Principle-based structured case discussions: do they foster moral competence in medical students? - A pilot study

BMC Medical Ethics 18 (1):21 (2017)
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Recent findings suggest that medical students’ moral competence decreases throughout medical school. This pilot study gives preliminary insights into the effects of two educational interventions in ethics classes on moral competence among medical students in Munich, Germany. Between 2012 and 2013, medical students were tested using Lind’s Moral Competence Test prior to and after completing different ethics classes. The experimental group participated in principle-based structured case discussions and was compared with a control group with theory-based case discussions. The pre/post C-scores were compared using a Wilcoxon Test, ANOVA and effect-size calculation. The C-score improved by around 3.2 C-points in the EG, and by 0.2 C-points in the CG. The mean C-score difference was not statistically significant for the EG or between the two groups. There was no statistical significance for the teachers’ influence on C-score. In both groups, students with below-average C-scores improved and students with above-average C-scores regressed. The increase of the C-Index was greater in the EG than in the CG. The absolute effect-size of the EG compared with the CG was 3.0 C-points, indicating a relevant effect. Teaching ethics with PBSCDs did not provide a statistically significant influence on students’ moral competence, compared with TBCDs. Yet, the effect size suggests that PBSCDs may improve moral competence among medical students more effectively. Further research with larger and completely randomized samples is needed to gain definite explanations for the results.



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Author Profiles

Orsolya Friedrich
Ludwig Maximilians Universität, München
Martin Fischer
Ludwig Maximilians Universität, München

References found in this work

Principles of biomedical ethics.Tom L. Beauchamp - 1989 - New York: Oxford University Press. Edited by James F. Childress.
The measurement of moral judgment.Anne Colby - 1987 - New York: Cambridge University Press. Edited by Lawrence Kohlberg.

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