Evaluation of Medical Ethics Education Based on a Film Wit: A Quantitative Content Analysis

Abstract

Aim: Medical ethics education, emphasized in the Declaration on Medical Education of the World Medical Association, is an important component of the medical profession. The ultimate aim of medical ethics education is to train virtuous physicians who are aware of ethical dilemmas, who can analyze and solve them. Various training techniques such as small and large groups or real patient use and simulation can be used to achieve these goals. In this context, it is important to provide students with an education that will achieve these goals and to evaluate whether the ethical education given is effective. The purpose of the study is to evaluate the effect of medical ethics education by comparing second and fifth year medical students’ identification and evaluation of ethical issues in the film "Wit" (2001). Methods: This is a quantitative content analysis study. The assignments submitted by the second year and fifth year medical students concerning ethical issues in the film were evaluated. Since the currently graded student assignments are obtained from the department archive with anonymously and analyzed for the purpose of evaluating the education, the ethics committee waived the requirement to obtain informed consent. Results: The researchers independently analyzed the essays and determined three categories as “Respect for Patient As a Human Being (RPHB)”, “Patient self-determination”, and “Do no harm” and ten sub-categories, based on the codes obtained from the students' expressions. The number of subcategories indicated by more than half of the fifth years was five. Among these, ‘Violation of DNR’, ‘Invalid informed consent for the research’, and ‘Disrespect for privacy’ were identified by fifth year students significantly more than the second year students. In contrast, the number of fifth year students referring to the subcategories 'Not establishing a good relationship' and 'Not seeing the patient as a human being' dropped dramatically compared to second years. The dramatic decrease in the two sub-categories of the "RPHB" category suggested that medical education caused erosion in the most important values. Conclusions: There were differences between 2 nd year students, who hadn’t received medical ethics education yet, and 5 th year students, who had completed their compulsory course load, in terms of their attitude towards medical ethics issues and their use of ethical terms. In this respect, it was concluded that medical ethics education is effective. It is suggested that students’ awareness on ethics be raised and their ethical dilemma-solving skills be improved using different education strategies during their clinical education. However, in order to reflect this education on attitude and behaviour, not only the teaching clinician – who is seen as a role model by students – but also the administration should support the process. The results of the research showed that the use of Wit as educational material, would be effective in attracting the attention of medical school students to the issues such as communication skills, physician's roles, professional values, patient rights, physician's responsibilities, patient-physician relationship.