A barrier to the development and refinement of ethics education in and across health professional schools is that there is not an agreed upon instrument or method for assessment in ethics education. The most widely used ethics education assessment instrument is the Defining Issues Test (DIT) I & II. This instrument is not specific to the health professions. But it has been modified for use in, and influenced the development of other instruments in, the health professions. The DIT contains certain (...) philosophical assumptions (“Kohlbergian” or “neo-Kohlbergian”) that have been criticized in recent years. It is also expensive for large institutions to use. The purpose of this article is to offer a rubric—which the authors have named the Health Professional Ethics Rubric—for the assessment of several learning outcomes related to ethics education in health science centers. This rubric is not open to the same philosophical critiques as the DIT and other such instruments. This rubric is also practical to use. This article includes the rubric being advocated, which was developed by faculty and administrators at a large academic health science center as a part of a campus-wide ethics education initiative. The process of developing the rubric is described, as well as certain limitations and plans for revision. (shrink)

Background: One of the barriers to interprofessional ethics education is a lack of resources that actively engage students in reflection on living an ethical professional life. This project implemented and evaluated an innovative resource for interprofessional ethics education. Objectives: The objective of this project was to create and evaluate an interprofessional learning activity on professionalism, clinical ethics, and research ethics. Design: The Brewsters is a choose-your-own-adventure novel that addresses professionalism, clinical ethics, and research ethics. For the pilot of the book, (...) a pre-test/post-test design was used. Once implemented across campus, a post-test was used to evaluate student learning in addition to a student satisfaction survey. Participants and research context: A total of 755 students in six academic schools in a health science center completed the activity as part of orientation or in coursework. Ethical considerations: The project was approved as exempt by the university’s Committee for the Protection of Human Subjects. Findings: The pilot study with 112 students demonstrated a significant increase in student knowledge. The 755 students who participated in the project had relatively high knowledge scores on the post-test and evaluated the activity positively. Discussion: Students who read The Brewsters scored well on the post-test and had the highest scores on clinical ethics. Clinical ethics scores may indicate issues encountered in mass media. Conclusion: The Brewsters is an innovative resource for teaching interprofessional ethics and professionalism. Further work is needed to determine whether actual and long-term behavior is affected by the activity. (shrink)

Physiotherapy raises serious bioethical questions that are far too little discussed. Concerns include the lack of a clearly defined end point, the closeness of interaction between therapist and patient, the patient’s own share of responsibility, and the common failure to refer patients for rehabilitation.Physiotherapy has evolved dramatically in recent years, to the point where it is now a major healthcare profession offering assessment, diagnosis and treatment for a wide range of conditions, from sports injuries to rehabilitation for major injuries and (...) diseases. According to the World Confederation for Physical Therapy, “Physical Therapy is providing services to people and populations to develop maintain and restore maximum movement and functional ability throughout the lifespan” .1However, almost uniquely among the healthcare professions, physiotherapy has aroused little or no philosophical interest or engagement. This is surprising, because some of the salient features of physiotherapy raise interesting and to some extent novel problems in ethics. There are, it is true, some papers on ethically related themes,2–5 but in comparison with the size of the discipline and the complexity of the problems, the profile of physiotherapy in bioethics is worryingly low.A first problem is that unlike many areas of medicine—surgery, for example, or radiography or obstetrics and gynaecology—physiotherapy has no obvious end point. In medicine, the end points of treatment are generally well defined, with only a few exceptions, such as plastic surgery or psychiatry. It is my impression that physiotherapy, with few exceptions, does not operate with the concept of end points. Although what physiotherapy aims at is clear, the point at which the aims are achieved is uncertain. For example, in many cases the patient would go on benefiting from sessions of physiotherapy, perhaps with diminishing returns but still with …. (shrink)

This study identified and described ethical problems encountered by physiotherapists in their practice and physiotherapists’ moral sensitivity in ethical situations. A questionnaire-based survey was constructed to identify ethical problems, and the Moral Sensitivity Questionnaire Revised version was used to measure moral sensitivity. Physiotherapists (n = 116) working in public health services responded to the questionnaire. Based on the results, most of the physiotherapists encounter ethical problems weekly. They concern mainly financial considerations, equality and justice, professionalism, unethical conduct of physiotherapists or (...) other professions and patients’ self-determination. The dimension of moral strength was emphasised in physiotherapists’ self-evaluations of their moral sensitivity. As a conclusion, ethical problems do occur not only at individual level but also at organisational and society level. Physiotherapists seem to have moral strength for speaking on behalf of the patient. Scarce resources make them feel insufficient but much could still be done to provide quality care in co-operation with other health-care professionals. (shrink)

