QUALITATIVE EVALUATION OF MORAL DILEMMA DISCUSSION PROGRAM FOR UNDERGRADUATE MEDICAL STUDENTS

https://doi.org/10.22146/jpki.75423

Fransiskus Aryo Pratomo(1*), Gandes Retno Rahayu(2), Yoyo Suhoyo(3)

(1) Medical and Health Professions Education, Faculty of Medicine, Universitas Gadjah Mada, Indonesia
(2) Department of Medical Education, Faculty of Medicine, Universitas Gadjah Mada, Indonesia
(3) Department of Medical Education, Faculty of Medicine, Universitas Gadjah Mada, Indonesia
(*) Corresponding Author

Abstract


Background: In order to achieve professionalism in the medical profession, competence in medical knowledge and skills is crucial. However, equally important are affective components that encompass moral values. At Widya Mandala University Medical School, moral dilemma discussions are employed as a method to enhance the ethical and moral development of students. To optimize the impact of this method on students, it is necessary to delve deeper into the processes that occur within it. This study aims to qualitatively evaluate the student experience of moral dilemma discussions in terms of their moral development and ethical reasoning, their perception of the method as a learning tool, and their assessment of its effects on their moral development and ethical reasoning.

Methods: This study utilized a qualitative phenomenological approach to assess the student experience of moral dilemma discussions. In-depth interviews were conducted with 15 student participants from three different academic years. The data obtained were qualitatively analyzed using the thematic analysis method.

Results: The in-depth interviews with the 15 study participants yielded four main themes, namely moral development, self-development, the process of assimilation and accommodation, and enabling factors.

Conclusion: All students who took part in the study reported a self-perception of higher stage of moral development. According to their experiences, moral development occurred through a process involving ethical contextualization, exposure to various points of view, and reflection. Important factors to consider include sufficient preparation, an active and enjoyable atmosphere, the use of relevant cases, and a longitudinal process.


Keywords


moral dilemma discussion, bioethics education, moral development, ethical reasoning, qualitative

Full Text:

