Qualitative outcome assessment of a medical ethics program for clinical clerkships: A pilot study

This study assessed the usefulness of an open-ended case analysis test inst rument for evaluating the effects of a 1-year ethics course on medical stud ents' decision-making skills. Through case-oriented seminars in gynecology, internal medicine, obstetrics, pediatrics, psychiatry, and surgery, third- year medical students were taught a structured analytic frame-work for anal yzing clinical ethical problems stressing the interactive relationships amo ng medical indications, patient preferences, quality of life, and contextua l (social, legal, economic) matters. At precourse, students were given a te st ease and asked to provide a line of reasoning for their clinical decisio ns. At postcourse, the students were given the same case. Content analysis of pre- and postcourse responses of a random student sample revealed increa ses in student awareness in the following areas: I) consideration of inform ed consent, 2) professional liability, 3) physician-assisted suicide, and 4 ) resource utilization. With some modifications, open-ended case analysis h olds promise for evaluating medical ethics courses. The authors make recomm endations for future research in evaluating the true impact of clinical eth ics courses in medical Education. (C) 1999 Elsevier Science Inc.