Aim: To explore whether the phrasing of the questions and the response alternatives would influence the answers to questions about legalisation of euthanasia.Methods: Results were compared from two different surveys in populations with similar characteristics. The alternatives “positive”, “negative”, and “don’t know” were replaced with an explanatory text, “no legal sanction”, four types of legal sanctions, and no possibility to answer “don’t know” . Four undergraduate student groups answered.Results: In the first questionnaire 43% accepted euthanasia , 14% did not, and (...) 43% answered “don’t know”. Two per cent of the respondents declined to answer. In comparison with previous surveys on attitudes to euthanasia the proportion of “don’t know” was large. The results of the second questionnaire , showed that 38% favoured “no legal prosecution” . However, 62% opted for different kinds of legal sanctions, and two of four groups expressed significantly different views in the two surveys. A proportion of 10% declined to answer the second questionnaire.Conclusion: An introduction of an explanatory text and a wider range of response alternatives produced differences between the results of the two surveys conducted. (shrink)

Nurses are experiencing new ethical issues as a result of global developments and changes in health care. With health care becoming increasingly sophisticated, and countries facing challenges of graying population, ethical issues involved in health care are bound to expand in quantity and in depth. Blended learning rather as a combination of multiple delivery media designed to promote meaningful learning. Specifically, this study was focused on two questions: (1) the students’ satisfaction and attitudes as members of a scenario-based learning process (...) in a blended learning environment; (2) the relationship between students’ satisfaction ratings of nursing ethics course and their attitudes in the blended learning environment. In total, 99 senior undergraduate nursing students currently studying at a public nursing college in Taiwan were invited to participate in this study. A cross-sectional survey design was adopted in this study. The participants were asked to fill out two Likert-scale questionnaire surveys: CAAS (Case Analysis Attitude Scale), and BLSS (Blended Learning Satisfaction Scale). The results showed what students felt about their blended learning experiences — mostly items ranged from 3.27—3.76 (the highest score is 5). Another self-assessment of scenario analysis instrument revealed the mean scores ranged from 2.87—4.19. Nearly 57.8% of the participants rated the course ‘extremely helpful’ or ‘very helpful.’ This study showed statistically significant correlations (r = 0.43) between students’ satisfaction with blended learning and case analysis attitudes. In addition, results testified to a potential of the blended learning model proposed in this study to bridge the gap between students and instructors and the one between students and their peers, which are typical of blended learning, and to create meaningful learning by employing blended pedagogical consideration in the course design. The use of scenario instruction enables students to develop critical analysis and problem solving skills through active learning and social exchange of ideas. (shrink)

In the past, several researchers in the field of physiotherapy have asserted that physiotherapy clinicians rarely use ethical knowledge to solve ethical issues raised by their practice. Does this assertion still hold true? Do the theoretical frameworks used by researchers and clinicians allow them to analyze thoroughly the ethical issues they encounter in their everyday practice? In our quest for answers, we conducted a literature review and analyzed the ethical theoretical frameworks used by physiotherapy researchers and clinicians to discuss the (...) ethical issues raised by private physiotherapy practice. Our final analysis corpus consisted of thirty-nine texts. Our main finding is that researchers and clinicians in physiotherapy rarely use ethical knowledge to analyze the ethical issues raised in their practice and that gaps exist in the theoretical frameworks currently used to analyze these issues. Consequently, we developed, for ethical analysis, a four-part prism which we have called the Quadripartite Ethical Tool (QET). This tool can be incorporated into existing theoretical frameworks to enable professionals to integrate ethical knowledge into their ethical analyses. The innovative particularity of the QET is that it encompasses three ethical theories (utilitarism, deontologism, and virtue ethics) and axiological ontology (professional values) and also draws on both deductive and inductive approaches. It is our hope that this new tool will help researchers and clinicians integrate ethical knowledge into their analysis of ethical issues and contribute to fostering ethical analyses that are grounded in relevant philosophical and axiological foundations. (shrink)