College of Medicine, Fu-Jen Catholic University, No. 510 Chung-Cheng Road, Hsin-Chuang District, New Taipei City, Taiwan, ROC.
J Med Ethics. 2012 Mar;38(3):168-73. doi: 10.1136/medethics-2011-100092. Epub 2011 Sep 24.
Moral orientation can affect ethical decision-making. Very few studies have focused on whether medical education can change the moral orientation of the students. The purpose of the present study was to document the types of moral orientation exhibited by medical students, and to study if their moral orientation was changed after preclinical education.
From 2007 to 2009, the Mojac scale was used to measure the moral orientation of Taiwan medical students. The students included 271 first-year and 109 third-year students. They were rated as a communitarian, dual, or libertarian group and followed for 2 years to monitor the changes in their Mojac scores.
In both first and third-year students, the dual group after 2 years of preclinical medical education did not show any significant change. In the libertarian group, first and third-year students showed a statistically significant increase from a score of 99.4 and 101.3 to 103.0 and 105.7, respectively. In the communitarian group, first and third-year students showed a significant decline from 122.8 and 126.1 to 116.0 and 121.5, respectively.
During the preclinical medical education years, students with communitarian orientation and libertarian orientation had changed in their moral orientation to become closer to dual orientation. These findings provide valuable hints to medical educators regarding bioethics education and the selection criteria of medical students for admission.
道德取向会影响伦理决策。很少有研究关注医学教育是否能改变学生的道德取向。本研究旨在记录医学生表现出的道德取向类型,并研究其在临床前教育后是否发生了变化。
2007 年至 2009 年,采用莫雅克量表测量台湾医学生的道德取向。研究对象包括 271 名一年级学生和 109 名三年级学生。他们被分为社群主义者、双重主义者或自由意志主义者群体,并随访 2 年,以监测他们莫雅克评分的变化。
在一年级和三年级学生中,经过 2 年的临床前医学教育,双重主义者群体没有明显变化。在自由意志主义者群体中,一年级和三年级学生的得分分别从 99.4 和 101.3 显著增加到 103.0 和 105.7。在社群主义者群体中,一年级和三年级学生的得分分别从 122.8 和 126.1 显著下降到 116.0 和 121.5。
在临床前医学教育期间,具有社群主义和自由意志主义取向的学生的道德取向发生了变化,变得更接近双重取向。这些发现为医学教育者提供了有价值的提示,涉及生物伦理学教育和医学生入学的选择标准。