医学学生在临床学习环境中的道德困扰:确定来源和教学影响
Annika D Reczek1, Daniel T Kim1, Sandra DiBrito1
1Alden March Bioethics Institute, Albany Medical College, Albany, NY, USA.
Medical teacher
|January 14, 2026
概括
医学学生经常经历道德上的痛苦,往往是由于他人的行为. 积极的指导和角色建模对于减轻这种痛苦和促进专业成长至关重要.
科学领域:
- 医学教育 医学教育
- 生物伦理学生物伦理学
- 专业发展专业发展
背景情况:
- 当临床医生由于约束不能根据道德信仰采取行动时,就会发生道德困扰.
- 医学学生在临床过渡期间容易受到道德困扰.
- 有限的权威和对后果的恐惧加剧了学生的脆弱性.
研究的目的:
- 检查医学生的经历和报告的道德困境.
- 调查监督医生在学生道德困境中的作用.
- 评估道德困扰对职业发展的影响.
主要方法:
- 对407个医学三年级学生病例报告进行了定量和定性分析.
- 评估道德困境的情况和学生与临床导师的经历.
主要成果:
- 在41.8%的病例中报告了道德困扰.
- 常见的原因包括"其他人的行为" (32.9%) 和"系统性问题" (22.9%).
- 导师身份没有显著影响道德困境得分 (p=0.6).
- 没有道德困扰的学生报告了更积极的导师评分和想要效仿导师的愿望.
结论:
- 医学学生中,道德困扰是很常见的,通常是通过观察他人的行为来引发的.
- 积极的角色建模和有效的指导显著影响道德困境.
- 导师在塑造学生的道德发展和专业身份方面发挥着关键作用.
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