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PubMed1993

The moral development of medical students: a pilot study of the possible influence of medical education.

Medicine endorses a code of ethics and encourages a high moral character among doctors. This study examines the influence of medical education on the moral reasoning and development of medical students. Kohlberg's Moral Judgment Interview was given to a sample of 20 medical students (41.7% of students in that class). The students were tested at the beginning and at the end of their medical course to determine whether their moral reasoning scores had increased to the same extent as other people who extend their formal education. It was found that normally expected increases in moral reasoning scores did not occur over the 4 years of medical education for these students, suggesting that their educational experience somehow inhibited their moral reasoning ability rather than facilitating it. With a range of moral reasoning scores between 315 and 482, the finding of a mean increase from first year to fourth year of 18.5 points was not statistically significant at the P < or = 0.05 level. Statistical analysis revealed no significant correlations at the P < or = 0.05 level between the moral reasoning scores and age, gender, Medical College Admission Test scores, or grade point average scores. Along with a brief description of Kohlberg's cognitive moral development theory, some interpretations and explanations are given for the findings of the study.

Adult↗
PubMed2003

Changes in students' moral development during medical school: a cohort study.

INTRODUCTION: The requirements of professionalism and the expected qualities of medical staff, including high moral character, motivate institutions to care about the ethical development of students during their medical education. We assessed progress in moral reasoning in a cohort of medical students over the first 3 years of their education. METHODS: We invited all 92 medical students enrolled at the University of Sherbrooke, Que., to complete a questionnaire on moral reasoning at the start of their first year of medical school and at the end of their third year. We used the French version of Kohlberg's Moral Judgment Interview. Responses to the questionnaire were coded by stage of moral development, and weighted average scores were assigned according to frequency of use of each stage. RESULTS: Of the 92 medical students, 54 completed the questionnaire in the fall of the first year and again at the end of their third year. The average age of the students at the end of the third year was 21 years, and 79% of the students included in the study were women. Over the 3-year period, the stage of moral development did not change substantially (i.e., by more than half a stage) for 39 (72%) of the students, shifted to a lower stage for 7 (13%) and shifted to a higher stage for 8 (15%). The overall mean change in stage was not significant (from mean 3.46 in year 1 to 3.48 in year 3, p = 0.86); however, the overall mean change in weighted average scores showed a significant decline in moral development (p = 0.028). INTERPRETATION: Temporal variations in students' scores show a levelling process of their moral reasoning. This finding prompts us to ask whether a hidden curriculum exists in the structure of medical education that inhibits rather than facilitates the development of moral reasoning.

Adult↗
PubMed1983

Moral development: a differential evaluation of dominant models.

This article examines and evaluates the supporting evidence from the prevailing models of moral development. Using the criteria of empirical relevance, intersubjectivity, and usefulness, the classical model from psychoanalytic theory, Kohlberg's and Gilligan's models from cognitive developmental theory, and the social learning theory model are reviewed. Additional considerations such as the theoretical congruency and sex role bias of certain models are briefly discussed before concluding with the current use of the models by nursing.

Cognition↗
PubMed1994

A motivational model for understanding moral action and moral development.

The neglected topic of moral action and the explanations given for such actions, with their shortcomings, are discussed. To avoid these limitations a new model is offered which integrates personal and situational variables, wherein motivation for moral action is the result of the interaction among moral motives, expectations about costs/benefits, and expectations about outcomes for self-evaluation. The numerical values for these variables are defined and support for this model is given through a reanalysis of Kohlberg's stages and some data from other researchers.

Humans↗
PubMed1991

How empathy, egocentrism, Kohlberg's moral development, and Erikson's psychosocial development are related to attitudes toward war.

In this exploratory study 91 students took a questionnaire which measured their feelings of oneness with all humanity, their egocentrism, level of moral development according to Kohlberg, psychosocial development according to Erikson, and their attitude toward war, diplomacy, the Gulf war, civilians and soldiers in the Gulf area, etc. The hypothesis that empathy with humankind leads to concern about those involved and opposition to war was supported. These individuals were more likely to endorse values expressed in Kohlberg's Level 6. Students endorsing Level 4, law-and-order mortality, especially if they had no friends overseas and used no news source other than the usual U.S. mass media, were more likely to be pro-war, believe President Bush and the military briefings, and opposite reliance on diplomacy. If people had experienced war, they were more frequently against it. However, hardship experienced, lack of egocentrism, believing in a greater good for a greater number of people (Kohlberg's Level 5), and Erikson's psychosocial development were not associated with students' orientation toward war. Further research is suggested.

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