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Quality in Mediated Instruction
Presented below is an article
that originally appeared in the ASHA Issues in Higher
Education Newsletter (Special Interest Division 10), 2
(2), October, 1998, pp. 3-7.
Ethics, Preferred Practices and the
Professoriate
Professor, Department of Communicative Disorders
University of Wisconsin-Madison
INTRODUCTION
Most faculty in communicative sciences and disorders are familiar with the codes of ethics offered and occasionally argued by groups such as the ASHA, the American Academy of Audiology and others. We also are familiar with evolving patterns of preferred practice, such as those for audiology (ASHA, 1997a) and for speech-language pathology (ASHA, 1997b).
Codes of ethics are based upon guiding principles (overarching values), rules specifying behavioral imperatives, rules specifying proscribed behaviors, and suggestions about encouraged (but not required) behaviors. Thus, codes of ethics convey the highest aspirations of a profession to both the public and practitioners. The ASHA Code of Ethics (ASHA, 1994) rests upon four principles, here paraphrased as honoring responsibilities to
- The welfare of those served,
- Maintaining professional competence,
- Advancing public understanding and fulfilling unmet needs, and
- Colleagues and other professionals.
Underpinning these principles are familiar concepts emphasizing best practice, best evidence and due diligence (i.e., professional competence), as well as informed consent (client welfare), and avoiding conflicts of interest (public need and understanding).
Of the 32 rules cited in the ASHA Code of Ethics, only four even remotely address the training of students. These deal with (1) the need to obtain consent from clients or patients used in instruction, (2) the exemption (via supervision) by which students and clinical fellows can provide clinical services, (3) crediting persons who contribute to presentations, publications or products, and (4) the proscription against inappropriate discrimination (i.e., on the basis of race, ethnicity, gender, age, religion, national origin, sexual orientation, or disability). It also is noteworthy that of 16 substantive issues identified by the ASHA Ethical Practices Board (EPB) between 1973 and 1997, only three relate to the training of students (see ASHA, 1997c, pages I-65 through I-102).
Recent articles (Resnick, 1991 and Swigert, 1998) suggest that professional ethics remain an important issue. Resnick (1993) offers thoughtful and comprehensive treatment of the subject with numerous case studies drawn from work settings other than academic.
Similarly, preferred practice patterns rest upon guiding principles. Although many of these principles are linked to the ASHA Code of Ethics, they deal less with ethics than with the content of practice, i.e., structural requirements, clinical processes, and intended outcomes. The audiology (ASHA, 1997a) and speech-language pathology (ASHA, 1997b) documents contain 16 and 15 points, respectively. Of these, 11 are identical, four are very similar, and one is unique. Similar principles include those of generic nature (e.g., the goal of addressing communication issues is to produce measurable changes in the communication status of patients / clients). The most distinct principles deal with audiologic practice (e.g., factors related to ambient noise, equipment calibration and scope of practice). None relate to education and training.
Other examples of behavioral imperatives and proscriptions include Chial's (1998) list of 25 "dos" and "don't" focusing on behavioral expectations of students who seek to enter the professions of communicative disorders. These were noted to clarify the values, attitudes, and behaviors that define professionalism. Independent of Chial's (1998) work, May, Straker, and Foord (1997) documented similar ideas in the form of a curriculum for physical therapy students.
Considering related issues, Woodward and Goodstein (1996) identified 15 ethical principles that could be invoked to define proper conduct in science. These authors argue convincingly that ethical guidelines for the conduct of science do not arise directly from the fundamental principles of scientific practice, and (further) that seemingly benign proscriptions such as "avoid over-interpretation of data" are neither necessary nor useful to the ultimate goals of scientific enterprise.
Conventional wisdom claims other ethical positions that are not as simple as they first may seem. Indeed, they may be problematic. Take, for example, the imperative "whatever else, do no harm." (incorrectly assumed to be part of the Hippocratic Oath--for a comprehensive treatment of the Oath, see http://ccme-mac4.bsd.uchicago.edu/CCMEPolicies/MedCodes/Hippo). Problems arise not because academicians are incapable of doing harm, but because in some contexts "harm" can be quite subjective. In a culture characterized by increased student consumerism, increased competition for admission to graduate programs, and increased group sensitivities, "harm" can become a synonym for "disagreement," "discomfort," "disappointment," "lack of fulfillment," or "lack of enjoyment." A professor who assigns a failing grade (or even a B) to a student may consider that grade appropriate, but the student may experience it as a "harmful" cause for litigation. This is not to say these things routinely compromise professors, but to acknowledge that such pressures exist and that they produce conflict.
