Advances in Health Sciences Education

, Volume 18, Issue 5, pp 1067–1085 | Cite as

Moral judgment competence of medical students: a transcultural study

  • Helvécio Neves Feitosa
  • Sergio Rego
  • Patricia Unger Raphael Bataglia
  • Karlos Frederico Castelo Branco Sancho
  • Guilhermina Rego
  • Rui Nunes
Article

Abstract

The authors conducted a cross-sectional short-term study using Lind’s Moral Judgment Test (MJT) to compare moral judgment competence (C-score) among students from a medical school in the Northeast region of Brazil and a medical school in the Northern region of Portugal. This study compares the C-scores of groups in the first and eighth semesters of study within each medical school and groups from corresponding semesters between the two medical schools. This study also evaluates the influence of such factors as age and gender on moral competence. A regression of moral judgment competence among the students in their eighth semester versus the students in the first semester of Brazilian medical school (p < 0.001) and a stagnation of moral competence among students in their eighth semester versus the first semester students in the Portuguese medical school (p = 0.06) were observed. For both the first semester and eighth semester groups, the students in the Portuguese medical school had higher C-scores than the students in the Brazilian medical school. In the analysis of the students’ performances in terms of MJT dilemmas, the phenomenon of “moral segmentation” was observed in all of the groups, and the students performed better on the worker’s dilemma than on the doctor’s dilemma. Among students in the same semester of study, older students had lower C-scores. There was generally no significant difference between men’s and women’s C-scores.

Keywords

Medical education Medical students Moral development Moral judgment competence Moral judgment test Undergraduate medical education 

