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Impact of a new course on students' potential behaviour on encountering ethical dilemmas
J Goldie1, L Schwartz, A McConnachie
1Department of General Practice, University of Glasgow, 4 Lancaster Crescent, Glasgow G12 0RR, UK.
Objective:
To evaluate the effectiveness of small-group ethics teaching in an integrated medical curriculum.
Design:
A quasi-experimental, pre- and post-test, non-equivalent control group design.
Setting:
University of Glasgow Medical School.
Subjects:
111 first-year students from Glasgow University's new learner-centred medical curriculum, with a control group of 51 students from the last year of the traditional curriculum.
Main Outcome Measure:
Student answers consistent with consensus professional judgement on the ethical dilemmas posed by the vignettes of the Ethics and Health Care Survey Instrument.
Results:
There was a significantly greater increase in the number of post-test consensus answers in the experimental group (P=0.0048): the odds ratio for obtaining the post-test consensus answer in the experimental group compared with the control group was 1.73 (95% confidence interval 1.28-2.33). Significant movement towards consensus occurred in the areas of autonomy, confidentiality and consent. Among controls there was a significant move away from consensus in the area of "whistle blowing" on colleagues (P=0.017).
Conclusion:
Small-group ethics teaching, in an integrated medical curriculum, had a positive impact on the first-year students' potential ethical behaviour. It was more effective than a lecture and a large-group seminar-based course in developing students' normative identification with the profession of medicine.