Strategies for Ethics Education with Health Profession Students Before, During, and After Placements
DOI:
https://doi.org/10.18552/ijpblhsc.v6i2.405Keywords:
allied health, ethics, ethics education, health professions students, placementsAbstract
Health professionals must practice ethically in order to ensure compassionate and effective client care; function as good interdisciplinary team members; and protect themselves from litigation, and conduct and ethics complaints. Ethics education is a routine inclusion in health profession degrees, but may only be taught in the classroom, divorced from practice. This article argues that students need ethics education before, during, and after practice placements. We suggest that many powerful opportunities for teaching ethics on and after placements are missed or under-utilised. We have reviewed the scant evidence, and the literature more broadly, to identify strategies for teaching ethics before, during, and after placements; and have added strategies drawn from our own experiences as clinical educators. We highlight where interdisciplinary perspectives can be added to ethics education. We conclude that more research is needed into approaches and strategies for teaching ethics in different contexts.
References
Atwal, A. and Caldwell, K. (2003) ‘Ethics, occupational therapy and discharge planning: Four broken principles’. Australian Occupational Therapy Journal, 50, 244–251 https://doi.org/10.1046/j.1440-1630.2003.00374.x
Banks, S. (2010) ‘Interprofessional ethics: A developing field? Notes from the Ethics & Social Welfare Conference’. Ethics and Social Welfare, 4 (3), 280–294 https://doi.org/10.1080/17496535.2010.516116
Beauchamp, T.L. and Childress, J.F. (2013) Principles of Biomedical Ethics. 7th edn. New York: Oxford University Press
Bourne, E., Sheepway, L., Charlton, N., Kilgour, A., Blackford, J., Alam, M., and McAllister, L. (2013) ‘Ethical awareness in allied health students on clinical placements: Case examples and strategies for student support’. Journal of Clinical Practice in Speech-Language Pathology, 15 (2), 94–98
Braunack-Mayer, A. (2001) ‘Casuistry as bioethical method: An empirical perspective’. Social Science & Medicine, 53 (1), 71–81 https://doi.org/10.1016/S0277-9536(00)00314-2
Brondani, M.A. and Rossoff, L.P. (2010) ‘The “hot seat” experience: A multifaceted approach to the teaching of ethics in a dental curriculum’. Journal of Dental Education, 74 (11), 1220–1229
Bushby, K., Chan, J., Druif, S., Ho, K., and Kinsella, E.A. (2015) ‘Ethical tensions in occupational therapy practice: A scoping review’. British Journal of Occupational Therapy, 78 (4), 212–221 https://doi.org/10.1177/0308022614564770
Cameron, M.E., Schaffer, M., and Park, H.-A. (2001) ‘Nursing students' experience of ethical problems and use of ethical decision-making models’. Nursing Ethics, 8 (5), 432–447
Charon, R. and Montello, M. (eds.) (2002) Stories Matter: The Role of Narrative in Medical Ethics. London: Routledge
Donaldson, T.M., Fistein, E., and Dunn, M. (2010) ‘Case-based seminars in medical ethics education: How medical students define and discuss moral problems’. Journal of Medical Ethics, 36 (12), 816–820 https://doi.org/10.1136/jme.2010.036574
Dunn, L. and Musolino, G.M. (2011) ‘Assessing reflective thinking and approaches to learning’. Journal of Allied Health, 40 (3), 128–136
Elkin S.A. (2004) ‘The integration of ethics teaching in the therapy professions’. Focus on Health Professional Education: A Multi-Disciplinary Journal, 5 (3), 1–6
Flatley, D.R., Kenny, B.J., and Lincoln, M.A. (2014) ‘Ethical dilemmas experienced by speech-language pathologists working in private practice’. International Journal of Speech-Language Pathology, 16 (3), 290–303 https://doi.org/10.3109/17549507.2014.898094
Garrity, M.K. (2013) ‘Developing nursing leadership skills through reflective journaling: A nursing professor’s personal reflection’. Reflective Practice: International and Multidisciplinary Perspectives, 14 (1), 118–130 https://doi.org/10.1080/14623943.2012.732940
Geddes, E.L., Wessel, J., and Williams, R.M. (2004) ‘Ethical Issues identified by physical therapy students during clinical placements’. Physiotherapy Theory and Practice, 20, 17–29 https://doi.org/10.1080/09593980490425076
Glen, S. (1999) ‘Educating for interprofessional collaboration: Teaching about values’. Nursing Ethics, 6 (3), 202–213 https://doi.org/10.1177/096973309900600303
Godbold, R. and Lees, A. (2013) ‘Ethics education for health professionals: A values based approach’. Nurse Education in Practice, 13 (6), 553–560 https://doi.org/10.1016/j.nepr.2013.02.012
Handelsman, M.M., Gottlieb, M.C., and Knapp, S. (2005) ‘Training ethical psychologists: An acculturation model’. Professional Psychology: Research and Practice, 36 (1), 59–65 https://doi.org/10.1037/0735-7028.36.1.59
Hanson, S. (2005) ‘Teaching health care ethics: Why we should teach nursing and medical students together’. Nursing Ethics, 12 (2), 167–176 https://doi.org/10.1191/0969733005ne773oa
Hill, A.E., Davidson, B.J., and Theodoros, D.G. (2010) ‘A review of standardized patients in clinical education: Implications for speech-language pathology programs’. International Journal of Speech-Language Pathology, 12 (3), 259–270 https://doi.org/10.3109/17549500903082445
