Ethics in Professional Practice: An Education Resource for Health Science Students
DOI:
https://doi.org/10.18552/ijpblhsc.v7i1.552Keywords:
ethics, ethics education, health science studentsAbstract
Ethical practice is a core health science graduate attribute yet ethical reasoning is rarely explicitly taught during professional placements. Our aim was to design an educational resource for health science students to 1) engage students in the topic of ethics and 2) facilitate their skills to identify, manage and communicate ethical issues during professional placements. The Ethics in Professional Practice (EPP) resource was developed using collaborative design-based research by an interprofessional, Work Integrated Learning team. We drew upon Barab and Squire’s (2004) approach, with cycles of design, analysis, redesign and feedback informing resource development. The EPP resource comprises five video case studies that reflect ethical issues from diverse professional practice environments and include perspectives from students, clinical educators, clients and caregivers. The student is cast as a central character who must decide what actions may be taken to resolve ethical conflict. Complementary ethics education resources include reflective questions, guides to ethical reasoning and goal-setting resources. The resource was implemented with a cohort of 15 graduate-entry exercise physiology students and 59 undergraduate speech pathology students from the University of Sydney. Student feedback was utilised to inform resource redesign. Findings indicated that students valued the authentic ethics scenarios but experienced challenges when navigating online learning activities. Redesign focussed on enhancing interactive design features and improving accessibility of learning activities. This project achieved our goals to address ethical sensitivity, reasoning, communication and goals for future ethical practice.
References
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Beauchamp, T.L., and Childress, J.F. (2013) Principles of Biomedical Ethics. 7th edn. New York: Oxford University Press
Body, R., and McAllister, L. (2008) Ethics in Speech and Language Therapy. Chichester, United Kingdom: Wiley-Blackwell
Boud, D., Keough, R., and Walker, D. (1985). Reflection: Turning Experience into Learning. London: Kogan Page
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
Brookfield, S. (2012) Teaching for Critical Thinking: Tools and Techniques to Help Students Question their Assumptions., San Francisco: Jossey-Bass
Brunger, F., and Duke, P.S. (2012) ‘The evolution of integration: Innovations in clinical skills and ethics in first year medicine’. Medical Teacher, 34 (6), e452-e458 https://doi.org/10.3109/0142159X.2012.668629
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
Caldicott, C.V., and Braun, E.A. (2011) ‘Should professional ethics education incorporate single-professional or interprofessional learning?’. Advances in Health Sciences Education 16, 143–146 https://doi.org/10.1007/s10459-008-9150-2
Callister, LC., Luthy, K.E., Thompson, P., and Memmott, R.J. (2009) ‘Ethical reasoning in baccalaureate nursing students’. Nursing Ethics, 16 (4), 499–510 https://doi.org/10.1177/0969733009104612
Campbell, A.V., Chin, J., and Voo, T. (2007) ‘How can we know that ethics education produces ethical doctors?’. Medical Teacher, 5, 431–436 https://doi.org/10.1080/01421590701504077
Carrese, J.A., Malek, J., Watson, K., Lehmann, L.S., Green, M.J., McCullough, L.B. …, and Doukas, D. (2015) ‘The essential role of medical ethics education in achieving professionalism: The Romanell Report’. Academic Medicine, 90, 744–752 https://doi.org/10.1097/ACM.0000000000000715
Curwood, J.S., Tomitsch, M., Thomson, K., and Hendry, G.D. (2015) ‘Professional learning in higher education: Understanding how academics interpret student feedback and access resources to improve their teaching’. Australasian Journal of Educational Technology, 31 (5), 556–571 https://doi.org/10.14742/ajet.2516
