The Use of Online Discussion Forums for Ethics Training

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1 The Use of Online Discussion Forums for Ethics Training Filip T. Loncke University of Virginia, Charlottesville Carol C. Dudding James Madison University, Harrisonburg, VA Ji eun Kim University of Virginia I n the past decade, several formats of online learning have been developed and employed, either as a complement to more traditional forms of classroom learning or as an alternative to meeting face-to-face. Numerous studies have identified the advantages and disadvantages of online learning (Arbaugh & Hornik, 2005; Jiang & Ting, 2000; Rourke, Anderson, Garrison, & Archer, 2001; Simonson, Smaldino, Albright, & Zvacek, 2000). Advantages include flexibility and convenience, opportunity for reflection, anonymity, and the ability to progress at one s own pace. Critics of online learning cite the lack of interaction or social presence in the online forum as compared to face-to-face settings and question the level of critical thinking that is achieved in the online environment (Bullen, 1998; Richardson & Swan, 2003; Ward & Newlands, 1998). In response to these criticisms, an abundance of studies have examined the social presence within the online environment (Picciano, 2002; Polhemus, Shih, Richardson, & Swan, 2000; Rourke et al., 2001; Rovai, 2002). These and other studies strongly support the existence and importance of a social presence in online learning. Findings suggest a strong correlation between students perceptions of social presence and their feelings of satisfaction and perceived learning (Jiang & Ting, 2000; Richardson & Swan, 2003). It behooves programs in communication sciences and disorders to consider the effectiveness of online learning environments, specifically online discussion forums, as a method for training future and current professionals. One area of consideration is the use of online discussion forums for ethics training. Clinicians will need to make decisions ABSTRACT: Purpose: This article reports the findings of a study that was designed to examine graduate student performance regarding ethical dilemmas that were presented in an online discussion forum. Method: Thirty-seven graduate students in communication sciences and disorders participated in online discussions that focused on ethical dilemmas in the field. The students responses were analyzed using quantitative and discourse analysis. The findings were further analyzed according to type and level of facilitation (content matter expert, noncontent matter expert, or no facilitator). Results: The results of the study suggest that participants did not change their views of the ethical dilemma as a result of participation in an online discussion. Additionally, the findings suggest that use of a facilitator, whether possessing knowledge of the content or not, yields lengthier responses with greater exploration of ideas as compared to no facilitator. Conclusion: Results do not support the importance of content knowledge in the facilitation of online ethical dilemmas. It does, however, suggest that the presence of a facilitator is of importance in terms of number of words per posting and extent of exploration of ideas. KEY WORDS: ethics, ethical dilemma, online discussion, discourse, facilitator CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS Volume Spring Loncke 2009 et NSSLHA al.: Online Discussion Forums /09/

2 and judgments varying from diagnostic to ethical dilemmas. As professionals, they must have the ability to reflect on the premises of their own thinking. On a nearly daily basis, clinicians are confronted with questions about which clients to serve given limited resources. Professionals need to be able to recognize conflicts of interest; decide when to act in cases of suspected abuse; and be critical toward their own judgments, especially if they diverge from the opinions of other professionals. Traditionally, students become familiarized with these concepts in ethical decision making through classroom discussions, often based on a real or fictitious case study. With the advent of online technologies, instructors have increasingly used online discussions as a way to provide students with the chance to reflect on and compare decisions, viewpoints, and consequences of clinical scenarios. Online discussion forums offer learning opportunities that are not possible in traditional classroom discussions, such as potentially higher participation by students whose comfort level may not allow them to speak in class, more time to reflect on postings, and the possibility to retrace the thread of the discussion. Online Discussion Forums An online discussion forum is an area on a course Web site where instructors and students can discuss issues related to the course content. Through proper design and facilitation of the discussion forum, instructors attempt to advance the level of critical thinking of the online learner. Discussion forums can be asynchronous, meaning that everyone posts at a different time, or synchronous, in which everyone is present online at the same time. Synchronous forums are sometimes known as chats. Discussion forums are similar to face-to-face formats with the exception that online forums lack the nonverbal and visual cues that are available in face-to-face formats. However, online discussion forums, especially asynchronous discussions, allow participants time for reflection before responding (Bates & Poole, 2003). Ethics Training An established code of ethics is an expression of the values specific to a profession. It defines, and makes public, common fundamental principles and