Document Type : Original Article

Authors

1 Department of Medical Education, Virtual Education Center, Jahrom University of Medical Sciences, Jahrom, Iran

2 Clinical Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

BACKGROUND: The use of active teaching methods in ethics education, instead of being merely
teacher centred, can lead students to problem‑solving in a practical way. Therefore, this study was
conducted with the aim of comprehensive medical ethics education based on educational approaches
and the effect of this approach on students’ learning and moral reasoning skills.
MATERIALS AND METHODS: This quasi‑experimental intervention study was performed on seventy
physiopathology medical students who had taken the medical ethics course. The students’ educational
program included teaching theoretical concept of medical ethics, discussing ethical cases and clinical
reasoning in class, and then discussing in forum environment and individual assignments in the
learning management system (LMS) system and completing the portfolio. Student evaluation was
associated students’ knowledge, attitu de, and moral reasoning skills and learning. A comprehensive
program including forum participation, individual assignments in LMS, theory and objective structured
clinical examination (OSCE) tests, and portfolio completion was used to evaluation of students. The
students’ learning was compared to students of the previous year, which was conducted through a
traditional teacher‑centered method. Data analysis was conducted using IBM® SPSS® Statistics 21
at two levels of descriptive statistics and analytic statistics.
RESULTS: The results showed that there was a significant difference between the mean learning of
students compared with traditional class (P < 0.05). Furthermore, comparison of students’ practical
scores through the OSCE test showed its impact on changing students’ knowledge, attitude, and
performance in moral reasoning.
CONCLUSION: According to research findings, it seems that the mentioned model is one of the
important and new issues as a suitable method of teaching medical ethics. Furthermore, it can be
suitable model in other medical courses. The more research in multicentral may be need to assess
other effects on students’ learning indicators.

