REASONING, DECISION MAKING AND ETHICS IN HEALTH AND SOCIAL CARE

SHE Level 3
SCQF Credit Points 20.00
ECTS Credit Points 10.00
Module Code M3B922586
Module Leader Sandra Robertson
School School of Health and Life Sciences
Subject Occupational Therapy
Trimester
  • B (January start)

Pre-Requisite Knowledge

Successful completion of Levels 1 & 2 of the BSc Hons Occupational Therapy Programme

Summary of Content

This module will provide student with a variety of learning experiences from which to appreciate the context of decision-making and professional responsibilities relating to the professional and regulatory bodies, COT & HCPC. The relationship of clinical and moral reasoning to practice is explored, building on the introduction to reflective practice and ethics in Level 1 and modules in Level 2. Critical incidents which have occurred so far within practice education will be identified and explored within the context of different types of reasoning in preparation for experiences in PE4. Theoretical concepts and tools from contemporary thinking will support the process of reflection, analysis and debate in applying the concepts to practice. The humanistic philosophical basis of occupational therapy will be integrated with the fundamental concepts of ethics and moral philosophy relevant to health and social care.

Syllabus

Personal vs professional reasoning Components and process of decision-making Critical thinking and decision-making within therapeutic practice Clinical and moral reasoning within a reflective practice context Foundations of clinical reasoning and problem-solving processes within occupational therapy. Novice vs expert reasoning Theoretical concepts of ethics and moral reasoning Conceptual tools and supportive structures for moral reasoning Ethical dilemmas and critical incidents within health & social care. Understanding scope and limits of practice. Code of Ethics and Professional Conduct (COT 2015) Standards of Conduct Performance & Ethics (HCPC 2013) Standards of Proficiency for Occupational Therapists (HCPC 2016)

