Ethics Curriculum Research Articles

Teachers’ perspectives on the implementation of an ethical education curriculum in Ireland

ABSTRACT This study examines the perspectives of ten secondary school teachers on the implementation of a pilot Ethical Education curriculum at senior cycle in three Educate Together schools in Ireland. Informed by a synergy between two ecological approaches, namely the meta-theoretical Consolidated Framework for Implementation Research (CFIR) and the OECD Learning Compass 2030 policy framework for curriculum change, teacher data from interviews and surveys informed a revision to this draft curriculum. Teachers reported that the Ethical Education curriculum facilitated an environment where students had the opportunity to exercise their agency in demonstrating their knowledge, skills, attitudes and values to develop as moral agents. Recommendations were formulated and are presented using an ecosystemic approach, congruent with the CFIR and the Learning Compass, to guide the implementation of this curriculum at a national level.

The current status and challenges of bioethics education in undergraduate medical education in Karachi, Pakistan

BackgroundThe importance of including bioethics in the medical curricula has been recognized globally. Certain countries including Pakistan continue to lag behind although some developments have occurred recently.ObjectivesThe research aimed to provide a snapshot of bioethics education in undergraduate medical colleges in Karachi, Pakistan. The secondary objectives included identifying factors promoting or inhibiting integration of bioethics into the curriculum.MethodsA two-pronged strategy was used to collect data including a website review of medical colleges, in existence for more than ten years, recognized by the Pakistan Medical and Dental Council (PMDC), the regulating body for undergraduate medical education in Pakistan. The other arm employed in-depth interviews with medical educationists in colleges fulfilling inclusion criteria. Data from the website was analyzed and presented as frequencies. Qualitative data was analyzed using content analysis method which involved coding of transcripts, multiple readings and arriving at subthemes and themes iteratively.ResultsThirteen medical colleges were included for the website review, of which four were from public sector. Three medical colleges used the word “ethics” in their vision and mission statement and four had provided a detailed curriculum for ethics on their website.Thematic framework included four broad themes: 1) Need for Bioethics Education, 2) Current Status of Bioethics Education 3) Challenges in integration of bioethics in medical curriculum and 4) Recommendations for integration of bioethics in the Curriculum. Participants were in agreement that bioethics was important in development of future physicians. Participants identified various challenges, foremost being shortage of trained faculty, lack of institutional buy-in and overcrowded curriculum.ConclusionThe study identified sporadic inclusion of bioethics in undergraduate medical curricula, left to the discretion of individual institutions. Since Karachi is a cosmopolitan city, the findings may reasonably reflect the situation in other parts of the country. While bioethics is recognized as an important field, it will continue to remain an orphan subject in the curricula unless the regulatory and accreditation bodies make it compulsory for institutions to include ethics in their curricula.

Exploring moral competence regression: a narrative approach in medical ethics education for medical students

BackgroundStudies from different countries report a stagnation or regression of moral competence in medical students between the first and the last year of their studies, and the value of various educational interventions remains uncertain.MethodsWe used Moral Competence Test (MCT) to measure C-scores of moral competence to determine the change in the MCT C-scores between the first- and the fifth-year medical students from two medical schools in the Czech Republic in the academic year 2022/2023 and to analyze factors associated with the C-scores (observational study). In addition, for the first-year students, we compared the results of the MCT before and after an intervention in medical ethics curriculum (interventional study). We used a cross-sectional and descriptive design for the observational study. Students completed the MCT, consisting of two moral dilemmas (Worker´s Dilemma and Doctor´s Dilemma), the results measured by the C-score, which represents moral competence.ResultsIn total, 685 students participated in the observational study. Objective 1: based on the analysis of the C-score, we observed a decrease in moral competence between the first and the fifth-year medical students (p < .001). Objective 2: we did not observe a statistically significant effect of gender (p = .278), or self-rated religiosity (p = .163). Objective 3: in the interventional study, 440 students participated in the pretest and 422 students participated in the posttest. The test of statistical significance found no improvement in students’ moral competence after the intervention (p = .253).ConclusionMedical students show a regression in moral competence during medical education; it was lower in medical students in their fifth year, compared to the first-year medical students without the effect of gender, or self-rated religiosity. Although educational intervention consisting of multiple tools of medical ethics teaching (PBL, CBL, KMDD and StorED) did not lead to increase in moral competence, the longitudinal effect of such intervention remains to be seen.

