Comparative Study of Medical Ethics Curriculum in General Medicine Course in 10Selected Universities in the World

Saeedeh Mohammadifar, Leila Afshar



Background: The complexity of the current health system, the expansion of the range, and types of activities of the medical group members have caused the physicians to encounter daily with many ethical issues, and as a result, attention to the medical ethics curriculum in medical science
universities ,in line with the increasing advances in science, has  enhanced.The present study aimed to use the global experience through a comparative study of the medical ethics curriculum in a number of selected universities.
Methods: This study compares the medical ethics curriculum in selected medical schools based on the Bereday model. .The top 10 Medical School, based on the Times Higher Education ranking system(THE),were selected , and the results presented in four levels of description, interpretation, juxtaposition , and simultaneous comparison .
Results: This study showed that teaching medical ethics have various objectives in different medical schools and .A wide range of topics is taught in addition to using traditional teacher-centered strategies,
such as lectures, new and active educational methods, such as discussion in small groups, independent student studies, and role play have been used. For assessing the student’s knowledge, written exams
were the most used methods as well as measuring the students moral skills by self assessment tools and objective structured exams. Most of the medical schools adopted a multidisciplinary approach in teaching medical ethics.
Conclusion: this comparative study showed that the medical ethics curriculum should adopt a student centered strategy and multidisciplinary approach to strengthen medical student’s ethical reasoning and decision making.



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Nafisi A.Tarikhe akhlaghe pezeshki. Isfahan: Isfahan University ofMedical Sciences; 1992. (Book in Persian)

IsfahaniMM. Akhlaghe herfe’e dar khadamate behdashti va darmani. Tehran: Iran University of Medical Sciences; 1993. (Book in Persian)

Selvakumar D, Joseph LB. The importance of including bio-medical ethics in the curriculum of health education institutes. Educ Health (Abingdon). 2004;17:93-6. Doi: 10.1080/13576280310001656204

Fischer GS, Arnold RM. Measuring the effectiveness of ethics education. J Gen Intern Med. 1994;9:655-6. Doi: 10.1007/bf02600316

Miles SH, Lane LW, Bickel J, Walker RM, Cassel CK. Medical ethics education: Coming of age. Acad Med. 1989;64:705-14. Doi: 10.1097/00001888-198912000-00004

Swenson SL, Rothstein JA. Navigating the wards: Teaching medical students to use their moral compasses. Acad Med. 1996;71:591-4.Doi: 10.1097/00001888-199606000-00009

Fox E, Arnold RM, Brody B. Medical ethics education: Past, present, and future. Acad Med. 1995;70:761-9.Doi:10.1097/00001888-199509000-00013

Singer PA, Pellegrino ED, Siegler M. Clinical ethics revisited. BMC Med Ethics. 2001;2:E1. Doi: 10.1186/1472-6939-2-1

Aghazadeh A. Amoozesh va parvareshe tatbighi.Tehran: Payame Noor University; 2006. (Book in Persian)

Eckles RE, Meslin EM, Gaffney M, Helft PR. Medical ethics education: Where are we? Where should we be going? A review. Acad Med. 2005;80:1143-52. Doi:10.1097/00001888-200512000-00020

Lawlor R. Moral theories in teaching applied ethics. J Med Ethics. 2007;33:370-2. Doi: 10.1136/jme.2006.018044

Goldie JG. The detrimental ethical shift towards cynicism: can medical educators help prevent it? Med Educ. 2004;38:232-4. Doi: 10.1046/j.1365-2923.2004.01759.x

Gross ML. Medical ethics education: To what ends? J Eval Clin Pract. 2001;7:387-97. Doi: 10.1046/j.1365-2753.2001.00277.x

Claudot F, Alla F, Ducrocq X, Coudane H. Teaching ethics in Europe. J Med Ethics. 2007;33:491-5. Doi: 10.1136/jme.2006.017921

Roff S, Preece P. Helping medical students to find their moral compasses: Ethics teaching for second and third year undergraduates. J Med Ethics. 2004;30:487-9. Doi: 10.1136/jme.2003.003483

Derse AR. The evolution of medical ethics education at the Medical College of Wisconsin. Wmj. 2006;105:18-20.