Design-Based Research Collective (2003) ‘Design-based research: An emerging paradigm for educational inquiry’. Educational Researcher, 32 (1), 5–8, 35–37 https://doi.org/10.3102/0013189X032001005
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Dunn, L., and Musolino, G.M. (2011) ‘Assessing reflective thinking and approaches to learning’. Journal of Allied Health, 40 (3), 128–136
Eckles, R.E., Meslin, E.M., Gaffney, M., and Heft, P.R. (2005). ‘Medical ethics education: Where are we? Where should we be going? A Review’. Academic Medicine 80, 1143–1152 https://doi.org/10.1097/00001888-200512000-00020
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
Godbold, R., and Lees, A. (2013) ‘Ethics education for health professionals: A values based approach’ Nurse Education Practice 13, 553–560 https://doi.org/10.1016/j.nepr.2013.02.012
Kenny, B., Lincoln, M., & Balandin, S. (2007). ‘A dynamic model of ethical reasoning in speech pathology’. Journal of Medical Ethics, 33, 508-513 http://dx.doi.org/10.1136/jme.2006.017715
Kenny, B., Lincoln, M., Blyth, K., & Balandin, S. (2009) ‘Ethical perspective on quality of care: The nature of ethical dilemmas identified by new graduate and experienced speech pathologists’. International Journal of Language & Communication Disorders, 44 (4), 421–439 https://doi.org/10.1080/13682820902928711
Kenny, B., Lincoln, M., & 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
Langlois, S., and Lymer, E. (2016). ‘Learning professional ethics: Student experiences in a health mentor program’. Education for Health, 29, 10–15 https://doi.org/10.4103/1357-6283.178927
Liaschenko, J., Oguz, N.Y., and Brunnquell, D. (2006) ‘Critique of the “tragic case” method in ethics education’. Journal of Medical Ethics, 36, 672–677 https://doi.org/10.1136/jme.2005.013060
Macklin, R. (2003) ‘Applying the four principles’. Journal of Medical Ethics, 29, 275–280 https://doi.org/10.1136/jme.29.5.275
McAllister, L., and Nagarajan, S. (2015) ‘Accreditation requirements in allied health education: Strengths, weaknesses and missed opportunities’. Journal of Teaching and Learning for Graduate Employability, 6 (1), 2–24 https://doi.org/10.21153/jtlge2015vol6no1art570
McInerney, J., and Lees, A. (2018) ‘Values exchange: using online technology to raise awareness of values and ethics in radiography education’. Journal Medical Radiation Science, 65, 13–21 https://doi.org/10.1002/jmrs.258
Miles, S.H., Lane, L.W., Bickel, J., Walker, R.M., and Cassel, C.K. (1989). ‘Medical ethics education: Coming of age’. Academic Medicine, 64 (12), 705–714. https://doi.org/10.1097/00001888-198912000-00004
Monteverde, S. (2016) ‘Caring for tomorrow’s workforce: Moral resilience and healthcare ethics education’. Nursing Ethics, 23 (1), 104–116 https://doi.org/10.1177/0969733014557140
Morrison, J. (2008) ‘Professional behaviour in medical students and fitness to practice’. Medical Education, 42, 118–120 https://doi.org/10.1111/j.1365-2923.2007.02981.x
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
Osgood, C.E., Suci, G.J., and Tannenbaum, P.H. (1957) The Measurement of Meaning. Oxford, England: University of Illinois Press
Papadakis, M.A., Teherani, A., Banach, M.A., Knettler, T.R., Rattner, S.L., Stern, D.T. …, and Hodgson, C.S (2005) ‘Disciplinary action by medical boards and prior behaviour in medical school’. New England Journal of Medicine, 353, 2637–2682 https://doi.org/10.1056/NEJMsa052596
Pollard, N., Nisbet, G., Kenny, B., Sheepway, L., Jacobson, J., Tartakover, E. …, and McAllister, L. (2018) ‘Strategies for ethics education with health profession students before, during, and after placements’. International Journal of Practice-based Learning in Health and Social Care, 6 (2), 95–110 https://doi.org/10.18552/ijpblhsc.v6i2.405
Schön, D.A. (1987) Educating the Reflective Practitioner: Toward a New Design for Teaching and Learning in the Professions. San Francisco: JosseyBass
