Ethically Related Decisions in Different Scenarios of Medical School Applicants for Graduate‐Entry Program

Abstract

Assessment tools for non-academic qualities such as ethics frequently employ hypothetical scenarios to lay out a contextual framework underlying the corresponding criteria of assessment. Due to the context-specific nature of the assessment criteria, details of the scenarios become very important in obtaining accurate results. This study aims to explore how medical school applicants differ in ethical decision making depending on the types of ethical dilemma scenarios, and how they correlate with academic achievements after admission. In 2014, all 82 applicants invited for an admission interview for a graduate-entry program were asked to complete a questionnaire comprised of 13 hypothetical scenarios. There were three domains (unethical business decisions, unethical academic decisions, and sexual quid pro quos) and participants were made to choose between the profitable-but-unethical choice or the unprofitable-but-ethical choice, using a four-point Likert-type scale. On average, tendencies toward unethical decisions were lowest for sexual favors (1.34±0.46), and highest for gaining academic advantages (2.22±0.56). Unethical decisions for academic advantages and sexual benefits showed significant correlation respectively with the female gender and those who graduated from overseas universities. In addition, the propensity for choosing unethical academic decisions was significantly correlated with high academic achievements in medical school (r=0.396). Not only does this study demonstrate that different levels of ethical decision making depend on the scenarios, but also those differences may be a determinant factor in subsequent academic performances in medical school. In conclusion, given the possible influence of the details of the hypothetical scenarios to the applicant’s responses, careful consideration must be given during their development.