General practice consultation has often been characterized by pragma-dialecticians as an argumentative activity type. These characterizations are typically derived from theoretical insights and qualitative analyses. Yet, descriptions that are based on quantitative data are thus far lacking. This paper provides a detailed account of the development of an instrument to guide the quantitative analysis of argumentation in doctor–patient consultation. It describes the implementation and preliminary results of a content analysis of seventy videotaped medical consultations of which (...) the extent and type of doctors’ argumentative support for medical opinions and advice are analyzed. Based on the study results, this paper addresses the merits of observational studies using content analysis as a method for the analysis of argumentative discourse in context as well as some of its key challenges and limitations, laying bare the opportunities for future research. (shrink)

BackgroundPsychiatric staff members have the power to decide the options that frame encounters with patients. Intentional as well as unintentional framing can have a crucial impact on patients’ opportunities to be heard and participate in the process. We identified three dominant ethical perspectives in the normative medical ethics literature concerning how doctors and other staff members should frame interactions in relation to patients; paternalism, autonomy and reciprocity. The aim of this study was to describe and analyse statements describing real work (...) situations and ethical reflections made by staff members in relation to three central perspectives in medical ethics; paternalism, autonomy and reciprocity.MethodsAll staff members involved with patients in seven adult psychiatric and six child and adolescent psychiatric clinics were given the opportunity to freely describe ethical considerations in their work by keeping an ethical diary over the course of one week and 173 persons handed in their diaries. Qualitative theory-guided content analysis was used to provide a description of staff encounters with patients and in what way these encounters were consistent with, or contrary to, the three perspectives.ResultsThe majority of the statements could be attributed to the perspective of paternalism and several to autonomy. Only a few statements could be attributed to reciprocity, most of which concerned staff members acting contrary to the perspective. The result is presented as three perspectives containing eight values.•Paternalism; 1) promoting and restoring the health of the patient, 2) providing good care and 3) assuming responsibility.•Autonomy; 1) respecting the patient’s right to self-determination and information, 2) respecting the patient’s integrity and 3) protecting human rights.•Reciprocity; 1) involving patients in the planning and implementation of their care and 2) building trust between staff and patients.ConclusionsPaternalism clearly appeared to be the dominant perspective among the participants, but there was also awareness of patients’ right to autonomy. Despite a normative trend towards reciprocity in psychiatry throughout the Western world, identifying it proved difficult in this study. This should be borne in mind by clinics when considering the need for ethical education, training and supervision. (shrink)

BackgroundHealthcare professionals use the ethics of justice and care to construct moral reasoning. These ethics are conflicting in nature; different value systems and orders of justice and care are applied to the cause of actual moral conflict. We aim to clarify the structure and factors of healthcare professionals’ moral conflicts through the lens of justice and care to obtain suggestions for conflict resolutions.MethodSemi-structured interviews about experiences of moral conflict were conducted with Japanese nurses recruited using the snowball sampling method. Interviews (...) were conducted based on the real-life moral conflict and choice interview. Interviews were recorded and transcribed verbatim, then analyzed based on the interpretive method of data analysis. Verbatim transcripts were read four times, first to get an overall sense of the conflict, then to understand the person’s thoughts and actions that explain the conflict, and third and fourth to identify perspectives of justice and care, respectively. Each moral perspective was classified into categories according to Chally’s taxonomy.ResultsAmong 31 responses, 2 that did not mention moral conflict were excluded, leaving 29 responses that were analyzed. These responses were classified into six cases with conflict between both justice and care perspectives or within one perspective, and into two cases without conflict between perspectives. The “rules” category of justice and the “welfare of others” category of care were included in many cases of conflict between two perspectives, and they frequently occurred in each perspective.ConclusionsThe nurses in this study suggest that they make moral judgments based on moral values that are intertwined with justice and care perspectives complex manner.Organizational, professional, and patient-related factors influenced conflicts between justice and care. Additionally, multiple overlapping loyalties created conflicts within justice perspectives, and multifaceted aspects of care-provider’s responsibility and patient need created conflicts within care. Decision-making biased towards one perspective can be distorted. It is important to consider ethical issues from both perspectives to resolve conflicts, especially the effective use of the ethics of care is recommended. (shrink)

The article describes an approach of systematic, rule guided qualitative text analysis, which tries to preserve some methodological strengths of quantitative content analysis and widen them to a concept of qualitative procedure. First the development of content analysis is delineated and the basic principles are explained (units of analysis, step models, working with categories, validity and reliability). Then the central procedures of qualitative content analysis, inductive development of categories (...) and deductive application of categories, are worked out. The possibilities of computer programs in supporting those qualitative steps of analysis are shown and the possibilities and limits of the approach are discussed. (shrink)

The search for a good method to analyse sermon content has been prevailing since the past decades to evaluate current practice so as to construct better theories for practice. I think that we have found it in the methodology of inductive, qualitative research of the Grounded Theory methodology. In this article, I am going to use the Grounded Theory approach to describe the phases of qualitative empirical research, namely, literature study, sampling, open coding of the (...) data, selective coding of additional new data and theoretical coding to be able to construct an emerging theory of praxis using the concepts developed for this specific action in our discipline. There are critical comments for this methodology. I will try to address these critical views and argue that the Grounded Theory is in line with the science of research. (shrink)

BackgroundA fundamental ethical challenge in conducting genomics research is the question of what and how individual level genetic findings and aggregate genomic results should be conveyed to research participants and communities. This is within the context of minimal guidance, policies, and experiences, particularly in Africa. The aim of this study was to explore the perspectives of key stakeholders' on returning genomics research results to participants in Kenya.MethodsThis qualitative study involved focus group discussions (FGDs) and in-depth interviews (IDIs) with 69 (...) stakeholders. The purposively selected participants, included research ethics committee (REC) members (8), community members (44), community resource persons (8), and researchers (9). A semi-structured interview guide was used to facilitate discussions. Six FGDs and twenty-five (IDIs) were conducted among the different stakeholders. The issues explored in the interviews included: (1) views on returning results, (2) kind of results to be returned, (3) value of returning results to participants, and (4) challenges anticipated in returning results to participants and communities. The interviews were audio-recorded, transcribed verbatim, and coded in Nvivo 12 pro. Thematic and content analysis was conducted.ResultsParticipants agreed on the importance of returning genomic results either as individual or aggregate results. The most cited reasons for returning of genomic results included recognizing participants' contribution to research, encouraging participation in future research, and increasing the awareness of scientific progress. Other aspects on how genomic research results should be shared included sharing easy to understand results in the shortest time possible and maintaining confidentiality when sharing sensitive results.ConclusionsThis study identified key stakeholders’ perspectives on returning genomic results at the individual and community levels in two urban informal settlements of Nairobi. The majority of the participants expect to receive feedback about their genomic results, and it is an obligation for researchers to see how to best fulfil it. (shrink)

The introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research (...) based on sharing, causing confusion about what is allowed, where and when. In order to understand better the ethics regulatory landscape around genomic research and biobanking, we conducted a comprehensive analysis of existing ethics guidelines, policies and other similar sources. We sourced 30 ethics regulatory documents from 22 African countries. We used software that assists with qualitative data analysis to conduct a thematic analysis of these documents. Surprisingly considering how contentious broad consent is in Africa, we found that most countries allow the use of this consent model, with its use banned in only three of the countries we investigated. In a likely response to fears about exploitation, the export of samples outside of the continent is strictly regulated, sometimes in conjunction with regulations around international collaboration. We also found that whilst an essential and critical component of ensuring ethical best practice in genomics research relates to the governance framework that accompanies sample and data sharing, this was most sparingly covered in the guidelines. There is a need for ethics guidelines in African countries to be adapted to the changing science policy landscape, which increasingly supports principles of openness, storage, sharing and secondary use. Current guidelines are not pertinent to the ethical challenges that such a new orientation raises, and therefore fail to provide accurate guidance to ethics committees and researchers. (shrink)

Two right-to-die organisations offer assisted suicide in Switzerland. The specific legal situation allows assistance to Swiss and foreign citizens. Both organisations require a report of the person’s health status before considering assistance. This qualitative study explored these reports filed to legal authorities after the deaths of individuals in the area of Zurich. Health status reports in the legal medical dossiers of the deceased were analysed using content analysis and Grounded Theory. From 421 cases of assisted suicide (...) (2001–2004), 350 reports on health status were filed. Many cases contained diagnosis lists only. Other reports had more elaborate reports revealing that some physicians were aware about the patient’s death wish and the intention to solicit assisted suicide. Physicians’ attitudes ranged from neutral to rather depreciative. Few physicians openly referred the patient to the organisations and supported the patient’s request by highlighting a history of suffering as well as reporting understanding and agreement with the patient’s wish to hasten death. In the health status reports five categories could be identified. Some files revealed that physicians were aware of the death wish. The knowledge and recognition of the patient’s death wish varied from no apparent awareness to strongly supportive. This variety might be due to difficulties to discuss the death wish with patients, but might also reflect the challenge to avoid legal prosecution in the country of origin. To require comparable health status reports as requirements for the right-to-die organisations might be difficult to pursue. (shrink)

Purpose This study investigates the incidence of ethical violations in the Ghanaian press which has become topical in the wake of misinformation in a charged political atmosphere. Public interest institutions have questioned the unprofessional conduct of journalists covering election campaigns in recent years. This study content analysed political stories from two leading Ghanaian newspapers (Daily Graphic and Daily Guide) to determine the nature and extent of ethical violations, and to examine the level of prominence accorded to political news stories (...) by the two dailies. Design/methodology/approach This paper relied on qualitative content analysis for data gathering and analysis. A total of 387 political news items published between 1 October and 30 November 2020, were analysed. Findings This study found infractions of various nature to Article 1 of the Ghana Journalists Association (GJA) codes of ethics, chief among which is the deliberate publications of news stories without cross-checking facts. Other infractions to Articles 17, 11, 6 and 5 of the GJA codes of ethics were observed. Political news coverage favours the governing New Patriotic Party (NPP) and the main opposition National Democratic Congress (NDC) than any other parties, with the two parties (NPP-NDC) given greater prominence and salience by the Ghanaian press. Originality/value The research makes a modest contribution to the growing concern of journalism ethics in an increasing ecology of fake news. (shrink)

Communication and interaction today happen in simply one mouse click away. Language and self-expression do not only develop as a recognized tool for oneself but is an avenue for others’ re-expression and identification. Through using Twitter, the elaboration of social interaction becomes easier and accessible. It becomes the primary method of doing things together and establishes a shared meaning that becomes the common ground of understanding by individuals and groups alike. The study aims to analyze the tweets of Kris Aquino, (...) known as the Philippines’ Queen of Multimedia using speech act categories of Searle and predict the meaning based on the speech acts committed. The study used content analysis for it represents systematic and objective means of describing and quantifying phenomena. The results showed that most tweets contained the ‘assertive’ label which refers to ‘those kinds of speech acts that state what the speaker believes to be the case or not’. Further, her influence as a public figure contributed to the forceful implication of realizing the speech act reflected by her readers. Since impression is reality and intention cannot be quantified, what the general audience perceives on a certain person serves to be the truth. Thus, misinterpretation develops due to poor judgment on the elucidation in the tweets of the posters, readers and vice-versa. Keywords - Sociolinguistics, speech act theory, Twitter, micro-blogging, SNS, qualitative, content analysis, Philippines. (shrink)

With a view to consolidating the existing theory development and stimulating new conceptual thinking, this paper explores the implications of culture, religion, and the legal framework on women’s employment and their limited advancement in the hospitality industry, one of the important elements of the economy in Jordan. A related aim is to contrast the egalitarian Islamic approach to gender equality with gender discriminatory tribal traditions that restrict women’s employment and progression. Guided by religion, culture, and gender literature, this (...) study uses a qualitative, content-based analysis. Drawing on open-ended questionnaires distributed to a diverse workforce across four tourist locations in Jordan, the results portray how tribalism and Bedouin customs embedded in the participants’ interpretation and practices of their religion are maintaining gender gaps in employment and positions of power. The results also reveal that despite the Islamic guidelines towards fairness and justice in employment, the tribal and Bedouin traditions restrict women’s employment through patriarchal interpretations of Islam. Thus, the salient novelty and significance of this study were achieved through contributing to the theory development of the interrelations between religion, culture, and gender equality. (shrink)

Research on nursing ideology and the ethics of child and adolescent psychiatric nursing care is limited. The aim of this study was to describe and explore the ideological approaches guiding psychiatric nursing in child and adolescent psychiatric inpatient wards in Finland, and discuss the ethical, theoretical and practical concerns related to nursing ideologies. Data were collected by means of a national questionnaire survey, which included one open-ended question seeking managers' opinions on the nursing ideology used in their area of practice. (...) Questionnaires were sent to all child and adolescent psychiatric inpatient wards (n = 69) in Finland; 61 ward mangers responded. Data were analysed by qualitative and quantitative content analysis. Six categories - family centred care, individual care, milieu centred care, integrated care, educational care and psychodynamic care - were formed to specify ideological approaches used in inpatient nursing. The majority of the wards were guided by two or more approaches. Nursing models, theories and codes of ethics were almost totally ignored in the ward managers' ideological descriptions. (shrink)