Keywords

1. Ayatollahi H. Practical suggestions for improving the morality
of medical students. Iran J Cult Health Promot 2019;3:103‑15.
2. Davoud Tahmasebzadeh S. Students’ attitudes toward
self‑directed learning at Tabriz University of Medical Sciences.
Iran J Med Educ 2017;17:175‑85.
3. Beigzadeh A, Yamani N, Bahaadinbeigy K, Adibi P. Challenges
and problems of clinical medical education in Iran: A systematic
review of the literature. Strides Develop Med Educ 2020;16:e89897.
4. Managheb SE, Sadeghi Mazidi Y. The priorities of medical ethics
course from the perspective of medical ethics teachers at Shiraz
and Jahrom Universities of Medical Sciences in 2012. Educ Ethics
Nurs 2015;4:1‑7.
5. Amiresmaili M, Nekoei Moghadam M, Moosazadeh M,
Pahlavan E. Challenges of general practice education in Iran:
A qualitative study. J Strides Develop Med Educ 2013;9:118‑31.
6. Jalal S, Imran M, Mashood A, Younis M. Awareness about
knowledge, attitude and practice of medical ethics pertaining
to patient care, among male and female physicians working in
a public sector hospital of Karachi, Pakistan – A cross‑sectional
survey. J Eur J Environ Public Health 2018;2:4.
7. Williams JR. Medical ethics in contemporary clinical practice.
Journal of the Chinese Medical Association. 2005 Nov
1;68 (11):495‑9.
8. Pasalar M, Kiyani M. Medical ethics in “Kholasat‑Al‑Hekmat”:
One of the textbooks of Iranian traditional medicine. J Iran J Med
Ethics History Med 2011;4:22‑30.
9. Sanagoo A, Kalantari S, Jouybari L, Saeedi S. Educational ethics
in academic environment: Medical students’ perspectives. Journal
of Medical Education Development 2016;9:34‑43.
10. Yadav H, Jegasothy R, Ramakrishnappa S, Mohanraj J, Senan P.
Unethical behavior and professionalism among medical students
in a private medical university in Malaysia. BMC medical
education. 2019;19 (1):1‑5.
11. Bertolami CN. Why our ethics curricula don’t work. Journal of
dental education. 2004 Apr; 68 (4):414‑25.
12. Ghaffari R, Yaghoobi A, Abbasi M, Ranjbarzadeh FS, Salmasi SH,
Golanbar P. Offering the comprehensive evaluation model for
assessing medical ethics course from the perspective of faculty
members. J Med Ethics J 2013;7:177‑91.
13. Goldie J, Schwartz L, Morrison J. A process evaluation of medical
ethics education in the first year of a new medical curriculum.
Medical Education. 2000;34 (6):468‑73.
14. Khaghanizadeh M, Maleki H, Abbasi M, Abbaspoor A. Identity
of the medical ethics curriculum based on the experiences of
teachers of medical ethics: Qualitative research. J Med Ethics J
2011;5:95‑116.
15. Sharp HM, Kuthy RA. What do dental students learn in an ethics
course? An analysis of student-reported learning outcomes.
Journal of Dental Education. 2008;72 (12):1450‑7.
16. Khajedaluee M, Movafaghi Z, Pouryazdanpanah M. Effectiveness
of the medical ethics curriculum: Viewpoints of interns in
Mashhad University of Medical Science. J Iran J Microbiol 2014 ;
1;6(1).
17. Ogundiran TO, Adebamowo CA. Medical ethics education:
A survey of opinion of medical students in a Nigerian university.
J Acad Ethics 2010;8:85‑93.
18. Tolsgaard MG. Clinical skills training in undergraduate medical
education using a student‑centered approach. Dan Med J. 2013 ;
1;60 (8):B4690.
19. Hosseinabadi R, Gholami M, Mirzayeesharifi S, Anbari K,
Tarverdian A. The comparison of perfomance and feedback
of nursing students on Objective structured clinical
examination (OSCE) and Traditional methods. Yafteh. 2019;20 (4).
20. Meng X, Yang L, Sun H, Du X, Yang B, Guo H. Using a novel
student‑centered teaching method to improve pharmacy student
learning. American journal of pharmaceutical education. 2019;
1;83 (2).
21. Schonfeld TL, Spetman MK. Ethics education for allied health students: An evaluation of student performance. Journal of allied
health. 2007; 31;36 (2):77‑80.
22. Najafi H. Comparing of the effect of blended and traditional
teaching on learning. Research in Medical Education 2019;11:54‑63.
23. Mosalanejad L, Abdollahifard S, Abdian T. Psychiatry gamification
from blended learning models and efficacy of this program on
students. Journal of Education and Health Promotion. 2020;9:68.
24. Nasrabadi AN, Joolaee S, Parsa‑Yekta Z, Bahrani N, Noghani F,
Vydelingum V. A new approach for teaching nursing ethics in
Iran. Indian Journal of Medical Ethics. 2009; 1;6 (2):85‑9.
25. Ebrahimi S, Alinejad N. The Impact of Ethics Workshop on the
Ethical Knowledge and Competency of fourth Years Medical
Students of Shiraz University of Medical Sciences. Iranian Journal
of Medical Ethics and History of Medicine 2017;10;10:55-66.
26. Mosalanejad L, Ebrahimi AM, Tafvizi M, Zarifsanaiey N. A
Constructive Blended Approach to Ethical Reasoning: The Impact
on Medical Students’ Reflection and Learning. Shiraz EMedical
Journal. 2020;31;21(7).
27. Nair SP, Shah T, Seth S, Pandit N, Shah GV. Case based learning:
a method for better understanding of biochemistry in medical
students. Journal of clinical and diagnostic research: JCDR. 2013
Aug; 7 (8):1576.
28. Abedini M, Mansouri S, Asadnia M, Mirzaghaie M. Teaching
approaches based on constructivism an appropriate teaching
approach in medical sciences. Res Med Educ 2015;7:73‑8.
29. Mason A, Locke R, Lusznat RM, Coles C, Masding MG. How
Do Contexts Affect Physicians’ Clinical Reasoning? A Narrative
Review. MedEdPublish. 2020;14:9.
30. Parandavar N, Rezaee R, Mosallanejad L, Mosallanejad Z.
Designing a blended training program and its effects on clinical
practice and clinical reasoning in midwifery students. Journal of
education and health promotion. 2019;8.