The development of moral judgment and organization of ethical knowledge in final year physical therapy students

Background and purpose: It is well recognized that physical therapy practitioners need to go beyond adherence to professional codes of conduct and have skills of ethical reasoning in order to address the ethical issues which arise in clinical practice. There is little consensus in physical therapy regarding approaches to teaching ethical reasoning. The purpose of this research was to study changes in the moral reasoning schema and organization of ethical reasoning knowledge of final year physical therapy students following a 6 week intensive ethics course with a teaching focus on two particular ethical reasoning models: the Four Component Model and the Ethical Reasoning Bridge. Methods: A pre-test post-test design was used to evaluate changes in moral reasoning schema (using the Defining Issues Test version two (DIT2)) and changes in the organization of students’ ethical reasoning knowledge using concept maps. Results: Thirty-seven students completed all four portions of the research, a response rate of 68.5%. There was a significant increase in post-conventional reasoning (so called N2) scores (35.2 to 39.7, P50.006). Concept maps post-test displayed a shift from a pre-test quantitatively oriented and organised set of ethical knowledge concepts to a more integrated and qualitatively oriented new knowledge framework. Conclusion: This study has demonstrated that a 6 week course using curricular strategies involving the interpretation of experience and perspective transformation can facilitate in a cohort of final year physical therapy students both the development of ethical reasoning ability (moral judgment) and a richer organization of the types of knowledge required for ethical decision making.