Curriculum Proposal: Bioethics Certificate
1. Overview
The Bioethics Certificate Program is a formal, competency-based course of study that would focus on
philosophical, legal, research, and clinical foundations of bioethics with an emphasis on practice-based
implications for health-related decisionmaking. The program, involving four 3-credit courses, will be offered
entirely on-line and so will directly respond to requests for continuing education programs from working
health and human service professionals including hospital administrators, nurses, physicians, pharmacists,
health lawyers, pharmaceutical representatives, social workers, psychologists, public health officials, clergy,
and educators as well as members of hospital-based ethics committees and Institutional Review Boards. In
addition to serving the needs of working professionals, the certificate coursework could offer a valuable
graduate and undergraduate elective program for persons preparing for careers in health and health-related
professions.
2. Need
a. To what specific need is the institution responding in developing the proposed program?
Bioethics Certificate Programs are currently offered by approximately a dozen universities throughout
the country. However, none of the existing programs are located in the mountain west and none have a
primary focus on the kinds of issues that complicate health and human service-related decisionmaking
in more rural areas of the country. The need for this kind of coursework has been substantiated by more
than 12 years of empirical bioethics research, conducted by Professors Ann Cook and Helena Hoas,
research professors in the Department of Psychology. The findings from their multi-method studies,
conducted in a 14 state area, show that the majority of health and human service respondents report
that they lack access to bioethics resources and have inadequate access to bioethics training.
Healthcare providers report that the lack of access to resources and training can inhibit clinical
decisionmaking and undermine the provision of quality health and human service interventions. Health
and human service providers who have participated in surveys, interviews, and focus groups have also
reported that existing certificate programs, as well as bioethics texts, national ethics conferences,
workshops and seminars, are not particularly relevant or helpful as they do not typically address the
rural context and problems that develop within that context. The findings from these studies have
validated the need for a course of study that has been shaped and enriched by empirical findings and so
is responsive to realities and needs that emerge when trying to make health-related decisions or
develop mechanisms, like hospital-based ethics committees and institutional review boards, in more
rural areas of the US and in rural settings worldwide.
b. How will students and any other affected constituencies be served by the proposed program?
The program will be offered on-line and so will be available to constituencies who live in even very
isolated rural communities. Health and human service providers in such communities often report an
inability to access options for continuing education. The decision of a rural physician or nurse to
participate in an off-site training opportunity, for example, can mean that the community may lack
access to medical support. The certificate program would provide an opportunity to link communities
of students – nationally and internationally – who want to pursue practical, relevant coursework in
bioethics. In addition to serving the needs of working professionals, certificate coursework offers a
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valuable graduate and undergraduate elective course of study for persons preparing for careers in
health and health-related professions.
c. What is the anticipated demand for the program? How was this determined?
This program responds to requests for bioethics education opportunities from health and human service
providers throughout the US and from other countries including Canada, Australia, New Zealand,
Ireland, Germany, and Sweden. The demand for this program emerged from a series of multi-method
studies that were designed to: (1) assess and document the needs for bioethics services in rural
communities and health-related settings; (2) identify emerging ethics-related issues; (3) coordinate
bioethics expertise and training; and (4) disseminate field-tested ethics-related materials and resources.
The findings from these studies have shed light on how health and human service providers and
residents in rural communities identify, discuss, and resolve bioethics-related issues that accompany the
delivery of health and human services. The findings have also helped identify approaches to ethicsrelated coursework that would be helpful.
3. Institutional and System Fit
a. What is the connection between the proposed program and existing programs at the institution?
While the certificate program is not directly associated with any existing program, it complements the
mission of other UM efforts such as the MPH program and could provide additional, highly relevant
options for MPH students. The program would also provide options for relevant coursework for premed students and students pursuing a number of other health and human service-related majors. The
certificate effort is also well aligned with existing UM-sponsored initiatives including the Institute for
Medicine and Humanities (a joint UM/St. Patrick Hospital venture) and the Area Health Education
Center (AHEC) housed within the College of Health Professions.
b. Will approval of the proposed program require changes to any existing programs at the institution? If
so, please describe.
Approval of this program would not require any changes to any existing programs.
c. Describe what differentiates this program from other, closely related programs at the institution (if
appropriate).
There is no program, currently offered through the Montana University system that could be defined as
“closely related.” While some bioethics courses may be offered at other institutions, the courses
offered through this program would be developed in response to research findings, would place a heavy
emphasis on relevance to a rural context, and would be offered entirely online and so would be
accessible to professionals working in even very isolated communities.
d. How does the proposed program serve to advance the strategic goals of the institution?
