Using graphic pathographies as moral dilemma scenarios in medical humanities education: effects on moral distress, need for cognition, and medical mistrust

Objective This study aimed to examine whether using graphic pathographies as moral dilemma scenarios in a medical humanities course resulted in improved learning outcomes in moral distress, need for cognition, and medical mistrust among medical university students. Methods The research employed a two-group, pre-posttest quasi-experimental study to investigate whether the use of graphic pathographies as moral dilemma scenarios in a medical humanities class would result in differences between the experimental group (GP—moral dilemma scenarios—MHS; N = 32) and the control group ( non GP—moral dilemma scenarios—MHS; N = 30) in terms of moral distress, need for cognition, and medical mistrust. The quantitative data were collected using a moral distress scale (MDS-HSP), a need for cognition scale (NFCS-MHC-SP), and a medical mistrust scale (MMtS-MHC-SP). Data were analyzed using one-way MANOVA, mixed-design ANOVA, and ANCOVA in SPSS. Results With respect to moral distress, the results demonstrated statistically significant between-group differences in “lack of professional competence,” “disrespect for patients’ autonomy,” “futile treatment,” “organizational and social climate,” and “not in patients’ best interest” ( p < 0.05 or 0.01), but not in “acquiescence to patients’ rights violations” ( p > 0.05). Regarding need for cognition, the results showed significant differences in “ambition for academic and professional growth,” “diverse thinking in problem-solving orientation,” “passion for rigorous inquiry and critical analysis,” and “intellectual curiosity for exploration” ( p < 0.05 or 0.01). Regarding medical mistrust, significant differences were found in “provider trustworthiness,” “healthcare accessibility,” “institutional integrity,” and “system reliability” ( p < 0.05 or 0.01) but not in “treatment justifiability” ( p > 0.05). Conclusion The use of graphic pathographies as moral dilemma scenarios in medical humanities education was associated with differences in students’ moral distress, need for cognition, and medical mistrust.