Teaching and asessing ethics in psychology training in

Teaching and asessing ethics in psychology training in the UK - Work in Progress… Tony Wainwright and Tony Roth

Running order 2. 00 Introduction and overview – Tony Wainwright 2. 25 Ethics and the competence framework for CAMHS – Tony Roth 2. 45 Group work – applying the four component model: Ethical Sensitivity Ethical Reasoning Ethical Motivation Ethical Implementation Task is to identify principles on: 1. Delivery of teaching. 2. Identification of relevant competence 3. Assessment method noting reliability and validity issues 3. 20 Feedback 3. 40 Closing discussion 3. 45 Close

Outline n n Context Survey of ethics teaching by BPS Ethics Committee Survey of ethics teaching experience by BPS Postgraduate Affairs Group Competencies

Context n EFPA SCE 1999 recommendations on teaching ethics n 2010 Survey data from Austria by Dr. Wolf-Dietrich Zuzan n Suggested this is an area for review

Some questions we have been considering n n n What should be the content and method for teaching undergraduate/postgraduate/professional psychology about ethics? Is there an equivalent to evidence-based practice that we use in other aspects of training? Can we operationalise ethics competencies and develop standards for assessment.

Competency based training n n BPS Accreditation criteria for psychology training are now ‘competency based’ For Clinical Psychology, for example: Requires trainees to develop competencies across the life-span, with a range of client groups, in various clinical settings and using different therapeutic modalities. Crosscutting competencies, such as working with diversity and ethical practice are also mentioned. Generally rather high level statements with limited operationalisation

Ethics teaching audit 1. Survey: i. Ethics Committee - UK courses ii. Postgraduate Affairs Group (Psy. PAG) - postgraduates 2. Review standards 3. Identify examples of good practice 4. Review competencies and assessment methods 5. Publish guidance on curriculum and assessment of teaching.

Surveys Psychology Departments n 113 institutions surveyed covering 612 accredited courses. n Responses received from 42 institutions (37%) n Good range of undergraduate courses responded n Good range of professional training courses n Sufficiently consistent to make develop some tentative broad conclusions. Individual postgraduate psychologists n Members of PSYpag n Approx 110 responses

The initial survey results 1. Departments 2. Individual postgraduates experiences

1. Please indicate in what primary capacity you are responding to this survey: 1 Head of Department 2 Head of Undergraduate Degree Programme 3 Head of Postgraduate Degree Programme 4 Head of Departmental Ethics Committee 5 Other: Included Research Directors Ethics officers (2) Chairs of ethics committees N Current 30. 06. 2011 12: 32 www. questback. com 42 Ethics Teaching Survey 10

2. Please indicate which Society accredited courses are currently run within your Department: 1 Undergraduate 2 Postgraduate: forensic psychology 3 Postgraduate: clinical psychology 4 Postgraduate: occupational psychology 5 Postgraduate: health psychology 6 Postgraduate: counselling psychology 7 Postgraduate: sports and exercise psychology 8 Postgraduate: educational psychology 9 Other: Ph. D Research Conversion Course N Current 30. 06. 2011 12: 32 www. questback. com 42 Ethics Teaching Survey 11

3. Is there a written curriculum covering ethics? The following questions relate to the delivery of ethics teaching in your Department. 1 Undergraduate 2 Postgraduate: forensic psychology 3 Postgraduate: clinical psychology 4 Postgraduate: occupational psychology 5 Postgraduate: health psychology 6 Postgraduate: counselling psychology 7 Postgraduate: sports and exercise psychology 8 Postgraduate: educational psychology N Undergraduate 32 Postgraduate: forensic psychology 6 Postgraduate: clinical psychology 11 Postgraduate: occupational psychology Postgraduate: health psychology 4 10 Postgraduate: counselling psychology 4 Postgraduate: sports and exercise psychology 3 Postgraduate: educational psychology 2 30. 06. 2011 12: 32 www. questback. com Ethics Teaching Survey 12

