Undergraduate teaching and assessment needs in ethics and professionalism on clinical ward rounds involving medical students, Faculty of Health Sciences, Stellenbosch University (SU) : a nonexperimental descriptive study.

[摘要] ENGLISH ABSTRACT: Background: The theoretical / cognitive component of ethics and professionalism teaching toundergraduate medical students at Stellenbosch University (SU) is well developed, but a concern existsabout the need for teaching and assessment of clinical ethics and professionalism on ward rounds. Someteaching does take place during clinical rotations in the form of role modelling as part of the hiddencurriculum. Opportunities should be created for explicit teaching of ethics and professionalism beyondthe hidden curriculum. Assessment of the cognitive component of ethical and professionalism occurs,but assessment of clinical ethics and professionalism during clinical rotations remains a challenge.Methods: This was a non-experimental study and included three subgroups of undergraduate medicalstudents in their clinical years as well as a random sample of educators involved in clinical training.Questionnaires were distributed to the students and educators. This was followed by focus groupinterviews among the students.Results: A majority of the students (88%) had indicated that they had experienced ethical andprofessional dilemmas while working in the wards or during ward rounds. The main dilemmas revolvedaround inadequate consent processes, lack of confidentiality and privacy, disrespect for patients, poorcommunication and students being expected to perform tasks they were not trained for. An average of64% of students indicated that ethical and professional issues were not discussed during the clinicalrotations in hospitals. Seventy-eight percent of students indicated that they did not feel free to discusstheir own feelings or beliefs on ward rounds. All of the educators felt that there was a need forincreased teaching and assessment of the medical students during their clinical rotations.Conclusions: Deliberate opportunities need to be created for teaching ethics and professionalism onclinical ward rounds. This could be a shared responsibility between the clinical departments withcontinuous input throughout the clinical years of study. Strong institutional support and commitmentare necessary to make the teaching sustainable and successful. Structured opportunities need to bedeveloped where students can discuss ethical and professional issues in a safe environment. Furtherresearch is needed for the development of an appropriate curriculum and assessment tools.

[发布机构] Stellenbosch University