Learning about ethical decision making in health care using web-based technology: a case study
Lees, Amanda B
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Structured ethical components in tertiary health care programmes are now recognised as being essential. There are however, perceived barriers to ethics education within health related degrees. Ethics is often compulsory and sometimes unpopular. There is a need for creativity and engagement both in its delivery and content. Literature shows several teaching strategies are utilised however few studies address the use of online technologies. The Values Exchange is a web based decision making tool that offers a unique way to deliver ethics education. Not only does the software utilise a relatively untapped method of delivery, its philosophical underpinnings differ from many other ethics education strategies. Decision making in health care is underpinned by an emphasis on being evidence based. However, the Values Exchange, and a growing body of additional literature supports a more balanced framework for decision making, one that acknowledges the role of individual values within the decision making process. The rationale for this is that values are already an integral part of how one views the world and how it is socially constructed. As a result evidence is already saturated with values. An acknowledgement of values focuses on the decision making process, rather than just the decision outcome, or product. Developed in New Zealand by Professor David Seedhouse, the software has been utilised at Auckland University of Technology since 2005. It is internationally used within university and school settings as well as within health care practice. Research using the Values Exchange is limited. However, anecdotal evidence suggests that the software offers an effective way to facilitate learning and teaching and may increase student engagement. A case study design explored the ways in which the software facilitated users to think about ethical issues. It considered the role of values in the decision making process and the ways in which the software facilitated learning from others. The study found that the online medium provided a supportive environment for decision making. The software contributed to new understandings about both the product and the process of decision making. The software enabled users to recognise the complexity of health care situations. Learning about oneself and others enabled users to arrive at new ways of seeing practice based issues, and new ways of seeing themselves. The Values Exchange demonstrates an effective and creative way to deliver ethics education. It utilises unique, engaging technology encouraging thoughtful reflection that has the potential to manifest itself in benefits for both patient and practitioner.