scholarly journals What Do Students Perceive as Ethical Problems? A Comparative Study of Dutch and Indonesian Medical Students in Clinical Training

2019 ◽  
Vol 11 (4) ◽  
pp. 391-408 ◽  
Author(s):  
Amalia Muhaimin ◽  
Derk Ludolf Willems ◽  
Adi Utarini ◽  
Maartje Hoogsteyns
Keyword(s):  
Medical Students ◽  
Clinical Training ◽  
Ethics Education ◽  
Ethical Problem ◽  
Working Environment ◽  
Group Discussions ◽  
Ethical Problems ◽  
Daily Work ◽  
Life And Death ◽  
The Everyday

AbstractPrevious studies show that medical students in clinical training face ethical problems that are not often discussed in the literature. In order to make teaching timely and relevant for them, it is important to understand what medical students perceive as ethical problems, as various factors may influence their perception, including cultural differences and working environment. The purpose of this qualitative study was to explore students’ perceptions of what an ethical problem is, during their clinical training in the hospital, and compare the results from two different countries. We observed a total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools, in Indonesia and the Netherlands. Data were interpreted and analyzed using content analysis. We found that students in both settings encounter problems which are closer to their daily work and responsibilities as medical students and perceive these problems as ethical problems. Indonesian students perceived substandard care and inequity in healthcare as ethical problems, while Dutch students perceived that cases which are not matters of life and death are less worthy to discuss. Our study suggests that there might be a gap between ethical problems that are discussed in class with teachers, and problems that students actually encounter in practice. Teachers should be aware of the everyday situations in clinical training which may be perceived by students as ethically problematic and should acknowledge and discuss these ethical problems with students as part of the learning processes in ethics education.

scholarly journals Ethics education should make room for emotions: a qualitative study of medical ethics teaching in Indonesia and the Netherlands

2019 ◽  
Vol 5 (1) ◽  
pp. 7-21 ◽  
Author(s):  
Amalia Muhaimin ◽  
Maartje Hoogsteyns ◽  
Adi Utarini ◽  
Derk Ludolf Willems
Keyword(s):  
Qualitative Study ◽  
The Netherlands ◽  
Medical Ethics ◽  
Clinical Training ◽  
Ethics Education ◽  
Working Environment ◽  
Self Awareness ◽  
Ethical Problems ◽  
Unethical Behaviors ◽  
Ethics Teaching

Abstract Studies have shown that students may feel emotional discomfort when they are asked to identify ethical problems which they have encountered during their training. Teachers in medical ethics, however, more often focus on the cognitive and rational ethical aspects and not much on students’ emotions. The purpose of this qualitative study was to explore students’ feelings and emotions when dealing with ethical problems during their clinical training and explore differences between two countries: Indonesia and the Netherlands. We observed a total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools. Data were interpreted and analyzed using content analysis. We categorized students’ negative emotions based on their objects of reflection and came up with three categories: emotions concerning their own performance, emotions when witnessing unethical behaviors, and emotions related to barriers and limitations of their working environment. Our study suggests that addressing emotional responses in a culturally sensitive way is important to develop students’ self-awareness. Teachers should be able to guide students to reflect on and be critical of their own thoughts and emotions, to understand their own moral values, especially when confronted with other individuals.

Nursing Students’ Experience of Ethical Problems and Use of Ethical Decision-Making Models

2001 ◽  
Vol 8 (5) ◽  
pp. 432-447 ◽  
Author(s):  
Miriam E Cameron ◽  
Marjorie Schaffer ◽  
Hyeoun-Ae Park
Keyword(s):  
Decision Making ◽  
Nursing Students ◽  
Baccalaureate Nursing ◽  
Ethics Education ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Problem ◽  
Baccalaureate Nursing Students ◽  
Ethical Problems ◽  
Decision Making Model

Using a conceptual framework and method combining ethical enquiry and phenomenology, we asked 73 senior baccalaureate nursing students to answer two questions: (1) What is nursing students’ experience of an ethical problem involving nursing practice? and (2) What is nursing students’ experience of using an ethical decision-making model? Each student described one ethical problem, from which emerged five content categories, the largest being that involving health professionals (44%). The basic nature of the ethical problems consisted of the nursing students’ experience of conflict, resolution and rationale; 85% of the students stated that using an ethical decision-making model was helpful. Although additional research is needed, these findings have important implications for nursing ethics education and practice.