Insights from the lived experience of Buddhist ethics: implications for social work ethics education

ABSTRACT Ethics is largely dominated by European curriculum which includes Western moral theories such as deontology, utilitarianism, virtue ethics, and care ethics. To decenter this dominant ethics curriculum, the present phenomenological study explored the moral lived experience of ethics for Korean Buddhist (male and female) monastics (N = 21). Using three-level qualitative coding, data were thematically analyzed. Findings revealed three overarching themes (1) the importance of the saṅgha and community care, (2) the presence of ethical tensions, and (3) ethics as a practice. Each theme had two sub-themes. The implications of these findings are discussed in the context of how these insights from the lived experience of Buddhist ethics may inform and advance social work ethics education beyond the Eurocentric curriculum.

TEACHERS' PERSPECTIVES ON PROFESSIONAL ETHICS

This research paper attempts to study school teachers' perspectives on the professional ethics required of them. The authors mainly studied the awareness and understanding of teachers on some essential professional ethics. It has been found that teachers are confronted with many moral issues while discharging their responsibilities and in decision-making. The paper's significant findings highlighted the need for a professional code of conduct for teachers considering policy perspectives that guide them in discharging their duties as teachers. The paper highlighted the need to incorporate the ethics curriculum in pre-service and in-service teacher education programmes, which is essential to empower them and support them to understand their role as professionals. The study further emphasises the need to develop a framework on professional ethics for teachers and use the developed framework during their professional development programmes at different levels.

A moral-based curriculum to improve civilization and human resource development in Bangladesh

This study investigates the necessity of creating an ethical curriculum based on Islamic ideas in Bangladesh’s educational system. Bangladesh proffers a distinctive backdrop for incorporating Islamic principles into its educational framework as a nation with a varied cultural and religious background. Qualitative methodologies were used to analyze this investigation. It covered a difference of research papers, books, and articles to inspect the social, cultural, and educational elements of implementing a curriculum, primarily contributing to the discussion of ethical education in Islamic culture. This study investigates the challenges and opportunities this effort gives, emphasizing the importance of inclusivity, cultural sensitivity, and a balanced approach to education. The study showed that teaching of ethical education in schools is not having a satisfactory effect on the students and this is because the curriculum of the book on ethical education is concise. The analysis of the impact of Islamic education on ethical education is compressed.

Identifying Relevant Topics for Inclusion in an Ethics Curriculum for Anesthesiology Trainees: A Survey of Practitioners in the Field.

Anesthesiology training programs are tasked with equipping trainees with the skills to become medically and ethically competent in the practice of anesthesia and to be prepared to obtain board certification, yet there is currently no standardized ethics curriculum within anesthesia training programs in the United States. To bridge this gap, and to provide a validated ethics curriculum to meet the aforementioned needs, in July 2021, a survey was sent to anesthesia scholars in the field of biomedical ethics to identify key areas that should be included in such an ethics curriculum. The responses were rated on a Likert scale and ranked. This paper identifies the top ten topics identified as high priority for inclusion in an anesthesiology training program and consequently deemed most relevant to meet the educational needs of graduates of an anesthesiology residency: (1) capacity to consent; (2) capacity to refuse elective versus lifesaving treatment; (3) application of surrogate decisionmaking; (4) approach to do not resuscitate (DNR) status in the operating room; (5) patient autonomy and advance directives; (6) navigating patient beliefs that may impair care; (7) "futility" in end-of-life care: when to withdraw life support; (8) disclosure of medical errors; (9) clinical criteria for "brain death" and consequences of this definition; and (10) the impaired anesthesiologist.