standards for practice, research, and education; supports self-reflection and public accountability; and recognizes individuals as a community of professionals with unique privileges and obligations (Chabon & Ulrich, 2006, p. 23). The American Speech- Language-Hearing Association (ASHA) first established its Code of Ethics as a separate document in 1952, and it has undergone several revisions, most recently in 2003 (Chabon & Ulrich, 2006). The profession of speech-language pathology has recognized the importance of ethics training by mandating that applicants for certification must demonstrate knowledge of, appreciation for, and ability to interpret the ASHA Code of Ethics. Program documentation may reflect course work, workshop participation, instructional module, clinical experiences, and independent projects (ASHA, 2005). However, as it has been pointed out by several authors, there is a dearth of research as to which methods of ethics training are most effective in the field of communication sciences and disorders (Gonzalez & Coleman, 1994; Pannbacker, Lass, & Middleton, 1993; Phillips, 2005). Gonzalez and Coleman stated that it is not enough simply to present an ethical code and encourage students to adhere to the principles when they become professionals (p. 47). Pannbacker et al. (1993) and Young (1994) conducted surveys of accredited graduate programs in speech-language pathology to determine the methods they employed in ethics training. Ninety percent of the responding programs did not offer a separate course on ethics: The training was most often included in another course or as a topic in clinical practica. The majority of programs spent less than 20 hr on ethics training. The teaching strategies employed, from most often to least, included discussions, lectures, course work, modeling, client by client, and role playing (Pannbacker et al., 1993). Research has suggested that case studies are an effective means of ethics training (Gonzalez & Coleman, 1994; Urofsky & Sowa, 2004). Gonzalez and Coleman reported that graduate students preferred a student-led case study for ethics training over traditional lecture or outside assignment formats. In their study, students assumed the roles of members of ASHA s Ethical Practices Board and participated in discussions surrounding the ethical scenarios that were presented. Researchers within counselor education have investigated methods of ethics training within programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP; Urofsky & Sowa, 2004). In a survey of 148 programs, it was demonstrated that the primary format for teaching ethics education was through case studies, with 85% using fictional ethics cases, 74% using actual ethics cases, and 80% using legal cases (Urofsky & Sowa, 2004). This article presents a study of online discussion forums as a method of ethics training. Specifically, the study explored participant performance in terms of the degree to which the characteristics and/or presence of the facilitator impacted the quality and development of participant discourse in an online discussion involving professional ethical issues, as well as the degree of change in decision making that occurred as a result of participation in the discussions. METHOD Thirty-seven graduate students in speech-language pathology from graduate programs accredited by ASHA s Council of Academic Accreditation participated in this study. The participants were recruited through posting of flyers and through messages sent to clinical supervisors of communication sciences and disorders graduate programs throughout the United States and Canada. Two participants were males and 35 were females. All but 3 of 58 CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS Volume Spring 2009

3 the participants reported to have had prior experience with online discussion boards in the role of a student. Participants were randomly assigned to one of three discussion groups. One discussion group was facilitated by a content matter expert, one group by a noncontent matter expert, and one group had no facilitator. The identity and/ or presence of a facilitator was not made known to the participants. The content matter expert was a clinical instructor with ASHA certification and a doctorate in audiology (AuD). The content matter expert had experience as a participant in online discussion forums as part of her AuD training. The noncontent matter expert was a graduate student in instructional technology. She had experience in facilitating online discussion forums but had no knowledge of speech-language pathology content or ethics training. Facilitators were assigned to a discussion group and were given instructions to post a response a minimum of 3 days per week with a maximum of six postings per week. These guidelines were to control for differences in amount of posting by the facilitator. Four online discussion forums were created and posted using a Blackboard courseware site. The dilemmas were selected after field testing by a group of experienced speech-language pathologists. During field testing, each dilemma was identified as having a high or low emotional impact. A dilemma was considered to have high impact if the problem described involved a possible severe infraction of personal values or had lasting consequences. A dilemma was considered to have low impact if the problem described had a limited infraction or temporary consequences. Two dilemmas scored as high impact and two scored as low impact were selected for use in this study. See the Appendix for a description of the dilemmas. Each dilemma was presented to the participant groups for 1 week. Dilemmas were discussed