Tsai, T.C. (2017) ‘Twelve tips for the construction of ethical dilemma case-based assessment’. Medical Teacher, 4, 341–346 https://doi.org/10.1080/0142159X.2017.1288862
Weaver, K., Morse, J., and Mitcham, C. (2008) ‘Ethical sensitivity in clinical practice’. Journal of Advanced Nursing, 62, 607–18 https://doi.org/10.1111/j.1365-2648.2008.04625.x
Australian Commission on Safety and Quality in Health Care (2014). Risk Management Approach. [online] available from: https://www.safetyandquality.gov.au/wp-content/uploads/2014/04/Risk-management-approach.pdf [July 17, 2018]
Bandura, A (1982) ‘Self-efficacy mechanism in human agency’. American Psychologist 37 (2), 122–147 https://doi.org/10.1037/0003-066X.37.2.122
Barab, S., and Squire, K. (2004) ‘Design-based research: Putting a stake in the ground’. The Journal of the Learning Sciences, 13 (1), 1–14 https://doi.org/10.1207/s15327809jls1301_1
Beauchamp, T.L., and Childress, J.F. (2013) Principles of Biomedical Ethics. 7th edn. New York: Oxford University Press
Body, R., and McAllister, L. (2008) Ethics in Speech and Language Therapy. Chichester, United Kingdom: Wiley-Blackwell
Boud, D., Keough, R., and Walker, D. (1985). Reflection: Turning Experience into Learning. London: Kogan Page
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
Brookfield, S. (2012) Teaching for Critical Thinking: Tools and Techniques to Help Students Question their Assumptions., San Francisco: Jossey-Bass
Brunger, F., and Duke, P.S. (2012) ‘The evolution of integration: Innovations in clinical skills and ethics in first year medicine’. Medical Teacher, 34 (6), e452-e458 https://doi.org/10.3109/0142159X.2012.668629
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
Caldicott, C.V., and Braun, E.A. (2011) ‘Should professional ethics education incorporate single-professional or interprofessional learning?’. Advances in Health Sciences Education 16, 143–146 https://doi.org/10.1007/s10459-008-9150-2
Callister, LC., Luthy, K.E., Thompson, P., and Memmott, R.J. (2009) ‘Ethical reasoning in baccalaureate nursing students’. Nursing Ethics, 16 (4), 499–510 https://doi.org/10.1177/0969733009104612
Campbell, A.V., Chin, J., and Voo, T. (2007) ‘How can we know that ethics education produces ethical doctors?’. Medical Teacher, 5, 431–436 https://doi.org/10.1080/01421590701504077
Carrese, J.A., Malek, J., Watson, K., Lehmann, L.S., Green, M.J., McCullough, L.B. …, and Doukas, D. (2015) ‘The essential role of medical ethics education in achieving professionalism: The Romanell Report’. Academic Medicine, 90, 744–752 https://doi.org/10.1097/ACM.0000000000000715
Curwood, J.S., Tomitsch, M., Thomson, K., and Hendry, G.D. (2015) ‘Professional learning in higher education: Understanding how academics interpret student feedback and access resources to improve their teaching’. Australasian Journal of Educational Technology, 31 (5), 556–571 https://doi.org/10.14742/ajet.2516
Design-Based Research Collective (2003) ‘Design-based research: An emerging paradigm for educational inquiry’. Educational Researcher, 32 (1), 5–8, 35–37 https://doi.org/10.3102/0013189X032001005
Donaldson, T., 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
Doukas, D.J., McCullough, L.B., Wear, S., Lehmann, L.S., Nixon, L.L., Carrese, J.A. …, and Kirch, D.G. (2013) ‘The challenge of promoting professionalism through medical ethics and humanities education’. Academic Medicine, 80, 1624–1629 https://doi.org/10.1097/ACM.0b013e3182a7f8e3
Dunn, L., and Musolino, G.M. (2011) ‘Assessing reflective thinking and approaches to learning’. Journal of Allied Health, 40 (3), 128–136
Eckles, R.E., Meslin, E.M., Gaffney, M., and Heft, P.R. (2005). ‘Medical ethics education: Where are we? Where should we be going? A Review’. Academic Medicine 80, 1143–1152 https://doi.org/10.1097/00001888-200512000-00020
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
Godbold, R., and Lees, A. (2013) ‘Ethics education for health professionals: A values based approach’ Nurse Education Practice 13, 553–560 https://doi.org/10.1016/j.nepr.2013.02.012
