Using simulated case studies to evaluate a clinical ethics course for junior students.

An experimental teaching program in clinical ethics was developed and evaluated. All junior medical students who rotated through a general internal medicine service (75 percent of the class) were required to attend 12 to 14 hours of a clinical ethics seminar which met on a general medicine unit. The teaching sessions were structured around actual cases presented by the junior medical students. One of the evaluation techniques developed is discussed here: the use of simulated clinical-ethical cases. The questions themselves, the method of scoring them, and the findings will be examined. On the basis of this evaluation procedure, some tentative conclusions can be drawn: (a) it is possible to develop evaluation techniques to assess objectively students' ethical reasoning after participating in such a course, and (b) junior medical students who participate in a clinical ethics course show increased reflectiveness regarding ethical decisions.