Iranian Journal of Medical Ethics and History of Medicine

Moral intelligence as a dimension of intelligence can provide a framework for the proper functioning of human. This function can be effective in the clinical environment such as dentistry. Therefore, the present study examined ethical intelligence of the first and sixth year dental students in the Tehran University of Medical Sciences. The present cross-sectional study was conducted in 2018 among 106 of the first and sixth year dental students. The students were selected by census sampeling and the Lennic & Kiel's Ethical Intelligence Questionnaire were used for data collection. The variables were analyzed by SPSS-Ver.22 software using descriptive and analytical statistical tests. Findings of the study indicate that there is no significant relationship between the ethical intelligence of the first and sixth year dental students. Also, in the first year students, only the indirect relationship between ethical intelligence and mother's education (P value = 0.026) and the level of household economic condition (P- value = 0.009) were found. In the sixth year students', only the direct relationship between ethical intelligence and the level of household economic condition was found (P -value = 0.015). This study showed that the ethical intelligence of dental students during education was not significantly improved, which indicates that the educational system not effecient on for promoting ethical intelligence of dental students.

Spiritual intelligence is a set of personal capacities that helps to adaptation and problem solving. The aim of this study was determining domains and construct validity of cultural and religious context of spiritual intelligence scale in Iranian students. In this mixed methodological study, we assessed the existing scales, and selected 62 items. Then we interviewed with 67 students and derived 42 items. We determined the scale construct validity by exploratory factor analysis with 1000 students' samples that were selected by stratified random sampling from universities. The ethics permission of study was obtained from ethical committee of Tehran university. Factor analysis reduced items number from 104 to 39. Among 10 dimensions in theoretical model, 7 dimensions explained the 60.21% of scale total variance. These dimensions were meaning perception and religious works effect; perception and extension of consciousness; perception of extraordinary phenomena superior than material being; existential critical thinking; personal meaning production ability; problem solving by using spiritual resources, and spiritual adaptation in interpersonal relationship. Inter items’ reliability was determined by internal consistency as 0.731 to 0.906 and the scale total reliability was 0.945. A 39 items’ spiritual intelligence scale with optimal psychometric properties and acceptable structural model based on Iranian religious and cultural practices can be used as a valid and reliable scale in community of Iranian students.
 

Nurses need to be familiar with the ethical issues of nursing and its sensitivity to all communications and interventions with patients. This sensitivity as a basis for nursing ethics should be considered from the beginning of nursing education. This study aimed to investigate the moral sensitivity of nursing students of Bushehr University of Medical Sciences. This descriptive cross-sectional study was conducted to determine the ethical sensitivity of 73 nursing students using standard questionnaire of ethical sensitivity of nurses in decision-making. Its validity and reliability were confirmed in previous studies (α=0.8). Dimensions of the questionnaire were: amount of respect for patient independence, level of knowledge about the relationship with the patient, level of professional knowledge, experience of difficulties and ethical conflicts, and the use of ethical concepts in ethical decision-making, honesty and benevolence. 0-50 were considered as low moral sensitivity, 50-75 as moderate, and 75-100 as high. All nursing students of the third and eighth semester were enrolled in the census in 2016. The average students' moral sensitivity was moderate (68.15±13.99). The highest average was for "honesty and benevolence", and the least for "professional knowledge" and "the use of ethical concepts in moral decision-making". The average moral sensitivity of the eighth semester students was higher than the third semester. There was a significantly relationship between students' moral sensitivity and academic term (p=0.000). Low ethical sensitivity in nurses leads to inappropriate decision-making; therefore, appropriate educational programs should be considered to increase the moral sensitivity of nurses and nursing students from the beginning of education.
 

Today, health care providers are moving toward becoming professionals, so only academic knowledge and skills are not enough in complex medical environments, morality is an integral part of medical decision making and paying no attention to it may have adverse effects on quality of care. This Research investigated the moral intelligence and its relative demographic factors between medical and nursing students. In this descriptive cross-sectional study, 214 students were selected by census sampling. Data were collected by using Kiel & lennik questionnaire which its reliability is reported as r=0.94 and has been validated in previous studies. The mean age of students was 21.79±2.82 years. The moral intelligence mean scores in medical and nurse students were 76.44±7.10 and 74.07±8.26, respectively. There was no significant relation between demographic factors and moral intelligence scores but there was significant difference among nursing and medical (p=0.025) and the first and last year students (p=0.002). Trustworthy domain was significantly higher in medical students (p=0.003). Although the results indicate that the students' moral intelligence score is in good condition, this situation can be upgraded to be very good and excellent. The significant difference in the score of moral intelligence in first and last year students shows the effect of educational curriculum. There was significant difference in the scores of medical and nursing groups. So, the educational climate and curriculums can effect on moral intelligence development. Therefore, considering the proven effect of moral intelligence on the quality of professional performance, ethical dimensions, and professionalism in clinical education should be emphasized, evaluated, and monitored more than ever.