Korean Nursing Students’ Ethical Problems and Ethical Decision Making

2003 ◽  
Vol 10 (6) ◽  
pp. 638-653 ◽  
Author(s):  
Hyeoun-Ae Park ◽  
Miriam E Cameron ◽  
Sung-Suk Han ◽  
Sung-Hee Ahn ◽  
Hyo-Sook Oh ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Students ◽  
Ethics Education ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Problem ◽  
Ethical Problems ◽  
Education Practice ◽  
Korean Study ◽  
Decision Making Model

This Korean study replicated a previously published American study. The conceptual framework and method combined ethical enquiry and phenomenology. The research questions were: (1) What is nursing students’ experience of ethical problems involving nursing practice? and, (2) What is nursing students’ experience of using an ethical decision-making model? The participants were 97 senior baccalaureate nursing students, each of whom described one ethical problem and chose to use one of five ethical decision-making models. From 97 ethical problems, five content categories emerged, the largest being health professionals (69%). The basic nature of the ethical problems was the students’ experience of conflict, resolution and rationale. Using an ethical decision-making model helped 94% of the students. A comparison of the Korean and American results yields important implications for nursing ethics education, practice and research.

scholarly journals Experience of Indonesian medical students of ethical issues during their clinical clerkship in a rural setting

2021 ◽  
Author(s):  
Raditya Bagas Wicaksono ◽  
Miko Ferine ◽  
Diyah Woro Dwi Lestari ◽  
Arfi Nurul Hidayah ◽  
Amalia Muhaimin
Keyword(s):  
Medical Students ◽  
Ethics Education ◽  
Ethical Issues ◽  
Healthcare Providers ◽  
Rural Setting ◽  
Clinical Clerkship ◽  
Ethical Problems ◽  
Unprofessional Behavior ◽  
Data Saturation ◽  
Depth Interviews

Although ethics is an essential part of medical education, little attention has been paid to ethics education during the clerkship phase, where medical students observe how physicians make decisions regarding various ethical problems. Specific nuances and cultural contexts such as working in a rural setting can determine ethical issues raised. This phenomenology study aimed to explore ethical issues experienced by Indonesian students during clinical clerkship in a rural setting. In-depth interviews were used to explore students’ experiences. Participants were ten students, selected on gender and clerkship year variations. Data saturation was reached after eight interviews, followed by two additional interviews. Thematic analysis was used in this study, and trustworthiness was ensured through data and investigator triangulation, member checking, and audit trail. Three main themes found in this study were limited facilities and resources, healthcare financing and consent issues, as well as unprofessional behavior of healthcare providers. Many ethical issues related to substandard care were associated to limited resources and complexities within the healthcare system in the rural setting. Early exposure to recurrent ethical problems in healthcare can help students prepare for their future career as a physician in a rural setting.

Do Medical Students Recall and Use the Language of Ethics They are Taught Preclinically Once They are in the Clinical Training Environment? An Empirical Study in Ethics Education

2013 ◽  
Vol 4 (2) ◽  
pp. 23-30 ◽  
Author(s):  
Lauris C. Kaldjian ◽  
Laura A. Shinkunas ◽  
Valerie L. Forman-Hoffman ◽  
Marcy E. Rosenbaum ◽  
Jerold C. Woodhead ◽  
...  
Keyword(s):  
Medical Students ◽  
Empirical Study ◽  
Clinical Training ◽  
Ethics Education ◽  
Training Environment

State Medical Board Disciplinary Hearings as Tools for Teaching Professionalism in Medical Education

