# Moral Reasoning and Final-Year Undergraduate Dentistry Students in Australia: A Cross-Sectional Questionnaire Study

## TL;DR

This study assesses the moral reasoning skills of final-year dental students in Australia and finds they need improvement to handle ethical challenges in healthcare.

## Contribution

The study evaluates moral reasoning in Australian dental students using a validated test and compares their scores to international benchmarks.

## Key findings

- Moral reasoning scores of dental students were lower than optimal levels for effective ethical decision-making.
- Age was moderately correlated with N2 scores, but differences based on gender or international background were not statistically significant.
- Scores were comparable to similar studies in other countries but still below recommended standards.

## Abstract

Background/Objectives: Proficiency in moral reasoning is essential for healthcare providers to successfully navigate ethically challenging decision-making. It is critical that student dentists about to enter practice have well-developed moral reasoning skills to ensure optimal patient care. The aim of the present study was to investigate the moral reasoning ability of students undertaking their final year of the undergraduate Bachelor of Dental Surgery (BDS) programme at the University of Adelaide (UofA) in Australia. Methods: Sixty-six final-year BDS students were invited to participate in an e-survey which included the Defined Issues Test 2 (DIT-2), a validated instrument for measuring moral reasoning. Calculated DIT-2 scores incorporatedthe postconventional (P) score and N2 score. Data analysis of demographic details and scores related to the DIT-2 included the use of t-tests, Mann–Whitney and the Spearman rank correlation coefficient tests. Results: A response rate of 45.5% (n = 30) was recorded. The mean (95% CI) P and N2 scores were 37.80 (32.04, 43.56) and 42.12 (37.72, 46.53), respectively. Scores for females and for those who had undertaken the majority of their pre-BDS studies outside of Australia and New Zealand were higher, but the differences were not statistically significant (p > 0.05). A Spearman Correlation Coefficient test indicated that age was moderately associated (r = 0.41; 95% CI: 0.01, 0.65; p = 0.04) with N2 scores. Conclusions: Moral reasoning scores were comparable to studies among similar cohorts conducted in other countries but were less than the scores considered optimal for a healthcare provider to proficiently manage challenges to ethical decision-making. Consideration should be given to the introduction of appropriate formal training in ethics to better manage these challenges.