Understanding the clinical dilemmas that shape medical students' ethical development: questionnaire survey and focus group study.

During the past 30 years new medical technologies and public concern about medical ethics have led medical schools in Europe and North America to increase their teaching of formal ethics considerably. Most of this teaching focuses on dilemmas that students may face in their future practice, rather than the ethical problems they encounter as medical students. Several studies and editorials suggest that students’ clinical experiences constitute an informal or “hidden” ethics curriculum, which can undermine their developing professionalism. Clinical teachers who act as negative role models, especially those who show unethical behaviour towards patients, is the most frequently cited problematic aspect of this hidden curriculum. Previous studies have focused on the prevalence of ethical dilemmas as perceived by students, rather than the nature of the dilemmas that students encounter. 5 Our study’s premise was that the prevalence and the nature of medical students’ ethical dilemmas need to be recognised and understood as a first step in resolving them.