simultaneously across the three discussion groups. Participants were required to post at least three responses over the period of 1 week. At the end of each week, the ethical dilemma was removed and the next one was posted for discussion. Responses were in text format and were archived for later analysis. During the fourth week of the discussion, Blackboard performed a system upgrade and all data for the final discussion forum was lost. As a result, analysis was conducted on the three earlier forums. Study Questions The purpose of the study was to answer the following questions: Would the participants demonstrate a change in ethical decision making as a result of participation in the online discussions? Would the characteristics of the facilitator have a significant effect on the quantitative aspects (number of postings and average words per posting) of the students responses? Would the characteristics of the facilitator have a significant effect on the qualitative nature (discourse) of the students responses? RESULTS Participant Change Postdiscussion questionnaires were examined to determine if there were any changes in the students perception of the ethical dilemma as a result of participation in the online discussion forum (Figure 1). Univariate analysis of variance (ANOVA) was conducted to determine the amount of change for each of the discussions. None of the F ratios was found to be statistically significant at.05 (Table 1). The findings suggest that participation in online discussions of ethical scenarios did not result in a change in the students perception of the dilemma. Interpretation and practical significance of these findings is limited in that we have no research suggesting that face-to-face discussions concerning ethical dilemmas result in changes in perceptions. Quantitative Aspects of Responses A one-way ANOVA examined the number of postings of the participants across the three groups. Differences between the groups did not achieve statistical significance at the.05 level in the number of postings for the three groups, F(2, 30) = 2.587, p =.092. This is an expected finding in that participants were all instructed to post at least three times per week. A one-way ANOVA was used to analyze the words per posting for each of the groups. Overall F, F(2, 30) = 3.468, p =.04, was significant at.05 (Table 2). Post hoc testing (Tukey HSD) was undertaken to examine all of the comparisons among the three groups. There were no significant differences between the groups employing a facilitator (content matter expert and noncontent matter expert). The only significant mean difference occurred for the noncontent matter expert group and the no facilitator group (MD = , p =.04). This finding suggests that the participants in the facilitated forums shared somewhat more information than did the participants in the forum with no facilitator. The type of data analysis presented thus far addresses questions about the quantitative aspects of participant responses to dilemmas in terms of how much was discussed Figure 1. Change in participants perception of the ethical dilemma. Loncke et al.: Online Discussion Forums 59

4 Table 1. Univariate analysis F ratios for students changes in perception among discussion forums. Discussion forum F ratio Significance Table 2. ANOVA for number of words per posting. categories of analysis. A majority of the postings were coded as integration for cognitive contributions, followed by exploration and interactive responses (Figure 2). In comparing the three participant groups employing univariate ANOVA suggests that, except for the category of exploration, there was no significant difference at the.05 level in the number of words posted for each of the six categories of analysis. The group without a facilitator evidenced significantly less words posted in the category of exploration (MD = 248, p =.003). It would appear that the participants in the facilitated forums evidenced greater exploration of ideas associated with each dilemma as compared with the group in which no facilitator was present. Source df Mean square F Significance Between groups *.044 by each of the three groups in terms of the number of words and number of postings. Also of interest was the qualitative nature of the responses so as to address in what ways the level of discourse varied among the three groups. Qualitative Aspects of Responses As in any conversation, participants can respond in a number of ways to postings of other participants. In a qualitative analysis approach, a distinction can be made depending on whether the contribution has a social function (e.g., keeping the conversation going, reinforcing others) or an informative function (e.g., providing new information, modifying an earlier position). Both groups of functions often overlap (e.g., adding information while reinforcing). Interaction analysts have proposed several taxonomies of analysis of responses. For this study, the two-level analysis proposed by Rourke et al. (2001) and by Garrison, Anderson, and Archer (2001) was used. In this taxonomy, the first level indicates whether the response is predominantly social or cognitive in nature. The second level differentiates between affective, cohesive, and interactive responses for social contributions, and between exploration, analysis, and integration responses for cognitive contributions (Table 3). The results of the two-level discourse analysis found the participants responses to be distributed among the six CONCLUSION The results of the study suggest that participants did not change their views of the ethical dilemma as a result of participation in an online discussion. These