Teaching Ethics Online to Health Sciences Professionals

Introduction

Ethics is a discipline that addresses complex moral issues at the intersections of health care delivery, medical research, technological advancement, and environmental studies. Access to ethics training is important for all future and practicing health sciences professionals (HSPs) regardless of their specific roles. The high demand for non-physician healthcare providers and research professionals in the United States to deliver medical care is continually growing (MacKinnon III, 2013; National Conference of State Legislators, 2013). Accordingly, nurses and HSPs should be as well versed in the ethical implications of their choices and actions as clinicians (Purtilo & Doherty, 2011). Paramedics, sonographers, physical therapists, clinical research associates, and medical laboratory scientists are just a few examples of the broad categories of HSPs who can benefit from ethics training and education. Healthcare ethics is typically part of the standard curriculum in health sciences courses (Wong, Greenhalgh, & Pawson, 2010).

In considering the need to develop ethics competencies relevant to HSPs, it is also important to assess the status and availability of pedagogical tools for ethics education in blended and online environments. Online education courses are academic offerings where the instructor and students are separated physically, and the coursework is offered through web-based platforms. Online course offerings can include a single session or a series of sessions throughout a semester or year. Students may meet asynchronously, synchronously, or both using virtual video conferencing tools, chat rooms, and web-based discussion tools. Students may take exams and quizzes, present or view slide presentations, discuss case studies in small virtual breakout groups, and more. Blended course formats may involve some face-to-face (F2F) interactions as part of the course in addition to online learning.

Online and blended courses may be attractive to future and currently practicing HSPs seeking a flexible course schedule (Bichsel, 2013; Todd, 2017). Moreover, individuals may opt for online opportunities to master a specific subject area, such as ethics or research ethics, or for personal reasons, such as health status or the affordability of online courses (Newell & Debenham, 2009; Oswal & Meloncon, 2014). Despite lower overall enrollment trends in higher education, several studies report enrollment growth among online programs compared to traditional, on-campus programs (Bichsel, 2013; Seaman & Seaman, 2017; US Dept. of Education, 2018), possibly due to economic downturn periods and greater ease of access for working professionals (Kimmel, Gaylor, Gruggs, & Hayes, 2012). On March 11, 2020 the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic (WHO, 2020). Traditional face to face learning at colleges and universities throughout the world were forced to close and quickly pivot to online learning as the preferred and in some cases the only instructional method available, with the time frame of returning to campus unknown (Burkle, 2019). Ethical dilemmas and challenges of operating during a disaster that have resulted from the COVID-19 crisis response require new approaches as a result of moral distress (Leider, DeBruin, Reynolds, Koch & Seaberg, 2017). The COVID-19 pandemic is a prime example of the necessity of having readily available options for online learning (Gewin, 2020).

To gain a better understanding of teaching ethics in an online format for HSPs, we conducted a literature review (January 1, 2000 to March 20, 2020) to assess the available empirical evidence on such courses. This chapter provides benefits and challenges of teaching ethics online, describes empirical research on online interventions and outcomes in fully online and blended ethics courses, and presents our own experiences teaching ethics in the health sciences programs offered at The George Washington University (GW).