Latar Belakang: Kompetensi "mengambil keputusan terhadap dilema etika yang terjadi pada pelayanan kesehatan individu, keluarga dan masyarakat" tercantum dalam SKDI 2005 sehingga harus ada dalam kurikulum dan dilaksanakan di dalam modul. Penerapan proses pengambilan keputusan etis (PKE) berkaitan dengan manajemen pasien, karena itu pembelajaran pada tahap klinis pendidikan kedokteran menjadi keharusan. Penelitian ini dilakukan untuk mengetahui proses pembelajaran pengambilan keputusan etis di tahap klinispendidikan kedokteran di FKUI. Metode: Penelitian merupakan penelitian deskriptif kualitatif dengan mengidentifikasi komponen Buku Kurikulum, Buku Rancangan Pengajaran modul praktik klinik, dan dokumen lain; wawancara mendalam pengelola program studi, pengelola modul, staf pengajar; serta Focus Group Discussion (FGD) pada mahasiswa. Hasil: Tidak ada modul praktik klinik yang lengkap mencantumkan PKE dalam dokumen. Pengelola modul kurang memahami kompetensi PKE SKDI 2006. Sebagai klinisi, staf pengajar mampu mengidentifikasi dan mengambil keputusan penyelesaian dilema etika. Mahasiswa memahami PKE dan menemukan kasus berdilema etika dalam proses pembelajaran tahap klinik. Mahasiswa mendiskusikan dilema etika yang ditemui dengan residen dan/atau dokter penanggungjawab kasus. Mahasiswa memiliki prior knowledge yang didapat pada tahap preklinik. Kesimpulan: Proses pembelajaran pengambilan keputusan etis di tahap klinis merupakan hidden curriculum.Perlu dilakukan peningkatan kapasitas staf pengajar di bidang teori etika kedokteran dan penyusunan modul agar PKE menjadi komponen tertulis dalam kurikulum.

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Background: Ethical Reasoning is one of competency component stated in the ?2006 Indonesian Medical Doctor Competencies Standard? therefor it has to be taught in medical faculties. The competency should be stated in all documents related to the curriculum. The learning of ethical reasoning should be done in clinical years since it is related to patient's managements. This research was done to evaluate the ethical reasoning learning process in the clinical stage medical education in Faculty of Medicine University of Indonesia.

Method: This is a descriptive qualitative research which identifies the component of curriculum inside the curriculum documents; indepth interview to the module developer, module organizer, and teachers; and focus group discussion with clinical year medical students.

Result: Ethical Reasoning Competency was not written as the aim of any module, as seen in the Instructional Design of all documents. The module developer did not recognize this competency despite their daily practice of ethical reasoning. The students learnt ethical reasoning in clinical stage by observing the medical staff during their interaction with patient with ethical dilemma. The student were able to identify the cases based on their prior knowledge from previous stage.

Conclusion: Ethical reasoning learning process in clinical stage is part of hidden curriculum.Capacity building for faculty members in medical ethics theory and module development for the faculty member are needed to make the ethical reasoning process as a part of the curriculum.