Assessment Resources

This section highlights key literature in ethics education assessment for health professional schools. This section also includes a rubric for ethics education assessment developed as a part of the QEP. We encourage other institutions to use this rubric. For permission to do so, please contact Nathan Carlin, PhD.

Health Professional Ethics Rubric

The rubric appears in the article, “The Health Professional Ethics Rubric: Practical Assessment in Ethics Education for Health Professional Schools” in the Journal of Academic Ethics. The paper was published in 2011 and authored by current and former faculty and administrators of UTHealth: Nathan Carlin, Cathy Rozmus, Jeffrey Spike, Irmgard Willcockson, William Seifert, Jr., Cynthia Chappell, Pei-Hsuan (Peggy) Hsieh, Thomas Cole, Catherine Flaitz, Joan Engebretson, Rebecca Lunstroth, Charles Amos, Jr., and Bryant Boutwell.

A barrier to the development and refinement of ethics education in and across health professional schools is that there is not an agreed upon instrument or method for assessment in ethics education. The most widely used ethics education assessment instrument is the Defining Issues Test (DIT) I & II. This instrument is not specific to the health professions. But it has been modified for use in, and influenced the development of other instruments in, the health professions. The DIT contains certain philosophical assumptions (“Kohlbergian” or “neo-Kohlbergian”) that have been criticized in recent years. It is also expensive for large institutions to use. The purpose of this article is to offer a rubric—which the authors have named the Health Professional Ethics Rubric—for the assessment of several learning outcomes related to ethics education in health science centers. This rubric is not open to the same philosophical critiques as the DIT and other such instruments. This article includes the rubric being advocated, which was developed by faculty and administrators at a large academic health science center as a part of a campus–wide ethics education initiative. The process of developing the rubric is described, as well as certain limitations and plans for revision.


A Practical Instrument for Assessment
Outcome Insufficient (1) Acceptable (2) Proficient (3) Score
Identifies an ethical issue Identification of ethical concerns is sparse or missing. Identifies 2 of the ethical concerns in a complex situation. Fully describes multiple ethical concerns in a complex situation.
Outlines options of addressing the issue Identification of options is sparse or missing. Identifies 2 options for addressing the issue. Fully describes multiple options for addressing the issue.
Personal action Description of personal action is sparse or missing. Developed a realistic approach/plan about action in a complex situation, missed some minor considerations. Developed a realistic approach/plan about action in a complex situation. Takes ownership of action/decision.
Able to identify professional values relevant to the ethical situation and able to articulate relevance Identification of professional values is sparse or missing. The relevance of these values is not articulated. Incorporates professional guidelines and applies ethical models or values to consideration of alternative options. Recognizes that alternate ethical perspective results in differing options. Fully incorporates professional guidelines and applies ethical models or values to consideration of alternative options. In choosing one option, recognizes that alternate ethical perspectives result in differing options and is able to evaluate the merits of these differing options.

The Health Professional Ethics Rubric © 2011 UTHealth
Designed by Cathy Rozmus, PhD, RN, Cizik School of Nursing, The University of Texas Health Science Center at Houston. For permission to use, please contact Nathan Carlin, PhD.

Other Assessment Sources

  • Bertolami, C. N. (2004). Why our ethics curricula don’t work. Journal of Dental Education, 68(4), 414-425.
  • Calhoun, J. G., et al. (2008). Development of a core competency model for the master of public health degree. American Journal of Public Health, 98(9), 1598-1607.
  • Chappell, C. L., & Carlin, N. (2011). Public health ethics education in a competency-based curriculum: A method of programmatic assessment. Journal of Academic Ethics, 9(1), 33-42.
  • Eckles, R. E., et al. (2005). Medical ethics education: where are we? Where should we be going? A review. Academic Medicine, 80(12), 1143-1152.
  • Fox, E., Arnold, R., & Brody, B. (1995). Medical ethics education: Past, present, and future. Academic Medicine, 70, 761-769.
  • Lynch, D. C., Surdyk, P. M., & Eiser, A. R. (2004). Assessing professionalism: a review of the literature. Medical Teacher, 26(4), 366-373.
  • Stern, D. T. (Ed.). (2006). Measuring medical professionalism. New York, NY: Oxford University Press.