Corporate sustainability reports are supposed to provide a complete and balanced picture of corporate sustainability performance. They are, however, usually voluntary and thus prone to interpretation and even greenwashing tendencies. To overcome this problem, the Global Reporting Initiative (GRI) provides standardized reporting guidelines challenging companies to report positive and negative aspects of an organization’s sustainability performance. However, the reporting of “negative aspects” in particular can endanger corporate legitimacy if perceived by the stakeholders as not being in line with societal norms (...) and values. Starting from the theoretical lenses of economics-based disclosure theories and socio-political theories of disclosure, the focus of this study therefore was to analyze the communicative legitimation strategies companies use to report “negative aspects,” i.e., negative ecological and social impact caused by corporate activity. Using qualitative content analysis of GRI-oriented sustainability reports from companies listed on the US Dow Jones Industrial Average Index and on the German DAX Index, we identified six legitimation strategies. We discuss these strategies regarding to symbolic and substantial management of legitimacy. We show that symbolic legitimation strategies aiming at modifying the perception of legitimizing stakeholders dominate in the reports at hand. Such persuasion, however, does not meet the requirement of impartiality as postulated by the GRI guidelines. Building upon this conclusion we propose a concise characterization of “negative aspects” and develop a GRI-compliant schema of reporting about them. In doing so, we offer a way to improve the overall “balance” of sustainability reporting contributing to a true and fair view in sustainability disclosure. (shrink)

The COVID-19-pandemic brought massive changes in the provision of psychotherapy. To contain the pandemic, many therapists switched from face-to-face sessions in personal contact to remote settings. This study focused on psychodynamic therapists practicing Guided Affective Imagery, Hypnosis and Autogenous Relaxation and their subjective experiences with psychotherapy via telephone and videoconferencing during the first COVID-19 related lockdown period in March 2020 in Austria. An online survey completed by 161 therapists produced both quantitative and qualitative data with the latter being (...) subject to a qualitative content analysis. Our research suggests that telephone and videoconferencing are considered valuable treatment formats to deliver psychodynamic psychotherapy. However, therapists’ experiences with remote psychotherapy are multifaceted and ambiguous. In particular, the findings raise questions concerning the maintenance of the therapeutic alliance, the development of the analytic process, the sensitivity to unconscious communication, and the indication for certain types of patients that still need further investigation. Our research indicates that the long-standing reticence toward remote treatments offers among psychodynamic therapists is becoming more differentiated and partially dissolves as therapists gain experiences in their use. Attitudes are becoming more open. At the same time, the way is being prepared to take a closer look at the specific processes and dynamics of remote psychotherapy and to examine them critically in future studies. (shrink)

This title presents a comprehensive guide to interpretative phenomenological analysis (IPA) which is an increasingly popular approach to qualitative inquiry taught to undergraduate and postgraduate students today.

The informed consent is an ethical and legal requirement for potential participants to enroll in a study. There is ample of evidence that understanding consent information and enrollment is challenging for participants in clinical trials. On the other hand, the reasoning process behind decision-making in HIV clinical trials remains mostly unexplored. This study aims to examine the decision-making process of people living with HIV currently participating in antiretroviral clinical trials and their understanding of informed consent. We conducted a qualitative (...) socio-constructivist study using semi-structured interviews. Eleven participants were selected by purposive sampling in Argentina until data saturation was reached. A content analysis was performed. The findings highlight the fact that some participants decided to enroll on the spot, while others made the decision a few days later. In all cases, the decision was based on different aspects of trust (in doctors, in the clinical research site, in the clinical trials system) but also on emotions associated with HIV and/or treatment. Moreover, while people living with HIV felt truly informed after the consent dialogue with a researcher, consent forms were unintelligible and unfriendly. The immediacy of patient decision-making has rarely been described before. Enrollment in an HIV clinical trial is mainly a trust-based decision but this does not contradict the ethical values of autonomy, voluntariness, non-manipulation, and non‐exploitation. Thus, trust is a key issue to be included in reshaping professional practices to ensure the integrity of the informed consent process. (shrink)

Social, legal and health-care changes have created an increasing need for ethical review within end-of-life care. Multiprofessional clinical ethics committees (CECs) are increasingly supporting decision-making in hospitals and hospices. This paper reports findings from an analysis of formal summaries from CEC meetings, of one UK hospice, spanning four years. Using qualitative content analysis, five themes were identified: timeliness of decision-making, holistic care, contextual openness, values diversity and consensual understanding. The elements of an engaged clinical ethics in (...) a hospice context is not generally acknowledged nor its elements articulated. Findings from this study have the potential to explain some of the most challenging ethical problems and to contribute to their resolution. It may also guide future deliberation and raise CEC members' awareness of the recurrent issues and values of their CEC practice. (shrink)

Background Nurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses’ experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts. Research aim To analyze frontline U.S. nurses’ experiences of ethics during the COVID-19 pandemic. Research design Qualitative analysis using (...) a directed content methodology. Participants and research context The study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States. Ethical considerations Participant privacy and data confidentiality were addressed. Findings Moral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients. Discussion This content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice. Conclusions Ethics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available. (shrink)

Weak Quantum Theory (WQT) and the Model of Pragmatic Information (MPI) are two psychophysical concepts developed on the basis of quantum physics. The present study contributes to their empirical examination. The issue of the study is whether WQT and MPI can not only explain ‘psi’-phenomena theoretically but also prove to be consistent with the empirical phenomenology of extrasensory perception (ESP). From the main statements of both models, 33 deductions for psychic readings are derived. Psychic readings are defined as settings, (...) in which psychics support or counsel clients by using information not mediated through the five senses. A qualitative approach is chosen to explore how the psychics experience extrasensory perceptions. Eight psychics are interviewed with a half-structured method. The reports are examined regarding deductive and inductive aspects, using a multi-level structured content analysis. The vast majority of deductions is clearly confirmed by the reports. Even though the study has to be seen as an explorative attempt with many aspects to be specified, WQT and MPI prove to be coherent and helpful concepts to explain ESP in psychic readings. (shrink)

