Structuring a Written Examination to Assess ASBH Health Care Ethics Consultation Core Knowledge Competencies

Abstract

As clinical ethics consultants move toward professionalization, the process of certifying individual consultants or accrediting programs will be discussed and debated. With certification, some entity must be established or ordained to oversee the standards and procedures. If the process evolves like other professions, it seems plausible that it will eventually include a written examination to evaluate the core knowledge competencies that individual practitioners should possess to meet peer practice standards. The American Society for Bioethics and Humanities (ASBH) has published core knowledge competencies for many years that are accepted by experts as the prevailing standard. Probably any written examination will be based upon the ASBH core knowledge competencies. However, much remains to be done before any examination may be offered. In particular, it seems likely that a recognized examining board must create and validate examination questions and structure the examination so as to establish meaningful, defensible parameters after dealing with such challenging questions as: Should the certifying examination be multiple choice or short-answer essay? How should the test be graded? What should the pass rate be? How may the examination be best administered? To advance the field of health care ethics consultation, thought leaders should start to focus on the written examination possibilities, to date unaddressed carefully in the literature. Examination models-both objective and written-must be explored as a viable strategy about how the field of health care ethics consultations can grow toward professionalization.

Conceptualizing Boundaries for the Professionalization of Healthcare Ethics Practice: A Call for Empirical Research

“…12 Within each of these issues dwell a variety of understandings of boundaries within day-to-day practice from which the descriptive and normative elements could be extracted to foster a more thorough reflection on standardization and the expectations of the professional role and to ensure it is actually enacted in practice. White et al (2014) recent target article in The American Journal of Bioethics arguing for the structuring of examinations to assess ASBH ''core knowledge competencies'' continues to beg the question of how well the PHE role is understood in our current context. As Ellen Fox (2014) writes in her response, ''… their approach-to begin the process by speculating about practice details and proffering completed tests-does not seem rigorous enough to do justice to such a serious endeavor'' (p. 1).…”

Toward a Model That Encourages the Recruitment of Ethics Consultants With Clinical Experience

“…White The maturity shown by the American model of clinical ethics consultation is undisputed. The proposal by White, Jankowski, and Shelton (2014) to assess and accredit future consultants is based on the experience of the American Society for Bioethics and Humanities (ASBH), which provides an excellent definition of the competencies that should be required.…”

Clinical Ethics Credentialing and the Perilous Cart-Before-the-Horse Problem

“…And now the latest cart-before-the-horse problem can be seen in the proposal for a written examination (White, Jankowski, Shelton 2014) to assess the mastery of the topic areas of the ASBH Core Knowledge Competencies (ASBH 2011). Parallel to the other proposed elements of clinical ethics credentialing, a written examination sounds deceptively straightforward.…”

“…The over-simplification needed to boil down a complex philosophical idea or framework into a testable one-sentence synopsis masks or destroys the insight that made the idea valuable in the first place. Take as an example of this problem Q19: "The principle of 'double effect' means…" for which, I am guessing, the correct answer is "C: An action or treatment is ethically permissible even though it has both a good and a bad effect because there is intent is [sic] to cause the good effect" (White, Jankowski, Shelton 2014). Neither the distinction between bad effects that are intended versus those that are merely foreseen nor the idea of harm as an unavoidable side effect of pursuing a good end is captured in this pithy summary.…”