How important is medical ethics and history of medicine teaching in the medical curriculum? An empirical approach towards students' views.

Objectives: It was investigated how students judge the teaching of medical ethics and the history of medicine at the start and during their studies, and the influence which subject-specific teaching of the history, theory and ethics of medicine (GTE) - or the lack thereof - has on the judgement of these subjects. Methods: From a total of 533 students who were in their first and 5th semester of the Bochum Model curriculum (GTE teaching from the first semester onwards) or followed the traditional curriculum (GTE teaching in the 5th/6th semester), questionnaires were requested in the winter semester 2005/06 and in the summer semester 2006. They were asked both before and after the 1st and 5th (model curriculum) or 6th semester (traditional curriculum). We asked students to judge the importance of teaching medical ethics and the history of medicine, the significance of these subjects for physicians and about teachability and testability (Likert scale from -2 (do not agree at all) to +2 (agree completely)). Results: 331 questionnaire pairs were included in the study. There were no significant differences between the students of the two curricula at the start of the 1st semester. The views on medical ethics and the history of medicine, in contrast, were significantly different at the start of undergraduate studies: The importance of medical ethics for the individual and the physician was considered very high but their teachability and testability were rated considerably worse. For the history of medicine, the results were exactly opposite. GTE teaching led to a more positive assessment of items previously ranked less favourably in both curricula. A lack of teaching led to a drop in the assessment of both subjects which had previously been rated well. Conclusion: Consistent with the literature, our results support the hypothesis that the teaching of GTE has a positive impact on the views towards the history and ethics of medicine, with a lack of teaching having a negative impact. Therefore the teaching of GTE should already begin in the 1st semester. The teaching of GTE must take into account that even right at the start of their studies, students judge medical ethics and the history of medicine differently.