Our concerns about empowering students with disabilities (e.g., a speech-language pathology student with a severe hearing loss, or an audiology student with a serious deficit arising from a stroke) may cause us to address conflicting values affecting our students vs. those affecting the clients or patients those students hope to serve. If these matters were easy--if we did not have to weigh different sets of values--life would be simpler.
Two generalizations emerge from the sources just cited. First, while our profession enjoys a rich body of ethical principles and rules, as well as elaborated guidelines for professional practice, we are less well developed in areas uniquely associated with the education and training of students. Second, the development of useful and effective principles to guide academic practice is not simply a matter of invoking platitudes and reciting maxims.
This essay explores questions related to principles that can or should guide our work with undergraduate and graduate students. First, what distinguishes our work from clinical practice? Second, what rubrics of principle speak to those distinctions? Third, how might these be applied? If what follows is successful, it will produce dialog about what we should and should not do in our efforts to train tomorrow's professionals.
DISCUSSION
Our Scope of Practice
The scope of practice of academics traditionally includes research, teaching and service. Elements of this classical triad are given varying definitions and varying emphases depending upon the missions of institutions and the values of professors, acting alone or collectively. Boyer (1990) argues that the idea of scholarship (the common theme of the triad) should be broadened to include not only the scholarship of discovery (research), but also the scholarship of integration, the scholarship of application, and the scholarship of teaching. Boyer's thoughts have been tremendously influential, as reflected in subsequent work by Rice (1996), Glassick, Huber and Maeroff (1997) and by ongoing projects supported by the American Association of Higher Education.
Glassick, Huber and Maeroff (1997) specify six standards of scholarship that apply to research and to the other forms of scholarly activity elaborated by Boyer (1990). These are--
- Clear Goals: The scholar states purposes clearly and objectives realistically.
- Adequate Preparation: The scholar understands existing scholarship and has the skills needed to do the work.
- Appropriate Methods: The scholar effectively applies appropriate procedures, modifying them as needed.
- Significant Results: The scholar meets goals in ways that add to the field and open new areas of exploration.
- Effective Presentation: The scholar organizes and conveys outcomes of work to appropriate audiences, clearly, effectively and with integrity.
- Reflective Critique: The scholar critically evaluates his or her own work for the purpose of improving future work.
Elaboration of the scope of scholarship is intended in part to rebalance what is seen by many college and university administrators as disproportionate emphasis on academic disciplines and angst about resulting insularity, inflexibility, and undue interference from external agencies (i.e., professional associations such as the ASHA). Perhaps these efforts also address criticisms of the sort offered by Sykes (1988) in his book Prof Scam: Professors and the Demise of Higher Education. Sykes' indictments allege abandonment of instructional responsibility in favor of research, much of which is trivial, incomprehensible to all but the initiated, and of little scientific or social value. He also charges professors with aggravated self-interest for marketing their time and work products for personal gain. He goes on to argue that cherished investments in tenure, academic freedom, academic governance and propriety language ("profspeak") are simply aliases by which professors resist meaningful reform.
Sykes intentionally presses his case in an inflammatory manner. He largely ignores the complicity of institutions whose policies encourage research contracts with industry, generation of patent royalties, and recovery of indirect costs through grants. But he makes some valid points. Even though professors are not licensed as such, we enjoy special status and we have far more control over what we do and how we do it than most folk who work for a living. Yet many of us can identify individuals who have not satisfied our own ideals, whatever they may be. Probably all of us have felt the chill of the glacial pace of change in academia.
Other Voices
Murray and others (1996) identify nine ethical principles for college and university teaching. Offered as "food for thought, . . .not a final product," these are the work of the Canadian Society for Teaching and Learning in Higher Education as influenced by the code of ethics of the American Psychological Association (1990). The nine principles, which can be considered preferred practice patterns, are quoted below.
Principle 1: Content Competence: A university teacher maintains a high level of subject matter knowledge and ensures that course content is current, accurate, representative and appropriate to the position of the course within the student's program of studies.Principle 2: Pedagogical Competence: A pedagogically competent teacher communicates the objectives of the course to students, is aware of alternative methods or strategies, and selects methods of instruction that, according to research evidence (including personal or self-reflective research), are effective in helping students to achieve the course objectives.