Background Despite decades of anti-racism and equity, diversity, and inclusion (EDI) interventions in academic medicine, medical racism continues to harm patients and healthcare providers. We sought to deeply explore experiences and beliefs about medical racism among academic clinicians to understand the drivers of persistent medical racism and to inform intervention design. Methods We interviewed academically-affiliated clinicians with any racial identity from the Departments of Family Medicine, Cardiac Sciences, Emergency Medicine, and Medicine to understand their experiences and perceptions of medical racism. (...) We performed thematic content analysis of semi-structured interview data to understand the barriers and facilitators of ongoing medical racism. Based on participant narratives, we developed a logic framework that demonstrates the necessary steps in the process of addressing racism using if/then logic. This framework was then applied to all narratives and the barriers to addressing medical racism were aligned with each step in the logic framework. Proposed interventions, as suggested by participants or study team members and/or identified in the literature, were matched to these identified barriers to addressing racism. Results Participant narratives of their experiences of medical racism demonstrated multiple barriers to addressing racism, such as a perceived lack of empathy from white colleagues. Few potential facilitators to addressing racism were also identified, including shared language to understand racism. The logic framework suggested that addressing racism requires individuals to understand, recognize, name, and confront medical racism. Conclusions Organizations can use this logic framework to understand their local context and select targeted anti-racism or EDI interventions. Theory-informed approaches to medical racism may be more effective than interventions that do not address local barriers or facilitators for persistent medical racism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Somatic Knowledge and Qualitative Reasoning:From Theory to PracticeRichard Siegesmund"Elliot Eisner is a writer to be reckoned with" is how my undergraduate student, Cheyenne, opened her final essay on The Arts and the Creation of Mind. After a semester of using his text in my art education methods class, reckoned seemed an apt word. The dictionary gives the definitions of reckoned as to settle accounts, make calculation, (...) judge, and take into consideration.1 The ideas in The Arts and the Creation of Mind are challenging on multiple levels, and Eisner does not provide any easy answers. There are no pithy how-to-do-it bullet points in the text. The issues he addresses are complex: nonlinguistic meaning, somatic knowledge, qualitative reasoning, the arts as habits of mind that guide experience and inquiry into the world — just to name a few. Nevertheless, in this text he brings these ideas into a format that is accessible to undergraduates entering the profession of teaching and experienced professionals, who wish to reflect on their own practice.The lucidity of Eisner's text can belie the complexity of the issues he addresses. Regrettably, some students only saw the outer shell of the content: the discussion of conceptual approaches to arts education or the delineation of the developmental stages of children's drawing. Yet for these aspects alone, they considered the text to be valuable; however, I was disappointed that they did not go deeper. Some just could not synthesize the big point: that the arts are not simply about mastery of technical skills, but that technical skills are merely a gateway into non-linguistic thinking. Educational objectives that are limited to content and skills are mundane.However, for more thoughtful and reflective students like Cheyenne, who was in her last semester of course work before student teaching in Guadalajara, the book was an inspiration. It provided a more robust conception of arts education that spoke to her feelings that compelled her to be a teacher. She reflected on what she read in The Arts and the Creation of Mind, and saw how an arts educator was more than an activities manager. She discovered she was embarking on a calling that could change minds — and [End Page 80] by changing minds, transform lives. For a young idealist, Eisner articulated her passion to serve. He said what up until that moment she had only felt. She discovered what she had previously sensed — known in her bones — but had not articulated. Eisner was a voice she wanted to take for her own. He provided a vision of the teacher she hoped to be. Indeed, Elliot Eisner is a writer to be reckoned with.Two ideas that my art students want to discuss when they first encounter The Arts and the Creation of Mind are the concepts of somatic knowing and qualitative reasoning. Somatic knowledge is a felt reaction of rightness within an experience. Qualitative reasoning is the ordering of relationships of qualities. Qualitative reasoning produces somatic knowledge. Using my students' questions and classroom discussions as inspiration, I want to explore these ideas for I believe they represent the essence of what is distinctive about learning in the arts. Furthermore, I share Eisner's belief that they provide the foundation on which to make an enduring case for the importance of the arts in education. These ideas reside at the heart of the process of education, which is, as he states, "learning to create ourselves."2It is immensely satisfying as a teacher to see the ah-ha moments in class discussion when students begin to integrate Eisner's ideas into their own experience. It is an even greater satisfaction to work with teachers who find these ideas illuminating for their educational aims and objectives and to see them played out in real classrooms where students flourish. In this essay, I want to try to build on my own experience with these moments to more deeply explore the significance of Eisner's work.To begin, I will briefly revisit the work of John Dewey. I will then discuss how Eisner's previous thinking sets a foundation for The Arts and the Creation of Mind. Finally, on a... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Somatic Knowledge and Qualitative Reasoning:From Theory to PracticeRichard Siegesmund"Elliot Eisner is a writer to be reckoned with" is how my undergraduate student, Cheyenne, opened her final essay on The Arts and the Creation of Mind. After a semester of using his text in my art education methods class, reckoned seemed an apt word. The dictionary gives the definitions of reckoned as to settle accounts, make calculation, (...) judge, and take into consideration.1 The ideas in The Arts and the Creation of Mind are challenging on multiple levels, and Eisner does not provide any easy answers. There are no pithy how-to-do-it bullet points in the text. The issues he addresses are complex: nonlinguistic meaning, somatic knowledge, qualitative reasoning, the arts as habits of mind that guide experience and inquiry into the world — just to name a few. Nevertheless, in this text he brings these ideas into a format that is accessible to undergraduates entering the profession of teaching and experienced professionals, who wish to reflect on their own practice.The lucidity of Eisner's text can belie the complexity of the issues he addresses. Regrettably, some students only saw the outer shell of the content: the discussion of conceptual approaches to arts education or the delineation of the developmental stages of children's drawing. Yet for these aspects alone, they considered the text to be valuable; however, I was disappointed that they did not go deeper. Some just could not synthesize the big point: that the arts are not simply about mastery of technical skills, but that technical skills are merely a gateway into non-linguistic thinking. Educational objectives that are limited to content and skills are mundane.However, for more thoughtful and reflective students like Cheyenne, who was in her last semester of course work before student teaching in Guadalajara, the book was an inspiration. It provided a more robust conception of arts education that spoke to her feelings that compelled her to be a teacher. She reflected on what she read in The Arts and the Creation of Mind, and saw how an arts educator was more than an activities manager. She discovered she was embarking on a calling that could change minds — and [End Page 80] by changing minds, transform lives. For a young idealist, Eisner articulated her passion to serve. He said what up until that moment she had only felt. She discovered what she had previously sensed — known in her bones — but had not articulated. Eisner was a voice she wanted to take for her own. He provided a vision of the teacher she hoped to be. Indeed, Elliot Eisner is a writer to be reckoned with.Two ideas that my art students want to discuss when they first encounter The Arts and the Creation of Mind are the concepts of somatic knowing and qualitative reasoning. Somatic knowledge is a felt reaction of rightness within an experience. Qualitative reasoning is the ordering of relationships of qualities. Qualitative reasoning produces somatic knowledge. Using my students' questions and classroom discussions as inspiration, I want to explore these ideas for I believe they represent the essence of what is distinctive about learning in the arts. Furthermore, I share Eisner's belief that they provide the foundation on which to make an enduring case for the importance of the arts in education. These ideas reside at the heart of the process of education, which is, as he states, "learning to create ourselves."2It is immensely satisfying as a teacher to see the ah-ha moments in class discussion when students begin to integrate Eisner's ideas into their own experience. It is an even greater satisfaction to work with teachers who find these ideas illuminating for their educational aims and objectives and to see them played out in real classrooms where students flourish. In this essay, I want to try to build on my own experience with these moments to more deeply explore the significance of Eisner's work.To begin, I will briefly revisit the work of John Dewey. I will then discuss how Eisner's previous thinking sets a foundation for The Arts and the Creation of Mind. Finally, on a... (shrink)

