Preparing Future Physicians in Medical Ethics: A Tension-Centered Study of Institutional and Situational Dualities

Abstract

Communication research on physician socialization has been silent on physician preparation in medical ethics. To develop knowledge in this area, I drew on a tension-centered model from organizational studies to analyze transcripts of interviews with 20 behavioral science course directors at 11 medical schools. I found participants describing ethics as situational dilemmas requiring resolution and as the equipping of students with the resources of ethics skills and, to a lesser extent, ethical character. I also found actors managing tension between the ethics-as-skill and ethics-as-character institutions of medical ethics education through a strategy of separation; skills were discussed as short-term course outcomes and character as long-term visions of who participants hoped students would one day become beyond their pre-clinical training. I conclude with discussions on the study's substantive and theoretical contributions and the implications for future research and training of medical students.