Defining features of moral sensitivity and moral motivation: Pathways to moral reasoning in medical students

Kohlberg's theory of moral development explores the roles of cognition and emotion but focuses primarily on cognition. Contemporary post-formal theories lead to the conclusion that skills resulting from cognitive-affective integration facilitate consistency between moral judgement and moral behaviour. Rest's four-component model of moral development delineates these skills specifically. The components, moral motivation, moral sensitivity, moral reasoning and moral character, operate as multidimensional processes that facilitate moral development and subsequently promote moral behaviour. The relationships between these components have been relatively unexplored, thereby missing the opportunity to unpack the processes underlying moral growth and development. In this study, moral motivation (spirituality), moral sensitivity (post-formal skills) and moral reasoning are operationalized to examine the mediational effects of moral sensitivity of medical students. In the complex moral environment of medical students opportunities arise to question values and develop cognitive-affective skills, among them spirituality and post-formal thinking which are linked to increases in post-conventional moral reasoning. The models tested indicate that moral sensitivity mediates the relationship between moral motivation and moral reasoning.