Role Model-Based Ethics Education and Moral Injury Prevention in Second-Year Medical Students: A Mixed-Methods Quasi-Experimental Study

This study examines whether role model-based ethics education can reduce moral injury and perceived stress, and improve resilience, among second-year medical students in Taiwan. Students participated in a general education ethics course and self-selected into one of two groups: a standard-intensity group receiving role model narratives and guided handouts, or an enhanced-intensity group receiving the same content plus reflective writing assignments and live guest appearances by featured practitioners. Validated questionnaires measuring moral injury (MIDS), perceived stress (PSS-14), and resilience (CD-RISC-10) were administered before and after the course. Open-ended written responses were also collected and analyzed. The study aims to inform early curricular integration of ethics education in medical training and to identify instructional designs that support moral agency without inadvertently promoting emotional disengagement.