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      Establishment of medical education upon internalization of virtue ethics: bridging the gap between theory and practice

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          Abstract

          During medical training, students obtain enough skills and knowledge. However, medical ethics accomplishes its goals when, together with training medical courses, it guides students behavior towards morality so that ethics-oriented medical practice is internalized. Medical ethics is a branch of applied ethics which tries to introduce ethics into physicians’ practice and ethical decisions; thus, it necessitates the behavior to be ethical. Therefore, when students are being trained, they need to be supplied with those guidelines which turn ethical instructions into practice to the extent possible. The current text discusses the narrowing of the gap between ethical theory and practice, especially in the field of medical education.

          The current study was composed using analytical review procedures. Thus, classical ethics philosophy, psychology books, and related articles were used to select the relevant pieces of information about internalizing behavior and medical education. The aim of the present study was to propose a theory by analyzing the related articles and books.

          The attempt to fill the gap between medical theory and practice using external factors such as law has been faced with a great deal of limitations. Accordingly, the present article tries to investigate how and why medical training must take internalizing ethical instructions into consideration, and indicate the importance of influential internal factors.

          Virtue-centered education, education of moral emotions, changing and strengthening of attitudes through education, and the wise use of administrative regulations can be an effective way of teaching ethical practice in medicine.

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          Most cited references71

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          The clinical application of the biopsychosocial model.

          G Engel (1980)
          How physicians approach patients and the problems they present is much influenced by the conceptual models around which their knowledge is organized. In this paper the implications of the biopsychosocial model for the study and care of a patient with an acute myocardial infarction are presented and contrasted with approaches used by adherents of the more traditional biomedical model. A medical rather than psychiatric patient was selected to emphasize the unity of medicine and to help define the place of psychiatrists in the education of physicians of the future.
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            Emotion, decision making and the orbitofrontal cortex.

            The somatic marker hypothesis provides a systems-level neuroanatomical and cognitive framework for decision making and the influence on it by emotion. The key idea of this hypothesis is that decision making is a process that is influenced by marker signals that arise in bioregulatory processes, including those that express themselves in emotions and feelings. This influence can occur at multiple levels of operation, some of which occur consciously and some of which occur non-consciously. Here we review studies that confirm various predictions from the hypothesis. The orbitofrontal cortex represents one critical structure in a neural system subserving decision making. Decision making is not mediated by the orbitofrontal cortex alone, but arises from large-scale systems that include other cortical and subcortical components. Such structures include the amygdala, the somatosensory/insular cortices and the peripheral nervous system. Here we focus only on the role of the orbitofrontal cortex in decision making and emotional processing, and the relationship between emotion, decision making and other cognitive functions of the frontal lobe, namely working memory.
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              Attitudes and attitude change.

              Attitudes and attitude change remain core topics of contemporary social psychology. This selective review emphasizes work published from 2005 to 2009. It addresses constructionist and stable-entity conceptualizations of attitude, the distinction between implicit and explicit measures of attitude, and implications of the foregoing for attitude change. Associative and propositional processes in attitude change are considered at a general level and in relation to evaluative conditioning. The role of bodily states and physical perceptions in attitude change is reviewed. This is followed by an integrative perspective on processing models of persuasion and the consideration of meta-cognitions in persuasion. Finally, effects of attitudes on information processing, social memory, and behavior are highlighted. Core themes cutting across the areas reviewed are attempts at integrative theorizing bringing together formerly disparate phenomena and viewpoints.
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                Author and article information

                Journal
                J Med Ethics Hist Med
                J Med Ethics Hist Med
                JMEHM
                Journal of Medical Ethics and History of Medicine
                Tehran University of Medical Sciences (Tehran, Iran )
                2008-0387
                2017
                5 April 2017
                : 10
                : 3
                Affiliations
                [1 ]PhD Candidate in Medical Ethics, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
                [2 ]Professor, Medical Ethics and History of Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
                [3 ]Lecturer, Department of Islamic Knowledge and Humanities, Amirkabir University of Technology, Tehran, Iran.
                Author notes
                [* ]Corresponding Author: Nazafarin Ghasemzadeh. Address: No. 23, 16 Azar Ave, Tehran, Iran. P.O. Box: 1417863181. Tel/Fax: + 98 21 66419661 nghasemzadeh@ 123456razi.tums.ac.ir
                Article
                JMEHM-10-3
                5742490
                29282423
                f0d35455-f55d-41c4-a5cb-94ba8193955f
                © 2017 Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences. All rights reserved.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 January 2016
                : 18 February 2017
                Categories
                Original Article

                medical education,virtue ethics,moral emotions
                medical education, virtue ethics, moral emotions

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