Importance and Impact of a Longitudinal Ethics, Law and Professionalism Curriculum on Medical Students' Knowledge and Professional Attitudes

Abstract

Introduction

With an ageing population and rising complexity of care, helping medical students to develop an ethically, legally, and professionally sound approach to clinical practice is becoming even more important. This cross-sectional study explores how medical students’ knowledge and application of ethical principles and professional attitudes develop during a longitudinal programme in health ethics, law and professionalism. Our research aims to evaluate the impact of longitudinal medical ethics curriculum on medical students’ knowledge of ethical principles and professional attitudes as they transition from pre-clinical to clinical years.

Methods

Anonymised self-reported questionnaires assessing ethical knowledge and decision-making were administered to two groups of medical students in 2015 and 2016—preclinical year students [Year 2 (n=162)] and clinical year students [Year 5 (n=167)]. The study focused on Years 2 and 5 students as our aim was to evaluate how their perspectives differed after the end of both the pre-clinical and clinical years. Information on demographics were also collected.

Results

As expected, more Year 5 as compared to Year 2 students had a positive attitude and confidence towards medical ethics and decision-making. Although Year 2 students had limited patient exposure, their knowledge of key medical ethics principles was comparable to the Year 5 graduating medical students. However, there was variance between pre-clinical and clinical students’ normative assessment of factors and practices in clinical ethical decision[1]making in scenarios such as resuscitation, disclosure of avoidable errors, truth concealment, and euthanasia.

Discussion

Medical ethics teaching has a positive impact on knowledge but strategies should be implemented to mitigate the effects of clinical exposure and to ensure more uniformity in normative assessment.

Conclusion

Longitudinal programme in health ethics, law and professionalism did enhance knowledge and professional attitudes in both preclinical and clinical year students. There was evidence of ethical erosion in a few of the domains for students in clinical years.