Principle-based structured case discussions: do they foster moral competence in medical students? - A pilot study

BMC Medical Ethics

Research Article

Georg Marckmann¹  Katja Kuehlmeyer¹  Orsolya Friedrich¹  Stefanie Nörtemann¹  Martin Fischer²  Kay Hemmerling³ 

[1] Institute for Ethics, History and Theory of Medicine at Ludwig Maximilian University (LMU), Lessingstr. 2, 80336, Munich, Germany;Institute for Medical Education at the University Hospital of LMU Munich, Lessingstr. 2, 80336, Munich, Germany;Institute for Pedagogic and Rehabilitation Psychology at the University of Leipzig, Neumarkt 9-19, 04109, Leipzig, Germany;

关键词: Educational intervention;    Medical ethics class;    Medical students;    Moral competence test;    Moral competence;   

DOI  :  10.1186/s12910-017-0181-1

 received in 2016-10-02, accepted in 2017-02-22,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundRecent findings suggest that medical students’ moral competence decreases throughout medical school. This pilot study gives preliminary insights into the effects of two educational interventions in ethics classes on moral competence among medical students in Munich, Germany.MethodsBetween 2012 and 2013, medical students were tested using Lind’s Moral Competence Test (MCT) prior to and after completing different ethics classes. The experimental group (EG, N = 76) participated in principle-based structured case discussions (PBSCDs) and was compared with a control group with theory-based case discussions (TBCDs) (CG, N = 55). The pre/post C-scores were compared using a Wilcoxon Test, ANOVA and effect-size calculation.ResultsThe C-score improved by around 3.2 C-points in the EG, and by 0.2 C-points in the CG. The mean C-score difference was not statistically significant for the EG (P = 0.14) or between the two groups (P = 0.34). There was no statistical significance for the teachers’ influence (P = 0.54) on C-score. In both groups, students with below-average (M = 29.1) C-scores improved and students with above-average C-scores regressed. The increase of the C-Index was greater in the EG than in the CG. The absolute effect-size of the EG compared with the CG was 3.0 C-points, indicating a relevant effect.ConclusionTeaching ethics with PBSCDs did not provide a statistically significant influence on students’ moral competence, compared with TBCDs. Yet, the effect size suggests that PBSCDs may improve moral competence among medical students more effectively. Further research with larger and completely randomized samples is needed to gain definite explanations for the results.

【 授权许可】

CC BY   
© The Author(s). 2017