Medical Ethics Course Research Articles

Effectiveness of E-learning on "Sexual Health" among students of Shahid Beheshti University of Medical Sciences based on the Kirkpatrick model.

Implementing educational programs such as E-learning is highly low-cost and highly effective. The aim was to design and implement a sexual health education program to enhance female students' knowledge based on the Kirkpatrick model. This study was a quasi-experimental intervention study conducted on 60 female students of the Medical Ethics course at Shahid Beheshti University of Medical Sciences based on the Kirkpatrick model. After needs assessment and determining the course syllabus, the teaching content was produced electronically and made available to the research population after scientific (Women's Group) and technical (E-Learning Group) approval. Data analysis was performed based on Mann-Whitney U test and independent t-test through SPSS version 26. The mean (standard deviation) scores of the Kirkpatrick level 2 measurement (learning) of the participants increased from 15.34 (4.89) before the intervention to 16.88 (5.20) after intervention (P < 0.001), which was statistically significant. The participants' satisfaction rate with the educational content was 86%, with the course duration was 94.4%, with the educational facilities and equipment was 85.4%, and with the presentation method and attractiveness of the materials was 86.3%. In total, the participants' satisfaction rate with the electronic course was 88%. The results of this study indicated a positive impact of the course on students' knowledge regarding sexual issues, and the students overall expressed satisfaction with this electronic course. Therefore, it is recommended to implement this course extensiver in other universities considering the advantages of E-learning.

Ethics Education in U.S. Allopathic Medical Schools: A National Survey of Medical School Deans and Ethics Course Directors.

An online questionnaire addressed to academic deans and ethics course directors identified by medical school websites was emailed to 157 Association of American Medical Colleges member medical schools in two successive waves in early 2022. Descriptive statistics were utilized to summarize responses. Representatives from 61 (39%) schools responded. Thirty-two (52%) respondents were course directors; 26 (43%) were deans of academic affairs, medical education, or curriculum; and 3 with other roles also completed the survey (5%). All 61 schools reported some form of formal ethics education during the first year of medical school, with most (n = 54, 89%) reporting a formal mandatory introductory course during preclinical education. Schools primarily utilized lecture and small-group teaching methods. Knowledge-based examinations, attendance, and participation were most commonly used for assessment. A large majority regarded ethics as equally or more important than other foundational courses, but fewer (n = 37, 60%) provided faculty training for teaching ethics. Despite a response rate of 39 percent, the authors conclude that medical schools include ethics in their curricula in small-group and lecture formats with heterogeneity regarding content taught. Preclinical curricular redesigns must innovate and implement best practices for ensuring sound delivery of ethics content in future curricula. Additional large-scale research is necessary to determine said best practices.

Do Moral Judgments in Moral Dilemmas Make One More Inclined to Choose a Medical Degree?

The role of moral intuitions and moral judgments has become increasingly prominent in educational and academic choices. The present research aims to examine if the moral judgments elicited in sacrificial trolley dilemmas have a distinct pattern for the decisions made by junior medical students, in comparison to those of senior high school students. We work with this sample because it represents the population out of which medical students are recruited in the case of Bucharest, Romania. Our findings show that moral judgments are indeed a significant predictor for a respondent’s status as medical students. This result, albeit with limitations, bears multiple practical implications, from developing empirically informed medical ethics courses in medical schools to evidence-based policy designs which consider factors such as morality alongside financial outcomes and incentives.

The Effect of an Elective Course in Medical Ethics on Medical Students' Tolerance for Ambiguity.

AbstractPurpose: Tolerance for ambiguity (TFA) is a character trait that is associated with a multitude of benefits for physicians, including increased empathy, greater desire to work in underserved areas, fewer medical errors, enhanced psychological well-being, and lower rates of burnout. Furthermore, it has been shown that TFA is a malleable trait that can be enhanced with interventions such as art courses and group reflection. This study describes the utility of a six-week medical ethics elective course in increasing TFA in first- and second-year medical students.Methods: First- and second-year medical students were enrolled in an elective medical ethics course at Cooper Medical School of Rowan University that guided students in critical thinking, group discussion, and respectful debate regarding various ethical dilemmas in medicine. Students took a validated survey before and after course completion to measure TFA. The average pre- and post-course scores for each semester, as well as the total cohort of 119 students, were compared using paired t-tests.Results: A statistically significant improvement in TFA scores was observed in the overall cohort, as well as in each individual semester of the medical ethics elective course offering.Conclusion: A six-week elective course in medical ethics can significantly improve medical students' TFA.

