Impact of a new course on students' potential behaviour on encountering ethical dilemmas

Objective: To evaluate the effectiveness of small-group ethics teaching in an integrated medical curriculum. Design: A quasi-experimental, pre- and post-test, non-equivalent control group design. Setting: University of Glasgow Medical School. Subjects 111 first-year students from Glasgow University's new learner-centred medical curriculum, with a control group of 51 students from the last year of the traditional curriculum. Main outcome measure Student answers consistent with consensus professional judgement on the ethical dilemmas posed by the vignettes of the Ethics and Health Care Survey Instrument. Results: There was a significantly greater increase in the number of post-test consensus answers in the experimental group (P = 0.0048): the odds ratio for obtaining the post-test consensus answer in the experimental group compared with the control group was 1.73 (95% confidence interval 1.28-2.33). Significant movement towards consensus occurred in the areas of autonomy, confidentiality and consent. Among controls there was a significant move away from consensus in the area of 'whistle blowing' on colleagues (P = 0.017). Conclusion: Small-group ethics teaching, in an integrated medical curriculum, had a positive impact on the first-year students' potential ethical behaviour. It was more effective than a lecture and a large-group seminar-based course in developing students' normative identification with the profession of medicine.