Ethical reasoning through simulation: a phenomenological analysis of student experience

Area of Science:

• Medical Education
• Ethics in Medicine
• Qualitative Research

Background:

• Medical students often feel unprepared for the emotional aspects of clinical ethical dilemmas.
• Simulation-based learning (SBL) provides a controlled environment to explore these challenges.
• Existing research lacks in-depth accounts of student experiences in ethics simulations.

Purpose of the Study:

• To understand the lived experiences of medical students facing emotional challenges in clinical ethical dilemmas during SBL.
• To inform pedagogical approaches for teaching medical ethics.

Main Methods:

• Qualitative study using an interpretivist epistemology.
• Eight senior medical students participated in an interprofessional SBL activity with ethical scenarios.
• Point-of-view (PoV) video footage and post-simulation interviews were analyzed using interpretative phenomenology and template analysis.

Main Results:

• Students identified explicit ethical dilemmas but struggled with subtle boundaries.
• Emotional complexity led to observed moral compromises, such as dishonesty.
• Prior negative experiences hindered students' ability to challenge unethical behavior in simulations.

Conclusions:

• SBL offers deep insights into students' embodied ethical reasoning and emotional responses.
• Understanding these human dimensions aids in navigating ethical and professional boundaries.
• This approach can facilitate a smoother transition for medical students into clinical practice.