Investigating the Moral Sensitivity of Physicians to Misbehavior of Colleagues in Hamadan, Iran

BRIEF TEXT

Background and Objective

Ethics is a branch of human sciences that deals with the goodness or badness of human behavior [1]. The tendency towards moral values ​​is innate in the human beings [2]. … [3]. Today, emphasis should be placed on medical ethics education during the student training period. In addition to the initial stages of the educational phase, it should also be presented in a practical way [4]. Also, emphasis should be placed on moral education issues with clinical processes [5]. … [6-8]. Since the moral sensitivity of physicians towards colleagues' misbehavior and how to report it can be effective in improving the quality of health and medical services to patients, we decided to evaluate the moral sensitivity of physicians towards colleagues' misbehavior in Hamadan, Iran, in 2024 so that necessary interventions can be made based on the results obtained.

Materials and Methods

This cross-sectional study was conducted in 25 medical centers in Hamadan, Iran, in 2024. After obtaining ethics approval, stratified sampling was conducted with 550 general practitioners, residents, and specialists. Of the total number of physicians participating in the study, 88 were specialists, subspecialists, and fellows, 339 were general practitioners, and 123 were residents. A specific questionnaire on the level of moral sensitivity of physicians included 16 questions, and a general questionnaire collected demographic characteristics, job, and educational backgrounds of the participants. … [9-11]. After completing the questionnaires, SPSS software (version 26) was used for analysis. To compare the level of moral sensitivity of physicians participating in the study in terms of quantitative variables, a one-way analysis of variance test and qualitative variables, chi-square and Fisher's exact test were used.

Results

In this study, out of 650 questionnaires distributed, 550 questionnaires were completed. The mean and standard deviation of participants' age in the study were 36.33 ± 9.51 years. Table 1 presents the demographic characteristics of the participants; 52.9% were male and 47.1% were female. In terms of marital status, 58.9% were married, and 41.1% were single. In terms of employment type, 121 were official, 84 were contract, 92 were service commitment, and 197 were other cases. Of the total number of physicians studied, 50 (9.01%) had low moral sensitivity, 169 (30.7%) had medium moral sensitivity, and 331 (60.1%) had high moral sensitivity toward colleague misbehavior. According to the findings in Table 2, a significant difference was observed in the moral sensitivity of the participating physicians to colleague misbehavior based on age (P < 0.001) and work experience (P = 0.005). Based on the results of the Tukey post hoc test, physicians who were highly sensitive to colleague misbehavior had a higher average age and more work experience than physicians with medium or low sensitivity. According to Figure 1, the frequency of low, moderate, and high sensitivity to colleague misbehavior in male physicians was 11.7, 33.7, and 54.6 percent, respectively, and in female physicians it was 6.2, 27.4, and 66.4 percent. Based on the results of the chi-square test, the level of moral sensitivity of female physicians to colleague misbehavior was significantly higher than that of men (P = 0.009) (Figure 1). The frequency of low, moderate, and high sensitivity to colleague misbehavior in physicians who had completed medical ethics refresher courses was 6.8, 27.7, and 65.5 percent, respectively, and in physicians who had not completed medical ethics refresher courses was 11.2, 33.6, and 55.2 percent. According to Table 3, physicians' moral sensitivity to colleagues' misbehavior did not differ significantly by marital status, specialty, or employment status (P > 0.05). However, it did differ by workplace (P = 0.016), with higher sensitivity in private practice. Based on the results of the chi-square test, the level of moral sensitivity of physicians who had completed medical ethics refresher courses was significantly higher than that of physicians who had not completed medical ethics refresher courses (P = 0.032).

Discussion

In the study by Agha Hosseini et al. (2023) examining the correlation between moral sensitivity and interprofessional collaboration among physicians, all physicians participating in the study (100%) had high moral sensitivity [12]. Our findings, in common with this study, were the high moral sensitivity of physicians. The difference is that, in our study, instead of the participant's moral sensitivity, his sensitivity to the misbehavior of his colleagues was examined. In the present study, greater moral sensitivity was observed with increasing age and work experience among the physicians participating in the study. In line with the findings of the present study, Hosseinabadi et al. (2019) observed a direct and significant correlation between nurses' age and moral sensitivity scores [11]. …. [13]… [14]… [10]… [15].

In line with the present study, Moreno-Segura et al. (2023) found in Spain that, in a gender-based comparison, women reported significantly higher moral sensitivity than men [13]. … [16-19].

Conclusion

In the present study, most participating physicians had moderate to high sensitivity to colleague misbehavior. Female physicians had significantly higher moral sensitivity than males, and increasing age and experience were also associated with increased moral sensitivity.

References

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Table 1. Demographic Characteristics of Participants

Table 2. Mean and Standard Deviation of Age and Work Experience of Participating Physicians and Moral Sensitivity Towards Colleague Misbehavior

.*One-way analysis of variance

Figure 1. Physicians' Level of Moral Sensitivity to Colleagues' Misbehavior by Gender of Study Participants

Table 3. The Level of Moral Sensitivity of Physicians to the Misbehavior of Colleagues According to the Marital Status, Occupation, Workplace, and Employment Status of the Study Participants

.*Fisher's exact test