Professional Ethics Course

This is a working outline for a Professional Ethics for physiotherapy students module at the University of the Western Cape. It will most likely continue to change right up until the module begins. Please feel free to comment in the Discussion page.

Context of the course

If you are interested in completing this online course, please be aware that I will be conducting research into my own students' participation in this module. I will be making the details of the project proposal available for scrutiny once it has bee approved by our institutional ethical review board. Of course, I will exclude all data from participants who are not registered students of the University of the Western Cape. I'm putting this out there from the beginning, in case it impacts how you feel about paticipating.

Higher education institutions from around the world have begun emphasising that their graduates should be able to do more than simply reproduce the discipline-specific knowledge and skills of their respective professions. There is a move towards the development of generic attributes and higher level academic abilities that include self-directed learning, collaborative problem solving, team building, and identifying, accessing, assimilating and communicating information (Ramsden, 2003).

In South Africa, these graduate attributes are also known as critical cross-field outcomes and are used to describe holistic higher education graduates. The characteristics of these graduates include a set of skills and competencies that “build the foundations for lifelong learning, including, critical, analytical, problem-solving and communication skills, as well as the ability to deal with change and diversity, in particular, the tolerance of different views and ideas” (Department of Higher Education, 1997; South African Qualifications Authority, 2011).

Unfortunately, while the description of graduate attributes seems simple enough, how to develop them is less clear. Barrie (2007) suggests that since these attributes include more than knowledge and skills, they should be developed as part of the process of higher education, rather than simply as its products.Developing these generic attributes places an additional responsibility on teachers, a responsibility that is significantly more challenging than simply teaching students the knowledge and skills required for their respective fields (Laurillard, 2012). When we move into the realm of complex combinations of values, dispositions and attitudes, we need to develop a spirit of personal inquiry. Learning should not be thought of as a subject, but as a social and moral practice (Ovens et al., 2011).

One approach to teaching and learning that may help to move students towards independent and critical thinking is known as Inquiry-based learning (referred to as Inquiry from here on). Inquiry aims to promote the development of higher order thinking by guiding students through the exploration of questions that they generate themselves (Justice et al., 2007a; Ovens et al., 2011). It requires an environment that supports open discussion, the questioning of assumptions, and the critical evaluation of information, evidence and argument. The learning environment allows students to independently explore concepts in relation to questions that fill self-identified gaps in their own understanding of the world, thereby preparing them for lifelong learning (Justice, Rice, Roy, Hudspith, & Jenkins, 2009). Inquiry changes the relationship between teacher and student, with teachers needing to move away from being content experts to being facilitators of student-directed learning (Justice et al., 2009).

The PHT402 (Professional Ethics in Physiotherapy) module is a 10 credit, yearlong module offered as part of the 3rd and 4th year undergraduate programme. The main aim of the PHT402 module is to help students learn how to engage with and work through the complex ethical dilemmas that they are likely to encounter in clinical contexts. In the past, the module has emphasised the medico-legal aspect of professional practice and has recently introduced an emphasis on a rights-based approach to practice, which brings it into alignment with the South African healthcare system and Constitution.

However, as the university moves towards the integration of graduate attributes into the curriculum, there are emergent challenges around the development of these behaviours and attributes in the classroom. The graduate attributes that have particular relevance for the PHT402 module are that students should be:

• Ethically, socially and environmentally aware and active
• Skilled communicators
• Autonomous and collaborative
• Flexible and have and the confidence to engage across differences
• Inquiry-focused and knowledgeable
• Critically and relevantly literate

In developing healthcare professionals who can make a positive contribution to South African society, we should strive for more than knowing what and knowing how, and rather aim for our graduates to take what they know and learn how to apply it in the context of ethical dilemmas in healthcare. The Professional Ethics module should be a space where both teachers and students are equipped with the “language of critique and the rhetoric of empowerment to become transformative agents who recognize, challenge, and transform injustice and inequitable social structures” (Zembylas, 2012, pg. 3). We should avoid simply teaching students how to reproduce knowledge and skills. The concepts they learn are more valuable than simply being used to pass a test; they can be used to make sense of something that is perceived to be of human importance (Ovens et al., 2011).

We need to create learning environments that encourage them to use the knowledge and skills to think more deeply and act more wisely. Students' learning practices should require them to engage in learning as whole persons, drawing on emotional and social intelligences, tacit and public knowledge, individual and collaborative skills, contextualised experiences and abstract thinking. They must develop their confidence and decisiveness, as well as their ignorance and doubt, and use them to better direct and motivate their learning, asking questions that deepen their understanding (Ovens et al., 2011).

Objectives and learning outcomes

The overarching theme of this module is to equip teachers and students with the language of critique and the rhetoric of empowerment to become transformative agents who recognize, challenge, and transform injustice and inequitable social structures (Zembylas, 2012). Another major theme is the development of empathy as a way of deepening our relationships with other human beings as a pathways towards social change.

