Sulmasy D P, Dwyer M, Marx E
Division of General Internal Medicine, Georgetown University Medical Center, Washington, D.C. 20007, USA.
Acad Med. 1995 Nov;70(11):1038-40. doi: 10.1097/00001888-199511000-00024.
It has been suggested that faculty members' inadequate knowledge of and unfavorable attitudes toward ethics may present barriers to effective education in ethics for house officers.
To test this hypothesis, the authors administered a questionnaire assessing the knowledge, confidence, and attitudes regarding ethics of the 73 house officers and 73 full-time faculty members in the Department of Medicine at the Georgetown University Medical Center in 1992-93. Statistical analysis of the responses was performed using chi-square, two-tailed t-tests, and linear regression.
Fifty-five house officers (75%) and 57 faculty (78%) responded. The knowledge scores were similarly low for both groups (53% correct for the faculty and 50% for the house officers). However, the faculty were significantly more confident than the house officers regarding ability to address ethical issues (mean ratings of 3.9 vs 3.4 on a scale from 1, very low, to 5, very high; p = .0001). Seventy-five percent of the faculty and 65% of the house officers believed that ethics training should be mandatory during residency.
The attitudes of the faculty per se do not appear to represent a barrier to teaching ethics. However, the gap between the faculty members' confidence and knowledge could interfere with their abilities to model and teach ethics to house officers.
有人认为,教员对伦理学知识掌握不足且态度消极,可能会对住院医师进行有效的伦理学教育构成障碍。
为验证这一假设,作者于1992 - 1993年对乔治敦大学医学中心内科的73名住院医师和73名全职教员进行了一项问卷调查,评估他们关于伦理学的知识、信心和态度。使用卡方检验、双侧t检验和线性回归对回答进行统计分析。
55名住院医师(75%)和57名教员(78%)回复了问卷。两组的知识得分同样较低(教员组正确率为53%,住院医师组为50%)。然而,在处理伦理问题的能力方面,教员比住院医师明显更有信心(评分均值:教员组为3.9,住院医师组为3.4;评分范围为1[非常低]至5[非常高];p = 0.0001)。75%的教员和65%的住院医师认为住院医师培训期间伦理学培训应是强制性的。
教员的态度本身似乎并不构成伦理学教学的障碍。然而,教员的信心与知识之间的差距可能会影响他们为住院医师树立榜样和教授伦理学的能力。