Tel Hai College, P.O.Box 1220800, Upper Galilee, Israel.
Faculty of Medicine, Bar-Ilan University, P.O. Box 1589, Safed, Israel.
BMC Med Educ. 2022 Feb 20;22(1):114. doi: 10.1186/s12909-022-03124-0.
Medical ethics is a significant learning topic for medical students, and often studied through small group learning (SGL) to encourage critical thinking (CT) and tolerance for ambiguity, both considered particularly important when coping with medical ethics dilemmas. However, a previous study about CT and tolerance for ambiguity in medical ethics SGL produced mixed results. Debating is a pedagogical tool known to enhance CT but never used before in medical ethics learning. This paper examines whether the use of debate may enhance medical ethics SGL by contributing to the CT of students and their tolerance of ambiguity.
Intervention study using the qualitative microanalysis research method, based on videotaped observations that were analyzed through Kamin's model of CT and non-CT. The study was conducted at Bar-Ilan University's Faculty of Medicine in the years 2017-2019. Forty-four students and 4 facilitators participated, equally split between 4 small groups. Twenty-four medical ethics SGL sessions at the beginning and end of the year were videotaped, 2 groups - with no intervention, 1 group included partial debate intervention and 1 group fully used debates. Results were compared for changes in CT and ambiguity before and during the intervention period.
The full intervention (debating) group had the highest increase in utterances reflecting CT, thus actually doubling the median number of CT utterances at the end of the year in comparison to the median number at the beginning of the year. In a similar manner, the debate group exhibited the only group in which there was an increase in the median utterances of tolerance to ambiguity. Nevertheless, the debate group also exhibited the largest increase in the median non-CT utterances and the lowest decrease of intolerance to ambiguity, when comparing the end of the year to the beginning of the year sessions.
Debating is an important enhancement to SGL in medical ethics; however, it does not guarantee a complete absence of non-CT.
医学伦理学是医学生的重要学习课题，通常通过小组学习（SGL）来学习，以鼓励批判性思维（CT）和对模糊性的容忍，这两者在处理医学伦理困境时被认为尤为重要。然而，之前关于医学伦理学 SGL 中 CT 和对模糊性的容忍的研究结果喜忧参半。辩论是一种增强 CT 的教学工具，但在医学伦理学学习中从未使用过。本文探讨了辩论的使用是否可以通过促进学生的 CT 和对模糊性的容忍来增强医学伦理学 SGL。
这是一项干预研究，使用基于录像观察的定性微观分析研究方法，并通过 Kamin 的 CT 和非 CT 模型进行分析。该研究于 2017 年至 2019 年在巴伊兰大学医学院进行。共有 44 名学生和 4 名辅导员参与，平均分为 4 个小组。在年初和年末共录制了 24 次医学伦理学 SGL 课程，其中 2 个小组没有干预，1 个小组进行了部分辩论干预，1 个小组完全使用了辩论。比较干预前后 CT 和模糊性的变化。
在年初和年末的课程中，完全干预（辩论）组的 CT 反映的话语增加最多，因此，与年初相比，年末的 CT 话语中位数实际上增加了一倍。同样，辩论组表现出唯一的一组模糊容忍度中位数增加的情况。然而，辩论组的非 CT 话语中位数增加最多，对模糊性的不宽容程度降低最小，将年末和年初的课程进行比较。
辩论是医学伦理学 SGL 的重要增强，但它并不能保证完全没有非 CT。