BackgroundNarrative medicine is a well-recognized and respected approach to care. It is now found in medical school curricula and widely implemented in practice. However, there has been no analysis of the perception and usage of narrative medicine across different medical specialties and whether there may be unique recommendations for implementation based upon specialty. The aims of this study were to explore these gaps in research.MethodsFifteen senior physicians who specialize in internal medicine, pediatrics, or surgery (5 physicians from each specialty) (...) were interviewed in a semi-structured format about the utilization, benefits, drawbacks (i.e., negative consequences), and roles pertaining to narrative medicine. Qualitative content analysis of each interview was then performed.ResultsThree themes emerged from our analysis: roles, practice, and outcomes. Through these themes we examined the importance, utilization, barriers, benefits, and drawbacks of narrative medicine. There was consensus that narrative medicine is an important tool in primary care. Primary care physicians (general internists and general pediatricians) also believed that narrative medicine is not as important for non-primary care providers. However, non-primary care providers (surgeons) generally believed narrative medicine is valuable in their practice as well. Within specialties, providers’ choice of language varied when trying to obtain patients’ narratives, but choice in when to practice narrative medicine did not differ greatly. Among specialties, there was more variability regarding when to practice narrative medicine and what barriers were present. Primary care physicians primarily described barriers to eliciting a patient’s narrative to involve trust and emotional readiness, while surgeons primarily described factors involving logistics and patient data as barriers to obtaining patients’ narratives. There was broad agreement among specialties regarding the benefits and drawbacks of narrative medicine.ConclusionsThis study sheds light on the shared and unique beliefs in different specialties about narrative medicine. It prompts important discussion around topics such as the stereotypes physicians may hold about their peers and concerns about time management. These data provide some possible ideas for crafting narrative medicine education specific to specialties as well as future directions of study. (shrink)

Recently, Australia became the second jurisdiction worldwide to legalize the use of mitochondrial donation technology. The Mitochondrial Donation Law Reform (Maeve’s Law) Bill 2021 allows individuals with a family history of mitochondrial disease to access assisted reproductive techniques that prevent the inheritance of mitochondrial disease. Using inductive content analysis, we assessed submissions sent to the Senate Committee as part of a programme of scientific inquiry and public consultation that informed drafting of the Bill. These submissions discussed a range (...) of bioethical and legal considerations of central importance to the political debate. Significantly, submissions from those with a first-hand experience of mitochondrial disease, including clinicians and those with a family history of mitochondrial disease, were in strong support of this legislation. Those in support of the Bill commended the two-staged approach and rigorous licencing requirements as part of the Bill’s implementation strategy. Submissions which outlined arguments against the legislation either opposed the use of these techniques in general or opposed aspects of the implementation strategy in Australia. These findings offer a window into the ethical arguments and perspectives that matter most to those Australians who took part in the Senate inquiry into mitochondrial donation. The insights garnered from these submissions may be used to help refine policy and guidelines as the field progresses. (shrink)

During the past decade or two the influence of theories of language and meaning has made itself felt in almost every field of study, either because, as in the case of psychology and the social sciences, meaning phenomena were part of the subject matter, or because, as in the case of physics and philosophy, the language used in the study demanded analysis and clarification. In recent years there has been developed, especially by H. D. Lasswell and his associates, a (...) technique known as content analysis, which attempts to characterize the meanings in a given body of discourse in a systematic and quantitative fashion. (shrink)

BackgroundLow literacy of study participants in Sub - Saharan Africa has been associated with poor comprehension during the consenting process in research participation. The concerns in comprehension are far greater when consenting to participate in genomic studies due to the complexity of the science involved. While efforts are made to explore possibilities of applying genomic technologies in diseases prevalent in Sub Saharan Africa, we ought to develop methods to improve participants’ comprehension for genomic studies. The purpose of this study was (...) to understand different approaches that can be used to seek consent from individuals with low literacy in Sub-Saharan African countries in genomic research to improve comprehension.MethodsUsing qualitative study design, we conducted focus-group discussions, in-depth interviews and participant observations as data collection methods. This study was embedded in a hospital based genomic study on Sickle Cell Disease at Muhimbili National Hospital in Tanzania. Thematic content analysis was used to analyse the transcripts and field notes.ResultsFindings from this study show that literacy level has little influence on understanding the research details. According to the participants of this study, the methods used to provide information, the language, and time spent with the study participants were the key factors influencing understanding. The availability of group sessions held before individual consent to allow for a detailed questions and answers format was agreed to be the best method to facilitate the comprehension.ConclusionThe quality of the consenting process of participants will be influence by a number of factors. The type of research consented for, where the research will be implemented and who are the potential study participants are amongst the factors that need to be assessed during the consenting. Measures to improve participants’ comprehension need to be developed when consenting participants with low literacy level in genomic studies. (shrink)

BackgroundMoral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela.ObjectiveThe purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants’ MD, clinical ethics knowledge, work satisfaction, and (...) patient care among ICU nurses.Sample and SettingThe sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period.MethodsAlvita K. Nathaniel’s Theory of Moral Reckoning guided development of the nursing ethics huddle process.1 The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects’ level of MD.2 Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects’ perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions.ResultsOverall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant (p < 0.0001). (shrink)

Background: Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the “Guide on the decision-making process regarding medical treatment in end-of-life situations”, aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly. Objectives: To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are (...) consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses’ current end-of-life care practices. Design: Qualitative secondary analysis. Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal. Ethical consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética. Ethical procedures are thoroughly described. Findings: All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues. Discussion: Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients’ preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it. Conclusion: While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses’ involvement and practices in end-of-life decision-making. (shrink)

