Education of Medical Ethics in medicine

在日本的医学院里，医学伦理学被作为一项医学原则来教授。但如何在实践中教授决策，这对医学生来说是一个两难的问题，目前还不清楚。因此，我们对日本的80所医学学校进行了全国性的调查，以找出目前医学伦理学教学中存在的问题。我们询问了学生在医学院学习医学伦理学的方式和时间，以及一到六年级和研究生的学习目标、成就目标、内容和课程。对医学院教育事务的初步研究(回复率为99%)表明，医学伦理学最有可能在最低年级(60.3%)教授，较不可能在高年级(分别为11%)教授。只有28%的医学伦理学讲师熟悉整个医学伦理学课程，只有15所医学院进行了跨院系教学。讲师对医学…教学体系的满意度在医学生中，“在床边教学中引入医德元素”与医德有较高的相关性。医学伦理学教学内容的充分性与“与临床医生讨论”有关，根据讲师的专业调整Logistic回归模型，认为医学伦理学教学应针对低年级学生，从小组讨论、案例研究和视觉辅助材料中对医学伦理学感兴趣开始，而不是只听讲课。在高年级，引入更多的现实案例，培养医疗保健中的伦理感，即临床伦理，对于建立医患信任关系，掌握沟通技能，管理风险具有重要意义。尽管最近在实践中对医学道德的认识有所增加，但用于医学院教学的人力资源仍然稀缺和不足。然而，在日本，医学伦理学的教学，特别是临床伦理学的教学，以及教师的教学和终身教育，都应该得到更多的重视。较少

Medical ethics is taught as a principle of medicine at medical schools in Japan. But it is not clear that how to teach decision making in practice which involves ethical dilemmas for medical students. Therefore, we conducted a national survey of 80 medical schools in Japan to identify the current issues in teaching medical ethics. We enquired how and when students learned medical ethics at medical school and also the objectives, achievement goals, contents and curricula for 1st to 6th grade and postgraduate studies.Preliminary study of educational affairs at the faculty of medicine (response rate 99%) showed that medical ethics is most likely to be taught in the lowest grade (1st year 60.3%) and less likely to be taught in the upper grades (5th-6th grade 11%,respectively). Only 28% of lecturers who teach medical ethics are familiar with the whole curriculum of medical ethics and only 15 medical schools had cross-faculty teaching. Lecturer's satisfaction for the system of teaching medic … More al ethics at medical school was related with 'introducing the element of medical ethics in bed-side teaching'. Sufficiency of contents for teaching medical ethics was associated with 'being discussed with clinicians' with logistic regression model adjusted by lecturer's specialty.It was indicated that teaching medical ethics should aim to have a discipline for the students in lower grades, starting from having an interest in medical ethics in group discussion, case study, and visual aids, rather than listening to lectures only. In the upper grades, introducing more realistic cases to cultivate the sense of ethics within healthcare, namely clinical ethics, is important to build relationship of trust between patients and doctors, acquire communication skill, and managing the risk. Despite the recent increased recognition of medical ethics in practice, the human resources for teaching at medical schools are scarce and insufficient. However, teaching medical ethics, especially clinical ethics should be more emphasized in Japan, along with teacher's teaching and career-long education. Less