Canadian Psychology 20 1 1 V o l .5 2 .No .3 . 1 8 5- l9l .

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on A Canadian Perspective Using Vignettesto TeachEthics in Psychology

Michelle C. E. McCarron
University of Regina & Regina Qu'Appelle Health Region

Donald W. Stewart
University of Manitoba

Vignettes depicting ethical dilemmas are used widely in teaching and learning professionalethics. Such an approach can facilitate learning by allowing opportunities to work through ethical dilemmas using practical, realistic, and complex material that enables participants to: engage in discussion; explore Despite their applicable ethical principles; and ideally, to achievea deeperlevel ofethical understanding. widespread use, little research has been conducted on how to maximise the benefits of using ethical dilemmas, nor on the most ethically appropriate ways of presenting scenariosderived, at least in part, from actual occurrences.In this article, we endeavour to contextualise the use of vignettes within the framework provided by the Canadian Code of Ethics for Psychologists, Third Edition (Canadian PsychologicalAssociation, 2000) and to use the principles and standardstherein to suggestguidelinesfor the ethical creation and use of vignettes. We begin by reviewing the literature on the use of ethical dilemmas in teaching and learning ethics, including a discussionof the benefits to be gained from using vignettes as one component of a comprehensive approach to ethics education. This is followed by discussionof ethical considerationsrelevant to the creation and use of vignettes of ethical dilemmas.We conclude with a series of recommendationsinformed by the Canadian Code of Ethicsfor Psychologists to guide psychologists in using such illustrative material in an ethically appropriate manner. Keywords: ethics, ethical dilemmas, vignettes

Ethics education is a required component of psychology prograrnmes accredited by the Canadian Psychological Association (Canadian Psychological Association, 2002) and the American PsychologicalAssociafion(American PsychologicalAssociation, 2008); however, the nature of this educational requirement is left to the discretion of each graduateprogramme. Accordingly, there is considerablevariation among programmes in both content and paedagogy. Several models for ethics education in psychology have been proposed. For instance, Handelsman, Gottlieb, and Koapp (2005) advocate training that promotes internalisation of ethical values and behaviours via a process of "ethical accuituration" (p. 59). Kitchener (1986) has describeda processof developing students' ethical decision-making skills by first enabling them to identify ethical issues, improving their ability to think critically about dilemmas, and finally, helping them to adopt and act upon ethical values.The former approachfocusesmore keenly of on students'analysesof their own processes adopting the ethical values associatedwith their newfound professional identities and reflecting on the ethical dilemmas that they have encountered

personaliy(Bashe,Anderson,Handelsman, Klevansky, 2007), & whereasthe latter advocatesthe use of vignettesportraying ethical dilemmas to promote integration of ethicai values and behaviours into one's own identity. A vignette is a "brief incident or scene" (Meniam-Webster's Online Dictionary, D.d., 3b) portraying a situation involving a potential ethical dilemma or violation. An ethical dilemma occurs whenever "two or more of the values found in the ethical principles conflict" (Behnke,2005,p. 1la). Vignettesmay be basedon actual events for which the details have been anonymised and/or fictionalised, or situations that are entirely hypothetical (e.g., Morrison, Morrissey,& Goodman,2006; Pope & Vasquez,2010). Their use is not limited to ethical issues; numerous examples of vignette-based studies-studies in which participantsare presented with one or more scenariosand are askedto formuiate hypothetical responses or make evaluations-can be found throughout the literaturein psychology(e.9.,Mikton & Grounds ,2007; Murdock, Edwards, & Murdock, 2010) and in disciplinessuch as medicine (e.g.,Falzer& Garman,2010; Janssen al., 2009),nursing (e.g., et Johnson,Newton, Jiwa, & Goyder, 2005; Yang & Thompson, 2010), and education (e.g., Kelter & Pope, 20lI Miller, Shoptaugh,& Wooldridge, 20Il). Case studies,by contrast: arereports case of materials obtained while workingwith an individillustrate ual, a group,a community, an organization. or Case studies a problem; indicate means solvinga problem; a for and/or shediight matters. or on neededresearch, clinical applications, theoretical (American p. Psychological 2010, 11) Association, At times, the two terms have been combined, such as in reference to anonymised and/or altered accounts of real-life events (e.g., "case vignettes," Koocher & Keith-Spiegel,2008, p. ix). Both case studies and vignettes may be narrow in scope or more complex, ranging from focusing on a single ethical consideration

Michelle C. E. McCanon, Researchand Perfornance Support, Regina Qu'Appelle Health Region & Department of Psychology, University of Regina, Saskatchewan, Canada;Donald W. Stewart,StudentCounselling and Career Centre, University of Manitoba, Winnipeg, Manitoba, Canada. This article is based on a symposium presentation delivered at the Canadian Psychological Association Annual Convention in 2011. We thank Carole Sinclair for her helpful feedback on an early draft of this article. to Correspondence concerning this article should be addressed Michelle C. E. McCanon,2l80-23rd Avenue (Suite M-704), Regina Qu'Appelle Health Region, Regina, SK, S4S 0A5. E-mail: Michelle.McCarron@ uregina.ca

