Naz Shaikh Saima, Abbas Uzair, Shah Tazeen, Uqaili Arsalan Ahmad, Allah Buksh Hudebia, Fatima Mehreen
Department of Physiology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
Department of Physiology, Dow University of Health Sciences, Karachi, Pakistan.
J Med Educ Curric Dev. 2025 Jan 12;12:23821205241311476. doi: 10.1177/23821205241311476. eCollection 2025 Jan-Dec.
Ethics and professionalism are fundamental elements in the practice of medicine consisting of a set of values, behaviors, and relationships that reinforce the trust and respect for the physician in a society. It consists of several key elements that are learnt during their formative years of study. This study aims to compare knowledge and self-reported practice of ethics and professionalism between preclinical and clinical undergraduate medical students.
We included 427 medical students including males and females of age 18 and above. They were further divided into preclinical and clinical groups. We assessed knowledge and practice of medical professionalism through a validated questionnaire containing 11 core elements (components) of medical professionalism and ethics. The assessment was carried out by comparing median scores assigned to the components of professionalism against each question. Data was analyzed through SPSS v.22 and GraphPad Prism v.8.
Clinical medical students had significantly higher knowledge of medical professionalism as compared to nonclinical students ( = .0016). Moreover, among the components of professionalism, there was a significantly higher score for confidentiality ( = .006), communication skills ( = .001), self-directed learning ( = .011), peer and self-assessment ( = .0011) along with ethics in research and patient care ( = .0042) in clinical students as compared to preclinical medical students. However, no significant difference was found between students of preclinical and clinical years for honesty, accountability, respect, responsibility, compassion, and maturity ( > .05). The findings were comparable across students of different ethnicities in our study cohort ( > .05).
Our findings suggest that knowledge and practice of certain elements of ethics and professionalism are enhanced through clinical exposure, however, few remain consistent across different stages of study. Moreover, lack of significant differences in practice of professionalism based on ethnic differences underscores the potential universal standards in medical education.
伦理与职业素养是医学实践的基本要素，由一系列价值观、行为和关系组成，这些强化了社会对医生的信任和尊重。它包含几个关键要素，是在医学生学习的形成期学到的。本研究旨在比较临床前和临床阶段的本科医学生在伦理与职业素养方面的知识及自我报告的实践情况。
我们纳入了427名医学生，包括18岁及以上的男性和女性。他们进一步分为临床前组和临床组。我们通过一份经过验证的问卷评估医学职业素养的知识和实践情况，该问卷包含医学职业素养和伦理的11个核心要素（组成部分）。评估是通过比较针对每个问题分配给职业素养各组成部分的中位数分数来进行的。数据通过SPSS v.22和GraphPad Prism v.8进行分析。
与非临床学生相比，临床医学生对医学职业素养的知识显著更高（=0.0016）。此外，在职业素养的组成部分中，与临床前医学生相比，临床学生在保密（=0.006）、沟通技巧（=0.001）、自主学习（=0.011）、同伴和自我评估（=0.0011）以及研究和患者护理中的伦理（=0.0042）方面的得分显著更高。然而，在临床前和临床阶段的学生之间，在诚实、问责、尊重、责任、同情心和成熟度方面未发现显著差异（>0.05）。在我们的研究队列中，不同种族的学生的研究结果具有可比性（>0.05）。
我们的研究结果表明，通过临床接触，伦理和职业素养某些要素的知识和实践得到了提高，然而，很少有要素在不同学习阶段保持一致。此外，基于种族差异在职业素养实践方面缺乏显著差异，凸显了医学教育中潜在的通用标准。