Kenny, B., Lincoln, M., & Balandin, S. (2007). ‘A dynamic model of ethical reasoning in speech pathology’. Journal of Medical Ethics, 33, 508-513 http://dx.doi.org/10.1136/jme.2006.017715
Kenny, B., Lincoln, M., Blyth, K., & Balandin, S. (2009) ‘Ethical perspective on quality of care: The nature of ethical dilemmas identified by new graduate and experienced speech pathologists’. International Journal of Language & Communication Disorders, 44 (4), 421–439 https://doi.org/10.1080/13682820902928711
Kenny, B., Lincoln, M., & 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
Langlois, S., and Lymer, E. (2016). ‘Learning professional ethics: Student experiences in a health mentor program’. Education for Health, 29, 10–15 https://doi.org/10.4103/1357-6283.178927
Liaschenko, J., Oguz, N.Y., and Brunnquell, D. (2006) ‘Critique of the “tragic case” method in ethics education’. Journal of Medical Ethics, 36, 672–677 https://doi.org/10.1136/jme.2005.013060
Macklin, R. (2003) ‘Applying the four principles’. Journal of Medical Ethics, 29, 275–280 https://doi.org/10.1136/jme.29.5.275
McAllister, L., and Nagarajan, S. (2015) ‘Accreditation requirements in allied health education: Strengths, weaknesses and missed opportunities’. Journal of Teaching and Learning for Graduate Employability, 6 (1), 2–24 https://doi.org/10.21153/jtlge2015vol6no1art570
McInerney, J., and Lees, A. (2018) ‘Values exchange: using online technology to raise awareness of values and ethics in radiography education’. Journal Medical Radiation Science, 65, 13–21 https://doi.org/10.1002/jmrs.258
Miles, S.H., Lane, L.W., Bickel, J., Walker, R.M., and Cassel, C.K. (1989). ‘Medical ethics education: Coming of age’. Academic Medicine, 64 (12), 705–714. https://doi.org/10.1097/00001888-198912000-00004
Monteverde, S. (2016) ‘Caring for tomorrow’s workforce: Moral resilience and healthcare ethics education’. Nursing Ethics, 23 (1), 104–116 https://doi.org/10.1177/0969733014557140
Morrison, J. (2008) ‘Professional behaviour in medical students and fitness to practice’. Medical Education, 42, 118–120 https://doi.org/10.1111/j.1365-2923.2007.02981.x
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
Osgood, C.E., Suci, G.J., and Tannenbaum, P.H. (1957) The Measurement of Meaning. Oxford, England: University of Illinois Press
Papadakis, M.A., Teherani, A., Banach, M.A., Knettler, T.R., Rattner, S.L., Stern, D.T. …, and Hodgson, C.S (2005) ‘Disciplinary action by medical boards and prior behaviour in medical school’. New England Journal of Medicine, 353, 2637–2682 https://doi.org/10.1056/NEJMsa052596
Pollard, N., Nisbet, G., Kenny, B., Sheepway, L., Jacobson, J., Tartakover, E. …, and McAllister, L. (2018) ‘Strategies for ethics education with health profession students before, during, and after placements’. International Journal of Practice-based Learning in Health and Social Care, 6 (2), 95–110 https://doi.org/10.18552/ijpblhsc.v6i2.405
Schön, D.A. (1987) Educating the Reflective Practitioner: Toward a New Design for Teaching and Learning in the Professions. San Francisco: JosseyBass
Tsai, T.C. (2017) ‘Twelve tips for the construction of ethical dilemma case-based assessment’. Medical Teacher, 4, 341–346 https://doi.org/10.1080/0142159X.2017.1288862
Weaver, K., Morse, J., and Mitcham, C. (2008) ‘Ethical sensitivity in clinical practice’. Journal of Advanced Nursing, 62, 607–18 https://doi.org/10.1111/j.1365-2648.2008.04625.x
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Published
2019-07-31
How to Cite
Kenny, B., Thomson, K., Semaan, A., Di Michele, L., Pollard, N., Nicole, M., Jimenez, Y., & McAllister, L. (2019). Ethics in Professional Practice: An Education Resource for Health Science Students. International Journal of Practice-Based Learning in Health and Social Care, 7(1), 86–101. https://doi.org/10.18552/ijpblhsc.v7i1.552
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