Irvine, R., Kerridge, I., McPhee, J., and Freeman, S. (2002) ‘Interprofessionalism and ethics: Consensus or clash of cultures’? Journal of Interprofessional Care, 16 (3), 199–210 https://doi.org/10.1080/13561820220146649
Johnston, C. and Haughton, P. (2007) ‘Teaching and learning ethics: Medical students’ perceptions of their ethics teaching’. Journal of Medical Ethics, 33, 418–422 https://doi.org/10.1136/jme.2006.018010
Kenny, B. (2015) ‘Food culture, preferences and ethics in dysphagia management’. Bioethics. Special Issue: International Association of Bioethics 12th World Congress 29, 9, 646–652 https://doi.org/10.1111/bioe.12189
Kenny, B., Lincoln, M., and Balandin, S. (2010) ‘Experienced speech-language pathologists’ responses to ethical dilemmas: An integrated approach to ethical reasoning’. American Journal of Speech-Language Pathology, 19, 121–134 https://doi.org/10.1044/1058-0360(2009/08-0007)
Kenny, B., Lincoln, M., and Killian, F. (2015) ‘Ethics cases: Do they elicit different levels of ethical reasoning’? Journal of Academic Ethics, 13 (3), 259-275 https://doi.org/10.1007/s10805-015-9234-6
Kinsella, E.A., Park, A.J.-S., Appiagyei J., Chang, E., and Chow, D. (2008) ‘Through the eyes of students: Ethical tensions in occupational therapy practice’. Canadian Journal of Occupational Therapy, 75 (3), 176–183 https://doi.org/10.1177/000841740807500309
Kirklin, D. (2007) ‘Minding the gap between logic and intuition: An interpretative approach to ethical analysis’. Journal of Medical Ethics, 33, 386–389 https://doi.org/10.1136/jme.2005.015156
Kulju, K., Suhonen, R., and Leino-Kilpi, H. (2013) 'Ethical problems and moral sensitivity in physiotherapy: A descriptive study'. Nursing Ethics, 20 (5), 568–577 https://doi.org/10.1177/0969733012468462
Liaschenko, J., Oguz, N.Y., and Brunnquell, D. (2006) ‘Critique of the “tragic case” method in ethics education’. Journal of Medical Ethics, 32, 672–677 https://doi.org/10.1136/jme.2005.013060
Maidment, J. (2006) ‘Using on-line delivery to support students during practicum placements’. Australian Social Work, 59 (1), 47–55 https://doi.org/10.1080/03124070500449770
Mann, K., Gordon, J., and MacLeod, A. (2009) ‘Reflection and reflective practice in health professions education: A systematic review’. Advances in Health Sciences Education, 14 (4), 595–621 https://doi.org/10.1007/s10459-007-9090-2
Numminen, O., van der Arend, A., and Leino-Kilpi, H. (2009) ‘Nurses educators’ and nursing students’ perspectives on teaching codes of ethics’. Nursing Ethics, 16 (1), 69–82 https://doi.org/10.1177/0969733008097991
Pasco, J., Bay, U., and Courtney, M. (2010) ‘You become the supervisor’. in Clinical and Fieldwork Placement in the Health Professions. ed. by Stagnitti, K., Schoo, A., and Welch, D. South Melbourne, Australia: Oxford University Press, 315–328
Pettifor, J.L., Estay, I., and Paquet, S. (2002) ‘Preferred strategies for learning ethics in the practice of a discipline’. Canadian Psychology/Psychologie canadienne, 43 (4), 260–269 https://doi.org/10.1037/h0086922
Praestegaard, J. and Gard, G. (2013) ‘Ethical issues in physiotherapy – Reflected from the perspective of physiotherapists in private practice’. Physiotherapy Theory and Practice, 29 (2), 96–112. https://doi.org/10.3109/09593985.2012.700388
Rowell, M. (1998) ‘Feminist approaches to bioethics: Theoretical reflections and practical applications’. Journal of Medical Ethics, 24, 213–213 https://doi.org/10.1136/jme.24.3.213
Seedhouse, D. (2009) 'The background to the ethical grid'. in The Heart of Health Care. ed. by Seedhouse, D. Chichester, UK: Wiley-Blackwell, 142–174.
Self, D.J., Wolinsky, F.D., and Baldwin Jr., D.C. (1989) ‘The effect of teaching medical ethics on medical students’ moral reasoning’. Academic Medicine, 64, 755–759 https://doi.org/10.1097/00001888-198912000-00014
Sharp, H.M. and Kuthy, R.A. (2008) ‘What do dental students learn in an ethics course? An analysis of student-reported learning outcomes’. Journal of Dental Education, 72 (12), 1450–1457
Smith, T., Williams, L., Lyons, M., and Lewis, S. (2005) ‘Pilot testing a multiprofessional learning module: Lessons learned’. Focus on Health Professional Education: A Multi-Disciplinary Journal, 6 (3), 21–23
Spike, J.P. and Lundstroth, R. (2016) ‘Framing interprofessional ethics cases’. in A Casebook in Interprofessional Ethics: A Succinct Introduction to Ethics for the Health Professions [online]. ed. by Spike, J.P. and Lundstroth, R. Switzerland: Springer International Publishing, 11–17 https://doi.org/10.1097/00001888-198912000-00014
Vergés, A. (2010) ‘Integrating contextual issues in ethical decision making’. Ethics & Behavior, 20 (6), 497–507 https://doi.org/10.1080/10508422.2010.521451
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons License "Attribution-NonCommercial No Derivs 4.0 International" (CC BY-NC-ND 4.0) which permits others to use the publication as long as the authors are appropriately cited.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
- The Author grants to Coventry University an irrevocable, royalty-free, worldwide, non-exclusive licence to publish this article in this journal in addition to the licence granted at paragraph 1 of this copyright notice.