Ethics

What can I do?

Impact
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Quality
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  1. Carve out specific time to support students develop ethical sensitivity, competence, and decision-making capacity, don’t just expect they’ll learn it through experience [1, 2, 3].
  2. Use online and face-to-face methods and collaborate across disciplines when teaching students about ethics [4]

What is this about?

Developing competence in ethical practice is a complex process. Students require exposure to ethical knowledge and ethical problems across multiple fora and at multiple timepoints during their development. This exposure must be interactive, multi-modal, and contextualised to real-life situations to support the application of ethics in practice. The ability to identify ethical problems, critically analyse these problems, engage in multi-disciplinary discussion, and negotiate ethical decision-making processes are important skills for development. Key skills that can be supported are the ability to:

  1. identify and rationalise ethical problems.
  2. engage in multi-disciplinary discourse.
  3. critically analyse ethical problems.
  4. consider multiple perspectives in the decision-making process.

What's the evidence say?

The evidence indicates that ethics education can enhance students’ development of ethical competence [1], ability to identify ethical problems [1,3], ethical analysis, sensitivity, and decision-making [2], and ethical confidence [3]. Variety in exposure to ethical situations [1,2,4] across multiple timepoints is needed, as experience level is generally suggestive of higher ethical effectiveness [2]. Contextualised and facilitated case-study discussions separated from the direct care interface are an important element of this development.

What's the underlying theory?

Social Cognitive Theory suggests that learning is influenced by the social environment and the interactions that occur within it. In a placement setting, teaching health students about ethics can provide them with the opportunity to learn about the standards and expectations of the healthcare environment, and to observe and learn from role models and peers who embody these values. This can help students to develop a sense of identity and belonging within the healthcare community, and to see the relevance and importance of ethics in practice.

Teaching health students about ethics on placement can also provide opportunities for social comparison, as students can reflect on their own ethical values and behaviors, and compare them to those of their peers and role models. This process can help students to clarify their own values and to identify areas for improvement.

Where does the evidence come from?

One meta-analysis [2] informs this evidence summary and three systematic reviews [1,3,4] are provided as further support for the conclusions. All are high-quality studies. Only one study included a multi-disciplinary perspective [1], with others including scientists [2] and medicine [3,4], limiting generalisability). The rigour of the included studies is indicative of a high-level of confidence in the findings. (➕➕➕➕ ).

References

  1. Andersson, H., Svensson, A., Frank, C., Rantala, A., Holmberg, M., & Bremer, A. (2022). Ethics education to support ethical competence learning in healthcare: an integrative systematic review. BMC Medical Ethics, 23(1), 29–29. https://doi.org/10.1186/s12910-022-00766-z
  2. Antes, A. L., Murphy, S. T., Waples, E. P., Mumford, M. D., Brown, R. P., Connelly, S., & Devenport, L. D. (2009). A Meta-Analysis of Ethics Instruction Effectiveness in the Sciences. Ethics & Behavior, 19(5), 379–402. https://doi.org/10.1080/10508420903035380
  3. de la Garza, S., Phuoc, V., Throneberry, S., Blumenthal-Barby, J., McCullough, L., & Coverdale, J. (2016). Teaching Medical Ethics in Graduate and Undergraduate Medical Education: A Systematic Review of Effectiveness. Academic Psychiatry, 41(4), 520–525. https://doi.org/10.1007/s40596-016-0608-x
  4. Wong, M. K., Hong, D. Z. H., Wu, J., Ting, J. J. Q., Goh, J. L., Ong, Z. Y., Toh, R. Q. E., Chiang, C. L. L., Ng, C. W. H., Ng, J. C. K., Cheong, C. W. S., Tay, K. T., Tan, L. H. S., Ong, Y. T., Chiam, M., Chin, A. M. C., Mason, S., & Radha Krishna, L. K. (2022). A systematic scoping review of undergraduate medical ethics education programs from 1990 to 2020. Medical Teacher, 44(2), 167–186. https://doi.org/10.1080/0142159X.2021.1970729

Additional Resources

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