Assessment of surgery residents' knowledge of medical ethics and law. Implications for training and education.

Medical ethics and law are essential topics that should be included in medical residency programs. However, surgery training programs in Iran lack a specific course in medical ethics and law, which can lead to patient dissatisfaction with surgical outcomes. This study aimed to assess surgery residents' knowledge of medical ethics and law and suggest improvements for future residency programs. This descriptive cross-sectional study involved 112 surgery residents from six teaching hospitals. A valid and reliable questionnaire comprising 15 items on medical ethics and 12 items on medical law was used to assess participants' knowledge. Most participants were female (31-40 years old), and their mean knowledge score for medical ethics was 3.26±0.53 out of 5, with the lowest score in "futile treatment and DNR orders." The mean knowledge score for medical law was 3.69±0.69, with the lowest score in "surrogate decision-maker." Age did not affect residents' knowledge, but gender did, with female residents demonstrating significantly better knowledge of medical ethics (3.344/5 vs. 3.112/5) and law (3.789/5 vs. 3.519/5). Surgery residents had a relatively favorable knowledge of medical ethics and law, but they require further training in some areas to improve their knowledge. Training should include journal clubs, role-play programs, standardized patient programs, and debates to achieve better results, as purely didactic lectures appear inadequate.

Factors Affecting the Learning of Medical Ethics and Etiquette from the Perspective of Medical Teachers and Students of Kermanshah Medical School in 2019

Background: Students’ understanding of the basic principles of attending the university, classrooms, and patient beds and acquiring the necessary skills to deal with the problems of student life, professors, other students, and patients are essential for their education and learning. Objectives: This study aimed to determine the factors affecting the learning of medical ethics courses based on the role of active teaching methods in better and practical learning of medical ethics and ethics courses. Methods: This cross-sectional descriptive study was conducted on the lecturers of relevant courses and medical students of Kermanshah Medical School in 2018-2019 on 201 people using a convenient sampling method. The data collection tool was a 22-question researcher-made questionnaire on a 5-point Likert scale ranging from no effect (1) to very much (5), whose validity and reliability were confirmed (Cronbach’s alpha= 0.8). The collected data were imported to SPSS software version 21 and analyzed with descriptive and inferential statistics. Results: From the students’ point of view, influential factors in learning these courses were clinical memories, professors’ experience (80.6%), professor’s intimacy with students, scientific mastery (76.6%), professor’s clear and expressive expression (76.6%), acquaintance with leading professors and ethical model in university (66%), physical space, classroom facilities, audio-visual facilities (65.8%), review of key points and summaries in the classroom, using animation (55%), educational images and infographics, applications and cyberspace in the classes of medical etiquette and ethics. The opinion of the professors was in line with the students (53.5%). Conclusions: Many factors affecting the learning of medical etiquette and ethics courses were similar to other courses, but there were differences in some cases. The teachers shared the opinions of the students and professors about the importance and priority of the factors affecting the learning of these courses.

Teaching Medical Professionalism with a Scenario-based Approach Using Role-Playing and Reflection: A Step towards Promoting Integration of Theory and Practice.

Professionalism, as one of the core competencies of physicians, is essential for providing the patients with higher quality care. It is an abstract concept and its education and assessment need objective and operational methods. The present study aimed at teaching the concepts of professionalism based on a scenario-based approach using role-playing and reflection. This is a pre-experimental study (one-group pretest-posttest design) with a mixed method approach. The study was conducted on 18 medical students (by voluntary sampling method) who had enrolled in the Medical Ethics Course at Kashan University of Medical Sciences in 2020. Twelve scenarios were designed about the most prevalent issues of medical professionalism. In each session, one group of students played out their scenarios and then, the participants and instructors discussed their role-playing. Participants' knowledge about professionalism was assessed at the beginning and end of each session, and they completed a satisfaction questionnaire and a reflection form. T-tests (one-sample and paired T-test) were applied for statistical analysis. Quantitative and qualitative data were analyzed using SPSS software (version 26), and P<0.05 was considered statistically significant. Conventional content analysis was used to analyze the qualitative data. The mean scores of the participants' knowledge in post-test were significantly higher than those in the pre-test (P=0.042, t=-2.074). The mean scores of the participants' role-playing quality (p<0.001) and satisfaction (p=0.001) were significantly higher than their corresponding test values. Qualitative analysis of the participants' reflections revealed their satisfaction with the study intervention. The scenarios, role-playing, and reflection could provide an opportunity for operationalizing the concepts of professionalism and deep learning of students. Medical instructors need to improve their knowledge and skills of using active methods in teaching professionalism to medical students.