4. Please indicate if there are specific teaching sessions devoted to ethics for each of the Society accredited courses run within your Department: 1 Undergraduate 2 Postgraduate: forensic psychology 3 Postgraduate: clinical psychology 4 Postgraduate: occupational psychology 5 Postgraduate: health psychology 6 Postgraduate: counselling psychology 7 Postgraduate: sports and exercise psychology 8 Postgraduate: educational psychology N Undergraduate 33 Postgraduate: forensic psychology 6 Postgraduate: clinical psychology 13 Postgraduate: occupational psychology Postgraduate: health psychology 4 11 Postgraduate: counselling psychology 4 Postgraduate: sports and exercise psychology 3 Postgraduate: educational psychology 3 30. 06. 2011 12: 32 www. questback. com Ethics Teaching Survey 13

5. Is there guidance for all teachers to include ethics in their teaching sessions? 1 Undergraduate level 2 Postgraduate level N Undergraduate level 34 Postgraduate level 34 30. 06. 2011 12: 32 www. questback. com Ethics Teaching Survey 14

8. Please indicate whether the Society-accredited course(s) run within your department covers the following areas of ethics: The following questions relate to the content of Society accredited courses run within your Department. 1 Undergraduate 2 Postgraduate: forensic psychology 3 Postgraduate: clinical psychology 4 Postgraduate: occupational psychology 5 Postgraduate: health psychology 6 Postgraduate: counselling psychology 7 Postgraduate: sports and exercise psychology 8 Postgraduate: educational psychology N Undergraduate 32 Postgraduate: forensic psychology 6 Postgraduate: clinical psychology 12 Postgraduate: occupational psychology Postgraduate: health psychology 5 11 Postgraduate: counselling psychology 5 Postgraduate: sports and exercise psychology 1 Postgraduate: educational psychology 2 30. 06. 2011 12: 32 www. questback. com Ethics Teaching Survey 15

9. Is there a specific person or persons responsible for ethics teaching within the Department? 1 Yes 2 No N Current 30. 06. 2011 12: 32 www. questback. com 42 Ethics Teaching Survey 16

7. Does the Department aim to develop an ethical identity in your students? We are concerned with how Departments foster the integration of ethics within the "identity" of the students as future graduates and/or practitioners of psychology. This is goes beyond the teaching of ethics (e. g. the skills of recognising the presence of common ethical issues, skills in ethical reasoning, or improved understanding of the language and concepts of ethics) and relates to the development of ethical, as well as techinically competent and knowledgeable, graduates and practitioners. 1 Yes 2 No 3 Unsure N Current 30. 06. 2011 12: 32 www. questback. com 42 Ethics Teaching Survey 17

Ethics Committee survey summary n n n n Large majority cover Professional Codes of Ethics Approximately half cover other areas: Philosophical ethical traditions Moral and ethical reasoning Moral behaviour Different domains of ethics (e. g. individual, social, environmental) Wide variation in the content and extent of ethics training delivered at both undergraduate and postgraduate level. Some respondents very positive about their work and have examples of excellent practice The BPS QA team have also examples of excellent practice.

Individual postgraduates survey 1. 2. 3. Four questions relating to codes of ethics Two questions relating to experience of ethics training as undergraduate or postgraduate. Twelve questions relating to the experience of gaining ethical approval for research

Psy. PAG survey - undergraduate experience n n n For undergraduate courses over half of those who responded to this survey did have some structured teaching in ethics although nearly 40% of respondents report no ethical instruction at this level. The most common method of delivery for the teaching of ethics is via a research methods module. Some training appears to be very thorough, whilst other training appears to be rather minimal.

Psy. PAG survey - Postgraduate experience n At postgraduate level ethical training appears to be much more consistent amongst those on clinical courses when compared to Ph. D and masters courses. n BPS Code well covered, HPC code much less so. n Some training very focused on the process of gaining ethical approval perhaps at the cost of a more in depth discussion of the purpose of ethics.