References

  1. Bataglia, P. U. (2001). A construção da competência moral e a formação do psicólogo [The development of moral competence and the training of psychology students] Unpublished doctoral dissertation.Google Scholar
  2. Bataglia, P. U. (2010). A validação do Teste de Juízo Moral (MJT) para diferentes culturas: o caso brasileiro [Proof of the Moral Judgment Test (MJT) for different cultures: The Brazilian case]. Psicologia: reflexão e crítica 23(1), 83–91.Google Scholar
  3. Bataglia, P., Agati, M. M., Torres, S. S., Crivelaro, D. B., Oliveira, D. D., & Quevedo, T. L. (2002). The development of moral competence and religious commitment in Brazil. Paper presented at the meeting of the Association for Moral Education, Chicago.Google Scholar
  4. Bataglia, P., Schillinger-Agati, M., Lind, G., & Quevedo, T. L. (2003). Testing the segmentation hypothesis with extended version of the MJT. Poster presented at the meeting of the Association for Moral Education, Krakow, Poland.Google Scholar
  5. Cohen, J. (1988, 2009). Statistical power analysis for the behavioral sciences, 2nd ed.Google Scholar
  6. Colby, A., Kohlberg, L., & Speicher, B. (1987, 2010). The measurement of moral judgment (Vols. I and II).Google Scholar
  7. Gilligan, C. (1982). Uma voz diferente: psicologia da diferença entre homens e mulheres da infância à idade adulta [A different voice: A psychological theory on the difference between men and women from childhood to adulthood].Google Scholar
  8. Hren, D., Marusic, M., & Marusic, A. (2011). Regression of moral reasoning during medical education: combined design study to evaluate the effect of clinical study years. PLoS ONE, 6(3), e17406.CrossRefGoogle Scholar
  9. Kauffmann, K. (2010). Theoretical introduction to the measurement of moral judgment. In Colby, A., Kohlberg, L., & Hewer, A. et al. (Eds.), The measurement of moral judgment: Theoretical foundations and research validation (Vol. I.1–61).Google Scholar
  10. Kohlberg, L. (1964). Development of moral character and moral ideology. In Hoffman, L. M, & Hoffman, L. W. (Eds.), Review of chid development research (Vol. I.383–431).Google Scholar
  11. Kohlberg, L. (1980). Stages of moral development as a basis for moral education. In B. Munsey (Ed.), Moral development, moral education and Kohlberg: Basic issues in phylosophy, psychology, and Educatin (pp. 15–98). Birmingham: Religious Education Press.Google Scholar
  12. Kohlberg, L. (1984). The psychology of moral development: Essays on moral development (Vol. 2).Google Scholar
  13. Lind, G. (2000a). The importance of role-taking opportunities for self-sustaining moral development. Journal of Research in Education 10, 9–15. Retreived September 20, 2012 from http://www.uni-konstanz.de/ag-moral/pdf/Lind-2000_Selfsustaining-moral-development.pdf.
  14. Lind, G. (2000b). Moral regression in medical students and their learning environment. Revista Brasileira de Educação Médica 24(3), 24–33. Retreived September 20, 2012 from http://www.uni-konstanz.de/ag-moral/pdf/Lind-2000_Moral_Regression_in_Medical_Students.pdf.
  15. Lind, G. (2005a). The cross-cultural validity of the Moral Judgment Test (MJT): Confirmation of 17 cross-cultural adaptations. Paper prepared for the MOSAIC conference in Konstanz - Germany, July 20th–22nd.Google Scholar
  16. Lind, G. (2007). La moral puede enseñarse: manual teórico-práctico de la formación moral y democrática [Morals can be taught: A practical-theoretical manual of ethical and democratic training].Google Scholar
  17. Lind, G. (2010). Scoring and interpretation the Moral Judgment Test (MJT), Moralisches Urteil-Test (MUT): An Introduction. Retreived January 15, 2012 from http://www.uni-konstanz.de/ag-moral/mut/mjt-intro.htm.
  18. Lind, G. (2011). Promoviendo las competencias morales y democráticas: expresarse y escuchar a otros [Promoting moral and democratic competence: expressing oneself and listening to others]. Postconvencionales 3, 26–41. Retreived September 20, 2012 from http://www.uni-konstanz.de/ag-moral/pdf/Lind-2011_Promoviendo_las_competencias_morales_y_democraticas.pdf.
  19. Lind, G., Bataglia, P., & Schillinger, M. (2005c). Certified foreign languages of the Moral Judgment Test (MJT). Retreived January 3, 2012 from http://www.uni-konstanz.de/ag-moral/mut/mjt-certification.htm#certified_versions.
  20. Lind, G., Bataglia, P., Schillinger-Agati, M., & Menezes, R. (2005b). Certified foreign languages of the Moral Judgment Test (MJT). Volume Retreived January 3, 2012 from http://www.uni-konstanz.de/ag-moral/mut/mjt-certification.htm#certified_versions.
  21. Lind, G., & Wakenhut, R. (1985). Moral development and social environment. pp 79–105.Google Scholar
  22. Moreno, C. (2005). Moral education in higher education and the transformation of a concern: A historical account: Paper presented at The Annual Meeting of the Association for Moral Education Cambridge, MA. Retreived January 18, 2012 from http://www.uni-konstanz.de/ag-moral/material/artikel/_MJT/Moreno-2005_moral-education-in-mexico.pdf
  23. National Conference on Education. (2001). Resolution CNE/CES no 04 - Nov 7 2001: Diretrizes Curriculares Nacionais para o Curso de Graduação em Medicina [Brazilian National Curriculum Guidelines for Undergraduate Studies in Medicine]. Retreived March 19, 2012 from http://portal.mec.gov.br/cne/arquivos/pdf/CES04.pdf
  24. Rego, S. (2003). A formação ética dos médicos: saindo da adolescência com a vida (dos outros) nas mãos [Ethical training of doctors: Leaving adolescence behind with the life (of others) in one’s hands].Google Scholar
  25. Rego, S., Gomes, A. P., & Siqueira-Batista, R. (2008). Bioética e humanização como temas transversais na formação médica[Bioethics and humanization as cross-sectional themes]. Revista Brasileira de Educação Médica, 32, 482–491.CrossRefGoogle Scholar
  26. Rego, S., & Schillinger-Agati, M. (2011). Educação médica: gestão, cuidado, avaliação [Medical education: Management, care, evaluation] pp 114–130Google Scholar
  27. Rest, J., Narvaez, D., Bebeau, M. J., & Thoma, S. J. (1999). Postconventional moral thinking: A Neo-Kohlbergian approach.Google Scholar
  28. Schillinger, M. (2006). Learning environment and moral development: How university education fosters moral judgment competence in Brazil and two German-speaking countries.Google Scholar
  29. Schillinger-Agati, M., & Lind, G. (2003). Moral judgment competence in Brazilian and German university students. Paper presented at the Annual Meeting of the American Education Research Association Retrieved January 18, 2012 from http://www.uni-konstanz.de/ag-moral/pdf/Schillinger-Lind-2003_moral-development-Brazil.pdf
  30. Schwartman, S. (2004). Equity, quality and relevance in higher education in Brazil. Anais da Academia Brasileira de Ciências, 26(1), 173–188.CrossRefGoogle Scholar
  31. Self, D. J., Baldwin, B. a., & DC, D. C. (1994a) Moral development in professions: Psychology and applied ethics (pp 147–162)Google Scholar
  32. Self, D. J., & Olivarez, M. (1993). The influence of gender on conflicts of interest in the allocation of limited critical care resources: justice vs care. Journal of Critical Care, 8(1), 64–74.CrossRefGoogle Scholar
  33. Self, D. J., Olivarez, M., & Baldwin, D. C. (1994b) Moral development in professions: Psychology and applied ethics (pp. 163–172)Google Scholar
  34. Self, D. J., Olivarez, M., & Baldwin, D. C. (1998a). The amount of small-group case-study discussion needed to improve moral reasoning skill of medical students. Academic Medicine, 73(5), 521–523.CrossRefGoogle Scholar
  35. Self, D. J., Olivarez, M., & Baldwin, D. C. (1998b). Clarifying the relationship of medical education and moral development. Academic Medicine, 73(5), 517–520.CrossRefGoogle Scholar
  36. Self, D. J., Schrader, D. E., Baldwin, D. C., & Wolinsky, F. D. (1991). A pilot study of the relationship of medical education and moral development. Academic Medicine, 66, 629.CrossRefGoogle Scholar
  37. Slovácková, B., & Slovácek, L. (2007). Moral judgment competence and moral attitudes of medical students. Nursing Ethics, 14(3), 319–328.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Helvécio Neves Feitosa
    • 1
    • 2
    • 3
  • Sergio Rego
    • 4
  • Patricia Unger Raphael Bataglia
    • 5
  • Karlos Frederico Castelo Branco Sancho
    • 1
  • Guilhermina Rego
    • 3
  • Rui Nunes
    • 3
  1. 1.Fortaleza University (UNIFOR)FortalezaBrazil
  2. 2.Federal University of Ceará (UFC)School of MedicineFortalezaBrazil
  3. 3.Doctoral Program in Bioethics, University of Porto (FMUP)School of MedicinePortoPortugal
  4. 4.Sergio Arouca National School of Public HealthOswaldo Cruz FoundationRio de JaneiroBrazil
  5. 5.School of Philosophy and Science – Campus: MaríliaSão Paulo State UniversitySão PauloBrazil

Personalised recommendations