Learning Outcomes

On successful completion of this module, students should be able to:Learning outcomes have been mapped to HCPC Standards of Proficiency (2013) in brackets.1. Identify and analyse some of the components of critical thinking and decision making within the therapeutic process (1, 1,1, 1.2, 2, 2.1, 2.2, 2.7, 2.8, 4, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 5, 5.1, 6, 7, 7.1, 7.2, 7.3, 8, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.9, 8.10, 9, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.9, 9.10, 10, 10.2, 11, 11.1, 11.2, 11.3, 12, 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 13, 13.1, 13.2, 13.3, 13.4, 13.5, 13.6, 13.7, 13.8, 13.9, 13.10, 13.12, 14, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9, 14.10, 14.11, 14.12, 14.13, 14.14, 14.15, 14.16, 14.17, 14.8, 14.19, 14.20, 14.21, 14.22, 14.24, 15, 15.1, 15.2, 15.3, 15.4, 15.5)2. Analyse and evaluate the relationship between reflective practice and clinical reasoning (1, 1,1, 1.2, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 3, 3.1, 3.2, 3.3, 4, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 8, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.9, 8.10, 9, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.9, 9.10, 10, 10.2, 11, 11.1, 11.2, 11.3, 12, 12.1, 12.3, 12.5 12.6, 13, 13.1, 13.2, 13.3, 13.4, 13.5, 13.6, 13.7, 13.8, 13.9, 13.10, 13.12, 14, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9, 14.10, 14.11, 14.12, 14.13, 14.14, 14.15, 14.16, 14.17, 14.18, 14.19, 14.20, 14.21, 14.22, 14.24, 15, 15.1, 15.2, 15.3, 15.4, 15.5)3. Identify and analyse theoretical concepts of ethics relevant to health and social care (1, 1,1, 1.2, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 3, 3.1, 3.2, 3.3, 4, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 5, 5.1, 5.2, 5.3, 5.4, 6, 7, 7.1, 7.2, 7.3, 8, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.9, 8.10, 9, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.9, 9.10, 10, 10.1, 10.2, 11, 11.1, 11.2, 11.3, 12, 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 13, 13.1, 13.2, 13.3, 13.4, 13.5, 13.6, 13.7, 13.8, 13.9, 13.10, 13.11, 13.12, 13.13, 13.14, 14, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9, 14.10, 14.11, 14.12, 14.13, 14.14, 14.15, 14.16, 14.17, 14.8, 14.19, 14.20, 14.21, 14.22, 14.24, 15, 15.1, 15.2, 15.3, 15.4, 15.5)4. Analyse and evaluate specific ethical principles which facilitate moral reasoning in the decision making process (1, 1,1, 1.2, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 3, 3.1, 3.2, 3.3, 4, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 5, 5.1, 5.2, 5.3, 5.4, 6, 7, 7.1, 7.2, 7.3, 8, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.9, 8.10, 9, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.9, 9.10, 10, 10.1, 10.2, 11, 11.1, 11.2, 11.3, 12, 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 13, 13.1, 13.2, 13.3, 13.4, 13.5, 13.6, 13.7, 13.8, 13.9, 13.10, 13.11,13.12, 13.13, 13.14, 14, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9, 14.10, 14.11, 14.12, 14.13, 14.14, 14.15, 14.16, 14.17, 14.8, 14.19, 14.20, 14.21, 14.22, 14.24, 15, 15.1, 15.2, 15.3, 15.4, 15.5)5. Demonstrate a working knowledge of the most current Code of Ethics and Professional Conduct (COT), Standards of Conduct Performance & Ethics (HCPC) and Standards of Proficiency - Occupational Therapists (HCPC which underpin practice. (1, 1,1, 1.2, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 3, 3.1, 3.2, 3.3, 4, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 5, 5.1, 5.2, 5.3, 5.4, 6, 7, 7.1, 7.2, 7.3, 8, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.9, 8.10, 9, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.9, 9.10, 10, 10.1,10.2, 11, 11.1, 11.2, 11.3, 12, 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 13, 13.1, 13.2, 13.3, 13.4, 13.5, 13.6, 13.7, 13.8, 13.9, 13.10, 13.11,13.12, 13.13, 13.14, 14, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9, 14.10, 14.11, 14.12, 14.13, 14.14, 14.15, 14.16, 14.17, 14.8, 14.19, 14.20, 14.21, 14.22, 14.24, 15, 15.1, 15.2, 15.3, 15.4, 15.5)6. Demonstrate understanding of scope and limits of practice. (1, 1,1, 1.2, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 3, 3.1, 3.2, 3.3, 4, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 5, 5.1, 5.2, 5.3, 5.4, 6, 7, 7.1, 7.2, 7.3, 8, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.9, 8.10, 9, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.9, 9.10, 10, 10.1,10.2, 11, 11.1, 11.2, 11.3, 12, 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 13, 13.1, 13.2, 13.3, 13.4, 13.5, 13.6, 13.7, 13.8, 13.9, 13.10, 13.11, 13.12, 13.13, 13.14, 14, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9, 14.10, 14.11, 14.12, 14.13, 14.14, 14.15, 14.16, 14.17, 14.8, 14.19, 14.20, 14.21, 14.22, 14.24, 15, 15.1, 15.2, 15.3, 15.4, 15.5)7. Develop skills in making informed, reasonable and justified decisions within therapeutic practice. (1, 1,1, 1.2, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 3, 3.1, 3.2, 3.3, 4, 4.1, 4.2, 4.3, 4.4, 4.5, 4.6, 5, 5.1, 5.2, 5.3,5.4, 6, 7, 7.1, 7.2, 7.3, 8, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6, 8.7, 8.9, 8.10, 9, 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.9, 9.10, 10, 10.1, 10.2, 11, 11.1, 11.2, 11.3, 12, 12.1, 12.2, 12.3, 12.4, 12.5, 12.6, 12.7, 13, 13.1, 13.2, 13.3, 13.4, 13.5, 13.6, 13.7, 13.8, 13.9, 13.10, 13.11,13.12, 13.13, 13.14, 14, 14.1, 14.2, 14.3, 14.4, 14.5, 14.6, 14.7, 14.8, 14.9, 14.10, 14.11, 14.12, 14.13, 14.14, 14.15, 14.16, 14.17, 14.8, 14.19, 14.20, 14.21, 14.22, 14.24, 15, 15.1, 15.2, 15.3, 15.4, 15.5)

Teaching / Learning Strategy

Teaching / learning strategies include keynote interactive lectures, independent and group learning and use of critical incidents from practice education. A variety of formative activities including case study material will be used to develop a shared understanding of the assessment criteria and to empower students to achieve the learning outcomes in a self-directed manner. Summative assessment comprises:- CW1 - a group presentation - week 5 CW2 - written assignment of 2000 words

