Other studies have investigated how students put social work ethics in action, from perspectives of confidentiality, moral reasoning, inter-professional working, practice learning and innovative learning opportunities. Saxon, Jacinto and Dziegielewski (2006)** investigated students’ attitudes to confidentiality, which they noted as one of the many facets of ethical decision-making in practice. Drawing on 80 participants’ responses to a case scenario, with space given for narrative rationale, they found that around two-thirds of their sample would breach confidentiality in a situation where service user safety was a consideration. Participants further into their course were more likely to do this than first year students, who appeared more principle- driven. Moreover, the study’s inclusion of both undergraduate and postgraduate participants led to the authors’ noting that, while there was no significant differences between the responses of the two groups, the postgraduate students seemed to struggle more with the scenario as presented, seeking clarification and
further information. Saxon, Jacinto and Dziegielewski speculate that this may be due to the greater emphasis on critical thinking in postgraduate education. They conclude that ethical decision-making is a complex process, often without simple right or wrong answers, and which like the vignette used in the study, students may find difficult. Landau (1999)** explored ethical reasoning over time with 590 student and qualified participants. The study employed vignettes and the Defining Issues Test, an instrument that rates ethical judgment by measuring how much weight is given to ‘principled moral considerations’ in resolving an ethical dilemma (Landau, p.62). Landau (p.67) found ‘no significant differences in the ethical judgment of first year social work students, third year students, and practicing social workers’. However, she discerned changes in decision-making orientation. Final year students tended to show more client-centredness and inclination towards non-intervention - suggesting a commitment to empowerment - than those at the start of their course. She found too that the only demographic factor positively correlated with higher ethical judgment was being religious or very religious. This presents a different picture to Johnson et al. (2006) who had found participants high in religiosity less adherent to social work values than others. For Johnson et al the religiously committed participants were (incidentally) Christian. In Landau’s study, they were Jewish, reinforcing the point that faith is an umbrella term and that its meaning needs to be considered in the light of specific circumstances. With regard to the apparently limited impact of education, Nathanson, Giffords and Calderon (2011)* counter Landau’s conclusions. The primary aim of this study was to show the efficacy of the Nathanson and Gifford Ethics Scale in measuring changes in student values, and thus monitoring educational standards. Building on a values inventory
developed by Pike (1996, cited in Nathanson Giffords and Calderon) the authors argue that rather than measuring values in terms of simple adherence, it is more useful to recognise the modifying role of context. Thus, moving away from Pike’s ‘discrete value adherence’ (p.136) the Nathanson and Gifford Ethics Scale – like Landau - presents participants with a series of practice vignettes to which they are asked to respond. Reporting the scale’s use in a pilot study with a total of 178 postgraduate students and alumni from three US campuses, and at different stages of their social work education, the authors conclude that it is reliable and valid. They find too that scores vary according to participants’ educational institution, arguing that students’ respective urban and suburban backgrounds are significant, as ethical development represents a fusion of taught input and personal morality. They conclude that educators must be mindful not only of curricula but of students’ existing positions in terms of societally inculcated values. They note too that growth in ethical awareness is discernible over time, with education appearing to ameliorate differences between and amongst student groups, and also to increase in employment.
Two studies compare social work students’ reasoning with those from other disciplines. In Hong Kong, Yeung et al. (2010)** found in focus groups with 30 each social work and nursing students that the former were driven more by imperatives of service- user self-determination, and the latter by care. Meanwhile in a Finnish study, Juujärvi (2006)**, administering questionnaires two years apart to 59 social work, nursing and police students in an investigation of moral reasoning, found social work students more prone to care than police students. For Yeung et al.’s
nursing student participants, however, the care they prioritise is physical; as one of them points out, ‘we nurses would put physical health as our first priority’ (p.1582). Juujärvi drew instead on the richer concept articulated in the ethic of care, and the philosophical debates that contrast it to justice (see Chapter Two). Neither study offers direct insight into individual experience, although Juujaärvi suggests that students undergo an ethical balancing process, with care and justice orientations coexisting. Together, however, these studies point to the need for close attention to meaning when using ethical vocabulary, suggesting the utility of qualitative research in clarifying participants’ understanding.
