interview after completion of a national, cross-sectional survey of moral distress in ICU physicians. RESULTS: Study participants described different ways to perceive and resolve morally challenging clinical situations, which were grouped into four clinical moral orientations: virtuous, resigned, deferring, and empathic. Moral orientations resulted from unique combinations of strength of personal moral beliefs and perceived power over moral clinical decision-making, which led to different rationales for moral decision-making. Study findings illustrate how sociocultural, legal, and clinical contexts influenced individual physicians’ moral orientation and how moral orientation altered perceived moral distress and moral satisfaction. The degree of dissonance between individual moral orientations within care team determined, in part, the quantity of “negative judgments” and/or “social support” that physicians obtained from their colleagues. The levels of moral distress, moral satisfaction, social judgment, and social support ultimately affected the type and severity of the negative consequences experienced by ICU physicians. CONCLUSIONS AND RELEVANCE: An expanded understanding of moral orientations provides an additional tool to address the problem of moral distress in the critical care setting. Diversity in moral orientations may explain, in part, the variability in moral distress levels among clinicians and likely contributes to interpersonal conflicts in the ICU setting. Additional investigations on different moral orientations in various clinical environments are much needed to inform the design of effective systemic and institutional interventions that address healthcare professionals’ moral distress and mitigate its negative consequences.

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Section: Discussionmentioning

confidence: 99%

Moral Orientation, Moral Decision-Making, and Moral Distress Among Critical Care Physicians: A Qualitative Study

Piquette

Burns

Carnevale

et al. 2023

Critical Care Explorations

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“…The preclinical medical education stage is especially important for moulding students' moral orientation because at the age 18-22 years students exhibit the most flexibility in their learning ability. A proper medical education at this stage will prepare them for the complex clinical situations they will encounter (Lin et al 2012).…”

Section: Discussionmentioning

confidence: 99%

Informal and hidden curricula in ethics teaching at Zagreb School of Medicine English program

Sharma

Bosanac

Borovečki

et al. 2016

International Journal of Ethics Education

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Development of medical students' professional ethical values can be influenced by the quality of role models and the experiences they encounter during their education. Essays from all enrolled 6-year students in Medical Studies in English Program at School of Medicine, University of Zagreb in the academic year 2014/2015 were anonymised and analysed according to acknowledged quantitative analysis methods. Three major themes occurred when reading students' essays: physician patient relationship, inter professional relationships among physicians and nurses and teacher student relationship. Students suggested a need for mandatory workshops on communicational skills for physicians and placing the ethics course earlier in the curriculum. The essays of the students show the importance of hidden curriculum in ethics teaching and how role models play an

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“…A su vez, el desarrollo moral de los universitarios se mostró influenciado por diversos factores e interacciones sociales (Monzon et al, 2010), relacionándose con la empatía afectiva, los valores personales (Juujärvi et al, 2012;Myyry et al, 2013;Skoe, 2010;Yuguero et al, 2019), la orientación comunitaria y libertaria (C. S. Lin et al, 2012), la comprensión de las necesidades de seguridad y las emociones del consultante y sus familias (Comrie, 2012;Peter et al, 2015), la motivación por el logro académico, el apoyo social percibido, la angustia psicológica (Al-Shuaibi et al, 2013), el desarrollo cognitivo, el auto concepto moral, la autoestima, los comportamientos prosociales y proambientales (Ploum et al, 2018;Rahnama et al, 2017;Vihos et al, 2019;Wang et al, 2013).…”

Section: Desarrollo Moral Y Educación Superiorunclassified

Desarrollo moral en contextos educativos: Una revisión sistemática

Reyes-Ruiz

Núñez-Ariza

Núñez-Ordóñez

et al. 2021

EJPAD

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El objetivo de esta revisión sistemática fue identificar la evidencia disponible en la literatura científica en relación con el estudio del desarrollo moral en contextos educativos. Se realizaron búsquedas en las bases de datos bibliográficas de PubMed, Scopus, Psychology and Behavioral Science Collection (EBSCO) y Scielo utilizando criterios de búsqueda predeterminados, siguiendo la metodología PRISMA. Se consideraron los estudios de investigación publicados desde 2010 hasta octubre de 2020 y, luego de la evaluación, fueron identificados 3.021 artículos que trataban el tema y se incluyeron finalmente 167 artículos en la revisión que cumplieron los criterios de inclusión. Los resultados sugieren la influencia del contexto educativo en el desarrollo moral, desde todos los niveles de formación educativa, donde convergen aspectos, individuales, cognitivos, socioeconómicos, interculturales, pedagógicos, institucionales, familiares e interactivos, incentivando al desarrollo de estudios que nutran la discusión científica sobre la evolución moral del ser humano y sus prácticas formativas asociadas.

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Is medical students' moral orientation changeable after preclinical medical education?

Cited by 7 publications

References 17 publications

Moral Orientation, Moral Decision-Making, and Moral Distress Among Critical Care Physicians: A Qualitative Study

Moral Orientation, Moral Decision-Making, and Moral Distress Among Critical Care Physicians: A Qualitative Study

Informal and hidden curricula in ethics teaching at Zagreb School of Medicine English program

Desarrollo moral en contextos educativos: Una revisión sistemática

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