A medical-ethics course was anonymously evaluated by first-year students over 2 years. The course emphasizes problem-based learning through group discussion of clinical cases and lectures on ethical issues. A tutorial system was added to the course in the second year. Students' evaluations indicated that most students had positive attitudes about the course and that both group discussion and lectures were helpful for achieving the general instructional objectives and specific behavioral objectives of the course. A comparison of the 2 years showed that a majority of evaluated items received higher evaluations from second-year students than from first-year students. We attribute the difference to the livelier discussion with the introduction of the tutorial system and the smaller discussion groups. These results indicate that students consider medical-ethics education to be useful.

Our medical ethics course emphasizes problem-based-learning (PBL) via group discussion of clinical cases. The significanceof instructors' assessments of PBL in ethics education was studied with different assessment tools during thelast 2 years. In the first year, students' behavior and level of functioning in group discussion were assessed on a group basiswith an 8-item instrument. In the second year, students' level of functioning and flexibility in response to differentopinions in group discussion were assessed on an individual basis with a 2-item instrument. Instsments ofstudent's performance in group discussion were positively but weakly correlated with scores of their reports derivedfrom group discussions. Instructors could consistently assess student performance in PBL in terms of behavior and levelof functioning in group discussions. Furthermore, instructors rated flexibility in response to other opinions as an importantfactor in group dynamics, including interaction between students and instructors. These results suggest that instructors'assessments can be used to help evaluate students in a medical ethics course. Instructors' assessments of studentflexibility during PBL can be particularly useful in this regard.