Blended teaching of medical ethics during COVID-19: practice and reflection

BackgroundWith the advancement of information technology, teachers have become able to overcome the limitations of time and room capacity by carrying out teaching activities online. This practice, however, also presents new challenges. The present study explores how to fully capitalize on the advantages of online and offline teaching and improve the quality and impact of the teaching delivered. This article presents an analysis of the planning, implementation, evaluation, and reflection process of reforming the Fujian Medical University (FJMU) medical ethics course.MethodsAfter early attempts using the Small Private Online Course (SPOC) and flipped classroom formats, this paper focuses on the comprehensive active implementation of blended teaching practice. In terms of teaching practice, this research makes targeted improvements to overcome the known shortcomings of SPOCs and flipped classrooms, including the significant preparatory workload and lacking enthusiasm for classroom participation, by redesigning the course and evaluation method and changing the role of the teacher in blended teaching. Subsequently, the study used a stratified sampling method to select 20 students enrolled in the clinical medicine course at Fujian Medical University (FJMU). Their course experience was investigated using a semi-structured interview. Interview content related to evaluating teaching effect was extracted and encoded for subsequent qualitative analysis.ResultsA qualitative analysis of the student evaluation of blended teaching as implemented on the medical ethics course showed that the main factors influencing student engagement are the method of assigning tasks and that of testing learning outcomes. Student participation in class is influenced by the richness of the curriculum resources available and the role played by the teacher.ConclusionThis research presents a discussion of blended teaching and suggests improvements that can be made to address low student engagement and poor classroom participation. This round of blended teaching was shown to improve learning autonomy and classroom participation and to support students in the development of their clinical abilities and higher-order thinking skills. These findings provide a reference for the implementation of online teaching during the COVID-19 pandemic.

Observance of Patients’ Rights by Physicians and Operating Room Technicians

Background: Patients’ rights refer to specific legal privileges related to physical, psychological, spiritual, and social needs that have been reflected in the form of medical standards, rules, and regulations, and the health system and medical staff are responsible for their observance. Objectives: The present study aimed to assess the observance of patients’ rights by physicians (surgeons and anesthesiologists) and technicians (anesthetists and operating room technicians). Methods: This descriptive-analytical cross-sectional study was conducted on 142 operating room technicians and physicians working in hospitals affiliated with Ahvaz University of Medical Sciences in 2018. The participants were selected using stratified random sampling. The patient rights observation checklist was completed by indirect observation of the participants’ performance, and the data were analyzed with SPSS version 20 using the chi-square test and independent samples t-test. Results: The mean scores for the extent to which patients’ rights were observed by all technicians and all physicians were 69.7 ± 10.5 and 57.17 ± 11.7, respectively. The corresponding values were 65.15 ± 9.36 and 54.27 ± 11.24 for the anesthesiologists and surgeons and 84.16 ± 7.31 and 66.63 ± 8.23 for the anesthetists and operating room technicians, respectively. The patients’ rights observance scores were significantly higher for the anesthetists than for the operating room technicians (P = 0.001) and higher for the anesthesiologists than for the surgeons (P = 0.005). Conclusions: This study indicated that although anesthesiologists and anesthetists observed patients’ rights more than operating room technicians and surgeons, the observance of patients’ rights in the operating room was generally moderate. Thus, it is essential to hold refresher courses in medical ethics and patient rights for medical staff.

탁월성을 추구하는 의료윤리교육을 통한 프로페셔널리즘 강화방안

This article examines the current status and limitations of medical ethics courses in 40 medical schools in South Korea. Weaknesses in these medical ethics curricula are identified through an analysis of students’ opinions. It is found that medical ethics education in South Korea is focused primarily on normative ethics and case-based learning while character education is largely overlooked. However, if the goal of medical ethics education is to nurture ethical virtues and medical professionalism, it is essential that medical students also receive some thinking training based on principles in virtue ethics. Accordingly, this article argues that the ten character virtues identified by the Korean Educational Development Institute should be incorporated into the casebased instructional methods used in medical ethics curricula in South Korea.

