The Karnieli-Miller Communication and Professionalism Lab
Gray Faculty of Medical and Health Sciences,
Tel Aviv University, Israel
The Department of Medical Education
Moral courage
Hospitals are hierarchical institutions and hierarchy is very important for functioning. However, in certain situations, hierarchy can be an obstacle, such as when identifying cases in which a senior acted in error or violated professional values (e.g., humiliation of or disrespect toward a patient); or situations in which juniors need to disclose either their own error or lack of understanding. In recent years, we have developed a quantitative instrument that measures moral courage efficacy, showing the difficulty involved in behaving with this kind of courage, and the need to create interventions to empower students for this purpose. Currently, our lab studies this issue through—a quantitative study, a qualitative study examining animated video clips that we developed to teach moral courage, and a qualitative study of interviews with students to hear about their experiences. We also have an ongoing ISF grant, on assertiveness in medicine that might be a good solution in these situations.
To learn more about our studies:
Cohen. D., Neufeld-Kroszynski, G., & Karnieli-Miller, O. (In preparation). Medical students' exposure to professionalism violations: The contribution/role of cognitive and emotional processes in forming a professional identity.
Matalon, I., & Karnieli-Miller, O. (In preparation). The experience of the use of an animated film to promote the thinking concerning moral dilemmas and enhance moral courage: A qualitative study from medical students perspectives.
Michael, K., Farajev, N., & Karnieli-Miller, O. (2026). Moral courage efficacy among medical students: associations with environmental professionalism, empathy attitudes, and communication self-efficacy. Frontiers in Medicine, 13, Article 1812249. https://doi.org/10.3389/fmed.2026.1812249
Neufeld-Kroszynski, G., Michael, K., & Karnieli-Miller, O. (2024). Associations between medical students’ stress, academic burnout and moral courage efficacy. BMC Psychology, 12, Article 296.
https://doi.org/10.1186/s40359-024-01787-6
Michael, K., Shohovithky, D., & Karnieli-Miller, O. (2024). The associations between resilience, self-care, and burnout among medical students. PLOS One, 19(9), Article e0309994. https://doi.org/10.1371/journal.pone.0309994
Gutgeld-Dror, M., Laor, N., & Karnieli-Miller, O. (2023). Assertiveness in physicians’ interpersonal professional encounters: A scoping review. Medical Education, 58(4), 392-404. https://doi.org/10.1111/medu.15222
Neufeld-Kroszynski, G., & Karnieli-Miller, O. (2023). To speak or not to speak? Medical students' deliberation process regarding professionalism breaches. Patient Education and Counseling, 109, 74-75.