Occupational therapy students’ reflections on ethical tensions experienced during fieldwork

Abstract

Introduction: Ethical tensions are routinely encountered by occupational therapists and students in fieldwork and may impact patient care and team morale, and lead to practitioner burnout. Ethics education is a means to reduce ethical tensions in fieldwork. Despite this, however, limited research exists regarding ethical tensions and ethics education amongst students in the South African context.

Methods: The study was conducted to explore South African occupational therapy students' reflections on ethical tensions experienced in fieldwork practice. A qualitative, descriptive design was used to review thirty-five ethics reflective journals by fourth-year occupational therapy students at a university in South Africa. Students identified ethical tensions, reflected on these using Sokol’s decision-making framework and Kolb’s Cycle of Experiential Learning, and incorporated their learning into practice. Data were analysed thematically. Trustworthiness was ensured through triangulation of researchers, multiple data sources, and an audit trail.

Findings: Three central themes emerged: (1) Ethics from the perspective of the student, (2) Ethical tensions experienced during fieldwork, and (3) How students navigated ethical tensions.

Conclusion: This study provides an insight into the ethical tensions and reflections of fourth-year occupational therapy students during fieldwork. Findings inform healthcare educators and clinicians regarding students’ perceptions about ethics education and the tensions experienced during fieldwork.

Implications for practice

• Students experienced ethical tensions during fieldwork and navigated these ethical tensions by following institutional procedures, acquiring knowledge through research, drawing from the “well” of experience, and reflective practice.
• The study offers a narrative for encountering and resolving ethical tension during
• The main distinction between the two classifications persists when reviewing the support given to the participant who has been empowered to resolve the ethical tension whilst receiving consultation from their site clinician and the institution.
• Findings inform healthcare educators and clinicians regarding students’ perceptions about ethics education and the tensions experienced during fieldwork.