Medical Students Encounter Values Conflicts Frequently in Clerkships: A Need for Values Clarification Education [5C

Abstract

INTRODUCTION: Few models of medical school clinical curricula emphasize values clarification (VC) education. VC is a psychotherapy technique that can help individuals increase awareness of personal values, reflect on personal moral dilemmas and allow values to be analyzed and clarified. METHODS: We surveyed students after they participated in a VC session, facilitated by trained faculty and centered around the topic of abortion, during their Women's Health (WH) clerkship at Johns Hopkins University School of Medicine. IRB committee approval was obtained (IRB 00106073). RESULTS: 66% of medical students responded to our survey (n=115). 83% of students agreed or somewhat agreed that a session dedicated to values clarification regarding difficult patient scenarios would be beneficial during their clinical rotations. At least 68% of students reported encountering conflicts in which their values were different from their patients' in multiple clerkships. 79.1% completed more than one clerkship before WH. Of significance, students encountered values conflicts more frequently in WH clerkship compared to Surgery (n=71, p=0.013) and Neurology (n=36, p=0.002). After participation in our VC session, greater than 75% of students agreed or somewhat agreed that they gained increased awareness of personal values and values conflicts as well as increased empathy. CONCLUSION: VC education is essential in medical clinical curricula because students encounter difficult patient scenarios and values conflicts. Providing such education is not a time-consuming addition to clinical curriculum, as we were able to accomplish this in an hour for a group of 25-30 students. We encourage medical schools to endorse VC education in clinical medical curricula.