This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pauls, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pauls, M.
Related Collections
Right arrow Professional conduct and regulation
Right arrow Other ethics
CMAJ • June 24, 2003; 168 (13)
© 2003 Canadian Medical Association or its licensors

Letters
Correspondance

The moral of the study

Merril Pauls

Assistant Professor, Departments of Emergency Medicine and Bioethics, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax, NS

The methods described and the interpretation presented in Johane Patenaude and associates'1 thought-provoking study on medical students' moral development call for some clarification.

First, it is unclear why the authors calculated a weighted score based on the students' responses. The most substantial evidence presented for the assertion that moral reasoning declined over the study period was the small but "statistically significant" changes in weighted scores, but the change for the total group was only 17.98 points (out of a possible 450). Does this small change really represent a significant difference in students' moral reasoning abilities?

Second, the authors argue that a lack of improvement in moral reasoning is of concern, and their concluding paragraph indicates a belief that ideally students' moral reasoning skills should increase through their medical education experience. However, many students come to medical school with significant life experience and have already completed advanced degrees. At what point can they be expected to attain the highest stage of moral reasoning that they will achieve?

Finally, although the moral reasoning of students who started at a higher stage declined, that of students starting at a lower stage improved. This finding could be interpreted positively: those who needed improvement most did improve. It also seems odd that the students who were the most morally mature would be most adversely affected by the medical school experience.

Merril Pauls Assistant Professor Departments of Emergency Medicine and Bioethics Dalhousie University and Queen Elizabeth II Health Sciences Centre Halifax, NS

Reference

  1. Patenaude J, Niyonsenga T, Fafard D. Changes in students' moral development during medical school: a cohort study. CMAJ 2003;168(7):840-4.[Abstract/Free Full Text]




This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pauls, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pauls, M.
Related Collections
Right arrow Professional conduct and regulation
Right arrow Other ethics