Document Type : Original Article
Authors
Abstract
BACKGROUND: During the course of their education, medical students must attain moral
competence. The current study aims at designing a formative structured examination that would create
the opportunity for learners to practice and interact with simulated patients under expert supervision.
MATERIALS AND METHODS: This article reports an experience in developing and implementation
of a formative assessment of moral competence and the point of view of medical students. In this
study, the formative structured examination of medical ethics for 80 medical students in 2 rounds
with eight stations was designed. In each station, a scenario was proposed, and the opportunity was
provided to the learners to interact with a simulated patient under the supervision of a medical ethics
expert. Then, the learners would receive structured feedback in accordance with their performance.
All learners expressed their experience in reflective writing, and their opinions were put under content
analysis.
RESULTS: The content analysis of this reflective writing revealed three main categories, namely
“Deeper understanding of ethical subjects,” “Collaborative thinking and synergy with peers,” and
“Effective feedback of supervisors.”
CONCLUSION: Within the framework of a formative structured examination of medical ethics, a safe
space was created for interacting with simulated patients and practicing ethical reasoning, as well
as dimensions of moral competence.
Keywords
medical education on the moral competence of medical students.
Proc Int Conf Arts Humanit 2019;4:127‑40.
2. Shidfar F, Sadeghi S, Kaviani A. A survey of medical ethics
education in Iran medical faculties. Iran J Allergy Asthma
Immunol 2007;6:47‑51.
3. Yardley S, Teunissen PW, Dornan T. Experiential learning: AMEE
Guide No. 63. Med Teach 2012;34:e102‑15.
4. Borhani F, Alhani F, Mohammadi E, Abbaszadeh A. Professional
Ethical Competence in nursing: The role of nursing instructors.
J Med Ethics Hist Med 2010;3:3.
5. O’Sullivan H, van Mook W, Fewtrell R, Wass V. Integrating
professionalism into the curriculum: AMEE Guide No. 61. Med
Teach 2012;34:e64‑77.
6. Motola I, Devine LA, Chung HS, Sullivan JE, Issenberg SB.
Simulation in healthcare education: A best evidence practical
guide. AMEE Guide No. 82. Med Teach 2013;35:e1511‑30.
7. Buxton M, Phillippi JC, Collins MR. Simulation: A new approach
to teaching ethics. J Midwifery Womens Health 2015;60:70‑4.
8. Tritrakarn P, Berg BW, Kasuya RT, Sakai DH. Medical school
hotline: Can we use simulation to teach medical ethics? Hawaii
J Med Public Health 2014;73:262‑4.
9. Fanous A, Rappaport J, Young M, Park YS, Manoukian J,
Nguyen LHP. A longitudinal simulation‑based ethical‑legal
curriculum for otolaryngology residents. Laryngoscope
2017;127:2501‑9.
10. Harnof S, Hadani M, Ziv A, Berkenstadt H. Simulation‑based
interpersonal communication skills training for neurosurgical
residents. Isr Med Assoc J 2013;15:489‑92.
11. Marei HF, Al‑Eraky MM, Almasoud NN, Donkers J,
Van MerrienboerJJ. The use of virtual patient scenarios as a vehicle
for teaching professionalism. Eur J Dent Educ 2018;22:e253‑60.
12. Harari DY, Macauley RC. The effectiveness of standardized
patient simulation in training hospital ethics committees. J Clin Ethics 2016;27:14‑20.
13. Calleja JL, Soublette Sánchez A, Radedek Soto P. Is clinical
simulation an effective learning tool in teaching clinical ethics?
Medwave 2020;20:e7824.
14. Bramstedt KA, Moolla A, Rehfield PL. Use of standardized
patients to teach medical students about living organ donation.
Prog Transplant 2012;22:86‑90.
15. Habibi Khorasani S, Ebrahimi S. Using video‑taped examples of
standardized patient to teach medical students taking informed
consent. J Adv Med Educ Prof 2015;3:72‑6.
16. Khan KZ, Ramachandran S, Gaunt K, Pushkar P. The Objective
Structured Clinical Examination (OSCE): AMEE Guide No. 81.
Part I: An historical and theoretical perspective. Med Teach
2013;35:e1437‑46.
17. Cleland JA, Abe K, Rethans JJ. The use of simulated patients
in medical education: AMEE Guide No 42. Med Teach
2009;31:477‑86.
18. Asghari F, Larijani B. Evaluation of moral competency using
standardized patient: Presenting an experience. J Med Ethics Hist
Med 2010;3:5.
19. Kucukkelepce GE, Dinc L, Elcin M. Effects of using standardized
patients on nursing students’ moral skills. Nurs Ethics
2020;27:1587‑602.
20. Lewis G, McCullough M, Maxwell AP, Gormley GJ. Ethical
reasoning through simulation: A phenomenological analysis of
student experience. Adv Simul (Lond) 2016;1:26.
21. Chen RP. Moral imagination in simulation‑based communication
skills training. Nurs Ethics 2011;18:102‑11.
22. Borhani F, Abbaszadeh A, Bahrampour A, Ameri GF,
Aryaeenezhad A. Role of judgment in promoting nurses’ decisions
and ethical behavior. J Educ Health Promot 2021;10:88.
23. Greco S, Lewis EJ, Sanford J, Sawin EM, Ames A. Ethical reasoning
debriefing in disaster simulations. J Prof Nurs 2019;35:124‑32.
24. KhalajiniaZ, Alipour Z, SafaeipourR. Exploring medical teachers’
and interns’ experiences regarding professional ethics. J Educ
Health Promot 2020;9:131.
)