At the end of this module, students should be able to:

1. Identify and describe relevant theoretical concepts related to professional ethics in physiotherapy
2. Gather evidence that can be used to support a claim or conclusion
3. Synthesise evidence from different sources and develop a conclusion that is both personal and informed by those sources
4. Engage with their peers in a public discourse on ethical challenges, which serves to inform autonomous choices
5. Manage differing opinions on complex ethical scenarios
6. Use a technology platform as a part of their learning environment
   

Timeframes and time management

This course will run from 16 July - 31 Augus, in alignment with the third term in the institutional calendar of the University of the Western Cape. We are one of many institutions who still maintain a traditional schedule for administrative reasons i.e. classes are held at set times during the week, for a set period of time. However, there is no academic or technological reason to stick to such a schedule, and so anyone is welcome to complete the course at any times that are suitable for them. Our students will be active during the specified period but their blogs will remain public for as long as they choose to keep them so, and the hope is that the conversations that begin as part of this module will continue long after it ends.

Our students would usually be in class for about 2 hours / week (for this module), and there would be an expectation that they would also do about 1 hour of homework / week. Therefore the activities in their entirety should not require more than 3 hours / week from each student. We would also have an expectation that they submit an assignment by the end of the term. In this case, their blogs will be their assignments.

Self-pacing in online learning isn’t about you deciding to work from time to time whenever you feel like it. Rather, it's about making sure that your work is scheduled. This enables you set a pace for your learning that suits you, as well as learning when and where it suits you. But note that being free to set your own schedule does not mean setting no schedule at all.

What is a portfolio?

The majority of the activity in this module will take place in your learning portfolio which, simply put, is a collection of "evidence" of your learning. Most of the work you do can be thought of as the process of learning as you work through the activities in this module. Once the module is over, you will select 2 products of your learning to present as evidence of whether you have achieved the objectives of the module (see Assessment of learning). Strictly speaking, a portfolio consists of a selection of work that you collect over a period of time, that is built around a particular topic or idea. It allows you to showcase a talent or skill in a way that is outside the boundaries of traditional assessment, and demonstrates your ability to make thoughtful choices about content and presentation.

The purpose of the portfolio is to make a personal statement about what you are learning during this module and how it has impacted on your development as a thoughtful practitioner. You should use it to present evidence of your progress towards achieving the learning objectives of the module. You would do this by clearly making connections between the work you have created and the learning objectives of the assignment. A portfolio also serves as a means for you to reflect on what it means to make ethical choices, both in your professional and personal capacity. You use it to tell your own personal story about what these themes mean to you. One way to think about your portfolio is in terms of collecting, reflecting, selecting and connecting.

Where will I create this portfolio?

Each of you will create a Wordpress blog that you will become a portfolio of your learning activities during the course of this module. When you are setting up your account, you need to to select the "blog URL such as USERNAME.wordpress.com" option. Once your blog has been created, play around with the themes and plugins to personalise it.

Here are some more resources on creating portfolios of learning:

• Defining portfolio assessment
  

Communicating with each other

Once you've set up your blog, you will need to subscribe to the feeds of everyone else in the module so that you can keep up with the conversation that's happening. To do this, you must use an RSS reader to subscribe to everyone's feed. Feedly is a great reader because it runs in any browser on the desktop, as well as on any devices running either Android or iOS. If you use a Blackberry, then you can use Feedly through the browser, or find an alternative RSS reader.

If you use Twitter, the module hashtag is #pht402, which you can use to follow new posts and general announcements. Whenever you publish a new blog post, you can share it to Twitter, which will increase the chances of someone reading your post. You can either do this manually or install an extension that will push the post to your Twitter account. Every tweet that is associated with this module should include the #pht402 hashtag otherwise it won't show up in searches.

Every week the module coordinator will publish a blog post with a summary of some of the conversation and additional reflections and resources, as well as general feedback on your portfolios as they are developing.

[[|]]Assessment of learning

Each week you will be given an activity (or several activities) that could include watching a video, reading an online article or a research paper, listening to a podcast or . Once you've done that, you'll need to write a blog post based on what you've just done.

While you are encouraged to read as many posts as you can , each of you will be given a grouup of students who you MUST read and comment on. Your comments must be in the form of peer-evaluation and should be aimed at improving the work of the other student. You will be given a rubric (i.e. a set of criteria) that you can use to assess each others' posts. You will receive a mark for your role in improving the work of your peers.

At the end of the module you will select of your own posts that you thought were your best work, which you will submit for your final grade. This work will be assessed by the module coordinator. The rubric that is used to mark your work will be the same rubric that you used to mark the work of your peers.

Course activities

These activities will most likely only be finalised closer to the time.

