Uncovering Ethical Dilemmas in International Service-Learning: A Grounded Theory

Abstract

Introduction. International Service-Learning (ISL) is a model of experiential learning offered by Doctor of Physical Therapy (DPT) programs in the United States. Over the past several years, the number of these experiences has grown rapidly. Review of Literature. Recent evidence has uncovered detrimental impacts of short-term health-related experiences, such as ISL, on the host community; however, to date, ethical situations arising in ISL in DPT education have not been explored. From the perspective of the American Physical Therapy Association (APTA's) Code of Ethics and the Realm-Individual Process-Situation (RIPS) model of ethical decision making, the aims of this study were to (1) explore the experiences, perceptions, and insights of faculty, students, and alumni, who attended an ISL experience and (2) analyze their ethical nature. Subjects. Ten students, 6 faculty members, and 5 alumni from 4 DPT programs participated. All participants, except one alumnus, traveled to the same Central American country and partnered with the same host organization for the ISL experience. Method. This study used a constructivist grounded theory approach. Results. Data analyses indicated that ISL as experienced by participants in this study did not align with APTA's ethical principles 2A, 3B, and 8B. Furthermore, the RIPS situational analysis indicated that the primary themes arising from this study reflected ethical issues/problems and an ethical temptation, with an overarching ethical silence. Discussion and Conclusion. In their desire to be altruistic and provide global experiential opportunities to students, educators may overlook ethical situations arising from ISL. Research demonstrating the benefit of ISL to patients and the host community, and to establish best practice standards to minimize detrimental impacts to the host should be undertaken.