2011 ◽  
Vol 97 (3) ◽  
pp. 8-12
Author(s):  
Onelia G. Lage ◽  
Sydney F. Pomenti ◽  
Edwin Hayes ◽  
Kristen Barrie ◽  
Nancy Baker
Keyword(s):  
Medical Students ◽  
Ethics Education ◽  
Faculty Members ◽  
Specific Method ◽  
Pilot Studies ◽  
Medical Board ◽  
Medical Institutions ◽  
State Medical Boards ◽  
State Medical Board ◽  
The Impact

ABSTRACT This article proposes a partnership of state medical boards with medical schools to supplement professionalism and ethics education for medical students, residents, physicians and faculty members of medical institutions. The importance of professionalism has been recognized by several studies, but a specific method of teaching and developing professionalism has yet to emerge. Studies suggest that there is an association between a lack of professionalism in medical school and future disciplinary actions by medical boards. However, there has been little collaboration between these institutions in addressing unprofessional behaviors. One collaborative concept that holds promise, however, is the idea of inviting medical students to attend physician disciplinary hearings. Students and physicians alike report that watching a hearing can significantly impact attitudes about professionalism as a part of medical practice. While formal research is scarce, the positive response of individual students who experience disciplinary hearings firsthand suggests that further pilot studies may be useful. Presented in this paper are the perspectives of three individuals — a medical student, a faculty member and a medical board chair — who discuss the impact and potential of attending disciplinary hearings in developing professionalism and ethics. Also included is a review of the current literature.

Automated argument adjudication to solve ethical problems in multi-agent environments

2021 ◽  
Vol 12 (1) ◽  
pp. 310-335
Author(s):  
Selmer Bringsjord ◽  
Naveen Sundar Govindarajulu ◽  
Michael Giancola
Keyword(s):  
Ethical Problem ◽  
Propositional Content ◽  
Ethical Principles ◽  
Artificial Agents ◽  
Artificial Agent ◽  
Ethical Problems ◽  
Multi Agent

Abstract Suppose an artificial agent a adj {a}_{\text{adj}} , as time unfolds, (i) receives from multiple artificial agents (which may, in turn, themselves have received from yet other such agents…) propositional content, and (ii) must solve an ethical problem on the basis of what it has received. How should a adj {a}_{\text{adj}} adjudicate what it has received in order to produce such a solution? We consider an environment infused with logicist artificial agents a 1 , a 2 , … , a n {a}_{1},{a}_{2},\ldots ,{a}_{n} that sense and report their findings to “adjudicator” agents who must solve ethical problems. (Many if not most of these agents may be robots.) In such an environment, inconsistency is a virtual guarantee: a adj {a}_{\text{adj}} may, for instance, receive a report from a 1 {a}_{1} that proposition ϕ \phi holds, then from a 2 {a}_{2} that ¬ ϕ \neg \phi holds, and then from a 3 {a}_{3} that neither ϕ \phi nor ¬ ϕ \neg \phi should be believed, but rather ψ \psi instead, at some level of likelihood. We further assume that agents receiving such incompatible reports will nonetheless sometimes simply need, before long, to make decisions on the basis of these reports, in order to try to solve ethical problems. We provide a solution to such a quandary: AI capable of adjudicating competing reports from subsidiary agents through time, and delivering to humans a rational, ethically correct (relative to underlying ethical principles) recommendation based upon such adjudication. To illuminate our solution, we anchor it to a particular scenario.

Moral Decision Making in Business: A Phase-Model

2000 ◽  
Vol 10 (4) ◽  
pp. 773-803 ◽  
Author(s):  
Aviva Geva
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Problem ◽  
Real Life ◽  
Phase Model ◽  
Second Phase ◽  
Illustrative Case ◽  
Moral Decision ◽  
Ethical Problems