General structure of a week

1. Learning objectives for the week.
2. Stimulus that students will be directed to. Will be something that enables them to learn something about general ethical principles. These will probably be the same things that our curriculum covers, since our students will be assessed at the end of this module. I like the idea of using visual prompts as a stimulus.
3. Activity that they need to engage in e.g. writing something (reflection / poem), create a concept map that can be embedded into their blogs, etc.
4. Interact with others
5. Assessment and general feedback (not yet sure how this will work, since I can't review 60 blogs / week)
6. Interested in using Google Forms for students to fill out a short survey each week. Not sure what data will be gathered though. Also, this would only be for UWC students and not for anyone else interested in participating.
7. Showcase of exceptional student work for the week (?)

Week 1 :: Who cares what you think? (date)

1. Introduction to Professional Ethics
2. Difference between "morality" and "ethics". Need a place for course facilitators to post the expected outline (see below).
3. Morality: role of society, community, nationality, culture, language, religion, gender, sex, etc.
4. Ethics: Professional guidelines, Declaration of Human Rights, Bill of Rights
5. Internal vs. External observation and reflection i.e. look at yourself, rather than others.
   
6. Video:
   

1. 
   

Week 3 :: Torture and Zero Dark Thirty

1. The idea here is to present a stimulus that the students can connect to (in this case, readings on the movie Zero Dark Thirty), and use that to connect to more complex ideas around individual rights vs the rights of society, medically sanctioned torture during Apartheid, etc.
2. Readings:

• http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)61402-0/fulltext
• http://www.wired.com/underwire/2013/02/zero-dark-thirty-torture-oscars
• http://www.newyorker.com/online/blogs/newsdesk/2012/12/torture-in-kathryn-bigelows-zero-dark-thirty.html
• http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)61402-0/fulltext

Week 4 :: 

In South Africa we have an enormous problem with gendered violence, with our statistics on rape being higher than anywhere else in the world. However, the social problem of violence (whether physical, emotional or psychological) against women is global. I'm thinking of using the three events below to guide students into a discussion of gendered violence. The important point would be to move beyond the usual outrage and condemnation that sees these events as trending topics on Twitter, only to be eclipsed by the next Justin Bieber concert, or something else as inane. How can we use social justice and critical pedagogy as a way to move towards action in ways that aim to transform the world and society?

• http://en.wikipedia.org/wiki/Steubenville_High_School_rape_case
  
• http://en.wikipedia.org/wiki/Rape_of_Anene_Booysen
• http://en.wikipedia.org/wiki/2012_Delhi_gang_rape_case

Week 6 :: Child health and education

1. http://www.dailymaverick.co.za/article/2012-10-18-sas-child-gauge-2012-suffer-the-little-children
2. http://www.section27.org.za/2013/02/20/the-shocking-state-of-infrastructure-in-limpopo-schools/ (schools / education, and relationship to health)

Student work

This is where we will index all of your blogs, and where you can come to find each others blogs. However, note that if you set up Feedly to aggregate everyone's work, then it will work a lot better than simply reading through a list of blog names.

This is also where we will showcase some of your work as good examples of the kind of thing that we're looking for. This will help you to evaluate your own work against the examples we present here.

References

• Barrie, S. C. (2007). A conceptual framework for the teaching and learning of generic graduate attributes. Studies in Higher Education, 32(4), 439-458.
• Department of Higher Education (1997). Education White Paper 3 - A Programme for Higher Education Transformation.
• Higher Education Quality Committee (2008) audit of UWC IOP. Audit report on the University of the Western Cape. HEQC Report No. 22.
• Justice, C., Rice, J., Roy, D., Hudspith, B., & Jenkins, H. (2009). Inquiry-based learning in higher education: administrators’ perspectives on integrating inquiry pedagogy into the curriculum. Higher Education, 58(6), 841–855.
• Justice, C., Rice, J., Warry, W., Inglis, S., Miller, S., & Sammon, S. (2007a). Inquiry in higher education: Reflections and directions on course design and teaching methods. Innovative Higher Education, 31(4), 201–214.
• Laurillard, D. (2012). Teaching as a design science: Building pedagogical patterns for learning and technology. London: Routledge.
• Ovens, P., Wells, F., Wallis, P., & Hawkins, C. (2011). Developing inquiry for learning: Reflecting collaborative ways to learn how to learn in higher education. London: Routledge.
• Ramsden, P. (2003). Learning to teach in higher education (2nd ed.). London: Routledge Falmer.
• Rowe, M., Bozalek, V. & Frantz, J. (2013). Using Google Drive to facilitate a blended approach to clinical education. British Journal of Educational Technology. In Press.
• South African Qualifications Authority (2011). Glossary of terms: critical cross-field outcomes. Accessed 18 October, 2011 from http://www.saqa.org.za/show.asp?include=about/glossary/terms.htm
• University of the Western Cape (2009). Institutional Operating Plan (2010-2014).
• Zembylas, M. (2012). Critical pedagogy and emotion: working through “troubled knowledge” in posttraumatic contexts. Critical Studies in Education, (November), 1–14.