Does moral judgement improve in occupational therapy and physiotherapy students over the course of their pre‐licensure training?

Abstract

Healthcare professionals often encounter moral dilemmas in clinical practice that require increased responsibility and accountability for ethical decision‐making. This paper reports the results of a 6‐year longitudinal study that explored changes in moral judgement of five consecutive cohorts of occupational therapy (OT) and physical therapy (PT) students over the course of their professional training. The training programme included an ethics education component. The Defining Issues Test (DIT) developed at the University of Minnesota was used to measure moral judgement. A total of 548 students participated in the study. At entry into their professional training, the DIT scores of the OT and PT students were similar but higher overall than the norms established for college level students or for graduates from professional programmes in the DIT standardization sample. At the time of graduation, results showed no significant differences in moral judgement scores between males and females, their chosen programme of study (OT or PT), year of entry, or previous education. Comparing entry scores to exit scores from both programmes for 288 students who provided data at both times, we found that moral judgement scores increased significantly in both OT and PT students over the 2‐year programme of study. No differences were found in scores across gender, programme, year of entry, or previous education. Implications are discussed for including a formal ethics education component in the curricula of all health professional training programmes. Recommendations for future research are outlined.

Ethics Education in Allied Health: A Systematic Review of Learning Outcomes for Entry-Level Students

“…There were multiple studies conducted in Australia [8,36,37], Canada [13,38,39], and the United States of America (USA) [10,35,40]. Most included studies (n=8/11, 72.7%) evaluated intradisciplinary learning outcomes for students enrolled in physiotherapy [8,[36][37][38], occupational therapy [13,35,40] and dietetics [41] programs.…”

“…However, it is important to note that three Australian studies sampled the same group of physiotherapy students [8,36,37] and the publications are based on the same educational program. There were three studies which recruited participants from more than one allied health discipline; combining students from physiotherapy with those from occupational therapy [10,39], and pharmacy [42] programs. The characteristics of included studies are summarised in Table 3.…”

“…The pedagogical approach used by educators was varied, comprising learning approaches across transformative learning [8,13,36,37], constructivist [37,42], arts-based [13], inter-professional learning [41,42], problem-based learning [38,39] and experiential learning [40] approaches. The remaining studies in this review did not specify a particular approach [10,35].…”

“…to first year students) [41,42] with the remaining study including ethics training throughout the overall curriculum [39]. Across studies, there was considerable variation in the content of ethics education, with most focusing on development of moral reasoning and thinking [8,10,36,37,39], or ethical theory and principles [13,38,42]. Relatively few studies focused on professional behaviours such as communication and empathy [40,41], or used a combined approach [35].…”

Ethics teaching in rehabilitation: results of a pan-Canadian workshop with occupational and physical therapy educators

“…In Canada, Geddes and colleagues [20] used the Defining Issues Test (DIT) and found a significant change in OT and PT students' ethical reasoning after the completion of their 2-year degree. In the US, Swisher and colleagues [21] used the same measure to evaluate the change in PT students following an intensive ethics course, and results indicated an increase in students' ethical reasoning.…”