i-Ethics — An Exemplar for Planning, Implementing and Evaluating an Integrated Curriculum in the Health and Human Service Programs at UBC

As the health and human service programs, through the Committee of Health Deans at UBC, examine and debate the best model for the integration of education, research, and practice, there is a need to plan, test, and evaluate a framework for an integrated curriculum in common areas of learning across programs. To our knowledge, there is no precedent for such a comprehensive and broad integrated curriculum. The topic chosen for the exemplar of an integrated curriculum was ethic as it is common across professions, resonates across all areas of practice, and is critical in today’s world of complex, often technology-enhanced healthcare. The UBC Integrated Ethics Curriculum (iEthics) brought together educators, learners, and patients/clients to develop a prototype of an integrated curriculum focusing on three pillars of learning: uni-professional, multi-professional, and inter-professional. This curriculum will strengthen learning that is unique to a profession and create opportunities for inter-professional learning that requires skilled collaboration among health care providers, patients/clients, and families. The interdisciplinary project team developed a curricular model, exit competencies, milestones, and foundational learning activities. These learning activities have been piloted with current health and human services students and faculty and refined based on their feedback. Subsequent phases of the project will see the development of the remaining activities in the curriculum.

Lesley Bainbridge, Associate Principal, College of Health Disciplines
Lynda Eccott, Director IPE Curriculum, College of Health Disciplines
Leandra Best, Associated Dean Academic Affairs, Faculty of Dentistry
Michael Burgess, Professor, School of Population and Public Health, Faculty of Medicine
Philip Crowell, Co-Chair Ethics Block, Medical Undergraduate Program, Faculty of Medicine
Victoria Wood, Project Manager, College of Health Disciplines
Donna Drynan, Senior Instructor / Fieldwork Coordinator, Occupational Science and Occupational Therapy
Bethan Everett, Clinical Ethicist, School of Physical Therapy
Judy Gillespie, Acting Director, School of Social Work (UBC-O)
Liz Jones, Chair of BSW Curriculum Committee, School of Social Work (UBC-V)
Patricia Marck, Director, School of Nursing (UBC-O)
Jo-Ann Osei-Twum, Research Assistant, College of Health Disciplines
Patricia (Paddy) Rodney, Associate Professor, School of Nursing (UBC-V)
Barbara Purves, Assistant Professor, School of Audiology and Speech Pathology
Claudia Ruitenberg, Associate Professor, Educational Studies
Robert Sparks, Director, School of Kinesiology
Anne Townsend, School of Population and Public Health, Faculty of Medicine

Products & achievements: Curriculum Model; Foundations of Ethical Practice Online Module; Foundations of Ethical Practice Interprofessional Workshop.

Intended outcomes/themes:

1. Student perceptions and satisfaction with the integrated curriculum – Students see the value of the iEthics curriculum to their future practice.
2. Faculty satisfaction and engagement – Faculty are engaged in the development and implementation processes.
3. Effective implementation of Phase I curriculum – Program is implemented into all health professional programs at UBC, and is a required component of learning for all students.
4. Expansion to other content areas relevant to the health disciplines – Efficient longitudinal development of integrated curricula in other topic areas using the model piloted in this first phase.

Evaluation approach: Student survey on perceptions and value of learning activities (online modules and workshop) – this formative feedback has been used to modify module and workshop activities. Project team members survey on curriculum development process.

Findings: Module – The majority of the students agreed that the online module was useful in preparation for the face-to-face session. All students agreed that it was important to have a foundational knowledge of ethical concepts for the subsequent face-to-face discussions. Also, the majority of students agreed that the online delivery method was effective and that online reflections were valuable. All students agreed that the module was organized in a logical fashion, building knowledge and skills as it progressed. As a result of the module: Students are able to define ethics and its relevance to personal and professional decision-making and ethical practice. The majority of students can recognize and respond to common, non-complex ethical issues in everyday life; can identify how personal values, beliefs and perspectives can impact responses to ethical situations; are aware of where their own values, beliefs and perspectives are reflected, and not, in their profession’s code of ethics; and can describe the purpose of an ethical decision making framework. All students recognize the need for professional ethics in health care and can define the principles of health care ethic.

Workshop - All students agreed that the face-to-face session added to the experience; that the interprofessional approach enhanced this learning experience; and that they learned with, from and about other professions. As a result of the workshop: Students can articulate how personal and professional values, beliefs and perspectives influence ethical decision-making. The majority of the students can identify the differences and similarities between different codes of ethics; use a professional code of ethics to describe professional responsibilities in relation to specific ethical scenarios; and describe how the fundamental elements of an ethical decision-making framework might be applied in specific cases.

In addition to providing an innovative approach to ethics education, this project provides a model that is changing teaching into an inter-professional activity.

Survey reports that show the evaluation tools used and summarize the data attached to the report.

Dissemination:

Conference Presentations:

1. Bainbridge L, Eccott L, Best L, Burgess M, Crowell P & Everett B. An Innovative Integrated Curriculum Model for the Health Professions: Sharing i-Ethics. 2014 Canadian Bioethics Society Annual Meeting, May 28 – 31 2014, Vancouver, BC, Canada.
2. Bainbridge L & Eccott L. Delivering an Interdisciplinary Ethics Curriculum, Post Conference Workshop, 2014 Canadian Bioethics Society Annual Meeting, May 31, 2014. Vancouver, BC, Canada.
3. Bainbridge L, Eccott L, Burgess M, Everett B, Rodney P & Townsend A. iEthics: An integrated curriculum for teaching ethical practice. 2014 AMEE, August 30 – September 3, 2014. Milan, Italy.
4. Bainbridge L, Eccott L, Burgess M, Crowell P, Wood V, Drynan D, Everett B, Jones E, Marck P & Rodney P. Technology Enabled Learning: Transforming Inter-professional Ethics Education in Health and Human Service Programs at the University of British Columbia. STLHE 2015, June 16 – 19 2015, Vancouver, BC, Canada (abstract submitted).

Peer-reviewed Journal Publications (In preparation/submitted):

1. Bainbridge L, Eccott L & Integrated Ethics Curriculum Committee. An Integrated Approach to Ethics Education in Health and Human Service Programs. Ethics and Education.
2. Bainbridge L, Eccott L, Osei-Twum J & Wood V. Evaluating Recent Canadian Physiotherapy Graduates’ Perspectives on Training for Ethics Practice. Journal of Physical Therapy Education.

Sustainability: The second phase of funding will enable the project team to develop the remaining components of the curriculum. The role of the College of Health Disciplines (soon to be the Office of the Associate Provost Health), under the umbrella of UBC Health, will be to support the delivery of the curriculum and development of integrated curriculum in other content areas. This, in combination with the integrative nature of the curriculum itself, will ensure the sustainability of the project components.