A constructive blended approach to ethical reasoning: The impact on medical students’ reflection and learning

Abstract

Background: Teaching medical ethics is currently one of the most essential parts of medical education. Objectives: The present study aimed to design a blended learning program based on a constructive approach to ethical reasoning and determine its effect on the students’ reflection and learning. Methods: This quasi-experimental, single-group, pretest-posttest study was conducted on 35 students who took the medical ethics course in a university of medical sciences. Case studies were presented to the students in a discussion forum, and the main concepts in question were then addressed through interactive lectures and group discussions. Data were collected using the Self-Reflection and Insight scale (SRIS) developed by Grant et al. to assess reflection, with 20 items in three domains. The students’ ethical reasoning was assessed using multiple-choice and open-ended questions and the Objective Structured Clinical examination (OSCE). The relationships between the tests were assessed by calculating the correlation between them. The results of the multiple-choice questions were compared with those of students in the previous year (with the same teacher and content), using the independent t-test. Results: Assessing the mean scores before and after the intervention showed a significant increase in the students’ reflection in all three domains, including the need for self-reflection, encouraging reflection, and insight after the intervention. The findings also showed a significant relationship between the students’ final scores and their virtual round and OSCE scores (P < 0.05). In the final theoretical test, the students’ mean scores were significantly higher than those of students in the previous year (P < 0.001). Conclusions: The proper use of technology with a blended learning approach can help improve the students’ quality of learning and reasoning.