Patient rights is one of the essential rights that should be considered by the medical staff, checking and comparing the attitudes of first and last year medical students to inform the ethical points of service delivery is important. The aim of this study was to compare and evaluate of first and last year medical students' attitude about respecting patients' rights in hospitals of Bushehr University of Medical Sciences. The present study was a descriptive, cross-sectional study carried out by using a questionnaire derived from Patient Right Charter approved by the Ministry of Health. The study population included all the first and last year of medical students of Bushehr University of Medical Sciences. The sample size was 113 and the sampling method was census. By using independent t-test and Pearson correlation, data analysis was performed by SPSS19 software. The attitude of first year students' was 76.36 ± 13.90 and among seniors was 71.63 ± 8.08, which was statistically significant (p<0.05). %52 of first and %84 of last year medical students had respectively and relatively favorable attitude regarding patients' rights. There was not statistically significant relationship between students' attitude and demographic factors. First year students had a better attitude among patient rights than the last year students. Therefore, planning to improve the students' attitude of observing patients' rights during the years of study is recommended.
 

Capacity, positive attitude, and proper nurses' function in dealing with death are greatly influenced by their religious beliefs. An important religious variable, the type of internal religious orientation (Implementing religious beliefs in all behaviors and practices) and the external (Using Religious Beliefs to Achieve Material Objectives). The purpose of this study was to investigate the relationship between religious orientation and nursing students' attitude towards death. The study had a cross-sectional correlational design, where 202 students from all nursing students were selected by random sampling in the academic year of 2017-2018. Data were collected via Allport Religious Orientation Questionnaire and the Standard Scale of Attitude toward Death (DAP-R) which were completed by participants after confirmation of validity and reliability and obtaining written consent from participants. Data were analyzed by SPSS version 18 software and independent t-test and Pearson correlation coefficient. Participants included 51.5% females, the average age was 21.7 years, 89.6% single, 95.5% undergraduates, 53% resident of the dormitory, 94.6% Shiite, and 50.5% had experience of seeing death. The average score of internal religious orientation was higher than that of the outside; and it was the same in both sexes. The difference between the mean score of internal orientation and the active acceptance of death was a positive correlation (P <0.001) and with avoidance of death, it had a significant negative inverse correlation (p= 0.01/0.17); Exterior orientation with fear of death and acceptance by escape had a significant positive correlation (P <0.001); the difference in mean score of both religious orientations was not significant in terms of gender, marital status, and religion (P>0.001). The difference between fear of death and avoidance of death and acceptance by escape based on gender, and in terms of admission or escape, having experience of seeing death, had a meaningful relationship (p=0.01). While there was no significant relationship between attitude toward death and family death experience (P>0.001). Findings show the type of religious orientation of nursing students and its relationship with people’s attitudes toward admission or escape from death; as the effective factor affecting the health of individuals and the quality of providing care for dying patients.

The white coat ceremonies are a recent phenomenon in medical education at the first steps of their education, that use as a symbol to impress upon medical students the importance of professionalism in medicine. This ceremony is known as one of the primary preparations for entrance of medical students to clinical courses. This study aims to investigate the effect of white coat ceremonies on professional ethics and student familiarity with their professional tasks in clinical departments. The present study is a qualitative study on the students' viewpoints regarding white coat ceremony and based on goal-based sampling. The statistical population included 4th-year medical students of Shiraz University of Medical Sciences in 1394. Data collection was done by a mixed method which one part of it was the half structural interview and another part by answering the open questions. Data collection continued to the saturation phase, furthermore; the data were analyzed by content analysis method according to the instructions. Most of the participants in this study considered holding a ceremony before entering the hospital as an important event for the readiness of students to go through a clinical course. The most important positive effects of white coat ceremony were increased students' commitment and accountability, improved interactions with patients, increased motivation and self-confidence, and familiarity with some of the basic principles of professional ethics. A white coat celebration can enhance the students' familiarity with their professional duties and motivations. More studies are needed to better understand the strengths, weaknesses, and shortcomings of this ritual.
 

