Nesbit Kathryn C, Jensen Gail M, Delany Clare
a Department of Physical Therapy , University of the Pacific Stockton , CA , USA.
b Graduate Studies and Department of Physical Therapy , Creighton University , Omaha , NE , USA.
Physiother Theory Pract. 2018 Jan;34(1):1-12. doi: 10.1080/09593985.2017.1368759. Epub 2017 Aug 30.
The purpose of this case report is to explore the active engagement model as a tool to illuminate the ethical reflections of student physical therapists in the context of service learning in a developing country.
The study participants were a convenience sample of six students. The study design is a case report using a phenomenological perspective. Data were collected from students' narrative writing and semi-structured interviews. The steps of the active engagement model provided the structural framework for student responses. The analysis process included open coding, selective coding, and member checking.
Results showed the emergence of two main themes: 1) gathering rich detail and 2) developing independent moral identity. Students' descriptions of their relationships were detailed and included explanations about the complexities of the sociocultural context. Independent and deliberate agency was evident by the students' preparedness to be collaborative, to raise ethical questions, to identify ethically important aspects of their practice and to describe their professional roles. The students noted that the use of the model increased their engagement in the ethical decision-making process and their recognition of ethical questions.
This case report illustrates attributes of the active engagement model which have implications for teaching ethical reflection: scaffolding for ethical reflection, use of narrative for reflection, reflection in action, and illumination of relevant themes. Each of these attributes leads to the development of meaningful ethical reflection. The attributes of this model shown by this case report have potential applications to teaching ethical reflection.
本病例报告的目的是探讨积极参与模式，作为一种工具，用以阐明在发展中国家的服务学习背景下，学生物理治疗师的伦理思考。
研究参与者是六名学生的便利样本。研究设计是采用现象学视角的病例报告。数据从学生的叙事写作和半结构化访谈中收集。积极参与模式的步骤为学生的回答提供了结构框架。分析过程包括开放编码、选择性编码和成员核对。
结果显示出现了两个主要主题：1）收集丰富细节和2）形成独立的道德身份。学生对他们关系的描述很详细，包括对社会文化背景复杂性的解释。学生们愿意合作、提出伦理问题、识别其实践中伦理上重要的方面并描述其专业角色，这体现了独立且深思熟虑的能动性。学生们指出，使用该模式增加了他们在伦理决策过程中的参与度以及对伦理问题的认识。
本病例报告阐述了积极参与模式的属性，这些属性对伦理反思教学具有启示意义：伦理反思的支架作用、利用叙事进行反思、行动中的反思以及相关主题的阐明。这些属性中的每一个都有助于发展有意义的伦理反思。本病例报告所展示的该模式的属性在伦理反思教学中具有潜在应用价值。