Principle 3: Dealing with Sensitive Topics: Topics that students are likely to find sensitive or discomforting are dealt with in an open, honest, and positive way.
Principle 4: Student Development: The overriding responsibility of the teacher is to contribute to the intellectual development of the student, at least in the context of the teacher's own area of expertise, and to avoid actions such as exploitation and discrimination that detract from student development.
Principle 5: Dual Relationships with Students: To avoid conflict of interest, a teacher does not enter into dual-role relationships with students that are likely to detract from student development or lead to actual or perceived favoritism on the part of the teacher.
Principle 6: Confidentiality: Student grades, attendance records, and private communications are treated as confidential materials, and are released only with student consent, or for legitimate academic purposes, or if there are reasonable grounds for believing that releasing such information will be beneficial to the student or will prevent harm to others.
Principle 7: Respect for Colleagues: A university teacher respects the dignity of her or his colleagues and works cooperatively with colleagues in the interest of fostering student development.
Principle 8: Valid Assessment of Students: Given the importance of assessment of student performance in university teaching and in students' lives and careers, instructors are responsible for taking adequate steps to ensure that assessment of students is valid, open, fair, and congruent with course objectives.
Principle 9: Respect for Institution: In the interests of student development, a university teacher is aware of and respects the educational goals, policies, and standards of the institution in which he or she teaches.
Principles 1, 2 and 8, above, emphasize competence, what otherwise might be termed "best practice." Best practice usually refers to ways of doing considered by knowledgeable peers as being more appropriate and more effective than the alternatives. For endeavors requiring specialized knowledge and skill, best practice is domain-specific. If our instructional venues differ (e.g., classroom instruction vs. practicum training vs. laboratory instruction vs. continuing professional education), we would expect at least some differences in best practice.
If "best" cannot be known with complete certainty, "good" may suffice. Chickering and Ehrmann (1987) described seven principles of good practice in undergraduate education. Presumably, these are preferred practice patterns and presumably they apply as well to graduate education and continuing education.
- Good practice encourages contacts between students and faculty. Contact in and out of class motivates involvement, stimulates commitment, and encourages reflection about values.
- Good practice develops reciprocity and cooperation among students. Collaboration not only produces learning, it also improves thinking and deepens understanding.
- Good practice uses active learning techniques. Effective learning requires reflection and application; "learning is not a spectator sport."
- Good practice gives prompt feedback. What is not known is as important as what is; performance followed by timely feedback and reflection should engender self-assessment skills.
- Good practice emphasizes time on task. Effective use of time and application of focused energy is necessary for learning.
- Good practice communicates high expectations. Expecting much produces more learning than expecting little.
- Good practice respects diverse talents and ways of learning. Individual differences matter; if students are to understand which ways of learning work for them, they must have the chance to try different ways.
The seven principles of good practice pertain as much to learning as to teaching. As such, they constitute a sort of sea change, if not an actual paradigm shift. The change of focus from instructor behaviors (e.g., the "sage on stage") to learning enablers is as fundamental as defining communication as a set of complex interactions, rather than the simple sum of the separate effects of senders, channels and receivers.
These principles rest upon research about the factors that influence successful learning, what we might otherwise call "efficacy studies"--those which address the effectiveness, efficiency, and consistency of instructional outcomes. More recently, these authors applied their principles to evolving communication and information technologies (Chickering and Ehrmann, 1997). Barr and Tagg (1995) integrate recent evidence about teaching and learning in more conventional contexts.
Missing Pieces
Conflict of interest is addressed at length by Sykes (1988), but only briefly by Boyer (1990), Murray and others (1996), and Chickering and Ehrmann (1987, 1997). The ASHA Code of Ethics addresses this matter (Principle II, Rule B) in the context of honoring responsibilities to the public. If such conflicts are possible in our work to promote student learning, it would seem that a code of ethics or a statement of preferred practices should seek to avoid them.
