Moral Reasoning and Values in Medical School: A longitudinal study in Finland

Changes in moral reasoning, value priorities and self-descriptions were examined in 43 medical students over the first two years of study. At both times, moral reasoning was assessed using a written Kohlberg Moral Judgment Interview, values by the Rokeach Value Survey and self-image by the Ha¨yrynen Inventory. Moral reasoning scores declined significantly while no significant changes were found in any other measures. Schwartz's value model was used to analyse the relationship of moral stages and values. In accordance with previous studies, universalism values correlated positively and self-enhancement values nega tively with moral stage. The instrumental value hierarchy of the students converged by the third year toward the typical medical student value hierarchy. The results are discussed in terms of the disillusionment hypothesis and alternative interpretations of the Kohlberg stages.