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  • Title: [Assessing bioethics education: Teaching to be virtuous doctors or just doctors with practical ethical skills].
    Author: Esquerda M, Pifarré J, Roig H, Busquets E, Yuguero O, Viñas J.
    Journal: Aten Primaria; 2019 Feb; 51(2):99-104. PubMed ID: 29627144.
    Abstract:
    OBJECTIVE: In the last decades, bioethics has been incorporated into the academic training of the Medical Schools. Some studies analyze the ethical-moral development of medical students and the effect of ethical education in other countries. This evaluation is done by measuring Kohlberg's moral reasoning (virtuous doctors), or ethical sensitivity to resolve clinical cases (physicians with ethical skills). The following study is proposed to assess the impact of bioethics training on these two variables, in Spanish medical students. DESIGN: Observational cross-sectional study. SITE: Faculty of Medicine, University of Lleida. PARTICIPANTS: 175 students from third year of medicine (78 before bioethics and 97 after bioethics, in different courses) were conducted. INTERVENTION: Bioethics course. MAIN MEASUREMENTS: A socio-demographic questionnaire, the Rest Defining Issue test scale, and Problem Identification Test with clinical vignettes were administered. RESULTS: A consistent and significant correlation has been found between moral reasoning and ethical sensitivity. Women presented greater post-conventional reasoning. There were no changes in Kohlberg's stage of global moral reasoning with ethical training. There were changes in ethical sensitivity with bioethical training, with a significantly and globally improvement. CONCLUSION: In our study, training in bioethics does not improve moral development but rather the ethical problem solving skills. It is asked if this improvement is enough to train doctors prepared for the new challenges. OBJETIVO: La bioética se ha incorporado en la formación de las Facultades de Medicina las últimas décadas. Diversos estudios analizan el desarrollo ético-moral de los estudiantes y el efecto de la educación ética, midiendo la evolución del razonamiento moral de Kohlberg (médicos virtuosos), y la sensibilidad ética para resolver casos clínicos (médicos con habilidades éticas). El objetivo del estudio es valorar el impacto de la formación en ética en estas dos variables en nuestro ámbito. DISEÑO: Estudio observacional transversal. EMPLAZAMIENTO: Facultad de Medicina, Universidad de Lleida. PARTICIPANTES: Un total de 175 estudiantes de tercer curso de medicina (78 antes de realizar bioética y 97 después de realizar bioética, en diferentes cursos). INTERVENCIÓN: Formación reglada en bioética. MEDICIONES PRINCIPALES: Se administra un cuestionario sociodemográfico, el Defining Issue Test de Rest como medida del razonamiento moral, y el Problem Identification Test de Hébert como medida de la sensibilidad ética. RESULTADOS: Se halla una relación consistente y significativa entre razonamiento moral y sensibilidad ética. Las mujeres presentan mayor razonamiento posconvencional, es decir, mayor desarrollo moral. No se aprecian cambios en el estadio de razonamiento moral global de Kohlberg con la formación ética. Sí se incrementa de forma significativa y global la sensibilidad ética, medida en forma de Problem Identification Test. CONCLUSIÓN: No se hallan diferencias en el desarrollo moral de estudiantes de medicina antes y después de la formación reglada en bioética, pero sí con respecto a las habilidades en resolución de casos. Se plantea si esta mejora es suficiente para formar médicos preparados para los nuevos retos.
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