Background As Korean neonatal nurses frequently experience the deaths of infants, moral distress occurs when they provide end-of-life care to the infants and their families. Although they need to care for the patients’ deaths and consequently experience burnout and turnover due to moral distress from the situation, there is a lack of a support for nurses. Moreover, not much information is available on the moral distress of neonatal nurses. There is a need to better understand Korean neonatal nurses’ moral distress (...) to develop and implement appropriate supports. Objective This study aimed to describe nurses’ experience of moral distress when they provide end-of-life care to infants and their families in neonatal intensive care units. Research design This is a secondary analysis qualitative study. Content analysis was performed based on Corley’s theory of moral distress to develop a codebook and identify themes regarding moral distress among the nurses. Participants and research context Qualitative data were collected from 20 nurses working in two NICUs in Seoul, South Korea. Ethical considerations The original study obtained permission from a university’s institutional review board (IRB). This secondary analysis study obtained the exemption from another university’s IRB. Nurses’ participation was voluntary and confidential. Findings The nurses’ moral distress was derived when they faced moral constraints and/or moral conflicts. Two distinct categories of moral constraints and four distinct categories of moral conflicts were identified among the neonatal nurses. In addition, impacts of moral distress on patients and nurses were identified. Conclusions This study identified occasions neonatal nurses experience moral distress, and thus can guide in developing and implementing effective interventions to decrease their moral distress and improve their resilience in end-of-life care by providing insight into neonatal nurses’ needs for support in end-of-life care. (shrink)

As medical ethics and professionalism education continues to equip medical students and residents with long-lasting tools, educators should continue to supplement proven teaching strategies with engaging, relatable, and generationally appropriate didactic supplements. However, popular teaching aids have recently been criticized in the literature and summative information on alternatives is absent. The purpose of this review is to evaluate and assess the functional use and application of short form audiovisual didactic supplements or "icebreakers" in medical ethics and professionalism teaching. A systematic (...) review of both the medical and humanities literature (i.e., PubMed/medline, Cochrane Library, and JSTOR) was conducted from inception to August 1, 2019. Final articles were subjected to a qualitative appraisal and thematic analysis. Thirteen articles were included for final analysis. Sixty-nine percent (n = 9) of the studies were published after 2000. Two studies were qualitative, one study was quantitative, and the remaining articles were commentaries. Short form audiovisual media was most popular outside of the United States (n = 10). Sixty-nine percent (n = 9) of articles advocated for self-contained media in the form of trigger films or short films/videos, while the remaining articles (n = 4) discussed the use of TV/film clips. Producibility of media was exclusive to short/trigger films. Nine themes were identified in the content analysis: adaptability, conversation catalyst, effective, engaging, nuance, practice, producibility, real, and subject diversity. The three most common themes in descending order of frequency were: conversation catalyst, realness, and adaptability. Trigger films represent an effective and unique pedagogical strategy in supplementing current medical ethics and professionalism teaching at the medical school level. (shrink)

Although theory refers to organizational culture as an important variable in corrupt organizations, only little empirical research has addressed the characteristics of a corrupt organizational culture. Besides some characteristics that go hand in hand with unethical behavior and other features of corrupt organizations, we are still not able to describe a corrupt organizational culture in terms of its underlying assumptions, values, and norms. With a qualitative approach, we studied similarities of organizational culture across different corrupt organizations. In this (...) study, we performed content analysis on interviews of 14 independent experts about their experience with corrupt organizations. With this approach, we gained insights about different corrupt organizations spanning different branches (e.g., government, foreign trade, pharmacy, sports, building industry). We found that corrupt organizations perceive themselves to fight in a war, which leads to their taken-for-granted assumption that “the end justifies the means”. This assumption inspires many values and norms of the organizational culture. An important value in a corrupt organization is “security”, and an important norm is punishment of deviant (i.e., non-corrupt) behavior. Furthermore, managers and employees differ in their perception of organizational culture. While the management endorses values, such as success, results, and performance, and implements these values in their norms of goal setting, employees make use of rationalization strategies and endorse values of security and team spirit. (shrink)

Students are expected to develop the intellectual capacity needed to accurately portray other world societies. Few research studies in social studies education, however, draw on a systematic textbook analysis to investigate global perspectives on non-Western societies such as those found in African nations. Situated in framing theory, this study employs a qualitative content analysis approach to examine textual and visual curricular representations of non-Western societies framed in the content of four U.S. world history/cultures and (...) geography textbooks by considering specifically how Nigeria, a very large, relatively wealthy and complex African nation, is represented. The results provide insights into curricular perspectives in U.S. classrooms about non-Western societies, particularly regarding national narratives. Deficit perspectives are the dominant frame so students are primed to construct social reality from the partial textual and visual information to which they are exposed in their classrooms. The findings indicate a lack of research by both textbook authors and publishers into the contents of the texts, which has the potential to negatively affect students’ construction of narratives and civic competence. This study contextualizes its results in visual literacy, cross-cultural behaviors, global perspectives, and attributes of global citizenship. (shrink)

Next SectionPurpose The importance of recognising patient dignity has been realised in recent years. Despite being a central phenomenon in medicine, dignity is a controversial concept, the definition of which in healthcare centres is influenced by a multitude of factors. The aim of this study was to explore the perspective of Iranian patients on respect for their dignity in healthcare centres. Methods With the use of purposeful sampling, 20 patients were interviewed over an 11-month period in three educational hospitals affiliated (...) with the government. They were questioned about experiences related to respect for their dignity during their hospital encounter. Data were processed by qualitative content analysis. Results Data analysis identified nine categories and four themes. Respondents expressed their expectations and attitudes about dignity by the following themes: seeking a haven; disrespecting privacy; communicating in a vacuum; and disregard for secondary caregivers. They described how respect for their privacy, effective communication, access to facilities, and a regard for the requirements of their companions made them feel that their dignity had been conserved. Conclusions The findings indicate that almost no patient is satisfied with the quality of services with respect to maintenance of their dignity. Regardless of their hospital location and state of health, most participants had common complaints. These findings agree with the literature and confirm that grounds should be provided for conserving dignity in the healthcare system. To reach this goal, healthcare professionals should be aware of the factors that violate or preserve dignity from the patient's perspective. (shrink)