Implementing a formal curriculum on surgical ethics and palliative care for otolaryngology residents

ObjectiveResidents are faced with ethical issues every day but most residency curriculums do not routinely include formal ethics skills training. In order to address this, a comprehensive curriculum on ethics and surgical palliative care was implemented for otolaryngology residents. MethodsAn 8-h ethics didactics curriculum was designed in collaboration with our institution's Institute of Ethics. Varied strategies were used to cover basic principles and practical skills. Anonymous assessments were completed by learners at 3 points during the curriculum on a 5-point scale. ResultsNine residents were surveyed. Prior to the curriculum, a large majority of residents (85 %) expressed little to no familiarity with basic ethical principles. There was statistically significant improvement in understanding of and familiarity with bioethics topics, including the four principles of bioethics (Δ = 2.4, p = 0.004). There was also statistically significant improvement in comfort with the implementation of ethical decision making and palliative care skills, including with difficult conversations with patients (Δ = 1.3, p = 0.03). Participation in sessions was excellent with positive qualitative feedback. ConclusionAn interactive curriculum in ethics and palliative care can be engaging and practical for busy surgical residents, with measurable improvement in comfort with challenging cases and ethical, patient-centered care.

Implementasi Kurikulum Merdeka dalam Pembelajaran Pendidikan Agama Hindu dan Budi Pekerti Pada Jenjang SMP di Kabupaten Bangli

Education is one aspect of life that receives extra attention for the progress of a nation. Indonesia is no exception, which is currently still making great efforts to improve the quality of its education. One of the efforts that has been made by Indonesian people is to implement a new curriculum called Merdeka Curriculum. However, as long as its existence, there were still many schools and teachers who need guidelines to implement it optimally. Based on these problems, it was very appropriate to conduct a study with the title Implementation of the Independent Curriculum in Learning Hindu Religious Education and Ethics at the Junior High School level in Bangli Regency. The aim of this research was to describe the implementation of Merdeka Curriculum in the learning planning stage, learning implementation stage, and learning evaluation stage. Through qualitative research methods with a descriptive naturalistic approach. The results of the research showed that, firstly, at the learning planning stage, the form of implementation of the Merdeka curriculum is carried out in several ways, including: 1) Holistic deepening of Merdeka curriculum, 2) Selection of the independent option to change as a reference for Merdeka curriculum, 3) Preparation of teaching modules based on Merdeka curriculum , 4) Preparing a variety of teaching materials, 5) Preparing a variety of learning media, and 6) Designing formative and summative assessments. Second, at the learning implementation stage, the implementation of Merdeka Curriculum is carried out in several ways, including: 1) Providing initial diagnostic assessments to determine student diversity, 2) Implementing differentiated learning, 3) Applying the Project Based Learning (PjBL) learning model, and 4) Application of Problem Based Learning (PBL) and Discovery Learning (DL) learning models. And thirdly, at the learning evaluation stage, the form of implementation of the Merdeka curriculum is carried out by implementing a combination of formative and summative assessments.

‘To make more room for 21st century themes’: the secular dynamics and demise of Quebec’s ‘Ethics and Religious Culture’ curriculum

ABSTRACT In this article, I examine the secular dynamics of Quebec’s controversial and ultimately short-lived Ethics and Religious Culture curriculum (ERC). I argue that the conflicting criticisms the ERC attracted over the course of its brief existence emerged from the tensions inherent in its conceptualisations of religion, learning, and knowledge. These tensions were themselves rooted in the constitutive concepts and epistemic assumptions of Quebec’s broader socio-spiritual context of political secularism. In this way, my analysis makes a broader argument about the dynamics and viability of religious education programming in secular societies, especially those programmes aimed at fostering ‘religious literacy’.

