JCPSLP Vol 17 No 3 2015

Fresh science and pioneering practice

Teaching ethics Application of ethical frameworks to an ethical dilemma based on a simulated client interview Helen Corbould, Andy Smidt, and Emma Power

The perspectives Lecturer As a university lecturer, it is difficult to present realistic challenges to students within a controlled environment. This activity involved students meeting a simulated client in order to collect case history information (MacBean, Theodoros, Davidson, & Hill, 2013). The activity was implemented within a case-based curriculum where students integrate a number of learning objectives around a single case (McCabe, Purcell, Baker, Madill, & Trembath, 2009). The meeting with the simulated client allowed students to experience face-to-face interviewing, to then produce a report using contrasting writing styles (for a carer and a medical audience), and to use reflective journaling to consider their own skills. The final task within the activity was to consider an ethical dilemma within one of several suggested ethical frameworks. As the lecturer, the challenge was to allow students to experience this as an authentic activity and to support them as they reflected on the challenges and the lessons to be learned (Meyers & Nulty, 2009). Student As a student SLP, I attend lectures and tutorials on phonology, language, voice, swallowing, and neurogenics and then apply this material to my placements. As for ethics, however, the transition from the classroom to real life is not so straightforward (Stansfield & Handley, 2010). The difficulty of translating ethics is especially true for ethical dilemmas, where the appropriate conduct is not easily, if at all, discernible. As part of the Masters of Speech Language Pathology program at the University of Sydney, we were required to apply one or more frameworks to a hypothetical ethical dilemma based on a simulated client interview. The simulated client interview added a dimension of authenticity to the ethical dilemma and allowed me to approach the ethical dilemma with empathy for the client’s circumstances. Overall, this task allowed me to develop skills in ethical reasoning and to structure my decision-making based on the procedures sanctioned by the narrative (Charon, 2001) and principles (Beauchamp & Childress, 2001) approaches. In using such frameworks we can develop ethical problem- solving skills, comply with the SPA (2010) Code of Ethics guidelines, and be sensitive to our clients’ and their families’ circumstances. Simulated client As a lecturer within the degree program not involved in this unit of study (UOS), I had two roles in this ethical learning

Speech language pathologists (SLPs) are regularly confronted with complex ethical dilemmas in clinical practice. These dilemmas are particularly challenging for student speech pathologists who, without years of clinical experience, often feel uncertain in their clinical reasoning and decision-making. While university course content can explain the different ethical theories and frameworks, hypothetical scenarios provide real-life examples to make this content meaningful. This article presents the perspective of a student speech pathologist as she applied two contrasting approaches to addressing ethical dilemmas to unravel a hypothetical ethical dilemma concerning the breaching of client confidentiality, and the perspectives of teaching staff involved in this activity. This exploration points to the potential for ethical frameworks to guide ethical decision-making and increase confidence, for both student/ novice clinicians and experienced clinicians alike. T his article presents the reflections and perspectives of three individuals (authors) following a simulated client interview and ethical dilemma activity conducted as part of a speech language pathology university course. During the activity, students interviewed the client (carer of a young man with traumatic brain injury (TBI) played by an experienced speech-language pathologist (SLP)) and then discussed an ethical dilemma. Perspectives are presented from the lecturer who designed the activity, a student who completed the activity, and the SLP who acted as the carer. The hypothetical ethical dilemma is analysed using two contrasting approaches – the principles-based and the narrative approaches – to share the complex thought process the participants engaged in during the activity and to illustrate the differences and respective benefits of each approach. The potential for these tools to guide ethical reasoning and decision-making is discussed, as well as the value of using hypothetical cases and simulated client interviews to support student learning.

KEYWORDS CASE-BASED LEARNING CONFIDENTIALITY ETHICS

NARRATIVE APPROACH PRINCIPLES APPROACH

THIS ARTICLE HAS BEEN PEER- REVIEWED

Helen Corbould (top), Andy Smidt

(centre), and Emma Power

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JCPSLP Volume 17, Number 3 2015

www.speechpathologyaustralia.org.au