Self D J, Baldwin D C, Olivarez M
Department of Humanities in Medicine (DHM), Texas A&M University Health Science Center College of Medicine, College Station.
Acad Med. 1993 May;68(5):383-5. doi: 10.1097/00001888-199305000-00025.
To evaluate a project on teaching medical ethics to first-year students by using film discussion to develop the students' moral reasoning.
The participants were 114 first-year students at Texas A&M University Health Science Center College of Medicine in 1989-90, 1990-91, and 1991-92: (1) 48 (20 women and 28 men) who participated during the fall quarter in an elective course on social issues in medicine, which consisted of weekly one-hour discussions of short films; (2) 37 (18 women and 19 men) who participated in the course during both the fall and winter quarters; and (3) a control group of 29 (8 women and 21 men) who did not take the course and so had no exposure to the film discussions. The influence of the discussions on the students' moral reasoning was measured by using Rest's Defining Issues Test for pretests and posttests. The scores of the three groups were compared by using multivariate analysis of variance.
There were statistically significant increases in the moral reasoning scores of both the course registrants with one-quarter exposure to the film discussions (p < .002) and those with two-quarter exposure (p < .008) compared with the scores of the students who did not take the course and had no exposure (p < .109).
No doubt there was a self-selecting bias on the part of the course registrants; however, since both groups of registrants showed significant increases on their posttest scores, clearly the course did have a positive influence on these students' moral reasoning. Thus, it is possible to develop young people's moral reasoning in medical school as well as in earlier educational environments.
通过影片讨论来培养一年级医学生的道德推理能力，从而对一个医学伦理学教学项目进行评估。
研究对象为1989 - 1990年、1990 - 1991年和1991 - 1992年在德克萨斯农工大学健康科学中心医学院的114名一年级学生：（1）48名（20名女生和28名男生）在秋季学期参加了医学社会问题选修课，该课程包括每周一次对短片进行一小时的讨论；（2）37名（18名女生和19名男生）在秋季和冬季学期都参加了该课程；（3）一个由29名（8名女生和21名男生）组成的对照组，他们没有参加该课程，因此没有接触过影片讨论。通过使用雷斯特界定问题测验对学生进行前测和后测，来衡量讨论对学生道德推理的影响。使用多因素方差分析对三组的分数进行比较。
与未参加课程且未接触影片讨论的学生分数相比（p < 0.109），接触影片讨论一个季度的课程注册学生（p < 0.002）和接触两个季度的学生（p < 0.008）的道德推理分数在统计学上均有显著提高。
毫无疑问，课程注册学生存在自我选择偏差；然而，由于两组注册学生的后测分数都有显著提高，显然该课程对这些学生的道德推理产生了积极影响。因此，在医学院以及早期教育环境中培养年轻人的道德推理能力是有可能的。
