Do Medical Students Recall and Use the Language of Ethics They are Taught Preclinically Once They are in the Clinical Training Environment? An Empirical Study in Ethics Education

Background: Ethics education is an established part of the medical school curriculum and typically involves preclinical instruction that includes formal ethical terminology. However, it is not clear whether the language of ethics taught in preclinical settings is applied by students during the clinical years of training. Methods: We used a survey and a content analysis of written reflections to determine whether third-year (clinical) medical students were able to recall and apply ethical principles and other sources of ethical value they were taught as second-year (preclinical) students. Results: The majority of clinical students were able to recall the four ethical principles, appreciated the relevance of preclinical ethics education, and had positive self-assessments of their clinical-ethical reasoning abilities. However, they were less able to recall other (nonprinciple) sources of ethical value and infrequently used ethical terms spontaneously in written reflections about ethically or professionally challenging issues. Conclusions: Ethics educators should consider the extent to which preclinical ethics education depends on a formal language of ethics and should develop ways to reinforce that language meaningfully through experience-based learning opportunities during the clinical years of training, with special emphasis on the way clear ethical reasoning and communication demonstrate respect for other persons.