Chen H Alexander, Silva-Rudberg Jason, Encandela John
Department of Psychiatry and Behavioral Sciences, Johns Hopkins Hospital, Baltimore, USA.
Department of Medicine, University of California San Francisco, San Francisco, USA.
Med Sci Educ. 2024 Dec 16;35(2):929-938. doi: 10.1007/s40670-024-02254-y. eCollection 2025 Apr.
Medical ethics education is crucial for equipping future physicians with the knowledge and skills needed to navigate complex moral decision-making in medical practice. However, the approaches various medical schools take to achieve this have been largely understudied. This investigation aimed to describe the current state of medical ethics education across a range of schools to inform future curriculum development.
A case study design was used to synthesize data from interviews with ethics curriculum educators at 11 US medical schools. Both descriptive and qualitative content analyses were performed on these interviews.
The study found significant variability in nearly every examined area, including contact hours (ranging from 6 to 137.5 h), course content, methods of instruction, and assessment. Most schools tended to integrate ethics into larger courses rather than teach it independently. However, significant vertical integration (i.e., ethics content distributed in all curricular phases) was observed at only a small minority of schools. Qualitative themes revealed several barriers to vertical integration, such as the dilution of ethics content within larger topics, concentration of ethics content in the preclinical phase, and overall competition for curricular time. An additional theme concerned the flexibility within ethics curricula.
Most of the reviewed schools' ethics curricula lacked comprehensive vertical integration-something that can be achieved with careful planning. We present an integrative model based on discussions with the minority of schools that have successfully integrated ethics seamlessly into their curricula.
医学伦理教育对于培养未来医生在医疗实践中应对复杂道德决策所需的知识和技能至关重要。然而，各医学院校实现这一目标的方法在很大程度上尚未得到充分研究。本调查旨在描述一系列院校的医学伦理教育现状，为未来的课程开发提供参考。
采用案例研究设计，综合来自对美国11所医学院校伦理课程教育工作者访谈的数据。对这些访谈进行描述性和定性内容分析。
该研究发现，几乎在每个考察领域都存在显著差异，包括接触时长（从6小时到137.5小时不等）、课程内容、教学方法和评估方式。大多数学校倾向于将伦理融入更大的课程中，而不是单独开设课程。然而，只有少数学校实现了显著的纵向整合（即伦理内容分布在所有课程阶段）。定性主题揭示了纵向整合的几个障碍，例如在更大主题中伦理内容被稀释、伦理内容集中在临床前阶段以及课程时间的整体竞争。另一个主题涉及伦理课程的灵活性。
大多数被审查学校的伦理课程缺乏全面的纵向整合——这可以通过精心规划来实现。我们基于与少数已成功将伦理无缝融入其课程的学校的讨论，提出了一个整合模型。
