Moreira Filipa, Teixeira Pedro, Leão Cecília
Hospital de Braga.
School of Medicine.
MedEdPublish (2016). 2021 Jun 15;10:175. doi: 10.15694/mep.2021.000175.1. eCollection 2021.
This article was migrated. The article was marked as recommended. Background Medical ethics is universally accepted as a fundamental part of medical education. One of the current challenges lies in assessing its effectiveness. The primary objective is to analyze the impact of training in medical ethics, and secondly to describe educational practices and discuss the most effective and appropriate pedagogical models. Methods The PubMed and EMBASE databases were searched for studies up June 2019. Studies with a focus on assessing teaching medical ethics were considered. The included population were medical students, residents or faculty physicians with quantitative measured outcomes with at least one of the following criteria: i) pre and post intervention evaluation or ii) a comparison with a control group that did not receive the educational intervention. Results A total of 26 studies ranging from 1990 to 2017 were included: 12 (46%) with medical students, 12 (46%) with residents and 2 (8%) with faculty physicians. The most common outcomes are Knowledge, Confidence and Attitudes/ Behaviour. Assessment instruments are knowledge tests, self-assessment questionnaires, reviewing clinical charts and OSCE. Positive statistically significant differences were found in outcomes in 19 (73%) studies. Conclusions A great heterogeneity was found in the way of teaching, assessment and measured outcomes. Most studies focus in medical students or residents. Very few studies present follow-up measures, simulation training and validated and standardized assessment tools with behavioural components. Therefore, the evidence to support the positive impact remains weak. Future research on medical ethical training ought to place similar effort and rigour as other clinical competence skills.
本文已迁移。该文章被标记为推荐。背景 医学伦理学被普遍认为是医学教育的一个基本组成部分。当前的挑战之一在于评估其有效性。主要目标是分析医学伦理学培训的影响，其次是描述教育实践并讨论最有效和合适的教学模式。方法 在PubMed和EMBASE数据库中检索截至2019年6月的研究。纳入关注医学伦理学教学评估的研究。纳入人群为医学生、住院医师或教师，其结果采用定量测量，至少符合以下标准之一：i）干预前后评估或ii）与未接受教育干预的对照组进行比较。结果 共纳入1990年至2017年的26项研究：12项（46%）针对医学生，12项（46%）针对住院医师，2项（8%）针对教师。最常见的结果是知识、信心和态度/行为。评估工具包括知识测试、自我评估问卷、临床图表审查和客观结构化临床考试。19项（73%）研究的结果存在统计学上的显著差异。结论 在教学方式、评估和测量结果方面存在很大的异质性。大多数研究集中在医学生或住院医师。很少有研究采用随访措施、模拟培训以及具有行为成分的经过验证和标准化的评估工具。因此，支持积极影响的证据仍然薄弱。未来关于医学伦理培训的研究应该像其他临床能力技能一样投入同样的精力和严谨性。
