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      Exploring medical ethics’ implementation challenges: A qualitative study

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          Abstract

          BACKGROUND:

          Adherence to medical ethics principles by medical professionals is required to improve health-care system's quality. Recognizing medical ethics' challenges and attempting to resolve them are important in the implementation of medical ethics in practice. This study aimed to explore such challenges at Iran's medical sciences universities in 2018.

          MATERIALS AND METHODS:

          This descriptive, qualitative study utilized a conventional content analysis approach for data analysis. This study was conducted using purposeful sampling from participants with experience in teaching or practicing of medical ethics field, and by considering maximum variety of disciplines (e.g., gynecology, internal medicine, surgery, and medical ethics). The data were gathered using semi-structured interviews. The interview guide was designed based on previous research findings by two members of the research team and contained the main interview questions and participants had the opportunity to express their perspectives in detail. Participants were chosen from clinical and ethical faculty members as well as managers. The data collection process continued until the data saturation stage, beyond which no new information or concept achieved by continuing interviews.

          RESULTS:

          After interviewing 14 faculty members and managers, findings were classified into 4 themes, 9 categories, and 42 sub-categories; four main categories of medical ethics challenges are affected by cognitive, educational, practical, and structural factors, respectively.

          CONCLUSION:

          This study suggested that medical ethics' cognitive and educational challenges can alleviate using educational programs intended for improving qualitative and quantitative aspects of medical ethics teaching for medical professionals ranging from students to faculty members. Medical ethics' structural and practical challenges are within policymaking and scheduling activities dealt with through future researches by health-care system's managers and planners.

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          Most cited references36

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          A hands-on guide to doing content analysis

          There is a growing recognition for the important role played by qualitative research and its usefulness in many fields, including the emergency care context in Africa. Novice qualitative researchers are often daunted by the prospect of qualitative data analysis and thus may experience much difficulty in the data analysis process. Our objective with this manuscript is to provide a practical hands-on example of qualitative content analysis to aid novice qualitative researchers in their task.
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            Role modeling in physicians' professional formation: reconsidering an essential but untapped educational strategy.

            Forming technically proficient, professional, and humanistic physicians for the 21st century is no easy task. Mountains of biomedical knowledge must be acquired, diagnostic competence achieved, effective communication skills developed, and a solid and applicable understanding of the practice and role of physicians in society today must be reached. The central experience for learners in this complex and challenging terrain is the "modeling of" and "learning how to be" a caregiver and health professional. Role modeling remains one crucial area where standards are elusive and where repeated negative learning experiences may adversely impact the development of professionalism in medical students and residents. The literature is mainly descriptive, defining the attributes of good role models from both learners and practitioners' perspectives. Because physicians are not "playing a role" as an actor might, but "embodying" different types of roles, the cognitive and behavioral processes associated with successfully internalizing roles (e.g., the good doctor/medical educator) are important. In this article, the authors identify foundational questions regarding role models and professional character formation; describe major social and historical reasons for inattention to character formation in new physicians; draw insights about this important area from ethics and education theory (philosophical inquiry, apprenticeship, situated learning, observational learning, reflective practice); and suggest the practical consequences of this work for faculty recruitment, affirmation, and development.
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              Role modelling--making the most of a powerful teaching strategy.

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                Author and article information

                Journal
                J Educ Health Promot
                J Educ Health Promot
                JEHP
                Journal of Education and Health Promotion
                Wolters Kluwer - Medknow (India )
                2277-9531
                2319-6440
                2021
                27 February 2021
                : 10
                : 66
                Affiliations
                [1 ] Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
                [2 ] Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
                [3 ] Department of Medical Education, Education Development Center, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran
                [4 ] Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
                [5 ] Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
                [6 ] Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
                [7 ] Endocrinology and Metabolism Research Center, Medical Ethics and History of Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                Address for correspondence: Prof. Bagher Larijani, Endocrinology and Metabolism Research Institute, Jalal Ale Ahmad, Tehran 14114, Iran. E-mail: emrc@ 123456tums.ac.ir , larijanib@ 123456tums.ac.ir
                Article
                JEHP-10-66
                10.4103/jehp.jehp_766_20
                8057159
                34084813
                a1419644-5121-48f9-83aa-a127ec147ed2
                Copyright: © 2021 Journal of Education and Health Promotion

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 01 July 2020
                : 18 July 2020
                Categories
                Original Article

                health-care system,medical ethics,qualitative research,teaching

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