Honghe Li1, Dennis H Novack2, Pamela Duke2, Edward Gracely3, Christina Cestone2, Tiffany Davis2. 1. Institute for International Health Professions Education and Research, China Medical University, Shenyang, China; Cambridge Health Alliance, Harvard Medical School, Cambridge, USA. Electronic address: hhli@cmu.edu.cn. 2. Office of Educational Affairs, Drexel University College of Medicine, Philadelphia, USA. 3. Family Community and Preventive Medicine, Drexel University College of Medicine, Philadelphia, USA.
Abstract
OBJECTIVE: To understand medical students' (MS) ethical decision-making using the Theory of Interpersonal Behavior (TIB). METHODS: We conducted two rounds of focus groups to develop a TIB-based questionnaire by eliciting students' perspectives on an ethical dilemma they will encounter in a standardized patient (SP) station, in which an SP "surgeon" asked them to intubate a sedated patient whom the student knew had requested no student involvement. We administrated questionnaires to 241 third-year MS following this SP station, asking for their decisions in the SP station and if a surgeon made the same request in their clerkship. Confirmatory factor analysis (CFA) was used to test whether observed data fit the proposed TIB-based model. RESULTS: The CFA provided an acceptable fit to the a priori proposed model. Fifty-five percent of students indicated they would intubate in an actual situation versus 18% in the SP station (p < 0.05). Using logistic regression, TIB domains affect and facilitating factors reported significant association with students' decisions in both the SP and hypothesized actual situations. CONCLUSIONS: The TIB appears to be an effective theoretical framework for explaining students' ethical decision-making. PRACTICE IMPLICATIONS: The TIB may guide design and assessment of educational programs for professional formation.
OBJECTIVE: To understand medical students' (MS) ethical decision-making using the Theory of Interpersonal Behavior (TIB). METHODS: We conducted two rounds of focus groups to develop a TIB-based questionnaire by eliciting students' perspectives on an ethical dilemma they will encounter in a standardized patient (SP) station, in which an SP "surgeon" asked them to intubate a sedated patient whom the student knew had requested no student involvement. We administrated questionnaires to 241 third-year MS following this SP station, asking for their decisions in the SP station and if a surgeon made the same request in their clerkship. Confirmatory factor analysis (CFA) was used to test whether observed data fit the proposed TIB-based model. RESULTS: The CFA provided an acceptable fit to the a priori proposed model. Fifty-five percent of students indicated they would intubate in an actual situation versus 18% in the SP station (p < 0.05). Using logistic regression, TIB domains affect and facilitating factors reported significant association with students' decisions in both the SP and hypothesized actual situations. CONCLUSIONS: The TIB appears to be an effective theoretical framework for explaining students' ethical decision-making. PRACTICE IMPLICATIONS: The TIB may guide design and assessment of educational programs for professional formation.