Review of ethics curricula in undergraduate medical education

Medical ethics education, it has been said, has 'come of age' in recent yea rs in terms of its formal inclusion in undergraduate medical curricula. Thi s review article examines the background to its inclusion in undergraduate curricula and goes on to examine the consensus that has arisen on the desig n of ethics curricula, using Harden's curriculum and S.P.I.C.E.S models as templates. While there is consensus on content for undergraduate medical et hics education, there is still significant debate on learning and teaching methods. Despite the broad agreement on the need to apply adult education p rinciples to ethics teaching, there would appear to be some tension between balancing the need for experiential learning and achieving the 'core curri culum'. There are also as yet unresolved difficulties with regards to resou rces for delivery, academic expertise, curriculum integration and consolida tion of learning. Assessment methods also remain contentious. Although ther e is consensus that the ultimate goal of medical ethics, and indeed of medi cal education as a whole, is to create 'good doctors', the influence of the 'hidden curriculum' on students' development is only beginning to be recog nized, and strategies to counteract its effects are in their infancy. The n eed for proper evaluation studies is recognized. It is suggested that the a reas of debate appearing in the literature could be used as a starting poin t for evaluation studies, which would form the empirical basis of future cu rriculum development.