Morality is a natural and a cultural phenomenon which develops through the interplay of psychological components of an individual, and through the interactions of people within a society.1 It directs behavior that affects others with the intent to lessen evil or harm.2 Moral judgement is the fundamental psychological structure by which individuals make decisions about their rights and responsibilities.3 Lawrence Kohlberg defines a moral competence as the capacity to make moral judgements and decide accordingly to one’s personal values.4 Lind extends this definition to include social situation, defining moral competence as the ability to solve conflicts on the basis of shared moral principles through thinking and discussion rather than through violence, deceit, and power.5 The development of moral competence can be (and needs to be) fostered through education.6, 7 Yet, education is only effective if it provides opportunities for responsbility-taking and guided reflection.8
The profession of medicine requires a very high level of moral competence. Therefore fostering moral competence of medical students should be the central focus of medical education.9, 10 But research does not confirm the hypothesis that medical education fosters students moral development. In the last two decades, many studies from different countries all over the world, using different research instruments, revealed disturbing data: medical education hinders students' moral development or even attenuates it. 7, 12, 14, 16, 20, 21 11-21 This poses a major challenge to medical education.
Recent studies in Croatia also evidenced regression of moral reasoning in medical students and reported high cheating prevalence at Croatian medical schools whe...
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...r understanding of classroom rules and roles. The Elementary School Journal 1987;88 (1):64–77.
39. Mccallum JA. Teacher reasoning and moral judgment in the context of student discipline situations. Journal of Moral Education 1993;22 (1):3–17.
40. Lind G. Konstanz Method of Dilemma Discussion. Fostering Moral-Democratic Competence with the KMDD® http://www.uni-konstanz.de/ag-moral/moral/dildisk-e.htm [Accessed 27 May 2014.]
41. Lind, G. Teaching students to speak up and to listen to others: Cultivating moral democratic competencies. In: Lund DE, Carr PR, eds. Doing democracy and social justice in education: Political literacy for all students. New York: Peter Lang Publishing. 2008; 319 -35.
42. Nowak E, Schrader DE, Zizek B, eds. Educating Competencies for Democracy. Frankfurt am Main, Berlin, Bern, Bruxelles, New York, Oxford, Wien: Peter Lang Publishing; 2013.
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