Ethik im Medizinstudium –: Entwicklungen und Herausforderungen

The influence of clinical experience on dental students' ethical awareness

INTRODUCTION

There has been no structured integration of ethical issues into the dental curriculum and currently no data for certain ethics modules exists in Germany. The study aimed at evaluating the attitudes to ethical issues that affect students at the Dental School in Kiel during patient treatment.

MATERIAL AND METHODS

In the summer of 2017, students were recruited from the 6th and 10th semesters. A qualitative study design with interviews was chosen. The dimensions included, for example, experience with ethical issues, definitions and expectations of teaching content and methods. A qualitative content analysis was performed.

RESULTS

Twelve and eleven students from semesters (32% each) participated. No student was able to name an ethical question based on his own experience (private/study). The need to address ethical issues was justified solely by personal treatment experiences.

DISCUSSION

The study revealed a lack of basic ethical knowledge resulting in a lack of ability to deal with ethical issues. Instead, participants described experiences of psychological pressure, feelings of helplessness.

CONCLUSION

The results suggest that ethical-theoretical foundations should be taught before the beginning of patient treatment. A didactic combination with clinical facts and case vignettes is recommended.

"History, Theory and Ethics of Medicine": The Last Ten Years. A Survey of Course Content, Methods and Structural Preconditions at Twenty-nine German Medical Faculties

Objective: "History, Theory, Ethics of Medicine" (German: "Geschichte, Theorie, Ethik der Medizin", abbreviation: GTE) forms part of the obligatory curriculum for medical students in Germany since the winter semester 2003/2004. This paper presents the results of a national survey on the contents, methods and framework of GTE teaching. Methods: Semi-structured questionnaire dispatched in July 2014 to 38 institutions responsible for GTE teaching. Descriptive analysis of quantitative data and content analysis of free-text answers. Results: It was possible to collect data from 29 institutes responsible for GTE teaching (response: 76%). There is at least one professorial chair for GTE in 19 faculties; two professorial chairs or professorships remained vacant at the time of the survey. The number of students taught per academic year ranges from <100 to >350. Teaching in GTE comprises an average of 2.18 hours per week per semester (min: 1, max: 6). Teaching in GTE is proportionally distributed according to an arithmetic average as follows: history: 35.4%, theory 14.7% and ethics 49.9%. Written learning objectives were formulated for GTE in 24 faculties. The preferred themes of teaching in history, theory or ethics which according to respondents should be taught comprise a broad spectrum and vary. Teaching in ethics (79 from a max. of 81 possible points) is, when compared to history (61/81) and theory (53/81), attributed the most significance for the training of medical doctors. Conclusion: 10 years after the introduction of GTE the number of students and the personnel resources available at the institutions vary considerably. In light of the differences regarding the content elicited in this study the pros and cons of heterogeneity in GTE should be discussed.

[The situation of the "small disciplines" using the example of the history, theory, and ethics of medicine]

There is no clearly defined concept of the "small disciplines" (i.e., smaller fields of study). They have minor facilities and therefore they do not take center stage in a medical school with regard to research and education. Thus, in times of tight resources, the necessity of those disciplines is questioned. In particular, disciplines which cover the field of social medicine in a broader sense and which are not based on molecular medicine, respectively, do not belong to a clinical major discipline may be threatened with "extinction". This is probably not the case with "History, Theory, Ethics of Medicine" (German abbreviation: GTE) which was introduced by the Approbationsordnung für Arzte (license to practise medicine order) in 2002. It is now established in almost all of the German medical schools. The paper describes the contemporary, sometimes controversially discussed situation of GTE stressing its importance for medical education and the scientific self-conception of medicine. The medical humanities are an essential location for the critical self-reflection of medicine - indispensable for medical schools and in the end also medical care.