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Uncovering ethical dilemmas in international service-learning (ISL): a grounded theory
Dissertation   Open access

Uncovering ethical dilemmas in international service-learning (ISL): a grounded theory

Kripa H. Dholakia
Doctor of Health Science (D.H.Sc.), Drexel University
Jun 2020
DOI:
https://doi.org/10.17918/00001030
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Abstract

Physical therapy--Moral and ethical aspects Physical therapy--Study and teaching (Continuing education)
Introduction: International Service-Learning (ISL) is a model of experiential learning offered by Doctor of Physical Therapy (DPT) programs in the United States. Although the number of ISL experiences is growing steadily, it is unclear whether faculty, students, and supervising alumni consider the ethicality of these experiences, and to what degree. Recent evidence has uncovered adverse effects of short-term health related service experiences such as ISL; however, to date, ethical implications of ISL in DPT education have not been explored. Furthermore, a more contemporary definition may be required to address the need for reciprocal benefit and ethical care in an international context. From the perspective of the APTA's Code of Ethics and the Realm-Individual Process-Situation (RIPS) model of ethical decision-making, the purpose of this study was: 1) to explore the experiences, perceptions, and insights of faculty, students and alumni who engage in ISL, 2) to uncover the ethical nature of these experiences, and 3) propose a more contemporary and comprehensive definition of ISL. Methods: Ten students, six faculty and five alumni participated in this study (n=21). Participants engaged in semi-structured interviews which explored their experiences, perceptions, and insights related to ISL using constructivist grounded theory methodology. All interviews were audio-recorded using a digital voice recorder, transcribed verbatim, and de-identified. Data were analyzed by Charmaz's coding process. Results: Data analyses indicated that ISL as experienced by participants in this study failed to uphold APTA's ethical principles 2A, 3B, and 8B. Furthermore, the RIPS situational analysis indicated that the primary themes arising from this study reflect ethical issues/problems and an ethical temptation, with an overarching ethical silence wherein ethical issues are present but not discussed or made explicit. Discussion and Conclusion: Students and educators, in their desire to be altruistic, may overlook ethical situations arising from of ISL, thereby compromising their duty towards patient and host community beneficence. The ongoing examination of ISL is critical. It is recommended that future research explore patient beneficence and that standards for an ideal ISL experience be established based on best practice guidelines. This is the first study to examine ISL in DPT education using an ethical lens and sheds light on the need to critically examine this teaching model.

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