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Journal of Medical Education

Author ORCID Identifier

Jennifer Kwon: https://orcid.org/0000-0002-1665-1671

Abstract

Background: This study introduces a reflective learning approach that combines ethical dilemmas with axiological analysis to explore how students' value hierarchies shape their professional identity formation. Moving beyond traditional frameworks such as Principlism, this approach invites learners to examine the tensions between personal and professional values, encouraging critical reflection on how their decisions relate to multiple identities and evolving professional commitments. Methods: Two open-ended ethical dilemmas were distributed via an anonymous online survey using Qualtrics. This method was intentionally chosen to elicit narrative responses from a large cohort of students while providing space for candid reflection on complex, value-laden situations. Responses were analyzed using axiological analysis in NVivo (Version 14, QSR International), focusing on identifying and interpreting conflicting values in students' written reflections. Results: The findings show that both scenarios deepened engagement with ethical dilemmas by prompting students to examine and prioritize competing values. Scenario 1 revealed tensions between professional obligations to patients and personal or family commitments, while Scenario 2 highlighted conflicts involving legal and institutional requirements, patient-centred care, and professional integrity. Students demonstrated value-based reasoning by negotiating these tensions through contextual judgment and effective communication, supporting self-reflection and professional identity development beyond rule-based decision-making. Conclusion: This study expands traditional case-based ethics learning by offering a structured, scalable method for engaging learners in value-oriented reflection. It highlights the utility of combining ethical scenarios with axiological analysis to enhance understanding of professional challenges while offering educators insight into how learners' values shape identity formation.

First Page

173

Last Page

183

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