Conflicts of interest typically involve compromised allegiances, unfair financial gain, or both. Is it a conflict of interest for a professor to require students to purchase a textbook from which the professor derives royalties? Is it a conflict of interest for a professor to teach the use of proprietary software or copyrighted tests from which the professor earns income, assuming that students (or their employers) must later purchase those materials? Is it a conflict of interest for a professor to operate a private practice (clinical or otherwise) that competes with services provided by her or his employer? Is it a conflict of interest for a professor to require a graduate student to present a lecture to the professor's undergraduate class? Is it a conflict of interest for a professor to devote scarce institutional resources (equipment, space, time, staff, and students) to the business of professional associations? Is it a conflict of interest to use such resources to perform work for pay from sources other than the institution? Is it a conflict of interest (or integrity) for a professor to attempt to influence legislation or third-party policies to implement clinical programs for which efficacy data do not exist, or for which data suggest unpredictable outcomes?
More broadly--of the codes, principles, rules and guidelines noted above, which (if any) address potentially conflicted interests of academics? These questions are left to the reader and perhaps to the Division 10 Email discussion group.
CLOSING COMMENT
What seems clear from the work of Boyer (1990), Murray and others (1996) and Chickering and Ehrmann (1987, 1997), is that there are indeed aspects of our duties as academicians that distinguish us from our colleagues in other settings. To be sure, there are parallels and similarities. Differences are related to the purpose of education, that is, producing relatively long-term positive change in attitudes, knowledge and skill, including the skills needed to continue learning.
The major value of codified professional ethics and statements of preferred practice is the guidance they provide when practitioners are faced with complexities. Like other worthy issues, ethical matters deserving of attention defy simplistic solutions and invite reflection about competing values. Academicians in the disciplines of communicative sciences and disorders serve more than one profession. We lack a code of ethics (or a statement of preferred patterns of practice) that addresses our particular duties as professors. Perhaps we really do not need one. Nonetheless, we would benefit from one.
REFERENCES
American Psychological Association (1990). Ethical principles for psychologists. American Psychologist. 45, 390-395.
American Speech-Language-Hearing Association (1994). Code of ethics. Asha, 36 (March, Suppl. 13), 1-2.
American Speech-Language-Hearing Association (1997a). Preferred practice patterns for the profession of audiology. Rockville, MD: Author.
American Speech-Language-Hearing Association (1997b). Preferred practice patterns for the profession of speech-language pathology. Rockville, MD: Author.
American Speech-Language-Hearing Association (1997c). ASHA Desk Reference, Volume 1: Cardinal documents of the Association. Rockville, MD: Author.
Barr, R. B., and Tagg, J. (1995). From teaching to learing: A New paradigm for undergraduate education. Change, 27 (November/December), 13-25.
Boyer, E. L. (1990). Scholarship Reconsidered: Priorities of the Professoriate. Princeton, NJ: The Carnagie Foundation for the Advancement of Teaching.
Chial, M. (1998). Conveying expectations about professional behavior. Audiology Today, 10 (4), 25.
Chickering, A. W., and Ehrmann, S. C. (1987). Seven principles for good practice in undergraduate education. Bulletin of the American Association for Higher Education, 39 (March).
Chickering, A. W., and Ehrmann, S. C. (1997). Implementing the seven principles: Technology as lever. Bulletin of the American Association for Higher Education, 49 (August). Available at http://www.aahe.org/technology/ehrmann.htm
Glassick, C., Huber, M., Maeroff, G. (1997). Scholarship Assessed: An Evaluation of the Professoriate. San Francisco, CA: Jossey-Bass Publishers.
May, W., Straker, G., and Foord, L. (1997 draft). Facilitating the development of professional behaviors in physical therapy education. Madison, WI: Physical Therapy Program, University of Wisconsin.
Murry, H., Gillese, E., Lenon, M., Mercer, P., and Robinson, M. (1996). Ethical principles for college and university teaching. Bulletin of the American Association for Higher Education, 48 (December). Available at http://www.aahe.org/bulletin.bulldec1.htm
Resnick, D. (1991). Issues in ethics. Audiology Today, 3 (5), 13-14.
Resnick, D. (1993). Professional Ethics for Audiologists and Speech-Language Pathologists. San Diego, CA: Singular Publishing Group, Inc.
Rice, R. E. (1996). Making a Place for the New American Scholar. Forum on Faculty Roles & Rewards Working Paper Series, Inquiry 1. Washington, DC: American Association for Higher Education.
Swigert, N. (1998). Taking ethics seriously. Asha, 40 (Summer), 11.
Sykes, C. J. (1988). Prof Scam: Professors and the Demise of Higher Education. New York, NY: St. Martin's Press.
Woodward, J., and Goodstein, D. (1996). Conduct, misconduct and the structure of science. American Scientist, 84 (September/October), 479-490.