The role of rationales for and criticisms of ethical decisions in the development of meta-moral cognitive skills

ABSTRACT Meta-moral cognitive skills consist of identifying reasons behind ethical decisions, potential criticisms for such reasons, and constructing counterarguments for these criticisms. We assessed the relationship among these three elements of ethical judgment justification using ethical dilemmas. A mixed-methods research design was used to investigate university students from India and Japan. Critical thinking skills, knowledge of professional ethics, discipline, perspective-taking, common sense, and culture influenced the respondents’ meta-moral cognitive skills. There was a correlation between the number/strength of reasons and criticisms and between criticisms and counterarguments. The respondents had difficulty connecting the reasons for their decisions and their counterarguments. The results imply that incorporating personal and professional cases as part of the ethics curriculum can improve meta-moral cognitive skills.

Designing a medical ethics curriculum in ophthalmology

Designing a medical ethics curriculum in ophthalmology

중등 도덕과 교육과정의 인간이해 내용 고찰

This Study aims to analyze the content of understanding human in Secondary School ethics Curriculum and propose ways to improve it. To achieve this, the study reviewed discussions on Eastern and Western theories and moral education, demonstrating a balanced perspective on the nature of humanity.&#x0D; Upon analyzing the secondary school ethics Curriculum, the results showed a lack of description regarding the essential concept of reason and a tendency to instill an anthropocentric thinking that emphasizes human characteristics. Secondly, there is a insufficient description of Xingshan Theory and Xinge Theory within the societal context, with a disproportionate emphasis on Hobbes' theory over Rousseau's theory that advocating Xingshan Theory. Thirdly, the description of human rights appears abstract and arbitrary, with limited content addressing social rights as universal rights.&#x0D; Based on the analysis, to improve the content of human understanding in secondary school ethics curriculum, firstly, it is necessary to connect the essential concept of reason to the pursuit of ethical life and emphasize the importance of the interaction between humans and the environment as part of the ecological context. This involves describing reason and emotion in a balanced manner concerning ethical behavior. Secondly, it is necessary to address Xingshan Theory and Xinge Theory within the context of societal institutions. Thirdly, expending and addressing human rights issues from the perspective of freedom rights and social rights are imperative.

Research on Case Study and Teaching Improvement of Civic Education Based on Ethics Theory

Abstract Curriculum Civic and Political Education is the requirement of cultivating talents in colleges and universities in the new era, and comprehensively promoting the construction of curriculum Civic and Political Education is a strategic move to implement the fundamental task of establishing morality and educating people. This paper begins with the case of civic and political education based on ethics and explores the case study approach to education. Then, it combines the DEMATEL algorithm and explanatory structural equation modeling and utilizes the DEMATEL-ISM algorithm to dig out the influencing factors affecting Civic and Political education so as to propose the improvement of the Civic and Political education method based on ethics. Furthermore, the improved teaching method is applied to explore the effects of civic and political education by combining the independent sample t-test method. Among them, the concept of nurturing, the idea of intention, and the environmental atmosphere, with a centrality of 7.982, 7.173, and 7.162, in turn, are the key influence indicators of ideological and political education. There are significant differences (P&lt;0.01) in the experimental classes in the dimensions of patriotism and idealism education, dialectical materialism education, scientific quality and social responsibility education, and ethical teaching. In the case analysis process of the silent running through the Civics, to explore the application of curriculum Civics in the process of ethics case teaching, and to promote the deep integration of ethics case teaching and curriculum Civics.

Ethics: Crisis Standards of Care Simulation.