Adherence to professional ethics based on spiritual intelligence is conducive to patient welfare and satisfaction. The purpose of this study was to determine the relationship between professional ethics and spiritual intelligence of Kerman University of Medical Sciences' students. In this descriptive co relational study, 150 undergraduate medical students were enrolled in the census. The tools used were spiritual intelligence and professional ethics questionnaires. Data were analyzed by SPSS version 22 using independent t-test, one-way ANOVA, and Pearson correlation coefficient. The mean and standard deviation of professional ethics score was 57.72±6.2 and the spiritual intelligence of students was 73.97±12 12.3. The lowest score of professional ethics was in the area of ​​responsibility and the most in sympathy with others. There was also a significant positive relationship between professional ethics scores and students' spiritual intelligence (P = 0.001). This means that by educating and enhancing students 'spiritual intelligence during their studies, one can expect to increase students' professional ethics during clinical work and professional communication with the patient. To this end, teachers' emphasis on aspects of ethical applied education, especially during clinical education, as well as honoring spiritual patterns as the foundation of ethical education during college education seems necessary.

The criminal responsibility of physicians and assistants is a complex area of ​​medical law. The purpose of this study was to investigate the responsibility of medical residents and medical students in performing diagnostic and therapeutic measures with case study of forensic medical files in Fars province from 2012 to 2017. In this study, 63 plaintiffs' cases were assessed, including 33 males (52.4%) and 30 females (47.6%). Most of the complainants were illiterate and under-graduate, and the least frequent was at doctoral level. Regarding the physical condition of the plaintiff (patient), the highest frequency was related to death ( 73%). Most of the complaints were from treatment group (95.2%) and physicians (4.8%). In terms of field of study, the field of obstetrics and gynecology (44.4%) included more complaints than other fields. In total, 26 (41.3%) cases were finally acquitted and 37 (58.7%) were convicted. The most common type of failure was neglect (91.9%). In this study, the highest frequency of associate education was related to senior resident (11.1%). Based on the results of the present study, medical errors were made by trainees (interns) and residents, specifying the criminal responsibilities of medical students and residents for errors and omissions and explaining their findings. Educational materials in each course are of particular importance. Additionally holding forensic courses and defining the legal and criminal responsibility for medical students are important for the improvement of treatment quality
 

Evaluating clinical performance of nursing students as a resource to determine educational needs and decision-making is essential to change the educational environment and improve the quality of education. The aim of this study was to evaluate the professional behavior of nursing students in the clinical environment with the Small Scale Professional Assessment Tool (P-MEX). This descriptive cross-sectional study was conducted with the participation of 86 nursing interns of Ahvaz University of Medical Sciences in 2019. Data collection tools were demographic information questionnaire and P-MEX Cruess evaluation form. The validity and reliability of this instrument was evaluated by observers and was determined with Cronbach's alpha coefficient of 76%. Data were analyzed using SPSS software version 20 and descriptive statistics, independent t-test, analysis of variance, and post hoc test. In professional skills, most participants in the first stage were 51.2% at the average and expected level and 48.8% above the expected level, and in the second stage, most were 84.9% at the average and expected level and 15.1% higher than they were as expected. In this study, based on the evaluation scores in two stages, although the average total clinical skills scores of most students were within the expected range of the 4-point Likert scale, the skill scores were lower in the special wards. Therefore, for the full development of professional skills, it is necessary to develop appropriate methods of planning and training in the field of professional behaviors.

Human is spiritual dimensions that has legal status in health and disease. The purpose of this study was to evaluate the knowledge of nursing and midwifery students about patient rights in Iran Universities of Medical Sciences teaching hospitals’ in 2017. This study was a descriptive cross-sectional study in 2017 with convenience sampling method. Data was collected by a three-part questionnaire including demographic information, Knowledge about the Patient Rights Charter, and strategies for student information to deal with patient rights. Mann-Whitney and Spearman tests were used for data analysis. A total of 1219 undergraduate students participated in this study. The mean score of students' awareness of the Patient Rights Charter was 13.54±4.45 out of 29 points. 1007 students (82.61%) reported that education about patient right was sufficient. Direct correlation was between patient knowledge awareness score with pre-internship training (r = 0.461) and learning from instructor information (r = 0.512) and there was a negative correlation between self-education (r = -0.151) and other methods of information acquisition (r = -0.067). Given that most students did not consider the educational content taught in the field of patient rights to be effective, it can be concluded that these methods were ineffective and failed to convey the correct information. Therefore, revising of the Patient Rights Curriculum for Nursing and Midwifery students is recommended