چالش هاي آموزش اخلاق پزشكي از ديدگاه اساتيد و دانشجويان دانشگاه علوم پزشكي تهران : يك گزارش كوتاه

Challenges of teaching medical ethics from the perspective of mentors and students of Tehran university of medical sciences: a brief report

رويكرد دوره هاي آموزش اخلاق پزشكي در دانشگاه علوم پزشكي تهران براي تغيير نگرش و ارتقاي دانش اخلاق پزشكي فراگيران داراي چالش هايي است. هدف پژوهش حاضر شناسايي چالش هاي موجود در آموزش اخلاق پزشكي دانشگاه علوم پزشكي تهران است. روش بررسي اين يك مطالعه كيفي، و با مصاحبه هاي نيمه ساختاريافته است كه در ارديبهشت سال 1398 در دانشگاه علوم پزشكي تهران انجام شد. با استفاده از نمونه گيري هدف مند 23 شركت كننده از اعضاي هييت علمي باليني و گروه اخلاق پزشكي و دانشجويان پزشكي دانشگاه علوم پزشكي تهران انتخاب شدند. داده ها با روش تحليل درون مايه مورد تحليل محتوا قرار گرفتند. يافته ها نتايج مطالعه نشان داد كه چالش هاي آموزش اخلاق پزشكي از ديدگاه شركت كنندگان در سه تم: 1- برنامه درسي (Curriculum) پنهان 2- ضرورت تكميل برنامه آموزشي اخلاق پزشكي 3- عوامل اجرايي و مديريتي كلان دسته بندي مي شوند. نتيجه گيري اثرگذاري و بازده ارايه درس اخلاق پزشكي جهت تغيير در رفتار و نگرش فراگيران قابل قبول نيست. مقابله با چالش هاي موجود نيازمند تلاش گروه اخلاق پزشكي براي استفاده حداكثري از منابع موجود و تعامل اثربخش با ساير بخش هاي دانشگاهي است.

The approach of medical ethics training courses at Tehran University of Medical Sciences to change the attitude and promote medical ethics knowledge of learners has challenges. This study aims to identify the challenges in teaching medical ethics at Tehran University of Medical Sciences. Methods This is a qualitative study with semi-structured interviews conducted in April 2018 at Tehran University of Medical Sciences. Using purposive sampling, 23 participants were selected from the clinicians and faculty members of medical ethics and medical students. Data were analyzed by the content analysis method. Results The challenges of teaching medical ethics from the participant's point of view are classified into three themes: 1- Hidden curriculum 2- Necessity of completing medical ethics education program 3- Executive and managerial macro factors. The results showed that medical ethics training courses are not effective for changing students' behavior and their moral decision-making. There are substantial shortcomings in the current curriculum in terms of content, format, and implementation that make it unresponsive to ethical needs and concerns. Teaching medical ethics should be turned into a longitudinal theme. The duties and missions of the Department of Medical Ethics at the university are not well understood. The Department does not act as a strong executor and supervisor of medical ethics in interaction with higher authorities to pursue the requirements of effective ethics education and to ensure the implementation of ethical codes. There is no effective mechanism for evaluating the ethical performance of activists and students and giving feedback to them. There is insufficient organizational support for students' complaints and reports about the misconduct and unethical behavior of faculty or staff. Conclusion The effectiveness and efficiency of medical ethics courses to change the behavior and attitude of learners are not acceptable. Dealing with the existing challenges requires the efforts of the Medical Ethics Department to make maximum use of available resources and interact effectively with other academic departments.