Lapid M, Moutier C, Dunn L, Hammond KG, Roberts LW. Professionalism and ethics education on relationships and boundaries: Psychiatric residents’ training preferences. Acad Psychiatry. 2009;33:461-9. Doi: 10.1176/appi.ap.33.6.461

Al-Jalahma M, Fakhroo E. Teaching medical ethics: implementation and evaluation of a new course during residency training in bahrain. Educ Health (Abingdon). 2004;17:62-72. Doi:


Azizi F. Medical education: Mission, vision, and challenges. Tehran: Ministry of Health and Medical Education: 2003.(Book in Persian)

Sha`bani H. Maharthaye amoozeshi va parvareshi (Raveshha va fonoone tadris).1st ed. Tehran: SAMT; 2004. (Book in Persian)

Goldie J, Schwartz L, McConnachie A, Morrison J. Impact of a new course on students’ potential behaviour on encountering ethical dilemmas. Med Educ. 2001;35:295-302. Doi: 10.1111/j.1365-2923.2001.00872.x

Rogers J. Competency-based assessment and cultural compression in medical education: Lessons from educational anthropology. Med Educ. 2005;39:1110-7. Doi: 10.1111/j.1365-2929.2005.02317.x

Yamani N, Shater Jalali M. Curriculum integration, with emphasis on integration in medical education. Iranian Journal of Medical Education. 2012;11:1202-13. (Article in Persian)

Papa FJ, Harasym PH. Medical curriculum reform in North America, 1765 to the present: A cognitive science perspective. Acad Med. 1999;74:154-64. Doi:10.1097/00001888-199902000-00015

Calman KC, Downie RS. Practical problems in the teaching of ethics to medical students. J Med Ethics. 1987;13:153-6. Doi:10.1136/jme.13.3.153

Lehmann LS, Kasoff WS, Koch P, Federman DD. A survey of medical ethics education at U.S. and Canadian medical schools.Acad Med. 2004;79:682-9.Doi:10.1097/00001888-200407000-00015

Abbasi M. Tab’eenenaghshe pezeshk, amoozeshe pezeshki, sonnat vafarayande hoghooghi. In: Abbasi M. The articles on medical law. 2nd ed. Tehran: Hoghooghi Publication; 2000. (Book in Persian)

Silverberg LI. Survey of medical ethics in US medical schools: A descriptive study. J Am Osteopath Assoc. 2000;100:373-8.

Savulescu J, Crisp R, Fulford KW, Hope T. Evaluating ethics competence in medical education. J Med Ethics. 1999;25:367-74. Doi: 10.1136/jme.25.5.367

Rameshkumar K. Ethics in medical curriculum; Ethics by the teachers for students and society. Indian J Urol. 2009;25:337-9. Doi: 10.4103/0970-1591.56192

Goldie J, Schwartz L, McConnachie A, Morrison J. The impact of three years’ ethics teaching, in an integrated medical curriculum, on students’ proposed behaviour on meeting ethical dilemmas. Med Educ. 2002;36:489-97. Doi:10.1046/j.1365-2923.2002.01176.x

Thulesius HO, Sallin K, Lynoe N, Lofmark R. Proximity morality in medical school-medical students forming physician morality “on the job”: Grounded theory analysis of a student survey. BMC Med Educ. 2007;7:27. Doi: 10.1186/1472-6920-7-27

Buyx AM, Maxwell B, Schone-Seifert B. Challenges of educating for medical professionalism: Who should step up to the line? Med Educ. 2008;42:758-64. Doi:10.1111/j.1365-2923.2008.03112.x

Johnston C, Haughton P. Medical students’ perceptions of their ethics teaching. J Med

Ethics. 2007;33:418-22. Doi: 10.1136/jme.2006.018010

Post SG. Encyclopedia of bioethics. New York: Macmillan Reference USA; 2004.

Singer PA. Strengthening the role of ethics in medical education. CMAJ. 2003;168:854-5.

Khaghanizadeh M, Maleki H, Abbasi M, Abbaspour A, Mesri M. The challenges of medical ethics curriculum: A qualitative study of instructors view. J Med Ethics Hist Med. 2012;5(2):70-9.(Article in Persian)

Malekahmadi P, Parsa P. Development of strategies for advancement of medical ethics education in Isfahan University of Medical Sciences. Iranian Journal of Medical Education. 2013;12:854-65. (Article in Persian)

Taboli H, Rezaeian M. Development of medical ethics strategies in Rafsanjan University of Medical Sciences. Journal of Rafsanjan University of Medical Sciences. 2010;9:195-209.(Article in Persian)

Dinc L, Gorgulu RS. Teaching ethics in nursing. Nurs Ethics. 2002;9:259-68. Doi:10.1177/096973300200900305

Borhani F, Abbaszadeh A, Mohsenpour M. Barrier to acquiring ethical sensitivity: Perceptions of nursing students. Medical Ethics Journal. 2011;5(15):83-104. (Article in Persian)


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