Abstract:The traditional model of ethical decision making in business suggests applying an initial set of principles to a concrete problem and if they conflict the decision maker may attempt to balance them intuitively. The centrality of the ethical conflict in the accepted notion of “ethical problem” has diverted the attention of moral decision modelers from other ethical problems that real-world managers must face—e.g., compliance problems, moral laxity, and systemic problems resulting from the structures and practices of the business organization. The present article proposes a new model for ethical decision making in business—the Phase-model—designed to meet the full spectrum of business-related ethical problems. Drawing on the dominant moral theories in business literature, the model offers additional strategies for tackling ethical issues beyond the traditional cognitive operations of deductive application of principles to specific cases and the balancing of ethical considerations. Its response to the problems of moral pluralism in the context of decision making lies in its structural features. The model distinguishes between three phases of the decision-making process, each having a different task and a different theoretical basis. After an introductory stage in which the ethical problem is defined, the first phase focuses on a principle-based evaluation of a course of action; the second phase provides a virtue-based perspective of the situation and strategies for handling unsettled conflicts and compliance problems; and the third phase adapts the decision to empirical accepted norms. An illustrative case demonstrates the applicability of the model to business real life.

scholarly journals Moral judgement development during medical student clinical training

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenny McDonald ◽  
Jane Graves ◽  
Neeshaan Abrahams ◽  
Ryan Thorneycroft ◽  
Iman Hegazi
Keyword(s):  
Medical Students ◽  
Moral Development ◽  
Clinical Training ◽  
Moral Judgement ◽  
Clinical Experiences ◽  
Cross Sectional ◽  
Moral Decisions ◽  
Moral Choices ◽  
Cognitive Maturity ◽  
Self Authorship

Abstract Background Whereas experience and cognitive maturity drives moral judgement development in most young adults, medical students show slowing, regression, or segmentation in moral development during their clinical years of training. The aim of this study was to explore the moral development of medical students during clinical training. Methods A cross-sectional sample of medical students from three clinical years of training were interviewed in groups or individually at an Australian medical school in 2018. Thematic analysis identified three themes which were then mapped against the stages and dimensions of Self-authorship Theory. Results Thirty five medical students from years 3–5 participated in 11 interviews and 6 focus groups. Students shared the impacts of their clinical experiences as they identified with their seniors and increasingly understood the clinical context. Their accounts revealed themes of early confusion followed by defensiveness characterised by desensitization and justification. As students approached graduation, some were planning how they would make moral choices in their future practice. These themes were mapped to the stages of self-authorship: External Formulas, Crossroads and Self-authorship. Conclusions Medical students recognise, reconcile and understand moral decisions within clinical settings to successfully reach or approach self-authorship. Curriculum and support during clinical training should match and support this progress.

The influence of narrated group discussions on the interpretational ability of medical students: a prospective observational study

2021 ◽  
Vol 6 (8) ◽  
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
First Year ◽  
Group Discussions ◽  
Prior Literature ◽  
Long Course ◽  
Long Term Impact ◽  
First Year Medical Students

Background: Clinical decision making is predominantly knowledge-based perception, interpretation under terms of uncertainty. It is unclear whether interpretational ability can be improved. We evaluated the effect of a narrated group-discussions course (NGDC) on the interpretational ability of first-year medical students. Objective: To evaluate the effect of our course on first year medical students in respect to: a) their interpretational abilities b) their attitude towards studying literature and the core subjects. Method: Using a pre-post questionnaire, of a semester-long course, among two consecutive classes, the authors evaluated the participant’s interpretational ability and depth of understanding when analyzing four complex passages. Results: Out of 235 students, 146 (62%) responded to both questionnaires. There was a significant increase in the participant’s interpretational ability (P=0.003). ninety one participants (38%) improved their level of understanding in at least one out of the four passages, and 37 participants (25%) improved in two passages. A multivariate analysis revealed that the improvement in the interpretational ability was associated with younger age (P=0.034, CI 95%=0.64-0.98, OR=0.79), positive pre-course attitude and motivation (P<0.001, CI 95%=1.43-3.05, OR=2.09), and lack of a prior literature background (P=0.064, CI 95%=0.17-1.05, OR=0.43). Conclusion: Our data suggests that NGDC may improve and refine interpretational ability. Further studies are required to establish the short- and long-term impact of this change and whether it can be translated into better clinical decision making.

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