regression of moral reasoning during medical education combined design study to evaluate the effect of clinical study years回归道德推理在医学教育综合设计研究来评估临床研究多年的影响.pdfVIP

Regression of Moral Reasoning during Medical Education: Combined Design Study to Evaluate the Effect of Clinical Study Years 1 ˇ ´2 ˇ ´2 Darko Hren *, Matko Marusic , Ana Marusic 1 University of Split Faculty of Philosophy, Split, Croatia, 2 Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia Abstract Background: Moral reasoning is important for developing medical professionalism but current evidence for the relationship between education and moral reasoning does not clearly apply to medical students. We used a combined study design to test the effect of clinical teaching on moral reasoning. Methods: We used the Defining Issues Test-2 as a measure of moral judgment, with 3 general moral schemas: Personal Interest, Maintaining Norms, and Postconventional Schema. The test was applied to 3 consecutive cohorts of second year students in 2002 (n = 207), 2003 (n = 192), and 2004 (n = 139), and to 707 students of all 6 study years in 2004 cross-sectional study. We also tested 298 age-matched controls without university education. Results: In the cross-sectional study, there was significant main effect of the study year for Postconventional (F(5,679) = 3.67, P = 0.003) and Personal Interest scores (F(5,679) = 3.38, P = 0.005). There was no effect of the study year for Maintaining rd Norms scores. 3 year medical students scored higher on Postconventional schema score than all other study years (p,0.001). There were no statistically significant differences among 3 cohorts of 2nd year medical students, demonstrating the absence of cohort or point-of-measurement effects. Longitudinal study of 3 cohorts demonstrated that students regressed from Postconventional to Maintaining Norms schema-base