This article is based on the Lasallian virtues while at the same time borrowing insights from five Biblical personalities namely Adam, Noah, Abraham, Joseph, son of Jacob, and Moses respectively. Therefore, the purpose of the study was to examine these personalities in relation to the twelve Lasallian virtues as well as their attitudinal disposition in responding to their call of faith. Specific objectives are in tandem with these virtues, that is, piety, prudence, patience, self-control, silence, gentleness, gravity, humility, wisdom, zeal, (...) vigilance, and generosity. A descriptive research design and qualitative research methods were adopted. The aforementioned five Biblical personalities were selected using purposive sampling technique. Pertinent data were collected from the Holy Bible through desk research. Inferential citations and selected Biblical texts were the point of focus. Content analysis-exegesis was employed in qualitative data analysis. The analysis was guided by the theory of underdogs, misfit and the art of battling giants. It was revealed that the studied personalities faced their figurative Goliaths. Adam faced the serpent, Noah faced the unbelieving people before the deluge, while Abraham, Joseph, and Moses had to confront the Egyptian Pharaoh. Obedience was the Lasallian virtue that featured in all of these personalities from Adam to Moses. Other dominant virtues included piety, wisdom, prudence, patience, humility, zeal, self-control, and generosity. The study recommended that we embrace the Lasallian virtues. Irrespective of the Goliaths that we may face in our lives, it is recommended that we put our trust in God and have faith in Him similarly to how the studied Biblical personalities approached challenges during their times. (shrink)

This study presents a qualitative description of situations at work that staff members perceive as giving rise to ethical issues. All staff members working with patients across seven wards were given the opportunity to freely describe ethical considerations in an ethical diary over the course of one week. One hundred and five staff members kept a diary. The diaries were analysed with qualitative content analysis where four dominant themes emerged: good care, order and clarity, loyalty, and (...) inadequacy. These results contain statements in which patients are respected and listened to, as well as statements that express a desire for relatively strict, routine-based care. Relatively few statements were of a reflective or discussing nature which highlights the need for clinical ethical support. There is a need of a visible and supportive leadership which encourages ethical reflection. Reflections on real cases could provide an opportunity to challenge existing practices and thereby promote ethical awareness. (shrink)

BackgroundNursing documentation as a pivotal part of nursing care has many implications for patient care in terms of safety and ethics.ObjectivesTo explore factors influencing nursing documentation from nurses’ perspectives in the Iranian nursing context.MethodsThis qualitative study was carried out using a qualitative content analysis of data collected from 2018 to 2019 in two urban areas of Iran. Semi-structured interviews (n = 15), observations, and reviews of patients’ medical files were used for data collection.Ethical considerationsThis study was (...) conducted in accordance with the ethical principles of research and regulations in terms of confidentiality of data, anonymity, and provision of informed consent.FindingsThe main theme of this study was “unsafe documentation.” Two categories, “types of errors in reporting” and “reasons of errors in reporting,” and 12 subcategories were developed indicating factors influencing nursing documentation in the Iranian nursing context.ConclusionIn general, individual, organizational, and national factors affected nursing documentation in Iran. In this respect, hiring more nurses, application of reforms in the healthcare management structure, devising appropriate regulations regarding division of labor, constant education of healthcare staff, establishment of clinical governance, improvement of interpersonal relationships, development of hardware and software techniques for documentation, and provision of support should be done to improve the quality of nursing documentation. The above-mentioned suggestions can help nurses with a safe, ethical, lawful, and reliable documentation in nursing practice. (shrink)

New Breeding Techniques such as CRISPR-Cas9 are revolutionizing plant breeding and food production. Experts believe that the social debate about these technologies could be similar to those on green genetic engineering: emotional and highly controversial. Future debate about Genome Editing could benefit from a better understanding of the GMO (genetically modified organism) controversy. Against this background, this paper (a) presents results of a content analysis of position papers criticizing green genetic engineering in Germany. In particular, (b) it focuses (...) on the controversy as a place where normative concepts of nature are debated and become visible. Hence, the study complements existing interpretations by showing that the emerging concepts are more diverse than the familiar reductionist breakdown of the debate into anthropocentric vs. non-anthropocentric conceptions suggests. (shrink)

Studies have shown that students may feel emotional discomfort when they are asked to identify ethical problems which they have encountered during their training. Teachers in medical ethics, however, more often focus on the cognitive and rational ethical aspects and not much on students’ emotions. The purpose of this qualitative study was to explore students’ feelings and emotions when dealing with ethical problems during their clinical training and explore differences between two countries: Indonesia and the Netherlands. We observed a (...) total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools. Data were interpreted and analyzed using content analysis. We categorized students’ negative emotions based on their objects of reflection and came up with three categories: emotions concerning their own performance, emotions when witnessing unethical behaviors, and emotions related to barriers and limitations of their working environment. Our study suggests that addressing emotional responses in a culturally sensitive way is important to develop students’ self-awareness. Teachers should be able to guide students to reflect on and be critical of their own thoughts and emotions, to understand their own moral values, especially when confronted with other individuals. (shrink)

Studies have shown that students may feel emotional discomfort when they are asked to identify ethical problems which they have encountered during their training. Teachers in medical ethics, however, more often focus on the cognitive and rational ethical aspects and not much on students’ emotions. The purpose of this qualitative study was to explore students’ feelings and emotions when dealing with ethical problems during their clinical training and explore differences between two countries: Indonesia and the Netherlands. We observed a (...) total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools. Data were interpreted and analyzed using content analysis. We categorized students’ negative emotions based on their objects of reflection and came up with three categories: emotions concerning their own performance, emotions when witnessing unethical behaviors, and emotions related to barriers and limitations of their working environment. Our study suggests that addressing emotional responses in a culturally sensitive way is important to develop students’ self-awareness. Teachers should be able to guide students to reflect on and be critical of their own thoughts and emotions, to understand their own moral values, especially when confronted with other individuals. (shrink)

Studies have shown that students may feel emotional discomfort when they are asked to identify ethical problems which they have encountered during their training. Teachers in medical ethics, however, more often focus on the cognitive and rational ethical aspects and not much on students’ emotions. The purpose of this qualitative study was to explore students’ feelings and emotions when dealing with ethical problems during their clinical training and explore differences between two countries: Indonesia and the Netherlands. We observed a (...) total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools. Data were interpreted and analyzed using content analysis. We categorized students’ negative emotions based on their objects of reflection and came up with three categories: emotions concerning their own performance, emotions when witnessing unethical behaviors, and emotions related to barriers and limitations of their working environment. Our study suggests that addressing emotional responses in a culturally sensitive way is important to develop students’ self-awareness. Teachers should be able to guide students to reflect on and be critical of their own thoughts and emotions, to understand their own moral values, especially when confronted with other individuals. (shrink)