Educational' Assessment of Medical Ethics Education Course at the College of Medicine/ University of Mosul

Introduction: Medical Ethics (MEs) education in the College of Medicine/ University of Mosul was very traditional in the form of theoretical lectures with no clinical integration or practical ethics training for the students. Aim: The aim of the present study is to assess students' knowledge about the current MEs teaching at College of Medicine/ University of Mosul. Subjects and Methods: The study was conducted in College of Medicine/ University of Mosul during the academic year 2013-2014. Across-sectional study design was adopted with a standardized self-administered questionnaire form distributed to 6th class undergraduate medical students. Results: The overall satisfaction for MEs course assessment questionnaire in the present study was (35.5%). According to the results about one fifth (22%) and less than one third (28.8%) of the students only supposed that MEs course they received had helped them to develop their problem solving skill and sharpened their analytic skills consequently. On the other hand, (72.9%) thought that there are no difficulties of getting through the course by just working hard around the examination, and (49.2%) assumed that feedback on students work was usually provided in the form of marks and grades. Their preference to teaching and assessment methods in the present study revealed in general no significant agreement on a single best method. Conclusions: Medical Students exposed their unsatisfaction regarding MEs course that they have been received. Actions regarding reviewing and reforming of the current MEs teaching became crucial which satisfy students' needs and the contemporary requirements of medical students' graduation.

Medical students' perception of professionalism climate in clinical settings.

Medical professionalism has a crucial role in educating medical students. The role of professionalism in the clinical environment is therefore an important factor in medical education. This study attempts to evaluate the opinions of medical students in the teaching hospitals of Tehran University of Medical Sciences (TUMS) about the professionalism environment in this university.A sample of 165 students filled out the Persian translation of UMKC-SOM (Climate of Professionalism Survey) questionnaire. This instrument evaluates students’ perspectives on the degree of adherence to professionalism by faculty, residents and other students.The results of the study revealed that the total score of professionalism climate was 53.9 for faculty, 42.09 for residents, and 50.76 for students and the difference between these three groups was statistically significant (p-value < 0.01). Results of further analysis through post-hoc tests for multiple comparisons among the groups revealed that the students found their fellow students and faculty more professional than residents. The study also showed that the medical ethics course had no impact on perceptions observations (p-values > 0.05).The study results also revealed that the students found their fellow students and faculty more professional than residents. This finding demonstrates the importance of teaching professionalism to residents since they serve as role models for students. Further multicenter studies are needed to improve the professionalism climate in the medical teaching environment.

There is value in taking the time to teach history of dentistry and ethics in dentistry curriculum

Abstract Objectives The teaching and assessment of soft skills such as ethical behaviour remains a challenge to dental schools. This paper aims to attempt to help the description and retrospective evaluation of a history of dentistry and medical ethics course in the dentistry curriculum of Cyprus Health and Social Sciences University. Methods The study included students (n=78) of the Faculty of Dental Sciences of Cyprus Health and Social Sciences University. History of dentistry and medical ethics are taught each for 1 h, total 2 h per week in the curriculum (theoretical/cases). Students’ academic performance was evaluated with mid-term and final exams. Participants were assessed according to their level of success and failure. Results Participants of the study were 51.3% (n=40) male and 48.7% (n=38) female students. The success rate of the midterm exam was 78.34%, while the success rate of the final was 76.32%. Mid-term exam success was not statistically significantly different than final exam (p&gt;0.215). Conclusions The success of our students in the history of dentistry and ethics course are promising clues for us to propose that there is value in taking the time to teach the course in dental curriculum.

ВИКЛАДАННЯ МЕДИЧНОЇ ЕТИКИ В ПЕРЕДОВИХ УНІВЕРСИТЕТАХ КИТАЮ

The article examines the issue of teaching medical ethics in leading Chinese universities in the training of medical professionals and found that medical ethics courses for physicians are an innovation for Chinese medical high schools. Due to different cultural traditions, researchers of Chinese medical ethics hold conflicting views on the scientific importance and practical necessity of medical ethics and bioethics. The study found that medical ethics education in China has gradually adapted the experience of leading countries such as the United States and the United Kingdom in teaching ethics. China is now in the process of discussing how to develop its own traditional ethics in the context of globalization. It is established that in the program of masters in medicine the formation of ethical knowledge is a mandatory subject. The teaching of medical ethics takes place not only while studying in Chinese universities, but is a long-term lifelong process in which the student summarizes the results of their efforts, combining moral reflection, learning and leadership. The article analyzes the methods and content of teaching medical ethics, which include relevant cultural, social and personal development, and the education of masters in medicine at Chinese universities.Teaching ethics in medical universities is a relatively new area of medical education in China, ethics curricula have different levels of development. In order to determine the peculiarities in the contents of curricula, teaching and learning methods, forms of evaluation and quality of teaching ethics in China, it was analyzed ethical education in several leading medical universities in China: Wuhan University School of Medicine, Guangzhou Medical University and Peking University School of Medicine. In the process of scientific research on the teaching of ethics in universities, it was found that medical ethics for some time was part of the mandatory course of disciplines, with a strong tendency to emphasize the correct ideological thinking of future physicians.Key words: specialist in medicine, medical ethics, master’s degree, higher medical education in China, professional competence of doctor.

