ETHICS EDUCATION IN ALLIED HEALTH: A SYSTEMATIC REVIEW OF LEARNING OUTCOMES FOR ENTRY-LEVEL STUDENTS

Background: The complexities of modern healthcare pose a range of ethical issues. Education of student health professionals must go beyond exposure to ethical theory, codes and standards to include preparation for ethical... [ view full abstract ]

Background:
The complexities of modern healthcare pose a range of ethical issues. Education of student health professionals must go beyond exposure to ethical theory, codes and standards to include preparation for ethical tensions that reflect practice. This study aimed to determine learning outcomes reported in allied health literature following ethics training.
Method:
Systematic review of primary studies of learning outcomes following evaluation of an ethic based educational intervention, using a priori protocol, adherence to PRISMA statement, critical appraisal via the Critical Appraisal Checklist for an Article on an Educational Intervention, data extraction and narrative synthesis.
Results:
From 1237 records published between 1991 and 2015, 11 studies of variable methodological quality met inclusion criteria with focus on occupational therapy, physiotherapy, pharmacy and dietetics students (n=588). Heterogeneity precluded meta-analysis. Outcome measures were standardized, e.g. Defining Issues Test (DIT) or surveys / likert scales. Pedagogical approaches varied with transformative, constructivist, arts-based, inter-professional, problem-based or experiential learning.
Conclusion:
Findings suggest teaching of ethics should have intensive focused content, link theory with practice, and expose students to multiple views via methods such as guided reflection and discussion of ambiguous, controversial topics. While the exact recommendation of ethics training to maximise efficacy and uptake is unknown, there is some suggestion that immediate learning outcomes may follow a proportional dose-response pattern. Longitudinal studies to determine if learning outcomes continue post-graduation are warranted.
Application to Practice:
Ability to apply ethics in action provides graduate health professionals tools to navigate dilemmas while being true to professional values and expectations.