Backround Education in ethics and professionalism should reflect the realities medical students encounter in the hospital and clinic.
Method We performed content analyses on Case Observation and Assessments (COAs) written by third-year medical students about ethical and professional issues encountered during their internal medicine and paediatrics clinical clerkships.
Results A cohort of 141 third-year medical students wrote 272 COAs. Content analyses identified 35 subcategories of ethical and professional issues within 7 major domains: decisions regarding treatment (31.4%), communication (21.4%), professional duties (18.4%), justice (9.8%), student-specific issues (5.4%), quality of care (3.8%), and miscellaneous (9.8%).
Conclusions Students encountered a wide variety of ethical and professional issues that can be used to guide pre-clinical and clinical education. Comparison of our findings with results from similar studies suggests that the wording of an assignment (specifying “ethical” issues, “professional” issues, or both) may influence the kinds of issues students identify in their experience-based clinical narratives.
- Clinical education
- end-of-life care
- ethical reasoning
- internal medicine
- medical errors
- medical ethics
- religious ethics
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Previous presentations Partial data from this study were presented at the AAMC Central Group on Education Affairs Annual Meeting, Rochester, Minnesota (26 March 2009), the Society of General Internal Medicine Annual Meeting, Minneapolis, Minnesota (30 April 2010), the Interdisciplinary Conference on Communication, Medicine and Ethics, Boston, Massachusetts (29 June 2010) and the Annual Meeting of the American Society of Bioethics and Humanities, San Diego, California (24 October 2010).
Funding This work was funded by the Educational Development Fund, University of Iowa Carver College of Medicine.
Competing interests None.
Ethics approval Ethics approval was provided by the Institutional Review Board at the University of Iowa.
Provenance and peer review Not commissioned; internally peer reviewed.
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