Ethical dilemmas exist with decision-making regarding resource allocations, such as critical care, ventilators and other critical equipment, and pharmaceuticals during pandemics. Triage artificial intelligence (AI) algorithms based on prognostication tools exist to guide these decisions; however, implicit bias may affect the decision-making process leading to deviation from the algorithm recommendations. Conflict within the ethical domain may be affected as well. A knowledge gap was identified within the Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) curriculum regarding ethics in crisis standards of care (CSC) medical decision-making. Incorporating a CSC simulation looked to address this knowledge gap. A simulation-based learning (SBL) experience was designed as a critical access setting where CSC are in place and three diverse, medically complex patients in need of critical care present to the hospital where one critical care bed remains open. Given the complexity of the simulation scenario, a table-top pilot test was selected. Three AG-ACNP fourth-quarter students in their critical care rotation volunteered for the pilot test. Students were provided with the topic, "ethics crisis standards of care" and the article, "A catalogue of tools and variables from crisis and routine care to support decision-making during pandemics" by M. Cardona et al. (2021), to read in advance. Students were provided with the triage AI algorithm (M. Cardona et al., 2021) utilizing prognostication tools to prioritize which patient requires the critical care bed. The expectation was that implicit bias would enter the decision-making process, causing deviation from the triage AI algorithm and moral distress. The debriefing session revealed that students deviated from the triage AI algorithm, experienced implicit bias, moral distress, and utilized clinical judgment and experience to care for all three patients. The pilot test results support that a CSC SBL experience addresses a critical knowledge gap in AG-ACNP education and an SBL experience incorporating ethical decision-making curriculum with standardized patients should be developed and trialed as the next step.

Epistemic ethics justice: a “radical imaginary”

ABSTRACT In the context of the Great Challenges for Social Work, this conceptual paper envisions a “radical imaginary” as a call to action to incrementally build an epistemically just ethics infrastructure in the coming decade that centers race, ethnicity, and culture. The existing challenges of the dominance of moral absolutes and Eurocentric ethics curriculum were examined. Three change processes were proposed to help build a futuristic infrastructure for ethics praxis with a thicker, more equitable, and more inclusive moral social fabric. This “radical imaginary” promotes anti-racist and anti-oppressive ethics praxis that seeks to eliminate both ethical social isolation and ethics-based racism.

Case-Based Immigrant Health Ethics Curriculum: A Pathway to Improve Care and Advocacy.

Introduction Immigrants comprised a significant portion of the total population in the United States (US), and a considerable number of children in the US live with at least one immigrant parent, which has continued to increase over the past decades. However, healthcare providers (HPs) in the US report lack of comfort in interacting with immigrant and refugee populations. Methods The authors, in partnership with the Midwest Consortium of Global Health Educators, developed an innovative,interactive ethics curriculum within the Immigrant Partnership Advocacy and Curricular Kit (I-PACK). They sought to increase HPs' confidence in navigating complex encounters with immigrant families by teaching a relevant ethical framework, highlighting the importance of cultural humility, and equipping learners with an ethics tool (five-box Method) for use in clinical encounters. They piloted the curriculum during threeworkshop sessions in 2020-2021, and this curriculum continues to be used nationally as a part of I-PACK. Results Pre- and post-session surveys indicated thatall participants (100%, n=22) reported acquisition of new skills/knowledge and 19 (86%) felt confident applying this to their clinical practice. The participants reported appreciation for an ethical framework with which to analyze cases, enjoyment of active participation in small group discussions, and utility of the five-box method tool. Some areas of improvement offered were to have more cases and more time dedicated to small-group discussions. Conclusions Given the success of the I-PACK ethics curriculum pilot, the authors plan to incorporate immigrant health cases in the general ethics training in medical school classes and pediatric residency training. Furthermore, they will advocate for the importance of including immigrant health ethics across graduate medical education, as fluency and competence in navigating the ethics of immigrant health are required to provide patient-centered, culturally informed care to all populations.

