The failure of medical education to develop moral reasoning in medical students

OBJECTIVES: The goal of this study was to determine differences in moral judgment among students in medical school. METHODS: This cross-sectional study involved students currently enrolled in undergraduate medical education. Recruited via email, 192 students took an online version of the Defining Issues Test to determine their current stage of moral judgment, as well as their percentage of post conventional thought. Independent variables included year of graduation, which indicated curriculum completion as well as participation in a professionalism course. Data was analyzed primarily using One-Way Analysis of Variance. RESULTS: Of the 192 participants, 165 responses were utilized. ANOVA showed no significant differences in moral judgment between or among any of the student cohorts, which were grouped by year of matriculation. Comparisons included students in the four years of medical school, divided by graduation year; students about to graduate (n=30) vs. those still in school (n=135); and students who had participated in a course in professionalism (n=91) vs. those who had not (n=74). CONCLUSIONS: These results demonstrate a lack of evolution in the moral reasoning of medical students and raise the issue of what might stimulate positive changes in moral judgment during the medical school experience.