Development Strategies in Medical Education

Introduction
The science of morality is the study of moral values, understanding their meanings, voluntarily doing good things, and refraining from doing bad things [1]. The two primary goals of ethics in medical education are training virtuous healthcare providers and helping them identify and solve medical doubts [2]. Medical Universities are responsible for educating people who, after completing their studies, can perform professional tasks by adhering to ethical principles [3]. Compliance with the principles of ethics in medical universities will not only help professors comply with teaching standards, but it can also play a role in forming effective bilateral relations between students and professors. Considering the ethical nature of the medical profession and the effect of observing ethical principles in various aspects of education on the institutionalization of moral values ​​and given that limited studies have been conducted on the importance of ethics in medical education, this study aims to determine the importance of ethics in education and the degree of compliance with ethical principles in Zahedan University of Medical Sciences (ZUMS) from the perspective of internship students.

Methods
In this descriptive cross-sectional study, 97 internship students of ZUMS in 2022 participated. Inclusion criteria were being an internship student, and studying at ZUMS, while the exclusion criteria were lack of cooperation, incomplete return of questionnaires, and being a visiting or transfer student. The data collection tools were a demographic form and a standardized questionnaire developed by Farahbakhsh et al. for measuring the importance of and degree of compliance with ethical principles. Data analysis was done in SPSS v.21 software using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (Mann-Whitney U test, Kruskal-Wallis test, Kolmogorov-Smirnov test). The significance level was set at 0.05.

Results
Most of the participants were female (n= 63, 64.9%). The mean score for the importance of “ethics in educational communication/behaviors in the educational environment” domain was 4.31 (out of 5), while the mean score for compliance in this domain was 3.18 (out of 5). The results of the Mann-Whitney U test showed no significant difference in the importance of ethics in educational communication/behaviors in the educational environment and the compliance with ethics in educational communication/behaviors in the educational environment in terms of age, gender, place of residence, work experience, and the history of participating in ethics workshops.
The mean score for the importance of “ethics in educational communication/behaviors at the bedside” domain was 4.55(out of 5), while the mean score for compliance in this domain was 3.33 (out of 5). The results of the Mann-Whitney U test showed no significant difference in the importance of ethics in educational communication/behaviors at the bedside and compliance with ethics in educational communication/behaviors at the bedside in terms of age, gender, place of residence, and the history of participating in ethics workshops. However, the difference in the importance of ethics in educational communication/behaviors at the bedside was significant in terms of work experience.
The mean score for the importance of “ethics in educational management at the bedside” domain was 4.51(out of 5), while the mean score for compliance in this domain was 3.02 (out of 5). The results of the Mann-Whitney U test showed no significant difference in the importance of ethics in educational management at the bedside and compliance with ethics in educational management at the bedside in terms of age, gender, place of residence, and the history of participating in ethics workshops. However, the difference in the importance of ethics in educational management at the bedside was significant in terms of work experience.
The lowest score regarding the importance of ethics was related to the domain of “ethics in educational communication/civil behavior in the educational environment.” Overall, the importance of ethics in medical education was 88.22%, and the overall level of compliance with ethics in medical education was 68.58%.

Conclusion
The results of this study showed that ethics in medical education is very important from the perspective of ZUMS students, and the level of compliance with ethical principles is higher than the average level in this university, but is far from the ideal level. The causes and factors affecting this perception regarding the observance of ethical standards in education should be identified to help the effectiveness of education and strengthen moral values ​​in medical education.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Zahedan University of Medical Sciences (Code: IR.ZAUMS.REC.1400.414).

Funding
This study was funded by Zahedan University of Medical Sciences.

Authors' contributions
The authors contributed equally to preparing this article.

Conflicts of interest
The authors declare no conflict of interest.

Acknowledgments
The authors would like to thank the Vice-Chancellor for Research of Zahedan University of Medical Sciences and all participants for their support and cooperation.

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