Moral judgement development during medical student clinical training

Area of Science:

• Medical Education
• Moral Psychology
• Professional Development

Background:

• Medical students often experience a slowdown or regression in moral development during clinical training.
• This contrasts with typical moral judgment development driven by experience in young adults.
• Understanding this unique developmental trajectory is critical for medical education.

Purpose of the Study:

• To explore the moral development of medical students during their clinical training years.
• To identify key themes and stages in medical students' moral reasoning.
• To map these findings against established theories of self-authorship.

Main Methods:

• A cross-sectional study involving 35 medical students from three clinical years.
• Data collected through 11 interviews and 6 focus groups at an Australian medical school.
• Thematic analysis was employed, with findings mapped to Self-authorship Theory.

Main Results:

• Students reported initial confusion and later defensiveness (desensitization, justification) due to clinical experiences.
• Identification with seniors and understanding clinical context influenced their moral perspectives.
• Emerging themes aligned with the stages of Self-authorship: External Formulas, Crossroads, and Self-authorship.

Conclusions:

• Medical students can successfully achieve or approach self-authorship by understanding and reconciling moral decisions in clinical settings.
• Curriculum and support systems should be tailored to facilitate and acknowledge this developmental progress.
• This research highlights the need for targeted interventions to support ethical development in medical trainees.