Case-Based Conferences on Clinical Ethics for Students During Clinical Clerkships / 医学教育

ABSTRACT

To examine ethical problems students may face during clinical clerkships and to help them to learn how to solve these ethical problems practically, we started a compulsory ethical case conference for medical students rotating through the department of general medicine. Actual cases were selected from among those students had encountered during their clinical clerkship. Groups of students were to analyze these cases and to discuss how to solve ethical problems. In this study, we evaluated this course on the basis of student's questionnaires and case sheets they submitted. Eighty students (92%) answered that they had encountered ethical problems. Each student encountered an average of 3.95±1.53 cases with ethical problems. Students noted 130 ethical issues (an average of 1.63±0.51 issues per case). Ethical issues included informed consent, treatment selection, refusal of treatment, medical distrust, and the doctor-patient relationship. In addition, such important subjects as economic burden, ability for self-determination, social rehabilitation, and patient-family relationships were mentioned, but only rarely. Eighty-five percent of students thought the conferences were valuable. Moreover, 87% of students thought such conferences would motivate them to think about ethical issues in the future. All students thought these compulsory ethical conferences should be continued. However, both the students' degree of participation and comprehensiveness of the conference contents could be improved.