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TO USING VIGNET.TES TEACH ETHICS SPECIALISSI.IE: rence familiar to them when, in fact, inspiration for the examples in question was drawn from unrelated sources. In this way, those who write and employ vignettes share a challengeexperiencedby those using case study methods.In light of common concernsabout effective methodsfor disguising source material, recommendationsand findings from the casestudy literature are relevant. In a survey of more than 150 authors who published articles involving disguisedcase material, VandenBos (2001) found that the most frequently used approach was to alter followed specific details, most often demographic characteristics, closely by altering family background and other identifying features. For authors who limited the amount of detail provided, information deemed to be uniquely identifying was most frequently removed, although it was more common for details to be alteredthan eliminated. Extrapolating thesefindings to the creation and use of vignettes which may be inspired, to differing degrees, who plan to by actualethicaldilemmasor violations,psychologists use such vignettesmay wish to considerthesefactors.However, alteration of these variables alone may be insufficient to ensure that any real-life events adapted for demonstrations of ethical concerns or transgressionsare sufficiently masked. Furthermore, these findings do not addresshow one may construct and implement vignettes portraying ethical dilemmas in order to maximise their educationalpotential. Therefore,we draw on the four guiding principles of the Code rn order to propose guidelines for the construction and use of vignettes for ethics education in psychology. Recommendations for the Ethical Vignettes In keeping with the hierarchical principle-basedstructureof the Code, the following recommendationsare offered for the creation and use of vignettes depicting ethical dilemmas in psychology. Following each guideline, the ethical principle from the Code (CanadianPsychological Association, 2000) that is most relevant By is identified in parentheses. satisfying each of these considerations, psychologists should feel assured that they have taken reasonablesteps to fulfill their ethical obligations acrossall relevant domains when creating and using vignettes for educational purposes. 1. Respectthe confidential context within which material incorporated into a vignette was generated.This includes, at a minimum, anonymising names, places, and other potentially identifying information such that none of the parties involved are recognisable.Amalgamation of two more events and fictionalisation of details provides further protection. (Principle I) 2. Identify whether use of the material in a vignette is potentially harmful to the individuals who were involved in any events upon which the examplesmay be based.Identify any factors that would preclude use of this material. (Principle U) 3. Maintain sufficient context (without compromising the anonymity of any parties who may have served as inspiration for the examples) so that vignettes are multidimensional and reflect the complexities of real-world dilemmas. (Principle III) (e.g., pertainingto sex, gender, 4. Avoid invoking stereotypes ethnicity, culture, sexual orientation, religion) except where such stereotypingis itself the ethical issue around which the transgression or diiemma occurred. (Principle I) Creation and Use of

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5. Ensure diversity of examples in terms of ethnicity, culture, race,religion, sex, sexual orientation,abilities, and other variables. Such representationshould extend beyond surface characteristics to include situations and contexts unique to marginalised groups. (Principle IV) 6. Strive to presentvignettesin a neutral manner, so as to allow the reader to make his or her own evaluations of the material. Evaluate one's own beliefs, biases,attitudes,and values when creating these examples and identify ifAiow they may have factored into the portrayal or selection of scenarios.(Principle III) 7. Construct and use vignettes in a manner that will ultimately support psychologists in becoming competent, or maintaining competency,in applying ethical principles and standardsto realistic ethical dilemmas. This may include constructing and using vignettes ranging in complexity and in the severity of potential outcomes.(Principle IV) 8. Encourageuse of the ethical decision-makingsteps,the Code (Canadian Psychological Association, 2000), and other relevant codes and guidelines to identify the ethical dilemmas and violations portrayed in the vignettes,and to identify potential solutions (Principle II) and their likely consequences. 9. Consult with colleaguesin determining whether theserecom(Principle III) mendationshave been adequatelyaddressed. Conclusion Despite some cautions and concerns associatedwith using examples of ethical dilemmas in teaching and learning professional ethics, vignettes afford studentsthe opportunity to obtain experiential knowledge via appiication of ethical standards,codes, and guidelines to realistic dilemmas that may arise in a variety of professionalcontexts.The demonstrated benefits of using portrayals of ethical dilemmas support their use in teaching and learning ethics, so long as all relevant ethical safeguardsare followed. Interested readers are directed to the Companion Manual to the Canadian Code of Ethics for Psychologists,Third Edition (Canadian PsychologicalAssociation,2001a) and the ResourceGuide for Psychologists: Ethical Supervision in Teaching, Research, Practice, and Administration (Canadian Psychological Association, 2010) for sample vignettes to employ when teaching and learning professional ethics across a wide range of situations involving teaching, research,practice, and administration.

R6sum6
On fait grandement usage de sketchs illustrant des dilemmes 6thiques dans l'enseignement et la formation relative ir la d6ontologie. Une telle approche peut faciliter I'analyse de dilemmes 6thiques au moyen de mat6riel pratique, r6aliste et complexe, qui permet aux participants de discuter, d'explorer les principes 6thiques pertinents et, id6alement, d'en tirer une meilleure compr6hension.Malgr6 l'usage r6pandu qui en est fait, peu de recherche a 6t6 effectu6e sur la fagon de maximiser I'utilisation de dilemmes 6thiques ni d'ailleurs sur les meilleures faEons, d'un point de vue 6thique,de pr6senterdes situationss'inspirant de faits vdcus, tout au moins en partie. Dans le pr6sentarticle, on tente de contextualiser I'usage de sketchs dans le cadre fourni dans la troisidme6dition du Code canadien de ddontologieprofessionnelle des psychologues (Soci6t6 canadiennede psychologie, 2000), et