Exploring Professionalism Dilemma and Moral Distress through Medical Students’ Eyes: A Mixed-Method Study

Cordelia Cho, Wendy Y. K. Ko, Olivia M. Y. Ngan () and Wai Tat Wong
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Cordelia Cho: Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
Wendy Y. K. Ko: Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
Olivia M. Y. Ngan: CUHK Centre for Bioethics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
Wai Tat Wong: Department of Anaesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China

IJERPH, 2022, vol. 19, issue 17, 1-18

Abstract: This study aims to understand professionalism dilemmas medical students have experienced during clinical clerkships and the resulting moral distress using an explanatory mixed-method sequential design—an anonymous survey followed by in-depth interviews. A total of 153 students completed and returned the survey, with a response rate of 21.7% (153/706). The top three most frequently occurring dilemmas were the healthcare team answering patients’ questions inadequately (27.5%), providing fragmented care to patients (17.6%), and withholding information from a patient who requested it (13.7%). Students felt moderately to severely distressed when they observed a ward mate make sexually inappropriate remarks (81.7%), were pressured by a senior doctor to perform a procedure they did not feel qualified to do (77.1%), and observed a ward mate inappropriately touching a patient, family member, other staff, or student (71.9%). The thematic analysis based on nine in-depth interviews revealed the details of clinicians’ unprofessional behaviors towards patients, including verbal abuse, unconsented physical examinations, bias in clinical decisions, students’ inaction towards the dilemmas, and students’ perceived need for more guidance in applying bioethics and professionalism knowledge. Study findings provide medical educators insights into designing a professional development teaching that equips students with coping skills to deal with professionalism dilemmas.

Keywords: moral distress; professionalism; bioethics; medical student; medical education (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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