0803-Knowledge, Opinions, Attitudes, and Practice of Medical Ethics among Medical Students

Paper presented by Professor Omar Hasan Kasule, Sr. at the Institute of Medicine, University of Brunei, Brunei Darussalam



This papers reports results of a cross sectional self-administered questionnaire study on ethical knowledge among medical students at the Institute of Medicine of Universiti Brunei Darussalam. The primary objective of the research was to establish the general level of knowledge and understanding medical students to provide a baseline that can be used to assess student progress as they move through the medical course. The results of data analysis would be used in refining the design of the ethico-legal section of the undergraduate medical curriculum. The questionnaire had previously been used in a similar study [1]. The questionnaire had a total of 40 scenarios distributed as follows: knowledge of ethics 8 (4 general and 4 Islamic), attitude & practice 21 (15 general and 6 Islamic), and opinions 11 (Islamic). After explaining the aims and procedures of the study as well as obtaining written consent, students were asked to complete and return the questionnaire. Students had to choose the best of 3-4 alternative solutions for the ethical dilemma in each scenario. Each alternative had, unknown to the student, an embedded interpretation based on general and Islamic ethical principles. The interpretation was the one coded for statistical analysis. Knowledge scenarios were coded as ‘do know’, ‘do not know’, ‘not sure’, or ‘avoid. Attitude and practice alternatives were coded as ‘avoid’, ‘take action’, ‘refer’, or ‘report’. Opinion alternatives were coded as ‘acceptable’, ‘not acceptable’ or ‘not sure’. SPSS and STATA statistical packages were used for data management and data analysis. Proportions were computed with 95% confidence intervals. Cross tabulations were made and associations were tested using Fisher’s exact test because of the small numbers. Twenty nine out of a study population of 30 students returned questionnaires. The gender distribution was 14 males and 15 females. There was no significant variation of gender by year of study. The results for general scenarios were as follows: (a) knowledge:  ‘do know’ 54.9%, ‘do not know’ 44%, and ‘not sure’ 11%; (b) attitude and practice: ‘avoid’ 10.3%, ‘take action’ 64.8%, ‘refer’ 7.9%, or ‘report’ 17.0%. The results for Islamic scenarios were as follows: (i) knowledge: ‘do know’ 54.4%, ‘do not know’ 21%, ‘not sure’ 14.5%, ‘avoid’ 2.4% or ‘refer’ 7.7%; (ii) attitude and practice:  ‘avoid’ 1.6%, ‘take action’ 85.9%, ‘refer’ 10.8%, or ‘report’ 1.6%; and (iii) opinions: ‘acceptable’ 80.1%, ‘not acceptable’ 17.2% or ‘not sure’ 2.6%. Year of study, gender, and ethnicity had no significant statistical effect on ethics KAP. Several conclusions can be drawn from the preliminary analysis pending confirmation in larger studies. The conclusion from the analysis is the proportion of students with expected knowledge of ethics was about 55%. Students are more likely to confront ethical dilemmas to find a solution than they are likely to avoid them, report them, or refer them to someone else. The proportions preferring taking action were 64.8% for general scenarios and 85.9% for Islamic scenarios. Ethical opinions were in high agreement with Islamic ethical principles.

1. Naznin Muhammad et al. The impact of the teaching of medical ethics in the medical and allied health sciences curriculum in International Islamic University Malaysia. Paper being submitted to the International Medical Journal (personal communication)



Key words: ethics knowledge medical students

ŠProfessor Omar Hasan Kasule, Sr. March, 2008