Do clinical clerks suffer ethical erosion? Studentsʼ perceptions of their ethical environment and personal development

Publisher Website
Google Scholar
Abstract
BACKGROUND . Little is known about the ethical dilemmas that medical students believe they encounter while working in hospitals or how students feel these dilemmas affect them . The authors examine how clinical students perceive their ethical environment , their feelings about their dilemmas , and whether these dilemmas erode students ' ethical principles . METHOD . An anonymous mail survey was sent in 1992 – 93 to the 1 , 853 third - and fourth-year medical students enrolled at six Pennsylvania medical schools . The survey addressed whether students had encountered situations they felt were ethically problematic , their attitudes toward these situations , and their perceptions of their personal ethical development . Data were analyzed with logistic regression ; respondents ' comments were analyzed qualitatively . RESULTS . Of the 665 students ( 36 %) who responded , 58 % reported having done something they believed was unethical , and 52 % reported having misled a patient ; 80 % reported at least one of these two behaviors . In addition , 98 % had heard physicians refer derogatorily to patients ; 61 % had witnessed what they believed to be unethical behavior by other medical team members , and of these students , 54 % felt like accomplices . Many students reported dissatisfaction with their actions and ethical development : 67 % had felt bad or guilty about something they had done as clinical clerks ; 62 % believed that at least some of their ethical principles had been eroded or lost . Controlling for other factors , students who had witnessed an episode of unethical behavior were more likely to have acted improperly themselves for fear of poor evaluation [ odds ratio , OR , 1 . 37 ( 95 % CI , 1 . 18 – 1 . 60 )] or to fit in with the team [ OR 1 . 45 ( 1 . 25 – 1 . 69 )]. Moreover , students were twice as likely to report erosion of their ethical principles if they had behaved unethically for fear of poor evaluation [ OR 2 . 25 ( 1 . 47 – 3 . 45 )] or to fit in with the team [ OR 1 . 78 ( 1 . 18 – 2 . 71 )]. CONCLUSION . The ethical dilemmas that medical students perceive as affecting them while serving as clinical clerks are apparently common and often detrimental , and warrant the attention of physicians , educators , and ethicists .

This publication has 0 references indexed in Scilit: