Where now for problem based learning?
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Achievement↗
Biomedical subjects
Jillian Morrison
Publications and source records attributed to Jillian Morrison.
New century, new challenges for community based medical education.
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Community Medicine↗
Students' attitudes and potential behaviour with regard to whistle blowing as they pass through a modern medical curriculum.
OBJECTIVE: To examine students' attitudes and potential behaviour with regard to whistle blowing as they progress through a modern undergraduate medical curriculum. DESIGN: Cohort design. SETTING: University of Glasgow Medical School. SUBJECTS: A cohort of students entering Glasgow University's new learner-centred, integrated medical curriculum in October 1996. METHODS: Students' pre- and post-Year 1, post-Year 3 and post-Year 5 responses to the whistle blowing vignette of the Ethics in Health Care Instrument (EHCI) were examined quantitatively and qualitatively. Analysis of students' multichoice answers enabled measurement of movement towards professional consensus opinion. Analysis of written justifications helped determine whether their reasoning was consistent with professional consensus and enabled measurement of change in knowledge content and recognition of the values inherent in the vignette. Themes in students' reasoning behind their decisions of whether or not to whistle blow were also identified. RESULTS: There was little improvement in students' performance as they progressed through the curriculum in terms of their proposed behaviour on meeting the whistle blowing scenario. There was also no improvement in the quality of justifications provided. Students' reasoning on whether or not to whistle blow was found to change as the curriculum progressed. CONCLUSIONS: The EHCI has the potential to elicit students' attitudes towards ethical issues at entry to medical school and to measure change as they progress through the curriculum. Students should be encouraged to contemplate dilemmas from all ethical standpoints and consider relevant legal implications. Whistle blowing should be addressed as part of the wider domain of professionalism.
Adult↗
The impact of three years' ethics teaching, in an integrated medical curriculum, on students' proposed behaviour on meeting ethical dilemmas.
OBJECTIVE: To evaluate the impact of 3 years' ethics teaching (30 hours mainly small group teaching in year 1, 14 hours mainly lecture-type teaching in years 2 and 3) on students' proposed behaviour on encountering ethical dilemmas. DESIGN: Cohort design. SETTING: University of Glasgow Medical School. SUBJECTS: A cohort of 111 students entering Glasgow University's new learner-centred, integrated medical curriculum; where ethics learning is formally assessed in years 1 and 5 only; in October 1996. MAIN OUTCOME MEASURE: Student answers consistent with consensus professional judgement on the ethical dilemmas posed by the vignettes of the Ethics and Health Care Survey Instrument. RESULTS: The instrument was completed pre- and post- year 1 and post- year 3 by 77%(85) of the cohort. There is a significant increase in the number of consensus answers given following the first year of the curriculum, but no further improvement was found. The odds ratio for giving the consensus answer post- year 1 relative to pre- year 1 was 1.42, 95% Confidence Interval (1.19, 1.71), P = 0.0001. Comparing post- year 3 to pre- year 1, odds ratio 1.30 (1.08, 1.57), P = 0.0062. Post- year 3 compared to post- year 1, odds ratio 0.91 (0.76, 1.10), P = 0.34. CONCLUSIONS: While small group ethics teaching can be effective in developing students' normative identification with the profession of medicine, its effectiveness is dependent on the amount of small group teaching provided. The lack of formal assessment in years 2 and 3 is also felt to contribute to the lack of impact. This information will inform future curriculum development.
Curriculum↗