Effectiveness of medical ethics education: a systematic review.

ABSTRACT

This article was migrated. The article was marked as recommended. Background Medical ethics is universally accepted as a fundamental part of medical education. One of the current challenges lies in assessing its effectiveness. The primary objective is to analyze the impact of training in medical ethics, and secondly to describe educational practices and discuss the most effective and appropriate pedagogical models. Methods The PubMed and EMBASE databases were searched for studies up June 2019. Studies with a focus on assessing teaching medical ethics were considered. The included population were medical students, residents or faculty physicians with quantitative measured outcomes with at least one of the following criteria i) pre and post intervention evaluation or ii) a comparison with a control group that did not receive the educational intervention. Results A total of 26 studies ranging from 1990 to 2017 were included 12 (46%) with medical students, 12 (46%) with residents and 2 (8%) with faculty physicians. The most common outcomes are Knowledge, Confidence and Attitudes/ Behaviour. Assessment instruments are knowledge tests, self-assessment questionnaires, reviewing clinical charts and OSCE. Positive statistically significant differences were found in outcomes in 19 (73%) studies. Conclusions A great heterogeneity was found in the way of teaching, assessment and measured outcomes. Most studies focus in medical students or residents. Very few studies present follow-up measures, simulation training and validated and standardized assessment tools with behavioural components. Therefore, the evidence to support the positive impact remains weak. Future research on medical ethical training ought to place similar effort and rigour as other clinical competence skills.