Effectiveness of ethics case based on blended learning approaches on medical students' learning: A quasi-experimental study.

BACKGROUND:The use of active teaching methods in ethics education, instead of being merely teacher centred, can lead students to problem-solving in a practical way. Therefore, this study was conducted with the aim of comprehensive medical ethics education based on educational approaches and the effect of this approach on students’ learning and moral reasoning skills.MATERIALS AND METHODS:This quasi-experimental intervention study was performed on seventy physiopathology medical students who had taken the medical ethics course. The students’ educational program included teaching theoretical concept of medical ethics, discussing ethical cases and clinical reasoning in class, and then discussing in forum environment and individual assignments in the learning management system (LMS) system and completing the portfolio. Student evaluation was associated students’ knowledge, attitu de, and moral reasoning skills and learning. A comprehensive program including forum participation, individual assignments in LMS, theory and objective structured clinical examination (OSCE) tests, and portfolio completion was used to evaluation of students. The students’ learning was compared to students of the previous year, which was conducted through a traditional teacher-centered method. Data analysis was conducted using IBM® SPSS® Statistics 21 at two levels of descriptive statistics and analytic statistics.RESULTS:The results showed that there was a significant difference between the mean learning of students compared with traditional class (P < 0.05). Furthermore, comparison of students’ practical scores through the OSCE test showed its impact on changing students’ knowledge, attitude, and performance in moral reasoning.CONCLUSION:According to research findings, it seems that the mentioned model is one of the important and new issues as a suitable method of teaching medical ethics. Furthermore, it can be suitable model in other medical courses. The more research in multicentral may be need to assess other effects on students’ learning indicators.

Team-Based Learning in Medical Ethics Education: Evaluation and Preferences of Students in Oman

Objectives: The purpose of this study was to explore the impact of integrating team-based learning sessions in undergraduate medical ethics education. Though used effectively in other pre-clinical courses, team-based learning is not frequently used in medical ethics education. Student’s accountability for learning, preference for team-based learning, and satisfaction were studied. Methods: Three team-based learning sessions covering focal topics in medical ethics was introduced in the pre-clinical Health Care Ethics course for students at the College of Medicine and Health Sciences, National University of Science and Technology. On the completion of three modules, the team-based learning student assessment instrument (TBL-SAI) by Heidi Mennenga was used to evaluate student perceptions. To this aim, 118 students who had registered for the Health Care Ethics course completed the survey. Results: The findings indicated that students reported a positive experience of team-based learning in medical ethics education. Students also indicated high accountability for their learning, a high preference for team-based learning to lectures in the medical ethics course, and high satisfaction. Conclusions: Team-based learning is thus preferred by students to cover topics and courses in medical ethics. Integrating team-based modules in medical ethics education will enhance self-directed learning, improve teamwork, and help students effectively recall and apply information. It is therefore recommended to integrate team-based learning sessions in medical ethics education.

Assessment of medical students’ achievement of Najaf Abad Islamic Azad University educational objectives of medical ethics course using manuscript of them from “Extreme Measures” film

Medical ethics is a practical key element in the medical curriculum. Movies can be used as an effective and innovative way to involve students in discussions and reflections on ethical issues. This study aimed to evaluate the appropriateness of medical movies as a tool in medical ethics education. During the last teaching session of the medical ethics courses, the movie “Extreme Measures” was shown to the medical students. The present study is a descriptive-analytical study of 302 students’ manuscripts. The quantitative content analysis of the students’ manuscripts was carried out using a checklist that contained 11 titles and 75 subtitles. Each student’s checklist was compared to the student’s final exam score. The most recognized issue was justice (98%), and the least recognized one was confidentiality and privacy (8%). Nonmaleficence, respecting autonomy and informed consent, honor and integrity, end of life, duty and responsibility, conflict of interest, beneficence, relationship with colleagues and altruism were located in-between. There was a relationship between students’ final exam scores and their manuscripts’ scores. According to our findings, relevant movies with standard categorization can be used as a useful method for medical ethics education and assessment.

