Changes in students' moral development during medical school: a cohort study.

Full Abstract

INTRODUCTION:
The requirements of professionalism and the expected qualities of medical staff, including high moral character, motivate institutions to care about the ethical development of students during their medical education. We assessed progress in moral reasoning in a cohort of medical students over the first 3 years of their education.

METHODS:
We invited all 92 medical students enrolled at the University of Sherbrooke, Que., to complete a questionnaire on moral reasoning at the start of their first year of medical school and at the end of their third year. We used the French version of Kohlberg's Moral Judgment Interview. Responses to the questionnaire were coded by stage of moral development, and weighted average scores were assigned according to frequency of use of each stage.

RESULTS:
Of the 92 medical students, 54 completed the questionnaire in the fall of the first year and again at the end of their third year. The average age of the students at the end of the third year was 21 years, and 79% of the students included in the study were women. Over the 3-year period, the stage of moral development did not change substantially (i.e., by more than half a stage) for 39 (72%) of the students, shifted to a lower stage for 7 (13%) and shifted to a higher stage for 8 (15%). The overall mean change in stage was not significant (from mean 3.46 in year 1 to 3.48 in year 3, p = 0.86); however, the overall mean change in weighted average scores showed a significant decline in moral development (p = 0.028).

INTERPRETATION:
Temporal variations in students' scores show a levelling process of their moral reasoning. This finding prompts us to ask whether a hidden curriculum exists in the structure of medical education that inhibits rather than facilitates the development of moral reasoning.

Learn Faster Today Improve your study skills

Author information

Author/s: Patenaude, Johane (J); Niyonsenga, Theophile (T); Fafard, Diane (D);

Affiliation: Department of Surgery, Faculty of Medicine, University of Sherbrooke and the Centre for Clinical Research, Centre hospitalier universitaire de Sherbrooke, QC. johane.patenaude(-atsign-)usherbrooke.ca

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne (CMAJ), published in Canada. (Language: eng)

Reference: 2003-Apr; vol 168 (issue 7) : pp 840-4

Dates: Created 2003/04/01; Completed 2003/04/23; Revised 2006/11/15;

PMID: 12668541, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: CMAJ. 2003 Apr 1;168(7):854-5. (PMID: 12668545)

CommentIn: CMAJ. 2003 Jun 24;168(13):1643-4. (PMID: 12821608)

CommentIn: CMAJ. 2003 May 27;168(11):1390. (PMID: 12771055)

CommentIn: CMAJ. 2003 May 27;168(11):1390. (PMID: 12771056)

CommentIn: CMAJ. 2003 Nov 25;169(11):1145-6. (PMID: 14638637)

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

This article has not been indexed for related articles as yet, however you can still use the live related article search links below.

See 100+ related articles.

See a large map of 100+ related articles.