The Health Professional Ethics Rubric: Practical Assessment in Ethics Education for Health Professional Schools

A barrier to the development and refinement of ethics education in and across health professional schools is that there is not an agreed upon instrument or method for assessment in ethics education. The most widely used ethics education assessment instrument is the Defining Issues Test (DIT) I & II. This instrument is not specific to the health professions. But it has been modified for use in, and influenced the development of other instruments in, the health professions. The DIT contains certain philosophical assumptions (“Kohlbergian” or “neo-Kohlbergian”) that have been criticized in recent years. It is also expensive for large institutions to use. The purpose of this article is to offer a rubric—which the authors have named the Health Professional Ethics Rubric—for the assessment of several learning outcomes related to ethics education in health science centers. This rubric is not open to the same philosophical critiques as the DIT and other such instruments. This rubric is also practical to use. This article includes the rubric being advocated, which was developed by faculty and administrators at a large academic health science center as a part of a campus-wide ethics education initiative. The process of developing the rubric is described, as well as certain limitations and plans for revision.

[1]  J D Arras,et al.  Getting down to cases: the revival of casuistry in bioethics. , 1991, The Journal of medicine and philosophy.

[2]  A. Haig,et al.  The effectiveness of portfolios for post-graduate assessment and education: BEME Guide No 12 , 2009, Medical teacher.

[3]  Ed Affiliates Ethics and Law in Dental Hygiene , 2001 .

[4]  Anne Colby,et al.  Social Intelligence Measuring the Development of Sociomoral Reflection , 1982 .

[5]  James R. Rest Development in Judging Moral Issues--A Summary of Research Using the Defining Issues Test. Minnesota Moral Research Projects, Technical Report No. 3. , 1977 .

[6]  L. Kohlberg,et al.  The psychology of moral development : the nature and validity of moral stages , 1984 .

[7]  D. Sulmasy,et al.  Knowledge, confidence, and attitudes regarding medical ethics: how do faculty and housestaff compare? , 1995, Academic medicine : journal of the Association of American Medical Colleges.

[8]  S. Shortell,et al.  Development of a core competency model for the master of public health degree. , 2008, American journal of public health.

[9]  Eric M Meslin,et al.  Medical Ethics Education: Where Are We? Where Should We Be Going? A Review , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[10]  R. J. Christie,et al.  Ethical decision making by family doctors in Canada, Britain and the United States. , 1991, Social science & medicine.

[11]  David Thomas Stern,et al.  Measuring Medical Professionalism , 2005 .

[12]  M. Siegler,et al.  Using simulated case studies to evaluate a clinical ethics course for junior students. , 1982, Journal of medical education.

[13]  E. Pellegrino Toward a Virtue-Based Normative Ethics for the Health Professions , 1995, Kennedy Institute of Ethics journal.

[14]  C. Gilligan In a Different Voice. Psychological Theory and Women’s Development. Cambridge, MA (Harvard University Press) 1982. , 1982 .

[15]  H. MacDonald Relational ethics and advocacy in nursing: literature review. , 2007, Journal of advanced nursing.

[16]  T. Beauchamp,et al.  Principles of biomedical ethics , 1991 .

[17]  D. Guinn Handbook of Bioethics and Religion , 2006 .

[18]  L. Kohlberg The Philosophy of Moral Development Moral Stages and the Idea of Justice , 1981 .

[19]  A. H. Jones Narrative based medicine: narrative in medical ethics. , 1999, BMJ.

[20]  G. Bagnall Ethics and law in dental hygiene, 2nd edition , 2009 .

[21]  J C Tronto An ethic of care. , 1998, Generations.

[22]  David B. Resnik,et al.  Responsible Conduct of Research , 2002 .

[23]  C. Bertolami Why our ethics curricula don't work. , 2004, Journal of dental education.

[24]  Ann E. Cudd,et al.  Feminist Theory: A Philosophical Anthology , 2005 .

[25]  R. Boyle,et al.  Introduction to clinical ethics , 1997 .

[26]  R. Arnold,et al.  Medical ethics education: past, present, and future. , 1995 .

[27]  G. L. Engel,et al.  The clinical application of the biopsychosocial model. , 1980, The American journal of psychiatry.

[28]  J Savulescu,et al.  Evaluating ethics competence in medical education. , 1999, Journal of medical ethics.

[29]  Albert R. Jonsen,et al.  The Abuse of Casuistry: A History of Moral Reasoning , 1988 .

[30]  James R. Rest,et al.  A Neo-Kohlbergian Approach: The DIT and Schema Theory , 1999 .

[31]  D. Lynch,et al.  Assessing professionalism: a review of the literature , 2004, Medical teacher.

[32]  C. Geertz The interpretation of cultures / Clifford Geertz , 1973 .

[33]  D. Resnik,et al.  Responsible Conduct of Research , 2022 .

[34]  S. Verdun,et al.  The Case Method , 1951 .

[35]  S. Phillips,et al.  Interprofessional Education in Ethics at an Academic Health Sciences Center , 2000, Academic medicine : journal of the Association of American Medical Colleges.

[36]  C. Popovic,et al.  The educational effects of portfolios on undergraduate student learning: A Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 11 , 2009, Medical teacher.