Abstract
Objective—To report the ethical development of medical students across four years of education at one medical school.
Design and setting—A questionnaire was distributed to all four classes at the Wake Forest University School of Medicine during the Spring of 1996.
Participants—Three hundred and three students provided demographic information as well as information concerning their ethical development both as current medical students and future interns.
Main measurements—Results were analyzed using cross-tabulations, correlations, and analysis of variance.
Results—Results suggested that the observation of and participation in unethical conduct1 may have disparaging effects on medical students' codes of ethics with 35% of the total sample (24% of first years rising to 55% of fourth years) stating that derogatory comments made by residents/attendings, either in the patient's presence or absence, were "sometimes" or "often" appropriate. However, approximately 70% of the sample contended that their personal code of ethics had not changed since beginning medical school and would not change as a resident.
Conclusions—Results may represent an internal struggle that detracts from the medical school experience, both as a person and as a doctor. Our goal as educators is to alter the educational environment so that acceptance of such behaviour is not considered part of becoming a physician.
Key Words: Ethics • ethical development • paradox • medical students • derogatory comments
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Selected References
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- Bickel J. Medical students' professional ethics: defining the problems and developing resources. Acad Med. 1991 Dec;66(12):726–729. doi: 10.1097/00001888-199112000-00003. [DOI] [PubMed] [Google Scholar]
- Bickel J. Proceedings of the AAMC Conference on Students' and Residents' Ethical and Professional Development. October 27-28, 1995. Introduction. Acad Med. 1996 Jun;71(6):622–623. doi: 10.1097/00001888-199606000-00013. [DOI] [PubMed] [Google Scholar]
- Christakis D. A., Feudtner C. Ethics in a short white coat: the ethical dilemmas that medical students confront. Acad Med. 1993 Apr;68(4):249–254. doi: 10.1097/00001888-199304000-00003. [DOI] [PubMed] [Google Scholar]
- Dwyer J. Primum non tacere. An ethics of speaking up. Hastings Cent Rep. 1994 Jan-Feb;24(1):13–18. [PubMed] [Google Scholar]
- Feudtner C., Christakis D. A., Christakis N. A. Do clinical clerks suffer ethical erosion? Students' perceptions of their ethical environment and personal development. Acad Med. 1994 Aug;69(8):670–679. doi: 10.1097/00001888-199408000-00017. [DOI] [PubMed] [Google Scholar]
- Feudtner C., Christakis D. A. Making the rounds. The ethical development of medical students in the context of clinical rotations. Hastings Cent Rep. 1994 Jan-Feb;24(1):6–12. [PubMed] [Google Scholar]
- Kunda Z. The case for motivated reasoning. Psychol Bull. 1990 Nov;108(3):480–498. doi: 10.1037/0033-2909.108.3.480. [DOI] [PubMed] [Google Scholar]
- Satterwhite W. M., 3rd, Satterwhite R. C., Enarson C. E. Medical students' perceptions of unethical conduct at one medical school. Acad Med. 1998 May;73(5):529–531. doi: 10.1097/00001888-199805000-00021. [DOI] [PubMed] [Google Scholar]
- Testerman J. K., Morton K. R., Loo L. K., Worthley J. S., Lamberton H. H. The natural history of cynicism in physicians. Acad Med. 1996 Oct;71(10 Suppl):S43–S45. doi: 10.1097/00001888-199610000-00040. [DOI] [PubMed] [Google Scholar]