Other studies investigate social work ethics in the context of educational experiences. For some, the focus is the classroom. Two studies investigated changes in students’ attitudes towards aspects of social justice after taught input. Van Soest (1996)** administered pre and post-test surveys to 222 postgraduate students at two US universities. They found that having attended teaching on oppression correlated positively with both a belief in social justice and engagement in advocacy for marginalised groups including gay people and African Americans. A decade later, in another US study, Van Voorhis and Hostetter (2006)** drew similar conclusions on surveying 52 participants. Together these studies reinforce further the role of professionally qualifying courses in delivering not simply knowledge, but socialisation. Moreover, and relevant for the present research, Van Soest also asked participants about their emotional response to the teaching, and found ‘belief in a just world’ (no page number) accompanied by distress at examples of injustice. She concludes that that learning about oppression can be profoundly troubling,
potentially leading to either a defensive entrenchment of existing beliefs or a disturbing dissonance between longstanding previous perceptions of the world and the new insights offered by education. Sanders and Hoffman (2010)** note the continuing debate in professional education about the relative efficacy of discrete and infused ethical teaching, but a dearth of research with regard to social work. Seeking to address this, they administer a vignette-based instrument to a total of 144 social work students in three US universities. One institution provides a discrete ethics module and one infuses ethical content throughout the curriculum. The third provides a discrete module with an emphasis on Gert’s concept of common morality, which rejects reliance on principles in favour of situated reasoning (Gert, 1998, cited in Sanders and Hoffman). This, the authors argue, is especially useful for social work. Accordingly, they hypothesise that the students taught from this perspective will show the greatest degree of moral judgment, and so respond most comprehensively to the scenarios presented. The hypothesis is upheld, although the authors note limitations of the study and the need for further research to clarify unresolved questions about the teaching of social work ethics. The research design precludes conclusions about individual understanding, however the finding that students’ ethical development occurs, albeit to varying extents, regardless of teaching mode, again points to the personal change inherent in social work education beyond mere acquisition of knowledge.
Three studies offer insight into challenges to and opportunities for ethical practice that participants may encounter on placement; one is quantitative and two qualitative. Dodd (2007)** administered questionnaires to 76 US postgraduate
students to investigate ethical dilemmas experienced on placement. She found that concerns most often reported were related to service users’ best interests, and points to the importance of having opportunities to reflect. Here, Dodd echoes studies noted above that emphasise the importance for ethical practice of supervision (Shlomo, Levy and Itzhaky, 2012; Levy, Shlomo and Itzhaky, 2014). She also found that students were especially challenged where the field supervisor’s practice or guidance contributed to an ethical dilemma. The qualitative studies both focus on students on final placements. In a Canadian study, Bellefeuille and Hemingway (2006)** investigated 26 students’ placement experiences using focus groups and reflective writing. Papouli (2016)** also employed written accounts in a Greek study with 32 participants, using a critical incident framework to facilitate reflection on events of significance to the students (Brookfield 1990, cited in Papouli). Both these studies offer insights for the present research. Bellefeuille and Hemingway found that participants’ readiness to practice ethically was constrained by fears of being perceived as naïve or troublesome, and of the stability of the placement being jeopardised. Thus, the very role of student, which requires demonstrable engagement with ethical learning and practice, may also make that engagement feel difficult. For Papouli, the range of incidents reported illustrated that ethical meaning for participants was not merely theoretical, but formed and informed in concrete experience, including encounters with service users, field instructors and professionals. She notes too, with Bellefeuille and Hemingway, the potential stress and need for support inherent in ethically difficult situations – especially where service user behaviour is perceived negatively.
