Knowledge, confidence, and attitudes regarding medical ethics: how do faculty and housestaff compare?

It has been suggested that faculty members' inadequate knowledge of and unfavorable attitudes toward ethics may present barriers to effective education in ethics for house officers.

To test this hypothesis, the authors administered a questionnaire assessing the knowledge, confidence, and attitudes regarding ethics of the 73 house officers and 73 full-time faculty members in the Department of Medicine at the Georgetown University Medical Center in 1992-93. Statistical analysis of the responses was performed using chi-square, two-tailed t-tests, and linear regression.

Fifty-five house officers (75%) and 57 faculty (78%) responded. The knowledge scores were similarly low for both groups (53% correct for the faculty and 50% for the house officers). However, the faculty were significantly more confident than the house officers regarding ability to address ethical issues (mean ratings of 3.9 vs 3.4 on a scale from 1, very low, to 5, very high; p = .0001). Seventy-five percent of the faculty and 65% of the house officers believed that ethics training should be mandatory during residency.

The attitudes of the faculty per se do not appear to represent a barrier to teaching ethics. However, the gap between the faculty members' confidence and knowledge could interfere with their abilities to model and teach ethics to house officers.