Does moral judgement improve in occupational therapy and physiotherapy students over the course of their pre-licensure training?

Healthcare professionals often encounter moral dilemmas in clinical practice that require increased responsibility and accountability for ethical decision-making. This paper reports the results of a 6-year longitudinal study that explored changes in moral judgement of five consecutive cohorts of occupational therapy (OT) and physical therapy (PT) students over the course of their professional training. The training programme included an ethics education component. The Defining Issues Test (DIT) developed at the University of Minnesota was used to measure moral judgement. A total of 548 students participated in the study. At entry into their professional training, the DIT scores of the OT and PT students were similar but higher overall than the norms established for college level students or for graduates from professional programmes in the DIT standardization sample. At the time of graduation, results showed no significant differences in moral judgement scores between males and females, their chosen programme of study (OT or PT), year of entry, or previous education. Comparing entry scores to exit scores from both programmes for 288 students who provided data at both times, we found that moral judgement scores increased significantly in both OT and PT students over the 2-year programme of study. No differences were found in scores across gender, programme, year of entry, or previous education. Implications are discussed for including a formal ethics education component in the curricula of all health professional training programmes. Recommendations for future research are outlined.     

Can the value of training be measured? A simplified approach to evaluating training

Measuring the value of any training intervention has long baffled trainers and managers alike. Complex models for calculating the return on investment offer little help in attempting to measure the results of these programs. Unfortunately, while the difficulty in measuring these programs has not lessened, the need to justify training costs in the health care field has increased dramatically. In this article, the authors offer a perspective of how 1 hospital dealt with this complex issue and offer a guide for a simpler approach to measuring the value of training programs that can be used by trainers and managers without resorting to complicated formulas.     

Are preferences over health states complete?

Most applied work in health economics accepts, if only implicitly, the axiom of completeness. Preferences over health states or health services are assumed to be well formed. They are effectively 'data' waiting to be collected. An alternative perspective suggests that values are initially incomplete and are constructed rather than just revealed in the process of answering choice-related questions such as willingness to pay or standard gambles. What might appear as measurement error may, therefore, be a more deliberate process of reflection and deliberation. This paper reports on a study that assessed the completeness of health preferences. The results show a mixed pattern. For most of the sample, values were stable over repeat administration, suggesting completeness. However, one-third of participants deliberately changed their answers and suggested that the interview process had forced them to think about their values more deeply. While it is premature to draw conclusions from this small sample, the suggestion is that completeness cannot be taken for granted.