By Stacey Kusterbeck
Graduate students at Angelo State University in San Angelo, TX, have received Responsible Conduct of Research/Professional Ethics Training since 2008 with very good results. “This training has been demonstrated to be quite successful for in-person trainees,” reports Cheryl Stenmark, PhD, lead author and professor in Angelo State’s department of psychology.1 Stenmark was involved with administering and evaluating early versions of the two full-day training program and later shortened it to a one-day program.2 The training includes lectures and interactive activities, including discussions, case studies, and role play activities.
Stenmark and colleagues wanted to know if the popular program would be equally successful if presented as a real-time, video-streamed, remote training. “We have a growing number of online graduate programs and, thus, a growing number of online graduate students,” explains Stenmark. Previous research has shown that asynchronous online programs are not as effective for ethics training as face-to-face programs.3 “Relatively little research has been done on synchronous online programs, so I thought examining this program as a synchronous online program would be a valuable area of research,” says Stenmark.
The online version of the training was not as effective as the in-person version.4 In-person participants performed significantly better than remote participants. For organizations that want to try to implement a similar live, remote ethics training program, Stenmark offers these recommendations:
- Make it very clear to participants upfront that the program requires a great deal of interaction. “This is not a training program that you can have on in the background as you do other things. It requires attention, focus, and some complex mental processing,” says Stenmark. Faculty can emphasize in informational materials, sign-up confirmations, and reminders that participants need a quiet space to complete the training without interruptions because of the interactive nature of the program.
- Hire an online training assistant to keep remote trainees engaged. If the training is being funded by a grant, as was the case in this study, funding for a training assistant should be written into the budget. “Funding could definitely be a challenge for having a training assistant if there is just no money available,” acknowledges Stenmark. Another potential challenge could be the lack of a qualified graduate student who would be effective in this role, particularly at smaller institutions with fewer students available. “The training assistant should go through the training at least once and should have access to the training materials to be knowledgeable enough to answer trainees’ questions,” says Stenmark. The assistant can monitor the chat for questions, answer questions if possible, or get the faculty’s attention if necessary. Additionally, the assistant can be given “co-host” access to the videocall so they are able to pop in and out of breakout rooms. The assistant can ask probing questions to facilitate in-depth discussions during small group sessions.
- If the training is hybrid (with both in-person and remote participants), be sure that the training facility is equipped with good microphones. “This effectively captures the voices of the in-person trainees, so that the remote and in-person trainees can seamlessly interact,” Stenmark explains.
In-person participants could clearly hear the remote participants through the classroom computer speakers. However, remote participants had trouble hearing the in-person participants. To address this, the trainer repeated what the in-person participants stated for the benefit of the remote participants. “That was a fine interim fix. But long-term, it would be best to have appropriate, functioning technology to allow all participants to hear and communicate with each other,” says Stenmark.
Despite the challenges of remote ethics training, many institutions have found it to be an effective approach to increase access to formal ethics education, especially in areas where a large academic medical center is not in close proximity. “Online ethics training offers numerous benefits over in-person training,” according to Jonathan Darrow, SJD, LLM, JD, MBA, a former professor at Harvard Medical School. These include lower per-person costs, partial or total automation of course content, enhanced data collection, flexibility, and consistency across various sites. ”Potential downsides include a less personal experience, reduced participant interaction and opportunity for networking, [and] challenges in ensuring effort and participation,” says Darrow.
Funding for formal ethics services is not available in all institutions. “Despite this, increasing ethics capacity at the bedside is critical. Remote ethics training is one way of helping to build this capacity,” says Aimee Milliken, PhD, RN, HEC-C, a clinical ethicist and associate professor of the practice at the Boston College Connell School of Nursing. In Milliken’s experience, these are the two biggest challenges with teaching ethics consultation remotely:
- There is no opportunity for face-to-face practice. “This is an experience that is hard to recreate in the virtual space,” acknowledges Milliken. To address this, ethicists can use small breakout rooms on Zoom for role-playing exercises. This allows participants who are learning ethics consultation to practice having difficult conversations.
- Remote ethics training often is conducted in a large group, making it difficult for all participants to practice leading an ethics consult. “In person, you may have more of an apprenticeship-style model. Or you may be able to offer smaller breakout groups over a longer period of time for all participants to be able to practice,” says Milliken.
Ethicists can change the way role plays and breakout groups are structured so remote participants can take turns leading the conversation. For example, participants can be given a case scenario and assigned “roles” to play. As the role play evolves, the assigned roles can change. This allows each participant to act as the ethics consultant over the course of a single role play. “Alternatively, multiple role play scenarios can be used, with each participant taking a turn leading as the ethics consultant,” suggests Milliken.
Remote ethics training offers a potential long-term benefit, by preparing participants for future remote meetings in the clinical setting. “In the post-COVID era, though in-person family meetings are preferred, virtual family meetings are frequently offered as an option. Remote training provides great practice for this method of ethics consultation,” says Milliken.
References
1. Mumford MD, Connelly S, Brown RP, et al. A sensemaking approach to ethics training for scientists: Preliminary evidence of training effectiveness. Ethics Behav. 2008;18(4):315-339.
2. Stenmark CK, Miller R. A little goes a long way: Adapting an ethics training program to work for smaller universities. J Empir Res Hum Res Ethics. 2021;16(4):461-474.
3. Todd EM, Watts LL, Mulhearn TJ, et al. A meta-analytic comparison of face-to-face and online delivery of ethics instruction: The case for a hybrid approach. Sci Eng Ethics. 2017;23(6):1719-1754.
4. Stenmark CK. Putting an ethics training program online: It may be more complicated than we think. J Empir Res Hum Res Ethics. 2025; Jan 19. doi: 10.1177/15562646251313577. [Online ahead of print].
Graduate students at Angelo State University in San Angelo, TX, have received Responsible Conduct of Research/Professional Ethics Training since 2008 with very good results. Cheryl Stenmark, PhD, and colleagues wanted to know if the program would be equally successful if presented as a real-time, video-streamed, remote training.
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