The proposed program advances the goals of the institution to increase the range and scope of online
courses, particularly those that address needs emerging in rural communities. This is therefore highly
relevant to the state of Montana.
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e. Describe the relationship between the proposed program and any similar programs within the
Montana University System. In cases of substantial duplication, explain the need for the proposed
program at an additional institution. Describe any efforts that were made to collaborate with these
similar programs; and if no efforts were made, explain why. If articulation or transfer agreements have
been developed for the substantially duplicated programs, please include the agreement(s) as part of
the documentation.
There is no duplication with existing programs. The letters of support that accompany this application
attest to its unique and well justified features.
4. Program Details
a. Provide a detailed description of the proposed curriculum. Where possible, present the information
in the form intended to appear in the catalog or other publications. NOTE: In the case of two-year
degree programs and certificates of applied science, the curriculum should include enough detail to
determine if the characteristics set out in Regents’ Policy 301.12 have been met.
(1) Clinical Topics in Rural Bioethics
This course will explore the moral values and norms that guide the actions of healthcare
professionals (physicians, nurses, pharmacists, administrators) and human service providers and so
influence the delivery and the reception of healthcare and human services in rural and underserved
communities. Assigned readings and resources will guide the examination of concrete bioethical
problems that are influenced by issues that include: professional responsibility, professional codes,
and relationships, policy development, research, environmental health, occupational health,
resource allocation and rationing, human error, and genetics. Weekly case studies, decisionmaking
guides, and other tools will give students opportunities to apply norms and values when trying to
resolve practical problems.
(2) Introduction to Empirical Research Ethics
This course will focus on the study and development of ethically attuned protocols for developing,
conducting, and evaluating qualitative and quantitative research studies with rural or vulnerable
populations. Coursework will focus on issues that include the examination of processes,
approaches, and protocols designed to optimize protection of human subjects and support
informed consent. The course will also support examination of emerging issues such as the tension
between the goals of science and the best interests of a population, the good of the community,
and rights of individuals.
(3) Ethical Foundations for Quality Improvement and Assessment in Healthcare
This course will explore processes for decisionmaking including the individual, professional, and
system conflicts and burdens that can accompany health and human service decisionmaking
especially in resource limited settings. Coursework will allow examination of practical issues such as
medical error in the context of health care delivery, the role of disclosure in quality improvement
processes, and approaches for engaging the public in health-related decisionmaking about issues
such as quality and resource allocation. Particular emphasis will be placed on the ethical issues that
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can challenge quality improvement activities. Coursework will also focus on the development of
ethically attuned services such as ethics committees and Institutional Review Boards.
(4) Bioethics and Healthcare Policy
This course will explore the foundations for health policy decisionmaking. It will include examination
of relevant factors such vulnerability, use of power, foreseeable risks, exploitation, and other issues
that can compromise policies designed to enhance health and safety.
b. Describe the planned implementation of the proposed program, including estimates of numbers of
students at each stage.
The initial course would be offered Spring semester, 2010. One course would be offered during the 10
week summer session, one course would be offered in the Fall and one during the Intersession. The
initial registration could involve 10-15 students but numbers would be expected to increase after the
first year.
5. Resources
a. Will additional faculty resources be required to implement this program? If
yes, please describe the need and indicate the plan for meeting this need.
This program can be supported with extant faculty members, although they will be covering this
program as an extra-to-load project. UMOnline is prepared to provide financial support in the form of
course development stipends and extra-comp salaries to teach the courses online each year.
Additionally, UMOnline is equipped to provide comprehensive instructional design guidance and
technical support for the faculty members.
6. Assessment
Assessment of the certificate program will focus on both the assessment of the student and the assessment
of the program. Student assessment will be tied to authentic assessment approaches that link learning
activities to attainment of specific competency based skills. Required readings will be directly linked to case
studies that have emerged in rural communities and/or with vulnerable populations. The standards for
student dialogue and resolution of case studies will be outlined on a Matrix for class assessment. The
Matrix. Which can be provided upon request, will define the standards for competency.
The success of the program will be measured by student evaluations and enrollment. Students who
complete the program will be enrolled, if willing, in a long term evaluation effort that will seek specific
feedback about the utility of the program, its impact on their professional lives, and suggestions for new
topics or issues for inclusion in the study program. Exit interviews will be conducted with students who
enroll but do not complete the program in order to better understand barriers that could be addressed so as
to optimize the success of the certification program.
7. Process Leading to Submission
The need for this program surfaced as a result of studies conducted throughout a multi-state area. The
subject and design of the courses has been influenced by insights of working professional including
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physicians, nurses, pharmacists, social workers, and healthcare administrators. Letters of support from
faculty and health professionals who attest to the need and utility of this program are provided.
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