Avaliação da competência moral de estudantes de Medicina

Abstract

Introduction: the medical ethics study has been highly appreciated in recent curricular platforms, aligned to integral and humanistic training. However, there are gaps about the teaching and assessment strategies. Several authors suggest stagnation or regression of moral judgment during medical graduation, mostly evaluated from the perspective of cognitive-evolutionary theories. The Moral Competence Test (MCT) of Lind is highlighted to assess "the capacity to make decisions and judgments which are moral (i.e., based on internal principles) and to act in accordance with such judgments", including cognitive and affective aspects of morality. Objective: 1) to evaluate the moral competence of medical students; 2) comparing differences in students' moral competence at different times of the course; 3) identify sociodemographic, curricular, academic and extracurricular aspects related to students' moral competence; 4) discuss the application of evaluation instruments of moral competence among students. Methods: cross-sectional quantitative study with 139 students from the 1st and 5th semesters and the last year of the medical course. Two questionnaires were applied: the MCTxt (extended version of MCT, with three dilemmas, in portuguese) and other with sociodemographic, academic and extracurricular data. Statistical analyses were performed by ANOVA and by linear regression model, considering statistical significance level p <0.05. Results: the mean MCTxt C-total scores were low in the three periods evaluated, ranging from 15.7 in the 1st period to 11.0 in the last year, and the mean scores in the 1st period were statistically higher than the others in the univariate analysis. However, in the multivariate analysis of correlation between periods, dilemmas and scores, it was observed that the mean C-segmented score for the dilemmas of the worker and the judge were similar and statistically superior to the doctor, regardless of the period, and this last one influenced negatively the overall score. No significant correlation was detected between sociodemographic, academic and extracurricular evaluated variables with the moral competence score. Conclusions: the study has identified mean scores of MCT low in all evaluated periods with regression or stagnation of moral competence during the medicine course; it has detected an offbeat and lower performance of "doctor's dilemma", characterizing the "segmentation phenomenon" of MCT, and identified no significant correlation of sociodemographic, curricular and extracurricular variables with the final score of moral competence