Universidade de São Paulo, Faculty of Medicine, Medical Education Development Center, Health Education - São Paulo (SP), Brazil.
Universidade Federal de São Paulo, Paulista School of Medicine, Department of Ophthalmology and Visual Sciences - São Paulo (SP), Brazil.
Rev Assoc Med Bras (1992). 2023 Jun 2;69(6):e20230108. doi: 10.1590/1806-9282.20230108. eCollection 2023.
The objective of this study was to evaluate fresh medical graduates' perceptions regarding the general aspects of ethics teaching in Brazilian medical schools.
A structured questionnaire was applied to 4,601 participants among the 16,323 physicians who registered in one of the 27 Regional Medical Councils of Brazil in 2015. Answers to four questions regarding general aspects of ethics education in medical school were analyzed. Sampling procedures involved two stratification variables: legal nature (public vs. private) of medical schools and monthly household income higher than 10 minimum wages.
A large percentage of the participants had witnessed unethical behaviors during contact with patients (62.0%), toward coworkers (51.5%), and in relationships with patients' families (34.4%) over the course of their medical training. Even though most of the responders (72.0%) totally agreed that patient-physician relationship and humanities education were part of their medical school curriculum, important topics such as conflicts of interest and end-of-life education were not satisfactorily addressed in the participants' medical training. Statistically significant differences were found between the answers of public and private school graduates.
Despite great efforts to improve medical ethics education, our findings suggest the persistence of deficits and inadequacies in the ethics training currently given in medical schools in Brazil. Further modifications in ethics training must be made to address the deficiencies shown in this study. This process should be accompanied by continuous evaluation.
本研究旨在评估巴西医学院医学毕业生对医学伦理教学一般方面的看法。
2015 年,对巴西 27 个地区医学委员会中注册的 16323 名医生中的 4601 名参与者应用了一份结构化问卷。分析了关于医学院校医学伦理教育一般方面的四个问题的答案。抽样程序涉及两个分层变量:医学院的法律性质(公立与私立)和月家庭收入高于 10 个最低工资。
在医学培训过程中,大部分参与者曾目睹过与患者(62.0%)、同事(51.5%)和患者家属(34.4%)接触时的不道德行为。尽管大多数应答者(72.0%)完全同意医患关系和人文教育是他们医学院课程的一部分,但在参与者的医学培训中,利益冲突和临终教育等重要主题并未得到令人满意的解决。公立和私立学校毕业生的回答存在显著差异。
尽管为改善医学伦理学教育做出了巨大努力,但我们的研究结果表明,巴西医学院目前的伦理学培训仍存在缺陷和不足。必须进一步修改伦理学培训以解决本研究中显示的缺陷。这一过程应伴随着持续的评估。