Psychiatric department, Fattouma Bourguiba's hospital, Monastir, Tunisia.
Tunis Med. 2024 Apr 5;102(4):189-193. doi: 10.62438/tunismed.v102i4.4695.
Ethical reasoning is an important skill for all physicians who often face complex ethical dilemmas in their daily practice. Therefore, medical training should include methods for learning ethical theories and concepts, as well as how to apply them in practical situations.
Assess the contribution of an Ethical Reasoning Learning session to fifth medical students' training through a comparison of results of the same objective and structured clinical examination (OSCE) in the form of simulated interview before and after sessions.
Four 45- minutes' sessions of Ethical Reasoning Learning (ERL) were implemented during a psychiatry internship for four groups of 5th-year students of the faculty of medicine of Monastir (Tunisia). Each session was divided into 7 parts: introduction, reading of a clinical vignette, brainstorming concerning the problems posed by this clinical situation, classification of the problems, identification of the principles of medical ethics, construction of the ethical matrix, and a conclusion.
Fifty-seven students participated in the study divided into 4 groups. We found a significant difference in the means of the OSCE scores before and after the ERL session and a significant difference between the probability of respecting medical secrecy during pre and post-ethical reasoning learning sessions (p <0.001). We have found an effect of ERL sessions on the acquisition of this ethical competence by medical students.
We learned that an ERL session has improved medical training in ethics applied to psychiatry. Other sessions dealing with other ethical skills are necessary to confirm these results.
伦理推理是所有医生的一项重要技能,他们在日常实践中经常面临复杂的伦理困境。因此,医学培训应包括学习伦理理论和概念的方法,以及如何将它们应用于实际情况。
通过比较模拟访谈形式的同一客观结构化临床考试(OSCE)的结果,评估伦理推理学习课程对五年级医学生培训的贡献。
在突尼斯莫纳斯提尔医学院的精神病学实习期间,为四组五年级医学生实施了四次 45 分钟的伦理推理学习(ERL)课程。每个课程分为 7 个部分:介绍、阅读临床病例、针对该临床情况提出的问题进行头脑风暴、问题分类、医学伦理原则识别、伦理矩阵构建和结论。
共有 57 名学生参加了这项研究,分为 4 组。我们发现 ERL 课程前后 OSCE 分数的平均值存在显著差异,并且在 ERL 前后尊重医疗保密的概率之间存在显著差异(p <0.001)。我们发现 ERL 课程对医学生获得这种伦理能力有影响。
我们了解到,ERL 课程提高了医学在精神病学中的伦理培训。需要进行其他涉及其他伦理技能的课程来确认这些结果。