While there is significant consensus that undergraduate medical education (UME) should include bioethics training, there is widespread debate about how to teach bioethics to medical students. Educators disagree about course methods and approaches, the topics that should be covered, and the effectiveness and metrics for UME ethics training. One issue that has received scant attention is the timing of bioethics education during medical training. The existing literature suggests that most medical ethics education occurs in the pre-clinical years. Follow-up studies indicate that medical students in their clinical rotations have little recall or ability to apply ethics concepts that were learned in their pre-clinical training. Trainees also report a desire for medical ethics to be taught in the context of practical application, which would suggest that the timing of pre-clinical ethics education is flawed. However, moving bioethics training to the clinical years should not be assumed to be the solution to the problems of recall and theory application. We argue that the effectiveness of timing bioethics education will depend on when medical students witness or experience particular categories of ethical dilemmas during their training. Our overarching hypothesis is that ethics education will be most effective when the bioethics training on a particular topic correlates to experiential exposure to that ethical issue. The purpose of our current study was to describe medical students exposure to particular categories of ethical conflicts, dilemmas, or issues. Our results may help bioethics educators better strategize about the most effective timing of medical ethics training in UME.

中文翻译：

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医学生在临床培训中暴露于伦理冲突：对 UME 生物伦理学教育时机的影响

虽然本科医学教育 (UME) 应包括生物伦理学培训已成为共识，但关于如何向医学生教授生物伦理学存在广泛争论。教育工作者对课程方法和方法、应涵盖的主题以及 UME 道德培训的有效性和指标存在分歧。一个很少受到关注的问题是医学培训期间生物伦理教育的时机。现有文献表明，大多数医学伦理教育发生在临床前几年。后续研究表明，临床轮换中的医学生几乎没有回忆或应用在临床前培训中学到的伦理概念的能力。受训者还报告希望在实际应用的背景下教授医学伦理学，这表明临床前伦理教育的时机存在缺陷。然而，不应假定将生物伦理学培训转移到临床年是解决回忆和理论应用问题的方法。我们认为，时机生物伦理学教育的有效性将取决于医学生在培训期间何时见证或经历特定类别的伦理困境。我们的总体假设是，当特定主题的生物伦理学培训与该伦理问题的经验暴露相关时，伦理教育将是最有效的。我们当前研究的目的是描述医学生面临特定类别的道德冲突、困境或问题。