Reflection on the Teaching of Ethics in Physical Therapist Education: Integrating Cases, Theory, and Learning

Abstract

Background and Purpose. Engaging in the scholarship of teaching and learning (SoTL) in our classrooms is an important professional role and responsibility for physical therapist educators. In physical therapist education, there is an increased emphasis on the moral and ethical development of students, yet we know little about which learning tools work best. The purpose of this case study was to explore student learning in the teaching of ethics in physical therapist education. Case Description. Evidence for this case comes from the experiences of 3 classes of physical therapist students taking the ethics course from 2003 to 2005. Data sources for the case include data gathered from the following: (1) student debriefing/self-reflection responses following 2 videotaped standardized patient (SP) interactions centered on ethical problems; (2) student peer and self-assessments; (3) student pre- and post-test scores on a self-efficacy survey tool; and (4) instructor reflections on student learning. Outcomes and Discussion. Standardized patient interactions centered on ethical issues provided structured, authentic learning experiences and opportunities for students to grapple with uncertainty in the context of performance. Student performance did vary as those students who were extremely confident in the SP interaction also demonstrated less critical self-reflection on performance. All students demonstrated significant increases between pre and posttest scores on a self-efficacy ethics survey. This case study suggests the following about ethics education in the health professions: (1) one of the most important goals of ethics education may be facilitating development of students' reflective capacity as a critical element in their professional formation, and (2) learning experiences that have clinical authenticity may well be an important element of pedagogical content knowledge. Key Words: Ethics, Moral education, Reflection, Scholarship of teaching and learning. INTRODUCTION A few years ago, I was on a plane returning from the East coast, dreading the thought of having to read and comment on the student papers in my briefcase. These papers were student responses to reflection questions done directly following a standardized patient (SP) interaction. As I began to read the student papers, I realized that something was very different about them. I found myself totally captured by the students' responses and had no problem writing copious comments on their In fact, the man sitting next to me said, You know, you should be reading a book, not grading papers. I replied, Usually that is the case, but I had students do a new assignment and these papers are incredible - I never knew what students were thinking before. Although I have spent the last 20 years priding myself on my role of advocate for promoting methods of facilitating reflection in my students, this became a critical incident for me. I will never forget that moment of my own personal insight as I realized, perhaps for the first time, I had a deeper insight into what students were actually thinking. Over the last 3 years, I have engaged in a process of inquiry focused on student and instructor learning in the teaching of ethics in physical therapy. This inquiry process has been driven by collaborative conversations with a Carnegie Scholar on our campus about pedagogy in higher education, as well as my own desire to learn more about my teaching and enhance student learning. This paper is a case study representing a collaborative reflective analysis of the teaching of ethics. The first author (GJ) provides the case materials from the teaching of an ethics course and, together with the second author, a Carnegie Scholar (AR), provides a critical analysis of the case. Early in my teaching career in physical therapist education, I taught lecture and laboratory courses in the musculoskeletal area that had direct clinical application and perceived relevance to students. …