Purpose
Teaching morality to medical students is often challenging. The Morality and Ethics Enhancement Program introduced a structured approach using scenario-based questions in general contexts, which is built on the idea that morality comes from the intention to benefit others without disrupting the larger system, which will classify human behavior into moral, normal, and no moral, was applied in curriculum. This study evaluates the program's impact on students' moral judgment and their attitudes toward medical professionalism.

Methods
The study included 95% of fourth-year medical students (n = 53) at Pranangklao Hospital Medical Education Center, Thailand. The program included role-playing as a moral educator exercise after the lecture, which integrated scenario-based questions into medical contexts. A pre- and post-test methodology was applied, using a 15-item scenario-based questionnaire to assess moral judgment. Additionally, a 32-item Medical Professionalism Scale was used to measure attitudes toward medical professionalism after the intervention. Data analysis included paired T-tests, correlations, and effect-size calculations.

Results
Post-test moral judgment scores significantly improved (p < 0.01, d = 0.485). All participants scored much higher than the standard passing level (p < 0.001, d = 0.632). No correlations were found between gender, GPA, and moral judgment scores. All six elements of the Medical Professionalism Scale had high scores, with a mean of 167.11. A significant relationship was found between post-test moral judgment scores and the excellence factor of the Medical Professionalism Scale (p = 0.04, r = 0.283).

Conclusions
The intervention showed moderate to high effectiveness in improving students' moral reasoning, especially in terms of altruism. The integration of scenario-based learning and role-playing seemed to promote engagement, active learning, and self-assessment. The improvement in moral judgment scores and high professionalism levels suggest that this program could be a valuable addition to medical curricula. However, long-term monitoring of moral competency in clinical performance is recommended.