Conclusions n n n The two surveys give a similar picture and provide some confirmation of the findings Survey indicates wide variation in ethics teaching and the exposure students get to this area of knowledge Plan to have core curriculum derived from good practice examples with material posted on the BPS website, together with published guidance in due course.

But… n Teaching is not the same as learning. n So how to assess ethical competence?

Psychology of moral development Piaget and Kohlberg

Evidence-based ethics n n n n The patient The ethical dilemma – questions, food for thought Medicine Law The ethics The formulation Afterthoughts References and further reading

Ethical competency assessment • There appears to be no consistent approach to ethical competence assessment in psychology training • Illingworth 2009 Guidance on assessment within Applied/Professional Ethics • http: //www. prs. heacademy. ac. uk/pdf. html/prsdocuments/104 • http: //prs. heacademy. ac. uk/projects/ethics/index. html

Illingworth 2009 Guidance on assessment within Applied/Professional Ethics The conclusion to this guide to assessment within applied and professional ethics is that there is at present, no reliable conclusion to be drawn regarding the best way to assess ethics learning and teaching. However, there are many tests available, particularly in respect of the measurement of moral reasoning capacity. What should one assess, and how should one assess it? Neither question has an easy answer, but it is vital that those concerned with ethics learning and teaching, particularly as it concerns professional ethics, continue to debate and develop this vital if contested area. • http: //www. prs. heacademy. ac. uk/pdf. html/prsdocuments/104

Assessing Ethical Competencies - George Lind Moral Judgment Test n n Given a series of dilemmas Asked to rate reasons for persons actions Scored on the degree to which it corresponds with developed ethical understanding. Studies cross culturally, and with large number of students. Been in use for 30 years. Translated into 35 languages. Has good psychometric properties and defensible evidence-base.

Four Component Model James Rest 1982 A Psychologist Looks at the Teaching of Ethics The Hastings Center Report, Vol. 12, No. 1 (Feb. , 1982), pp. 29 -36 • • • Ethical Sensitivity Ethical Reasoning Ethical Motivation Ethical Implementation Developed the Defining Issues Test

Psychology and Ethical Competence

National competency frameworks developed - Professors Tony Roth and Stephen Pilling n Ethical competencies particularly developed in the Children Competency framework which is publically available on http: //www. ucl. ac. uk/clinicalpsychology/CORE/child-adolescent. php.

Tony Roth n Competencies

Examples of competence areas n n n legal responsibility professional standards of behaviour maintaining competence harassment dual relationships

Group work – four components Ethical sensitivity Ethical reasoning Ethical motivation Ethical implementation 1. 2. 3. What teaching could be delivered relevant to this component? What are the relevant competencies? How might you go about assessing these competencies?

Ethical Sensitivity Component I: the Situation. This involves Interpreting the perception that something one might do or is doing can affect the welfare of someone else either directly or indirectly (by violating a general practice or commonly held social standard). From Rest 1982

Ethical Reasoning Component II: Formulating the Morally Ideal Course of Action. In seeking the morally ideal course of action, the person tries to integrate the various considerations person A's needs, person B's needs, personal needs, expectations founded on previous promises or roles or instituted practices, and so on-insofar as they influence the alternative courses of action available in a particular situation. From Rest 1982

Ethical Motivation Component III: Deciding What one actually intends to do. Simply because the morally ideal course of action has been defined does not mean that the person will choose to follow it. From Rest 1982

Ethical Implementation Component IV Executing and implementing a plan of action, involves figuring out the sequence of concrete actions, working around impediments and unexpected difficulties, overcoming fatigue and frustration, resisting distractions and other allurements, and keeping sight of the eventual goal. From Rest 1982

Thank you for listening a. w. wainwright@exeter. ac. uk t. roth@ucl. ac. uk