Physiotherapy Students' Experiences about Ethical Situations Encountered in Clinical Practices

Ethical and cultural competence of social- and health care educators from educational institutions - Cross-sectional study

BACKGROUND

The international mobility has increased cultural diversity in social- and health care. As such, ethical and cultural competence is an essential skill among educators. They are promoting the ethical and cultural competence and professional growth of students with diverse backgrounds and, therefore, must be ethically and culturally competent.

AIM

The aim of the study was to identify distinct ethical and cultural competence profiles of social- and health care educators and explore the associated factors.

RESEARCH DESIGN

A descriptive cross-sectional survey design was used to collect quantitative observational data in 2020-2021. Competence profiles were identified by K-means clustering based on answers to an instrument focussing on educators' ethical and cultural competence.

PARTICIPANTS AND RESEARCH CONTEXT

Participants (N = 1179, n = 243) were social- and health care educators based at 10 universities of applied sciences and 10 vocational colleges in Finland.

ETHICAL CONSIDERATIONS

The research adhered to good scientific practice. A research permit was received from each educational institution that participated in the study. The privacy of the participants was protected throughout the study.

RESULTS

The analysis identified three profiles of educators (A, B, C) based on self-assessed ethical and cultural competence. Profile A educators demonstrated high scores across all three competence areas. Profile B educators had high scores for ethical knowledge and intermediate scores for other competence areas. Profile C educators demonstrated intermediate scores across all three competence areas. An educator's pedagogical education was found to significantly influence which profile they belonged to.

CONCLUSIONS

The educators generally evaluated their ethical and cultural competence highly. Educators understand the importance of professional ethics in their work, but they need additional support in developing ethics skills in their daily work. Among all educators, there is a need for developing international and culturally diverse collaboration.

Physiotherapists' ethical behavior in professional practice: a qualitative study

Background

In health professions, ethics is considered a fundamental competence. The increase in clinical autonomy in the field of physiotherapy is associated with an increase in ethical situations in their clinical practice.

Objective

To explore the ethics of the clinical relationship between physiotherapists and patients, the ethics training received by physiotherapists, and if in the clinical context, physiotherapists identify the necessary attitudes and apply the ethical recommendations of the profession for the ethical situations they experience.

Methods

A qualitative exploratory and descriptive study was performed with physiotherapists. Data were collected through semi-structured interviews. The data were analyzed using content analysis, as proposed by Krippendorf. The study protocol was approved by the University of Valencia Ethics Committee of Human Research.

Results

This study included 15 physiotherapists (66.66% women, average age = 42.2 years), which was sufficient to reach data saturation. We identified four categories: (i) Ethics of the clinical relationship (ethical values, principles, and norms; type of clinical relationship), (ii) Ethics training received (during the physiotherapy studies; current training of students; low importance of ethics in the curriculum), (iii) Necessary attitudes for professional ethical practice (main attitudes were identified: personal attitudes and professional attitudes); (iv) Experiences from professional practice (general; public sector vs. private sector).

Conclusion

The ethics of the clinical relationship between physiotherapists and patients is determined by the attitudes of the practitioner, which are the result of his or her values and previous experiences; and are very centered on ethics of indication (founded mainly on the principles of Beneficence and Non-Maleficence). It is necessary to improve the ethical training received by physiotherapists, which is poorly focused on professional attitudes.

Physical Therapists' Ethical and Moral Sensitivity: A STROBE-Compliant Cross-Sectional Study with a Special Focus on Gender Differences

(1) Background: Healthcare professionals´ clinical practice, their care of patients and the clinical decision-making process may be influenced by ethical and moral sensitivity. However, such outcomes have been scarcely studied in physical therapists. This study aimed to explore ethical sensitivity and moral sensitivity in practicing physical therapists, and to compare both variables by gender. (2) Methods: Cross-sectional study. 75 physical therapists (58.7% women; average age = 34.56 (8.68) years) were asked to fill in questionnaires measuring ethical sensitivity (Ethical Sensitivity Scale Questionnaire) and moral sensitivity (Revised-Moral Sensitivity Questionnaire). (3) Results: The sample showed high ethical sensitivity (116.14 ± 15.87 over 140) and high moral sensitivity (40.58 ± 5.36 over 54). When comparing by gender, women reported significantly higher ethical sensitivity than men (p = 0.043), as well as higher scores in the following dimensions: Caring by connecting with others (p = 0.012) and Working with interpersonal and group differences (p = 0.028). However, no differences were found in moral sensitivity (p = 0.243). (4) Conclusion: Physical therapists showed high levels of ethical and moral sensitivity, whilst women reported higher ethical sensitivity than men. Understanding physical therapists´ ethical and moral sensitivity is essential to design and implement integrated education programs directed to improve the quality of care of patients in their daily clinical practice.