This study is a qualitative analysis of the author's previous publications, academic and operational practitioners input, the literature, and accreditation requirements for ethics education in healthcare. Two research questions were addressed: 1. Is a typology of ethics education in healthcare needed, and 2. Is more specificity of ethics education in healthcare required? Both research questions were answered in the affirmative. The results indicated that a typology of ethics education in healthcare is needed with the primary reason being the need for a focused manuscript that uses content validity to illustrate the hierarchy of ethical reasoning in healthcare. No one manuscript brings together the six ethics education domains that were identified as required for appropriate ethics education in healthcare. The second research question result indicated that there are sparse educational objectives available in the context of cognitive and affective educational domains, especially for the six ethics domains presented here: 1. Decision ethics, 2. Professional ethics, 3. Clinical ethics, 4. Business ethics, 5. Organizational ethics, and 6. Social ethics. Due to the limited specificity of the ethics education objectives identified in the literature, the author developed and presented a typology, beginning with 270 ethics educational objectives, for use in healthcare instruction. A discussion is provided on how healthcare can be improved by including more specific ethics education objectives within healthcare programs. Further recommendations include the creation of a taxonomy based on the typology developed here.

Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: The complex ethical dilemmas created by advanced technological medicine and problematic doctor-patient relationships have lead to an increasing interest in medical ethics education since the 1980's. The Medical School of the University of Pretoria has embarked on a new undergraduate medical curriculum in 1997. Ethics is educated in a longitudinal fashion over the six years of the medical curriculum and has focussed largely on the principal-based approach as described by Beauchamp and Childress. The research participants were the first final year class of this new curriculum, while the facilitators were medical educators or philosophers. The major finding was that the students were not yet able to identify ethical dilemmas with ease, although they were successful in the application of the principal-based approach to the vignettes of the study. The students did not cope well with the uncertainty created by ethical dilemmas and sought to solve the situation by creating boundaries provided by medical law. Therecommendations of the study are that the theoretical component of the ethics curriculum should: 1) include more approaches to ethics, than only the principal-based approach; 2) address daily experienced ethical dilemmas during the study years in small group discussions; 3) and implement a portfolio assessment which can serve as a tool for students to track their own development in reflection on ethical dilemmas. In conclusion, the question remains whether we are currently ready to come ""face to face" with the "other" as Levinas argues or are we still divided into "only two classes of mankind in the world - doctors and patients" as remarked by Kipling in the 19th century. / AFRIKAANSE OPSOMMING: Die komplekse etiese dilemmas, veroorsaak deur hoogs gespesialiseerde tegnologiese medisyne en die problematiese dokter-pasiënt verhouding, het gelei tot 'n verhoogde belangstelling in mediese etiekonderrig sedert die 1980's. Die Mediese Skool van die Universiteit van Pretoria het in 1997 'n nuwe voorgraadse mediese kurrikulum geïmplimenteer. Etiek is op 'n longitudinale manier onderrig oor ses jaar in die mediese kurrikulum en het gefokus op die beginsel-benadering soos beskryf deur Beauchamp en Childress. Die navorsingsdeelnemers was die eerste finale-jaar klas van die nuwe kurrikulum, terwyl die fasiliteerders mediese dosente of filosowe was. Die hoofbevinding van die kurrikulum was dat die studente nie die etiese dilemmas met gemak kon identifiseer nie, alhowel hulle suksesvol die beginsel-benadering kon toepas op die gevallestudies. Die studente hanteer nie onsekerheid, veroorsaak deur die etiese dilemmas, met gemak nie en probeer om die saak op te los deur die skep van grense verskaf deur mediese reg. Die aanbevelings van die studie is dat die teoretiese komponent van die etiekkurrikulum die volgende moet bevat: 1) bekendstelling aan meerdere benaderings tot die etiek, bo en behalwe die beginsel-gebaseerde benadering; 2) aanspreek van die daaglikse etiese dilemmas gedurende die studiejare in kleingroepbesprekings; 3) en die implementering van 'n portfolio-evaluasie, wat kan dien as 'n instrument vir die studente om hul eie ontwikkeling aangaande nadenke oor etiese dilemmas na te gaan. Opsommend, die vraag is steeds of ons tans gereed is om "aangesig-tot-aangesig" te verkeer met die "ander" soos Levinas redeneer of is ons steeds verdeel in "slegs twee klasse van menswees in die wêreld - dokters en pasiënte" soos opgemerk deur Kipling in die 19deeeu.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: Recent literature on medical professionalism claims that self-awareness and the ability to reflect upon one’s experiences is a critical component of professionalism; however there is a paucity of empirical evidence to support this claim. This study employed a mixed methods approach to explore the utility of reflective writing and self- and peer assessments in explaining professionalism lapses among medical students. Methods: A retrospective case-control study was conducted using students from Indiana University School of Medicine (IUSM) who had been disciplined for unprofessional behavior between 2006-2013 (case group; n=70). A randomly selected control group (n=230) was used for comparison. Reflective ability was assessed using a validated rubric to score students’ professionalism journals. Mean reflection scores and assessment scores were compared using t-tests. Logistic regression analysis was used to determine the impact of reflection scores and self- and peer assessment scores on the likelihood of having been disciplined for unprofessional behavior. Subsequent qualitative analysis further explored when and how students learned professionalism during their clinical experiences. Results: The study found that students in the case group exhibited lower reflective ability than control students. Furthermore, reflective ability was a significant factor in explaining the odds that a student had been cited for professionalism lapses. There were no differences in self-assessment scores between the two groups, but students in the case group had significantly lower peer assessment scores than control students. Peer assessment scores also had the greatest influence on the odds that a student had been cited for professionalism deficiencies during medical school. Qualitative analysis revealed that students learn professionalism from role models who demonstrated altruism and respect (or lack thereof). Conclusions: These findings suggest that students should be provided with guidance and feedback on their reflective writing to promote higher levels of reflection, which may reduce the number of students who are cited for professionalism lapses. These findings also indicate that peer assessments can be used to provide students with insightful feedback regarding their professional development. Finally, role models have a strong influence on students’ professional development, and therefore must be cognizant of the implicit messages their behaviors convey.