PDF


References

  1. NPDB. NPDB statistics. 2020 [Cited 10th February 2020]; Available from: https://www.npdb.hrsa.gov/resources/publicData.jsp
  2. Wibisono SG. Sampai akhir 2012, terjadi 182 kasus malpraktek. Tempo.co. 2013 [Cited 10th February 2020]; Available from: https://nasional.tempo.co/read/469172/sampai-akhir-2012-terjadi-182-kasus-malpraktek
  3. Stirrat GM, Johnston C, Gillon R, Boyd K. Medical ethics and law for doctors of tomorrow: the 1998 Consensus Statement updated. Journal of Medical Ethics. 2010 Jan 1;36(1):55-60.
  4. Carrese JA, Malek J, Watson K, Lehmann LS, Green MJ, McCullough LB, Geller G, Braddock III CH, Doukas DJ. The essential role of medical ethics education in achieving professionalism: the Romanell Report. Academic Medicine. 2015 Jun 1;90(6):744-52.
  5. KKI. Standar kompetensi dokter. Jakarta: Konsil Kedokteran Indonesia. 2012.
  6. Dent JA, Harden RM, Hunt D, Hodges BD, editors. A practical guide for medical teachers. Fifth edition. Edinburgh ; New York: Elsevier; 2017.
  7. Mohammadifar S, Afshar L. Comparative Study of Medical Ethics Curriculum in General MedicineCourse in 10Selected Universities in the World. Journal of Medical Education. 2019 Jan 1;18(1):29-37
  8. Sastrowijoto S, Soenarto SY, Mahardinata NA, Hartanti W. Challenges, Changes, Concepts for Future Generations. Handbook of Global Bioethics.2014.
  9. Irby DM, Hamstra SJ. Parting the clouds: three professionalism frameworks in medical education. Academic Medicine. 2016 Dec 1;91(12):1606-11.
  10. Salvador RO. Reexamining the “discussion” in the moral dilemma discussion. Journal of business ethics. 2019 Apr;156(1):241-56.
  11. Serodio A, Kopelman BI, Bataglia PU. The promotion of medical students’ moral development: a comparison between a traditional course on bioethics and a course complemented with the Konstanz method of dilemma discussion. International Journal of Ethics Education. 2016 Apr;1(1):81-9.
  12. Berkowitz MW. What works in values education. International journal of educational research. 2011 Jan 1;50(3):153-8.
  13. Lind G. Effective moral education: The Konstanz method of dilemma discussion. Hellenic Journal of Psychology. 2006 Aug;3(3):189-96.
  14. Giubilini A, Milnes S, Savulescu J. The medical ethics curriculum in medical schools: present and future. J Clin Ethics. 2016 Jan 1;27(2):129-45.
  15. O'sullivan H, Van Mook W, Fewtrell R, Wass V. Integrating professionalism into the curriculum: AMEE Guide No. 61. Medical teacher. 2012 Feb 1;34(2):e64-77.
  16. Stolper M, Molewijk B, Widdershoven G. Bioethics education in clinical settings: theory and practice of the dilemma method of moral case deliberation. BMC Medical Ethics. 2016 Dec;17(1):1-0.
  17. Torre DM, Daley B, Stark-Schweitzer T, Siddartha S, Petkova J, Ziebert M. A qualitative evaluation of medical student learning with concept maps. Medical Teacher. 2007 Jan 1;29(9-10):949-55.
  18. Vasileiou K, Barnett J, Thorpe S, Young T. Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period. BMC medical research methodology. 2018 Dec;18(1):1-8.
  19. Kohlberg L. The psychology of moral development. Ethics 1987;97:441–56.
  20. Hren D, Marušić M, Marušić A. Regression of moral reasoning during medical education: combined design study to evaluate the effect of clinical study years. PloS one. 2011 Mar 30;6(3):e17406.
  21. Murrell VS. The failure of medical education to develop moral reasoning in medical students. Int J Med Educ 2014;5:219–25.
  22. Yuguero O, Esquerda M, Viñas J, Soler-Gonzalez J, Pifarré J. Ethics and empathy: The relationship between moral reasoning, ethical sensitivity and empathy in medical students. Revista Clínica Española (English Edition). 2019 Mar 1;219(2):73-8.
  23. Schwartzstein RM. Getting the right medical students—nature versus nurture. N Engl J Med. 2015 Apr 23;372(17):1586-7.
  24. Lee M, Ihm J. Empathy and attitude toward communication skill learning as a predictor of patient-centered attitude: a cross-sectional study of dental students in Korea. BMC medical education. 2021 Dec;21(1):1-1.
  25. Rest JR. Moral Development: Advances in Research and Theory. New York: Praeger. 1986
  26. Azim S, Shamim M. Educational theories that inform the educational strategies for teaching ethics in undergraduate medical education. JPMA. 2020 Sep 4;70(1):123-8.
  27. Branch WT. Teaching professional and humanistic values: Suggestion for a practical and theoretical model. Patient Education and counseling. 2015 Feb 1;98(2):162-7.
  28. Sambunjak D, Straus SE, Marusic A. A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine. Journal of general internal medicine. 2010 Jan;25(1):72-8.
  29. Thistlethwaite JE, Davies D, Ekeocha S, Kidd JM, MacDougall C, Matthews P, Purkis J, Clay D. The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23. Medical teacher. 2012 Jun 1;34(6):e421-44.



DOI: https://doi.org/10.22146/jpki.75423

Article Metrics

Abstract views : 509 | views : 924

Refbacks

  • There are currently no refbacks.


Copyright (c) 2023 Fransiskus Aryo Pratomo, Gandes Retno Rahayu, Yoyo Suhoyo

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Jurnal Pendidikan Kedokteran Indonesia (The Indonesian Journal of Medical Education) indexed by:

  

 JPKI Stats