findings were consistent across all three conditions of facilitation (content matter expert, noncontent matter expert, and no facilitator). A study conducted by Kenny, Lincoln, and Reed (2004) indicated that face-to-face training in ethical reasoning skills did not have a significant effect on the number of ethical principles or problem-solving strategies identified in a face-to-face scenario. Further research conducted by Haidt (2001) concluded that dilemmas that are of high emotional impact (i.e., physical abuse) are not prone to changes in perception. These researcher findings support the current study in that regardless of the format (online or face-to-face), opinions of certain ethical dilemmas are not prone to change even after discussion. Another implication of Haidt s study would suggest that ethics training, whether online or face-to-face, should not be limited to the use of high emotional impact issues such as physical abuse and major fraud. Scenarios should include issues with lower perceived impact such as eligibility for services, biased recommendations, and conflict of interest. Additional findings of this study suggest that the knowledge of content matter on the part of the facilitator did not significantly affect the students number of postings or number of words per posting, with the exception that the group without a facilitator posted significantly fewer words per posting than did the groups with a facilitator. It appears Table 3. Levels of discourse analysis. First level Second level Description Social process Affective response Responses that include emotional/affective content (Rourke et al., 2001) Cohesive response Indication of building group cohesion and having a sense of group commitment Interactive response Indication of open communication, attentiveness and interaction among members Cognitive process Exploration Exploration of information and ideas (Aviv, 2000; Analysis Analysis of information and ideas Garrison et al., 2001) Integration Connection of ideas and the construction of resolution 60 CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS Volume Spring 2009

5 Figure 2. Words per category of analysis Number of words CME NonCME No Fac 0 Affective Cohesive Interactive Exploration Analysis Integration Response categories Note. CME = content matter expert, NonCME = noncontent matter expert, NoFac = no facilitator. *significant at.05. that the prompting and/or presence of a facilitator, whether knowledgeable of the content or not, resulted in a greater number of words per posting when compared to the group without a facilitator. It was the hypothesis of the researchers that the content knowledge and/or presence of the facilitator would lead to more in-depth dialogue on the part of the participants. The results of this study are inconclusive in this area. Participant responses in all groups were largely integrative in nature, in that there were attempts to connect ideas and arrive at a resolution. Given the ethical nature of these discussions, this was not an unexpected finding. Nor was it unexpected to find the next largest categories of responses coded as exploration and interactive responses, suggesting openness to the ideas and interactions of other online participants. However, with the exception of the exploration of ideas, no significant differences among the groups were found. Again, this suggests that the content knowledge of the facilitator may not have had significant impact on the level of discourse occurring within the online discussions. Overall, results do not support the importance of content knowledge in the facilitation of online ethical dilemmas. They do, however, suggest that the presence of a facilitator is of importance in terms of the number of words per posting and the extent of exploration of ideas. Based on these findings, it is suggested that all online instructors, whether content matter experts or not, receive training in the facilitator role. Such training should include knowledge of the types of responses that a facilitator can provide. Anderson, Rourke, Garrison, and Archer (2001) identified several types of responses to include identifying areas of agreement and disagreement, consensus seeking, encouraging, acknowledging and reinforcing, and topic maintenance. Facilitators in online forums should be prepared to use each of these response modes as the discussion unfolds, in a manner much like they would do in a face-to-face format, where the facilitator responds to a variety of verbal and nonverbal cues. This study invites more research in the area of ethics training in general and how it extends to online formats. REFERENCES American Speech-Language-Hearing Association. (2003). Code of ethics [Ethics]. Available from American Speech-Language-Hearing Association. (2005). Standards and implementation for the Certificate of Clinical Competence in Speech-Language Pathology. Retrieved February 25, 2007, from Anderson, T., Rourke, L., Garrison, D. R., & Archer W. (2001). Assessing teaching presence in a computer conferencing context. Journal of Asynchronous Learning Networks, 5(2), Arbaugh, J. B., & Hornik, S. C. (2006). Do Chickering and Gamson s seven principles also apply to online MBAs? Journal of Educators Online, 3(2). Retrieved from Bates, A. W., & Poole, G. (2003). Effective teaching with technology in higher education. San Francisco, CA: Jossey-Bass. Bullen, M. (1998). Participation and critical thinking in online university distance education. Journal of Distance Education, 13(2), Chabon, S. S., & Ulrich, S. R. (2006, February 7). Uses and abuses of the ASHA Code of Ethics. The ASHA Leader, 11(2), pp , 30. Garrison, D. R., Anderson, T., & Archer, W. (2001). Critical thinking, cognitive presence, and computer conferencing in distance education. The American Journal of Distance Education, 15, 1, Gonzalez, L. S., & Coleman, R. O. (1994, April). Students prefer case study approach. Asha, 36(8), Loncke et al.: Online Discussion Forums 61

