Bebeau M J, Thoma S J
Department of Preventive Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455-0348.
J Dent Educ. 1994 Sep;58(9):684-92.
This study explored the effects of problem-oriented dental ethics curriculum, consisting of 39 contact hours distributed over four years on moral reasoning development and on attitudes about the value of instruction. Students (n = 720) in the classes of 1985 through 1992 participated in the required curriculum and completed, as freshman and seniors, the Defining Issues Test (DIT), a well-validated test of moral reasoning. In addition, students responded to open-ended questions about the value of ethics instruction. Cross-sectional comparison of the eight classes of entering freshman with two classes of third quarter juniors (n = 265) who completed the DIT prior to implementing the ethic curriculum indicated that the dental curriculum offered prior to 1981 had little influence on moral reasoning. Pre- to posttest DIT comparisons for seven of the eight classes of instructed students indicated statistically significant improvement. Comparison of the effect sizes (Cohen's d) of our intervention with the average effect size reported in a meta analysis of effective interventions indicates that results cannot be attributed to student maturation alone. Analysis of individual change patterns suggest that the success occurred despite a higher than average (17 percent vs. 6 percent) number of students who showed regression from pre- to posttest. Substantive explanations (gender, motivation, regression to the mean) did not appear to account for the change patterns, but theoretical explanations, based on observations in other settings, offer insights for further research and curriculum development. In conclusion, the results indicate that students not only benefit from ethics instruction, but value it.
本研究探讨了以问题为导向的牙科伦理课程的效果，该课程为期四年，共39个课时，研究其对道德推理发展以及对教学价值态度的影响。1985年至1992年班级中的学生（n = 720）参加了该必修课程，并在大一和大四时完成了界定问题测试（DIT），这是一项经过充分验证的道德推理测试。此外，学生们还回答了关于伦理教学价值的开放性问题。对八届入学新生班级与在实施伦理课程之前完成DIT的两届大三学生（n = 265）进行横断面比较，结果表明1981年之前开设的牙科课程对道德推理影响甚微。对八届受指导学生中的七届进行的DIT前后测比较显示出统计学上的显著进步。将我们干预措施的效应量（科恩d值）与有效干预荟萃分析中报告的平均效应量进行比较，结果表明结果不能仅归因于学生的成熟。对个体变化模式的分析表明，尽管从测试前到测试后出现倒退的学生数量高于平均水平（17%对6%），但仍取得了成功。实质性解释（性别、动机、向均值回归）似乎无法解释这种变化模式，但基于其他环境中的观察得出的理论解释为进一步研究和课程开发提供了见解。总之，结果表明学生不仅从伦理教学中受益，而且重视它。