Other studies explore student experiences of ethical learning in settings beyond placement or classroom. Lindsey (2005)*** reports a qualitative study investigating the values development of a total of 41 social work students from the US and Scotland engaged in an exchange study programme between 1996 and 2001. Using students’ reflective written accounts as data, the study employs an analysis strategy drawn from grounded theory methodology. It finds that overall students report increased commitment to social work and to its values, with categories identified including ‘Awareness and Insight Into One's Own Values and Beliefs; Appreciation of Difference, Cultural Sensitivity, and Anti-Discriminatory Practice; Social Justice’ (Lindsey, p.236). The study makes cautiously optimistic claims, suggesting that educational exchange, hitherto the preserve of liberal arts courses, is now of increasing relevance for social work given the growing interest in the international dimension to the profession. Furthermore, Lindsey reports differences between the participant groups’ responses. In particular, the US participants tended to write about the challenges they experienced to their own values while the Scottish students tended to have theirs confirmed. Lindsey argues that these distinctions reflect both cultural characteristics and also the age profile of each group, suggesting again the inevitably situated nature of social work ethics. Moorhead, Boetto and Bell (2014)** report the results of a mixed-methods evaluation of a short-term programme offering 12 undergraduate and two postgraduate Australian social work students the opportunity to visit India. Employing surveys before and after the visit and workshop discussion, the authors investigated participants’ expectations, experiences and changed understandings of themselves and social work. They found that students reported increased self-awareness and a growing sense of personal
congruence with professional values. Moorhead, Boetto and Bell conclude that study abroad offers a useful experiential educational tool, contributing to the development of professional values and identity. Both these studies are potentially compromised by their data being collected as part of assessed activities thus raising questions about participant motivation to take part. However, they raise important questions for my own research about implications for values development when students encounter cultures other than their own - not only in structured educational exchange programmes, but in their own classroom. Similarly, two US studies report the benefits for ethical development of engagement in community projects. Williams and Reeves (2004, p.383)*** investigate 21 postgraduate social work students’ experiences of a week spent assisting at a ‘burn camp’ – a facility run by firefighters for severely burnt children. Using focus groups, journals, and project evaluations to gather data, the study explored values development alongside broader educational outcomes. The authors conclude that both students’ professional identity and their commitment to social work values were enhanced by their experience, with extracts of their words effectively conveying a sense of a growing self-awareness and acceptance of difference. Given the study design, what is elucidated about individual experience is limited. However, like Lindsey, and Moorhead, Boetto and Bell above, it suggests that values may be brought into relief, and refined, by exposure to challenging opportunities. Similarly Levy and Edmiston (2015**) report survey data from 36 social work undergraduates who participated in work with a range of community agencies. The limitations of this study mean that findings are slight. Nonetheless participants’ general concurrence regarding an increase in reported social work values suggests with Williams and Reeves that values can be clarified,
and professional ethical commitment reinforced, by these innovative educational interventions.
Finally, researchers in Lithuania and the US asked participants to look beyond their education to the ethical challenges and experiences they anticipated they would encounter as qualified practitioners. Offering a multi-cultural perspective, Urbonienė and Leliūgienė (2007)* used questionnaires to investigate the values development of final year students in Lithuania, Belarus and Sweden. In this study students were asked by means of an open question to consider what might make it difficult for them to follow social work values in the future. Participants from all three countries identified value conflicts and inefficient professional organisations as possible barriers. In addition, Lithuanian and Belarussian students also mentioned their sense that some service users were ‘unattractive’ to them because of their actions, including criminal behaviour, and difficult to understand or respect (p.45). The differences between the three cultures represented in this study, and their consequently various constructions of social work, make it difficult to interpret its findings comparatively, and equally to apply them directly to the UK. However, the study suggests that claims for the universality of social work values must be made with caution. In the US, Kane (2004)** notes the pervasive ‘managed care’ model noted in the previous chapter and defined here as ‘intended to mediate the distance between consumers’ demands for service and payers’ unwillingness to absorb the cost’ (p.400). Surveying 116 postgraduate social work students in Florida, Kane found that they generally had a simplistic understanding of the ethical challenges managed care may present, and advocates for more targeted educational input and the
provision of more placement experience of managed care agencies. This study addresses practice within a regime specific to the US, and does not present information about individual experience. Despite these limitations, noteworthy for the present study is the inference that effective ethical education must respond to local and specific issues. It may also involve disrupting students’ expectations – Kane notes with concern that participants seem unaware of the ethical challenges they may need to embrace if they are to be ethically effective practitioners.