Hematology and Oncology, The University of Chicago, Chicago, IL, USA.
Department of Biological Sciences, The University of Chicago, Chicago, IL, USA.
BMC Med Educ. 2020 Oct 22;20(1):380. doi: 10.1186/s12909-020-02313-z.
Efforts have begun to characterize the ethical and professional issues encountered by medical students in their clinical years. By applying previously identified taxonomies to a national sample of medical students, this study seeks to develop generalizable insights that can inform professional identity formation across various clerkships and medical institutions.
In a national survey of medical students, participants answered an open-ended survey item that asked them to describe a clinical experience involving an ethical or professional issue. We conducted a content analysis with these responses using the Kaldjian taxonomy of ethical and professionalism themes in medical education through an iterative, consensus-building process. Noting the emerging virtues-based approach to ethics and professionalism, we also reexamined the data using a taxonomy of virtues.
The response rate to this survey item was 144 out of 499 eligible respondents (28.9%). All 144 responses were successfully coded under one or more themes in the original taxonomy of ethical and professional issues, resulting in a total of 173 coded responses. Professional duties was the most frequently coded theme (29.2%), followed by Communication (26.4%), Quality of care (18.8%), Student-specific issues of moral distress (16.7%), Decisions regarding treatment (16.0%), and Justice (13.2%). In the virtues taxonomy, 180 total responses were coded from the 144 original responses, and the most frequent virtue coded was Wisdom (23.6%), followed by Respectfulness (20.1%) and Compassion or Empathy (13.9%).
Originally developed from students' clinical experiences in one institution, the Kaldjian taxonomy appears to serve as a useful analytical framework for categorizing a variety of clinical experiences faced by a national sample of medical students. This study also supports the development of virtue-based programs that focus on cultivating the virtue of wisdom in the practice of medicine.
人们已经开始描述医学生在临床阶段遇到的伦理和专业问题。通过将先前确定的分类法应用于全国医学生样本，本研究旨在得出可推广的见解，为各种实习和医疗机构的专业身份形成提供信息。
在一项全国性的医学生调查中，参与者回答了一个开放式调查项目，要求他们描述一次涉及伦理或专业问题的临床经历。我们通过迭代、达成共识的过程，使用 Kaldjian 医学教育伦理和专业精神主题分类法对这些回答进行内容分析。鉴于新兴的基于美德的伦理学和专业精神方法，我们还使用美德分类法重新检查了数据。
这项调查项目的回复率为 144 人，共 499 名符合条件的受访者（28.9%）。所有 144 个回复都成功地归入了原始伦理和专业问题分类法的一个或多个主题下，共产生了 173 个编码回复。专业职责是最常被编码的主题（29.2%），其次是沟通（26.4%）、护理质量（18.8%）、学生特有的道德困境问题（16.7%）、治疗决策（16.0%）和正义（13.2%）。在美德分类法中，从 144 个原始回复中编码了 180 个回复，最常被编码的美德是智慧（23.6%），其次是尊重（20.1%）和同情或同理心（13.9%）。
最初从一个机构的学生临床经验中开发出来的 Kaldjian 分类法似乎是一个有用的分析框架，可以对全国医学生样本所面临的各种临床经验进行分类。本研究还支持以培养医学实践中的智慧美德为重点的基于美德的项目的发展。
