Abstract
In research ethics reviews, traditional approaches of research ethics boards (REBs) balance the risks with the potential for benefit of proposed studies, and this review process has been similar for health professions education research (HPER) as it has been for clinically based studies. Health professions students are the primary population from which most education researchers draw their participants although relatively little discussion has taken place in the literature regarding student participation in HPER. The majority of HPER studies could be considered minimal risk and therefore many have suggested that such studies be exempted from REB review. However, there are not only risks to student participants which require consideration, but I argue that when this issue is viewed through the lens of Aristotle’s virtue ethics, there are also potential benefits to the student, for which REB oversight can be helpful, that have not factored strongly into discussions. This paper seeks to highlight the key factors involved in student participation in HPER; to explore Aristotle’s doctrine of the mean and to evaluate how this ethical framework can add value to the discussion; and to propose possible applications of the Aristotelian mean to this issue and address some of the challenges that would arise with its application.
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References
Aristotle. (1981). The politics (T. A. Sinclair, Trans.). New York: Penguin.
Aristotle. (1998). Nicomachean ethics (D. P. Chase, Trans. 3rd ed.). Mineola: Dover Publications.
Aristotle. (2008). Nicomachean Ethics. Retrieved June 15, 2008 from http://classics.mit.edu/Aristotle/nicomachaen.html.
Boetzkes, E., Waluchow, W. J., et al. (Eds.). (2000). Readings in health care ethics. Peterborough, ON: Broadview Press, Ltd.
Callahan, C. A., Hojat, M., & Gonnella, J. S. (2007). Volunteer bias in medical education research: An empirical study of over three decades of longitudinal data. Medical Education, 41(8), 746–753. doi:10.1111/j.1365-2923.2007.02803.x.
Clark, A. M., & Findlay, I. N. (2005). Attaining adequate consent for the use of electronic patient records: An opt-out strategy to reconcile individuals’ rights and public benefit. Public Health, 119(11), 1003–1010. doi:10.1016/j.puhe.2005.08.013.
Dekkers, W., & Gordijn, B. (2007). Practical wisdom in medicine and health care. Medicine, Health Care, and Philosophy, 10(3), 231–232. doi:10.1007/s11019-007-9072-4.
Dyrbye, L. N., Thomas, M. R., Mechaber, A. J., Eacker, A., Harper, W., Massie, F. S., Jr, et al. (2007). Medical education research and IRB review: An analysis and comparison of the IRB review process at six institutions. Academic Medicine, 82(7), 654–660. doi:10.1097/ACM.0b013e318065be1e.
Dyrbye, L. N., Thomas, M. R., Papp, K. K., & Durning, S. J. (2008). Clinician educators’ experiences with institutional review boards: Results of a national survey. Academic Medicine, 83(6), 590–595. doi:10.1097/ACM.0b013e318172347a.
Ellis, G. (1995). Exempt research and research that may undergo expedited review (No. 95–02). Washington, DC: Office for Protection from Research Risks.
Eva, K. W. (2007). The yin and yang of education research. Medical Education, 41(8), 724–725. doi:10.1111/j.1365-2923.2007.02806.x.
Evans, A. W. (2002). Ethics approval for research in medical education. Medical Education, 36(4), 394. doi:10.1046/j.1365-2923.2002.1178i.x.
Flaming, D. (2001). Using phronesis instead of ‘research-based practice’ as the guiding light for nursing practice. Nursing Philosophy, 2, 251–258. doi:10.1046/j.1466-769X.2000.00066.x.
Hammack, F. M. (1997). Ethical issues in teacher research. Teachers College Record, 99, 247–265.
Henry, R. C., & Wright, D. E. (2001). When do medical students become human subjects of research? The case of program evaluation. Academic Medicine, 76(9), 871–875. doi:10.1097/00001888-200109000-00006.
Junghans, C., Feder, G., Hemingway, H., Timmis, A., & Jones, M. (2005). Recruiting patients to medical research: Double blind randomised trial of “opt-in” versus “opt-out” strategies. BMJ (Clinical Research Ed.), 331(7522), 940. doi:10.1136/bmj.38583.625613.AE.
McLachlan, J. C., & McHarg, J. (2005). Ethical permission for the publication of routinely collected data. Medical Education, 39(9), 944–948. doi:10.1111/j.1365-2929.2005.02223.x.
Morrison, J., & Prideaux, D. (2001). Ethics approval for research in medical education. Medical Education, 35(11), 1008–1009. doi:10.1046/j.1365-2923.2001.01076.x.
Office for Human Research Protections.IRB guidebook (2004). Retrieved June 16, 2008 from http://www.hhs.gov/ohrp/irb/irb_chapter6ii.htm#g11.
Prescott, H. M. (2002). Using the student body: College and university students as research subjects in the United States during the twentieth century. Journal of the History of Medicine and Allied Sciences, 57(1), 3–38. doi:10.1093/jhmas/57.1.3.
Pugsley, L., & Dornan, T. (2007). Using a sledge hammer to crack a nut: Clinical ethics review and medical education research projects. Medical Education, 41(8), 726–728. doi:10.1111/j.1365-2923.2007.02805.x.
Shelp, E. E., Russell, M. L., & Grose, N. P. (1981). Students’ attitudes to ethics in the medical school curriculum. Journal of Medical Ethics, 7(2), 70–73. doi:10.1136/jme.7.2.70.
Svenaeus, F. (2003). Hermeneutics of medicine in the wake of Gadamer: The issue of phronesis. Theoretical Medicine and Bioethics, 24(5), 407–431. doi:10.1023/B:META.0000006935.10835.b2.
The Belmont Report (1979). Ethical Principles and Guidelines for the protection of human subjects of research. The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; National Institutes of Health; Department of Health, Education, and Welfare.
Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (1998). Canadian Institutes of Health Research; Natural Sciences and Engineering Research Council of Canada; Social Sciences and Humanities Research Council of Canada.
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Chen, R.P. Student participation in health professions education research: in pursuit of the Aristotelian mean. Adv in Health Sci Educ 16, 277–286 (2011). https://doi.org/10.1007/s10459-009-9164-4
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DOI: https://doi.org/10.1007/s10459-009-9164-4