Evaluating ethical sensitivity in medical students: using vignettes as an instrument

  • Hebert P
  • Meslin E
  • Byrne N
 et al. 
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http://jme.bmj.com/cgi/content/abstract/16/3/141 Updated information and services can be found at: These include: References http://jme.bmj.com/cgi/content/abstract/16/3/141#otherarticles Authors' abstract As a preliminary step to beginning to assess the usefulness ofclinical vignettes to measure ethical sensitivity in undergraduate medical students, five clinical vignettes with seven to nine ethical issues each were created. The ethical issues in the vignettes were discussed and outlined by an expert panel. One randomly selected vignette was presented to first, second and thirdyear students at the University ofToronto aspart ofanother examination. The students were asked to list the issues presented by thepatient problem. Responses from 281 students were obtained. These students identified an average of2.72 ethical issues per vignette. Each response was classified under the domains ofautonomy, beneficence andjustice. Comparisons were made between classes and between vignettes. There was considerable vaniation between classes and the responses to different vignettes seem to indicate that different vignettes measure the various domains in different ways. It does appear that the use of vignettes is one way to measure aspects ofethical sensitivity in medical students but more study is required to clarfy exactly what is being measured. Introduction Many universities, including the University of Toronto, have begun to teach courses and conduct rounds and workshops related to ethical issues for medical students and postgraduate trainees (1,2,3,4). Although there is some literature indicating that ethics can be taught, there is little research in the literature supporting the idea that teaching strategies actually increase students' sensitivity to and response towards ethical dilemmas. Before any attempt can be made to assess ethical sensitivity, instruments need to be developed which can measure aspects of ethical thought and behaviour. At the University of Toronto a group of five individuals convened at the request of the

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  • P. Hebert

  • E. M. Meslin

  • N. Byrne

  • S. Ross Reid

  • E. V. Dunn

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