RESUMEN
PURPOSE: To assess the effect of a class in medical ethics on first-year medical students. METHOD: A test instrument was developed to measure the attitudes of medical students toward certain ethical questions and to assess their factual knowledge regarding particular legal and ethical issues. The instrument was administered in 1992-93 to 110 first-year students at the University of Virginia School of Medicine before and after the students took a required course in medical ethics. The instrument employed clinical vignettes as well as multiple-choice, true-false, and Likert-scale questions. Its reliability and validity were assessed. RESULTS: The required course in medical ethics had little influence on the students. There was only one significant change (p = .05) in the pattern of responses to any of the clinical vignettes. In a few of the attitude-oriented queries, there were statistically significant changes (p < .05) after the course. Although there were statistically significant changes for only four of the factual-knowledge questions, for all such questions more students identified the correct answers after the class (before the course the range of correct answers was 43% to 99% compared with 64% to 100% after the course). CONCLUSION: The class in medical ethics seemed to have little effect on the first-year students, probably because students arrive at medical school with well-established ethical perspectives.
Asunto(s)
Actitud , Educación de Pregrado en Medicina , Evaluación Educacional , Ética Médica , Estudiantes de Medicina/psicología , Adulto , Discusiones Bioéticas , Comprensión , Curriculum , Femenino , Humanos , Masculino , Desarrollo Moral , Estudios Prospectivos , Valores SocialesRESUMEN
The results of conservative surgical treatment of tubal pregnancy (salpingotomy in 10 cases, partial salpingectomy and anastomosis in two cases) were compared with radical treatment in seven cases. The subsequent pregnancy rate was 55% and 71% for the conservative and radical groups, respectively. There were no recurrent tubal pregnancies in either group. Prior presence of pelvic adhesions did not have an effect on fertility in these patients. The rate of multiparity was significantly higher in patients who became pregnant after the surgery than those patients who did not become pregnant.