The impact of an ethics curriculum in a longitudinal integrated clerkship: a qualitative study of graduates

Background: Little is known about the effectiveness of ethics education in developing knowledge and skills in medical schools that persist into residency and beyond. While previous research has demonstrated that graduates of Longitudinal Integrated Clerkships (LICs) continue practices of patient-centeredness and empathy, to our knowledge, no studies have looked at effect of a medical ethics curriculum integrated into LICs. Methods: In 2011, the University of North Carolina School of Medicine-Asheville initiated an Ethics and Humanism course alongside the LIC. The goals of the program were for students to be able to identify ethical issues as they arose and exercise moral imagination in resolving these issues. Later, practices of mindfulness and writing were added. We conducted a qualitative case study using The Kirkpatrick Model of training evaluation to assess graduates of this course in their capacity to apply those skills in ongoing clinical practice. Semi-structured interviews were conducted, transcribed and independently coded. The Kirkpatrick Model informed the organization of codes into themes. Results: The qualitative analysis reached thematic saturation with review of 22 graduates’ interview transcripts. The findings of this study suggest that the Ethics and Humanism curriculum successfully shaped how respondents approached ethical tensions and the healthcare system more broadly. Furthermore, the interviews revealed that respondents used moral imagination in their approaches to conflict resolution and advocacy projects. Discussion: We found graduates of this ethics curriculum continued to identify ethical dilemmas in their daily clinical practice and using moral imagination to address and resolve conflicts. Our findings suggest that linking ethics education to the clinical curriculum may develop persistent skills in navigating ethical dilemmas and increase graduates’ capacity to be resilient, holistic physicians. The potential benefits of this program in preventing burnout are explored. We believe this demonstrates the value of a dedicated ethics curriculum integrated into an LIC.

Internalization of and advocacy for social work professional ethics through microfilm: a progressive teaching reform for MSW ethics curriculum

ABSTRACT Social work ethics is vital to social work education and professional development. However, traditional didactic teaching does not always translate to internalization of social work ethics, and few visual teaching tools measure the extent to which the students have truly internalized professional ethics. Using the perspective of action research, the present study introduced a progressive teaching reform to a Master of Social Work (MSW)-level social work ethics curriculum at a social work school in China. The progressive reform went through two action cycles. In the first cycle, a preliminary attempt, the instructor redesigned the course structure and applied student-generated microfilms as a final assignment. In the second cycle, educators from China and the United States collaborated in class to revise the course in response to issues raised in the first cycle and explore refined and more effective pathways to help MSW students internalize and advocate for professional ethics through filmmaking. The present study examined successes and failures throughout the reform process, providing practical lessons and evidence for social work educators interested in adopting filmmaking as an experiential teaching tool in MSW educational practices.

Surgeon Perspectives on Daily Presentation of Ethical Dilemmas: A Qualitative Study.

Surgeons encounter and navigate a unique set of ethical dilemmas. The American College of Surgeons (ACS) previously identified 6 core ethical issues central to the practice of surgery, but there have been no reports of the true range and complexity of ethical dilemmas encountered by surgeons in their daily practice. Qualitative research is well positioned to address this question. We conducted in-depth interviews with attending surgeons across multiple surgical subspecialties at a large, urban, academic medical center asking them to describe the most common ethical dilemmas they encounter in day-to-day practice. Interviews were recorded, transcribed, and coded according to a grounded theory, inductive approach. Thirty attending surgeons were interviewed, representing twelve different general surgery subspecialties. The majority of dilemmas identified pertained to 4 of the 6 ACS identified core ethical issues: professional obligations, competition of interests, truth telling, and end-of-life care. No participants described dilemmas relating to the themes of confidentiality or surrogate decision-making. Approximately one-third of participants identified ethical issues not well characterized by the ACS core principles, most often relating to the pressure to provide care that is not medically indicated. There was strong support for a formalized surgical ethics curriculum. Although the ACS-defined core ethical issues in surgery appropriately captured many ethical dilemmas identified by participants, surgeons described several scenarios not well characterized by these themes. A dedicated surgical ethics curriculum may help to better equip surgeons to navigate the ethical dilemmas they are likely to face in practice.