Exploring and evaluating Vertically Integrated Teaching in Ethical Decision-Making (VIT-EDM) in pharmacy

Abstract

Background: With increased patient-centred care, pharmacists are often faced with ethical dilemmas and expected to provide solutions for practice dilemmas, relying on ethical judgment, principles of professional ethics, standards of practice, and moral reasoning capabilities. Pharmacists need to be competent in ethical decision-making which will enable them to act in a morally preferable and justifiable manner with patients. Literature has shown that moral reasoning skills are teachable and measurable competencies in healthcare. Objective: To evaluate the impact of implementing a vertically integrated teaching approach in ethical decision-making (VIT-EDM), on moral reasoning capabilities of pharmacy students as they progressed from year-one (pre-exposure to teaching intervention) to final year (post-intervention) of pharmacy studies, using the Professional Ethics in Pharmacy test (PEP) as a surrogate measure of moral reasoning capabilities. Methods: Cross-sectional, parallel cohort, comparison study, using PEP. A de-identified electronic survey link was emailed to enrolled students in each targeted cohort. Descriptive and inferential statistics were conducted using SPSS. Results: Fourth-year students’ confidence measures were significantly higher in decision-making. Furthermore, students’ decision-making and moral reasoning measures were higher in fourth-year students. They generally demonstrated moral reasoning capabilities belonging to stage four of moral reasoning levels, which is related to benefitting patients while respecting authorities and legal requirements. However, the difference in the P-scores (fourth-year and first-year) was not found statistically significant. Conclusion: Findings of this study underlined the positive impact of the (VIT-EDM) approach, a relatively novel mixed-method pedagogy in teaching pharmacy ethics. It highlighted the enhanced confidence of students in ethical decision-making when facing an ethical dilemma.