Studies have shown that students may feel emotional discomfort when they are asked to identify ethical problems which they have encountered during their training. Teachers in medical ethics, however, more often focus on the cognitive and rational ethical aspects and not much on students’ emotions. The purpose of this qualitative study was to explore students’ feelings and emotions when dealing with ethical problems during their clinical training and explore differences between two countries: Indonesia and the Netherlands. We observed a (...) total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools. Data were interpreted and analyzed using content analysis. We categorized students’ negative emotions based on their objects of reflection and came up with three categories: emotions concerning their own performance, emotions when witnessing unethical behaviors, and emotions related to barriers and limitations of their working environment. Our study suggests that addressing emotional responses in a culturally sensitive way is important to develop students’ self-awareness. Teachers should be able to guide students to reflect on and be critical of their own thoughts and emotions, to understand their own moral values, especially when confronted with other individuals. (shrink)

Background This study used a scenario- and discussion-based approach to teach preclinical medical students the socio-philosophical aspects of psychiatry and qualitatively evaluated the learning outcomes in a medical humanities course in Taiwan. Methods The seminar session focused on three hypothetical psychiatry cases. Students discussed the cases in groups and were guided by facilitators from multiple disciplines and professions. At the end of the semester, students submitted a narrative report comprising their reflections on the cases and discussions. The authors utilized (...) content analysis to categorize students’ narratives into three facets, namely, the philosophical, social and individual. Results In total 163 preclinical medical students participated in the class; 150 of them mentioned the scenario-based lesson in their reports; 33.3% of these reports discussed the case at the philosophical dimension (n = 50), 45.3% at the social dimension (n = 68), and 26.6% at the individual dimension (n = 40). Four major themes emerged: (1) a psychiatric diagnosis has far-reaching consequences for an individual’s life, (2) the social structure affects how patients experience psychiatric disorders, (3) students related personal experience or those of friends and family to understand psychiatric disorders, and (4) medical humanities are of particular importance in psychiatric education. Conclusions This study demonstrated that the scenario-based discussions led by a multidisciplinary team of facilitators can benefit medical students with limited clinical experience to contemplate the socio-philosophical aspects of psychiatry. The authors suggest that this pedagogical model during preclinical education should be encouraged. (shrink)

ABSTRACT This paper explores how children (aged 7–11) in the UK are educated about sustainability and climate change, through exploring a sample of 155 learning resources from public, private and third sector organisations. Using qualitative content analysis, key codes captured a) how sustainability was represented; b) how responsibilities for sustainability are imagined and allocated within society; and c) how children are encouraged to act for sustainability. The paper shows how sustainability resources represent children as powerful agents of (...) social change charged with the responsibility and means to change their (and their close relatives’) behaviour within the household and school. Drawing on critical debates about sustainability education, I argue these representations are problematic because they do not equip children with an understanding of the political and moral economies that shape their actions (or inactions) as citizens, nor provide them with opportunities to develop collaborative competencies. (shrink)

Background Improving the competencies of nurses requires improving educational methods through the use of novel methods in teaching and learning. We aim to explore the perceptions of stakeholders (including nursing education directors, faculty members and nursing students) of the requirements of implementing innovative educational approaches in nursing. -/- Methods In this qualitative descriptive study, 19 participants, including educational directors, faculty members, and undergraduate and graduate nursing students, were selected through the purposeful sampling method. Achieving the theoretical saturation in extracted (...) categories was considered as a criterion for determining the sample size and the completion of sampling. The data were collected from December 2019 to May 2020 in nursing schools of Tehran, Iran, through in-depth semi-structured individual face-to-face interviews and were then analyzed based on the Graneheim and Lundman method. -/- Results Using qualitative content analysis, eight sub-themes and three themes were extracted. The extracted themes were ‘novel educational policymaking’, ‘Innovative education-oriented platform’, and ‘managing barriers of innovative educational approaches’. -/- Conclusions Developing and implementing innovative educational approaches entail providing appropriate context, structure, and required facilities by the policymaking system and educational authorities. In addition, developing capacity and related competencies of faculty members and students as the major stakeholders in employing these approaches is crucial. (shrink)

Background Cardiopulmonary resuscitation and subsequent care are subject to various ethical and legal issues. Few studies have addressed ethical and legal issues in post-resuscitation care. Objective To explore nurses’ experiences of ethical and legal issues in post-resuscitation care. Research design This qualitative study adopted an exploratory descriptive qualitative design using conventional content analysis. Participants and research context In-depth, semi-structured interviews were conducted in three educational hospital centers in northwestern Iran. Using purposive sampling, 17 nurses participated. Data (...) were analyzed by conventional content analysis. Ethical considerations The study was approved by Research Ethics Committees at Tabriz University of Medical Sciences. Participation was voluntary and written informed consent was obtained. For each interview, the ethical principles including data confidentiality and social distance were respected. Findings Five main categories emerged: Pressure to provide unprincipled care, unprofessional interactions, ignoring the patient, falsifying documents, and specific ethical challenges. Pressures in the post-resuscitation period can cause nurses to provide care that is not consistent with guidelines, and to avoid communicating with physicians, patients and their families. Patients can also be labeled negatively, with early judgments made about their condition. Medical records can be written in a way to indicate that all necessary care has been provided. Disclosure, withdrawing, and withholding of therapy were also specific important ethical challenges in the field of post-resuscitation care. Conclusion There are many ethical and legal issues in post-resuscitation care. Developing evidence-based guidelines and training staff to provide ethical care can help to reduce these challenges. (shrink)

BackgroundThis is the first qualitative study to investigate how researchers, who do empirical work in bioethics, relate to objectives of empirical research in bioethics (ERiB). We explore reasons that make some objectives more acceptable, while others are deemed less acceptable.MethodsUsing qualitative exploratory study design, we interviewed bioethics researchers, who were selected to represent different types of scholars working in the field. The interview data of 25 participants were analyzed in this paper using thematic analysis. ResultsFrom the eight (...) objectives presented to the study participants, understanding the context of a bioethical issue and identifying ethical issues in practice received unanimous agreement. Participants also supported other objectives of ERiB but with varying degrees of agreement. The most contested objectives were striving to draw normative recommendations and developing and justifying moral principles. The is-ought gap was not considered an obstacle to ERiB, but rather a warning sign to critically reflect on the normative implications of empirical results.ConclusionsOur results show that the most contested objectives are also the more ambitious ones, whereas the least contested ones focus on producing empirical results. The potential of empirical research to be useful for bioethics was mostly based on the reasoning pattern that empirical data can provide a testing ground for elements of normative theory. Even though empirical research can inform many parts of bioethical inquiry, normative expertise is recommended to guide ERiB. The acceptability of ambitious objectives for ERiB boils down to finding firm ground for the integration of empirical facts in normative inquiry. (shrink)