Adults with dysphagia experience difficulties swallowing food and fluids with potentially harmful health and psychosocial consequences. Speech pathologists who manage patients with dysphagia are frequently required to address ethical issues when patients' food culture and/ or preferences are inconsistent with recommended diets. These issues incorporate complex links between food, identity and social participation. A composite case has been developed to reflect ethical issues identified by practising speech pathologists for the purposes of illustrating ethical concerns in dysphagia management. The case examines (...) a speech pathologist's role in supporting patient autonomy when patients and carers express different goals and values. The case presents a 68-year-old man of Australian/Italian heritage with severe swallowing impairment and strong values attached to food preferences. The case is examined through application of the dysphagia algorithm, a tool for shared decision-making when patients refuse dietary modifications. Case analysis revealed the benefits and challenges of shared decision-making processes in dysphagia management. Four health professional skills and attributes were identified as synonymous with shared decision making: communication, imagination, courage and reflection. (shrink)

Health science students frequently experience ethical dilemmas on clinical placements, yet ethics education rarely prepares students with the ethical leadership skills required. The Leadership in Ethical Practice (LEP) program is an ethics education resource designed to enhance health science students’ knowledge and skills in ethical leadership to prepare them for clinical placements and future professional practice. This qualitative study aimed: to explore the nature of students’ ethical leadership goals; determine whether a specific, measurable, achievable, relevant, and time-bound (SMART) format was (...) an effective tool for students to create ethical leadership goals; and identify any changes in students’ pre- and post-self-ratings of ethical leadership knowledge following the LEP program. Eighty-two diagnostic radiography students from the University of Sydney participated in the study. Inductive and deductive qualitative content analysis (Elo & Kyngas, 2008) were used to explore students’ goals. Descriptive statistics were used to investigate students’ pre- and post-self-ratings. Four themes emerged from students’ goals: initiative, competence, and courage in ethical reasoning; communicating ethical stories through listening, questioning, and connecting; reflecting and growing as an ethical leader; and safe practice and person-centred outcomes. SMART goal format elements were evident in 61% of students’ goals. Students' ethical leadership self-ratings showed positive changes after participating in the LEP program. Findings indicated students planned to further develop ethical leadership skills during clinical placements and future professional practice. This study demonstrated the ethics education approaches used within the LEP could assist health science students to apply ethical leadership in future clinical practice. (shrink)

Background Ethics of care provides a framework for health care professionals to manage ethical dilemmas and moral resilience may mitigate stress associated with the process and outcomes of ethical reasoning. This review addresses the empirical study of ethics of care and moral resilience, published in the health care literature, and identifies potential research gaps. Methods and procedure Arksey O’Malley's framework was adopted to conduct this scoping review. A literature search was conducted across six databases: CINAHL Plus with full text, PubMed, (...) PsycINFO, EMBASE, Scopus and MEDLINE. We collected and synthesised information on the nature of studies including study design, methods and key findings. Results While there is an abundance of literature describing the potential strengths of an ethics of care approach to ethical reasoning and growing interest in the role of moral resilience in protecting against moral distress, both concepts have received little empirical attention. A total of six relevant publications were selected for review. No studies explored the relationship between ethics of care and moral resilience. However, studies focused upon ethics of care approach as a facilitator of patient-practitioner professional relationships and effective ethical decision making in health care practice. Current evidence explores key characteristics consistent with moral resilience in health care professionals. Conclusion This review identified a dearth of research in ethics of care and moral resilience in healthcare practice. Further empirical investigation may provide a deeper understanding of the translation of ethics of care and moral resilience to health care practice to facilitate workplace culture. (shrink)

The importance of graduating ethical health professionals is indisputable. Yet evaluating the quality of ethics education programs remains problematic for educators. A divide between learning and integrating ethics in everyday professional practice lies at the heart of this issue. The Ethics in Professional Practice (EPP) project addresses health professions' students’ self-efficacy for ethical practice. Students are cast as central characters in authentic vignettes and complete guided learning activities to facilitate their ethical reasoning skills. A design-based research approach was utilised to (...) create EPP resources and this study focuses on the analysis phase of the design process. The aim was to investigate EPP learning outcomes by developing innovative measures based upon Kirkpatrick’s ( 2006 ) evaluation model: namely, reaction, learning, behaviour and effects. Health professions students from Exercise and Sports Science, Rehabilitation Counselling and Speech Pathology (n = 58) participated in the EPP. Qualitative content analysis of reflective statements demonstrated their ethical sensitivity in four categories: Expectations and Empathy in Quality Care; Managing Overwhelming Demands; Informed, Engaged and Empowered; Access to Flexible Models of Service Delivery. Findings from the Rehabilitation Counselling cohort (n = 16) were explored in-depth using Semantic Differential Scales and demonstrated positive ethical reasoning outcomes. Participants also developed individual, ethical practice goals for professional practica. Qualitative content analysis of these goals demonstrated clear ethical reasoning learning effects. Participants integrated concepts of becoming an ethical professional with effective communication, collaboration, empowerment and quality care. Study outcome measures are critiqued and findings may inform redesign of future ethics education resources. (shrink)