Investigating Ethical Skills in Dentists and Dental Students: A Comparative Study

Background: Commitment to professional ethics is important for all medical practitioners, including dentists. This skill should be taught to students during their studies. The purpose of this study was to investigate the moral skills of dentistry students and dentists.&#x0D; Methods: This cross-sectional study was performed on 160 dentistry students and dentists. The Moral skills Inventory (MSI) Questionnaire was cross-culturally adapted and used in this study. The MSI was developed by Chamber’s and has 40 items covering four domains including: moral sensitivity, moral reasoning, moral integrity, and moral courage. Each domain’s scores ranged from zero to 20. The results were analyzed using SPSS software version 21.&#x0D; Results: comparing with dentists, dentistry students got higher score in moral sensitivity domain (5.5 ± 3.64 vs. 3.87 ± 2.22) and moral integrity (6.4 ± 3.2 vs. 5.78 ± 2.72). However, in moral reasoning, dentists got higher score than students (15.40 ± 2.11 vs. 13.92 ± 2.35). In the moral courage domain, students’ score was 13.47 ± 3.10 and dentists’ was 13.62 ± 2.96. The mean±SD of total score of moral skills in all domains was 39.3± 4.50 for dental students, 38.68 ± 4.48 for dentists, and 38.99 ± 4.49 for all participants.&#x0D; Conclusion: The professional ethics skills are relatively low in all four domains among dentistry students and dentists. Workshops, reviewing the syllables of medical ethics course, and practicing moral skills during training courses and monitoring professional performance can help to improve moral skill.

The Effect of Dental Hygienist’s on the Medical Ethics Course in College on Medical Information Protection Agreement and Practice

Objectives: The objective of this study was to identify the effect of dental hygienist’s ethic course attendance on medical information protection agreement and practice and to analyze the relevant factors. Methods: The study population consisted of 125 active dental hygienists. Each medical information protection agreement measurement tool and medical information protection practice measurement tool consisted of 21 items for a total of 42 items. A multiple regression analysis was performed to determine the factors affecting the degree of medical information protection agreement and practice. Results: There was significant differences in the mean values of degree of dental hygienist’s medical information protection agreement and practice, showing the higher agreement score being correlated with higher practice score (p<0.05). Among dental hygienists who attended ethics courses, those with longer work experience tended to show higher degree of medical information protection agreement and practice (p<0.05). Conclusions: It is determined that in order to improve the degree of medical information protection agreement and practice among dental hygienists, dental hygiene curriculum should add additional instructional hours to the relevant courses to the curriculum, and at the same time, it is necessary to continue to train current active dental hygienists through continuing professional education and new dental hygienist education.

A Constructive Blended Approach to Ethical Reasoning: The Impact on Medical Students’ Reflection and Learning

Background: Teaching medical ethics is currently one of the most essential parts of medical education. Objectives: The present study aimed to design a blended learning program based on a constructive approach to ethical reasoning and determine its effect on the students’ reflection and learning. Methods: This quasi-experimental, single-group, pretest-posttest study was conducted on 35 students who took the medical ethics course in a university of medical sciences. Case studies were presented to the students in a discussion forum, and the main concepts in question were then addressed through interactive lectures and group discussions. Data were collected using the Self-Reflection and Insight scale (SRIS) developed by Grant et al. to assess reflection, with 20 items in three domains. The students’ ethical reasoning was assessed using multiple-choice and open-ended questions and the Objective Structured Clinical examination (OSCE). The relationships between the tests were assessed by calculating the correlation between them. The results of the multiple-choice questions were compared with those of students in the previous year (with the same teacher and content), using the independent t-test. Results: Assessing the mean scores before and after the intervention showed a significant increase in the students’ reflection in all three domains, including the need for self-reflection, encouraging reflection, and insight after the intervention. The findings also showed a significant relationship between the students’ final scores and their virtual round and OSCE scores (P &lt; 0.05). In the final theoretical test, the students’ mean scores were significantly higher than those of students in the previous year (P &lt; 0.001). Conclusions: The proper use of technology with a blended learning approach can help improve the students’ quality of learning and reasoning.