Indicative Reading

BEAUCHAMP, T.L and CHILDRESS, J. 2013. Principles of Biomedical Ethics 7 th edit. Oxford University, Oxford -547 BUSHBY, K. et al, 2015. Ethical Tension in Occupational Therapy. British Journal of Occupational Therapy [online] 78(4) pp. 212-221 [viewed 13 December 2015] Available from: <http://bjo.sagepub.com.gcu.idm.oclc.org/content/78/4.toc>bjo.sagepub.com.gcu.idm.oclc.org/content/78/4.toc <http://bjo.sagepub.com.gcu.idm.oclc.org/content/78/4.toc> CARRIER, A., LEVASSEUR, M., BEDARD, D., DESROSIERS, J. 2012. Clinical reasoning process underlying choice of teaching strategies: A framework to improve occupational therapists' transfer skill interventions. Australian Occupational Therapy Journal . 59 (5), pp355-366. COLLEGE OF OCCUAPTIONAL THERAPY 2015. Code of Ethics and Professional Conduct RCOT London DELANY, C. & GALVIN, J., 2014. Ethics and shared decision-making in paediatric occupational therapy practice. Developmental Neurorehabilitation. 17 (5), pp347-354. DELULIIS, E., 2017. Professionalism Across Occupational Therapy Practice. Thorofare, NJ: Slack Inc. HANCOCK, J. 2018. 'Professional ethics, regulation and fitness to practice'. In: CLOUSTON, T.J., WESTCOTT, L. & WHITCOMBE, S.W. eds. Transition to practice: Essential concepts for health and social care professions. Keswick: M & K Publishing. pp.3-16. HEALTH AND CARE PROFESSIONS COUNCIL 2013. Occupational Therapy Standards of Proficiency HCPC England -547 HEALTH AND CARE PROFESSIONS COUNCIL 2016. Code of Conduct, Performance and Ethics England HIGGS, J. et al 2018. Clinical Reasoning in the Health Professions Elsevier America -547 JASPER M., ROSSER, M. & MOONEY, G. 2013. Professional Development, Reflection and Decision-Making , [online] 2 nd Edition, Wiley-Blackwell Chichester [viewed 21 January 2016] Available from: <https://www.dawsonera.com/readonline/9781118303269> JONGH, J.C. BRANDT. L. WEGNER L. 2019 Occupational therapy students perspectives of ethics in two countries: South Africa and the United States of America. International Journal of Health Sciences 13(4) <https://ijhs.org.sa/index.php/journal/article/view/3767> KINSELLA, E.A., PHELAN, S.K., PARK LALA, A. & MOM, V., 2015. An investigation of students' perceptions of ethical practice: engaging a reflective dialogue about ethics education in the health professions. Advances in Health Sciences Education. 20 (3), pp.781-801. MATTINGLY, C. & FLEMING, M.H. 1994. Clinical Reasoning: Forms of Inquiry in a Therapeutic Practice. A Davis Philadelphia Publishers MORRISON, E.E. & FURLONG, B., 2018. Health Care Ethics. 4 th ed. Burlington, MA: Jones & Barlett Learning. PURTILO, R. DOHERTY, R. 2016. Ethical Dimensions in the Health Professions. 6 th ed . Elsevier ROYAL COLLEGE OF OCCUPATIONAL THERAPY. 2017. Embracing Risk Enabling Choice London SCHELL, B. SCHELL, J.W. 2017. Clinical and Professional Reasoning in Occupational Therapy Wolters Kluwer SEEDHOUSE, D. 2009; Ethics: The Heart of Health Care . 3 rd ed. John Wiley and Sons (Ebook) STOLT, M., LEINO-KILPI, H., RUOKONEN, M., REPO, H. & SUHONEN, R., 2018. Ethics interventions for healthcare professionals and students: A systematic review. Nursing Ethics. 25 (2), pp.138-152. STRONG, G., 2018. 'Professionalism: A journey from novice to expert practitioner. In: CLOUSTON, T.J., WESTCOTT, L. & WHITCOMBE, S.W. eds. Transition to practice: Essential concepts for health and social care professionals. Keswick: M & K Publishing. pp.31-44. THOMAS, Y. SEEDHOUSE, D. PEUTHERER, V. LOUGHLIN, M. 2019. An empirical investigation into the role of values in occupational therapy decision-making <https://journals.sagepub.com/doi/abs/10.1177/0308022619829722> British Journal of Occupational Therapy 82(6) p357-366 TITTERTON, M. 2005. Risk and risk taking in health and social welfare , London: Jessica Kingsley. Available at:https://ebookcentral.proquest.com/lib/gcal/reader.action?docID=290663&ppg=5 VANDERKAAY, S. JUNG, B. LETTS, L. 2019 Continuing competency in ethical decision making: An interpretive description of Occupational therapists' perspectives <https://journals.sagepub.com/doi/abs/10.1177/0008417419833842> Canadian Journal of Occupational Therapy 86(3) p209-219 WAYNE, K., 2019. How Can Ethics Support Innovative Health Care for an Aging population? Ethics and Behavior. 29 (3), pp.227-253.

Transferrable Skills

Should increase ability to: -360 - reflect upon and critically evaluate own practice and the practice of others. - integrate personal opinion with professional practice. - identify and verbalise complexity of relationships within the workplace. - work as a team member. - develop critical reading and writing skills. -360 - demonstrate through self-led learning, a critical and evaluative approach to lifelong learning.

Module Structure

Activity Total Hours
Lectures (FT) 12.00
Tutorials (FT) 24.00
Independent Learning (FT) 134.00
Assessment (FT) 30.00

Assessment Methods

Component Duration Weighting Threshold Description
Course Work 01 n/a 100.00 40% Essay, 2000 words