Bore Miles, Munro Don, Kerridge Ian, Powis David
Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia.
Med Educ. 2005 Mar;39(3):266-75. doi: 10.1111/j.1365-2929.2005.02088.x.
Consideration has been given to the use of tests of moral reasoning in the selection procedure for medical students. We argue that moral orientation, rather than moral reasoning, might be more efficacious in minimising the likelihood of inappropriate ethical behaviour in medicine. A conceptualisation and measure of moral orientation are presented, together with findings from 11 samples of medical school applicants and students.
To provide empirical evidence for the reliability and validity of a measure of moral orientation and to explore gender, age, cultural and educational influences on moral orientation.
A questionnaire designed to measure a libertarian-dual-communitarian dimension of moral orientation was completed by 7864 medical school applicants and students in Australia, Israel, Fiji, New Zealand, Scotland and England and by 84 Australian psychology students between 1997 and 2001.
Older respondents produced marginally higher (more communitarian) moral orientation scores, as did women compared to men. Minor but significant (P <0.05) cultural differences were found. The Israeli samples produced higher mean moral orientation scores, while the Australian psychology student sample produced a lower (more libertarian) mean score relative to all other samples. No significant change in moral orientation score was observed after 1 year in a sample of Australian medical school students (n=59), although some differences observed between 5 cohorts of Australian medical students (Years 1-5; n=234) did reach significance. Moral orientation scores were found to be significantly correlated with a number of personality measures, providing evidence of construct validity. In all samples moral orientation significantly predicted the moral decisions made in response to the hypothetical dilemmas embedded in the measurement instrument. Discussion The results provide support for the conceptualisation of a libertarian-dual-communitarian dimension of moral orientation and demonstrate the psychometric properties of the measurement instrument. A number of questions concerning the use of such tests in selection procedures are considered.
人们已经考虑在医学生选拔过程中使用道德推理测试。我们认为，道德取向而非道德推理，可能在将医学中不适当道德行为的可能性降至最低方面更有效。本文介绍了道德取向的概念化和测量方法，以及来自11个医学院申请者和学生样本的研究结果。
为道德取向测量的可靠性和有效性提供实证证据，并探讨性别、年龄、文化和教育对道德取向的影响。
1997年至2001年间，澳大利亚、以色列、斐济、新西兰、苏格兰和英格兰的7864名医学院申请者和学生，以及84名澳大利亚心理学专业学生完成了一份旨在测量道德取向的自由意志主义-二元-社群主义维度的问卷。
年龄较大的受访者道德取向得分略高（更具社群主义倾向），女性得分也高于男性。发现了微小但显著（P<0.05）的文化差异。以色列样本的平均道德取向得分较高，而澳大利亚心理学专业学生样本的平均得分较低（更具自由意志主义倾向），相对于所有其他样本。在一组澳大利亚医学院学生（n=59）中，1年后道德取向得分未观察到显著变化，尽管在5组澳大利亚医学院学生（1至5年级；n=234）之间观察到的一些差异确实具有显著性。发现道德取向得分与多项人格测量显著相关，为结构效度提供了证据。在所有样本中，道德取向显著预测了针对测量工具中嵌入的假设困境所做出的道德决策。讨论结果为道德取向的自由意志主义-二元-社群主义维度的概念化提供了支持，并证明了测量工具的心理测量特性。考虑了在选拔过程中使用此类测试的一些问题。
