title: Students' responses to scenarios depicting ethical dilemmas: a study of pharmacy and medical students in New Zealand.
abstract: One of the key learning objectives in any health professional course is to develop ethical and judicious practice. Therefore, it is important to address how medical and pharmacy students respond to, and deal with, ethical dilemmas in their clinical environments. In this paper, we examined how students communicated their resolution of ethical dilemmas and the alignment between these communications and the four principles developed by Beauchamp and Childress. Three hundred and fifty-seven pharmacy and medical students (overall response rate=63%) completed a questionnaire containing four clinical case scenarios with an ethical dilemma. Data were analysed using multiple methods. The findings revealed that 73% of the qualitative responses could be exclusively coded to one of the 'four principles' determined by the Beauchamp and Childress' framework. Additionally, 14% of responses overlapped between the four principles (multiple codes) and 13% of responses could not be coded using the framework. The subsequent subgroup analysis revealed different response patterns depending on the case being reviewed. The findings showed that when students are faced with challenging ethical dilemmas their responses can be aligned with the Beauchamp and Childress framework, although more contentious dilemmas involving issues of law are less easily categorised. The differences between year and discipline groups show students are developing ethical frames of reference that may be linked with their teaching environments and their levels of understanding. Analysis of these response patterns provides insight into the way students will likely respond in 'real' settings and this information may help educators prepare students for these clinical ethical dilemmas.
authors.affiliation: Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand.
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Henning
authors.affiliation: Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Phillipa
authors.initials: P
authors.lastname: Malpas
authors.affiliation: School of Pharmacy, University of Auckland, Auckland, New Zealand.
authors.forename: Sanya
authors.initials: S
authors.lastname: Ram
authors.affiliation: Ross University School of Medicine, Miramar, Florida, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Rajput
authors.affiliation: Department of Philosophy, University of Auckland, Auckland, New Zealand.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Krstić
authors.affiliation: Independent researcher, formerly University of Auckland, Auckland, New Zealand.
authors.forename: Matt
authors.initials: M
authors.lastname: Boyd
authors.affiliation: Department of General Practice and Primary Healthcare, Faculty of Medical and Health Sciences, University of Auckland, Auckland New Zealand.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Hawken
mesh_terms: D001291:Attitude of Health Personnel; D016022:Case-Control Studies; D004992:Ethics, Medical; D006801:Humans; D028681:Moral Obligations; D009520:New Zealand; D026684:Personal Autonomy; D011340:Problem Solving / Q000941:ethics*; D011369:Professional-Patient Relations / Q000941:ethics*; D036301:Qualitative Research; D012941:Social Responsibility; D013337:Students, Medical; D013339:Students, Pharmacy
keywords: Education for Health Care Professionals; Education/Programs; Ethics; Philosophical Ethics; Professional Misconduct