6 Haidt, J. (2001). The emotional dog and its rational tail: A social intuitionist approach to moral judgment. Psychological Review, 108(4), Jiang, M., & Ting, E. (2000). A study of factors influencing students perceived learning in a Web-based course environment. International Journal of Educational Telecommunications, 6(4), Kenny, B. J., Lincoln, M. A., & Reed, V. A. (2004). Proceedings of the 26th International Association of Logopaedics and Phoniatrics (IALP) 2004 Congress. Queensland, Australia: International Association of Logopaedics and Phoniatrics. Pannbacker, M., Lass, N. J., & Middleton, G. F. (1993, August). Ethics education in speech language pathology and audiology training programs. Asha, 35(4), Phillips, K. (2005). Ethical decision making in speech language pathology: Faculty and student perceptions. Retrieved February 25, 2007, from pf_article_detail.asp?article_id=284. Picciano, A. G. (2002). Beyond student perceptions: Issues of interaction, presence, and performance in an online course. Journal of Asynchronous Learning, 6(1). Retrieved December 5, 2006, from v6n1_picciano.asp. Polhemus, L., Shih, L.-F., Richardson, J. C., & Swan, K. (2000, November). Building an affective learning community: Social presence and learning engagement. Paper presented at the World Conference on the WWW and the Internet (WebNet), San Antonio, TX. Richardson, J., & Swan, K. (2003). Examining social presence in online courses in relation to students perceived learning and satisfaction. Journal of Asynchronous Learning Networks, 7(1), Rourke, L., Anderson, T., Garrison, R., & Archer, W. (2001). Methodological issues in the content analysis of computer conference transcripts. International Journal of Artificial Intelligence and Education, 12, Rovai, A. P. (2002). Development of an instrument to measure classroom community. The Internet and Higher Education, 5, Simonson, M., Smaldino, S., Albright, M., & Zvacek, S. (2000). Teaching and learning at a distance: Foundations of distance education. Upper Saddle River, NJ: Merrill. Urofsky, R., & Sowa, C. (2004). Ethics education in CACREPaccredited counselor education programs. Counseling and Values, 49, Ward, M., & Newlands, D. (1998). Use of the Web in undergraduate teaching. Computers and Education, 31(2), Young, J. (1994). Ethics education in programs accredited for the preparation of speech language pathologists and audiologists. (Doctoral dissertation, University of Georgia, 1994). Dissertation Abstracts International, 55-09A, Contact author: Filip T. Loncke, Communication Disorders Program, University of Virginia, 2205 Fontaine Avenue, Charlottesville, VA APPENDIX. DISCUSSION FORUM QUESTIONS Scenario #1 High Impact Scenario #2 Low Impact Scenario #3 High Impact You have been working with Dominic for a while. He has cerebral palsy and no functional speech. The AAC assessment that you have requested proposed the use of a speechgenerating device for Dominic. His trial with the communication device has opened up a new world for him! For the first time he is able to communicate with others using speech output. It will allow Dominic to say and ask everything he wants and greatly add to his independence. While in the early stages of learning to use the device, Dominic accidentally hits the speech buttons and generates speech that is often irrelevant, too loud, and, frankly, disruptive for the class. One of the teachers routinely has another child turn off Dominic s communication device during instructional times. Several of the teachers question whether Dominic really needs it. They believe he can learn as much just by listening and have the speech output turned off, and we should not use the device at all. That makes administrators question whether the expense of the device is worthwhile. As the speech language pathologist, what should you do? You and your clients are asked to participate in an experiment. The experiment is harmless (IRB approval, etc.) but it takes away considerable time from the treatment that you have planned for your clients. Still, you feel that your participation will lead to a better understanding of the nature of the disorder and that, in the long run, more clients will benefit from this. What should you do? You work in a rehabilitation center as a speech language pathologist. One day you are asked to evaluate a client who has suffered a stroke and has no functional speech. The client and her husband are close friends of your parents. Soon after your evaluation, you have been able to give her a communication device that allows her to express simple messages with picture symbols. The training goes well: She is able to express basic ideas with fair reliability. She is attempting to communicate verbally with some success. One day, she points to the symbol for John (her husband) and makes a vehement gesture. Is she trying to tell you that her husband hits her? Other professionals report similar events. At first, you find it hard to believe but the thought keeps bothering you. What should you do? Note. During the fourth week of the discussion, Blackboard performed a system upgrade and all data for the final discussion forum was lost. As a result, only three scenarios were used in the study. 62 CONTEMPORARY ISSUES IN COMMUNICATION SCIENCE AND DISORDERS Volume Spring 2009

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