Ethical issue awareness is an integral part of decision-making for the healthcare professional. Students and new graduates of educational programs have recent academic experiences in which decision-making and critical ethical issues are explored. The practicing professional makes many decisions daily, but opportunities to explore and discuss ethical issues are infrequent. To increase the awareness of ethical issues by professionals with different experience levels, an instructional design theory was formulated. This study evaluated a model of the newly constructed prescriptive theory. The research goal was to improve the usefulness of the model in the design of instruction for healthcare professionals.

A formative research approach was used to collect suggestions for improvement during the separate stages of the study. In this qualitative study, data were collected during observations of instruction and interviews with instructors and small discussion group participants. The instructors and participants were employed by the study site, a 600-bed metropolitan hospital. The model was used by the instructors to design the instruction for conventional topics in which an increased awareness of ethical issues was a desired outcome. The prescribed tactics included a case study and a sequence of convergent, probing, and divergent questions to be used during the discussion of the case.

The findings supported the usefulness of each tactic in increasing the awareness of ethical issues, however, revisions to the prescription were suggested. The study also concluded that the formative evaluation approach to research, when used in a qualitative study, was an effective methodology in the improvement of one model of the instructional design theory.

Recommendations for further study include revising the Instructional Theory for Awareness of Ethical Issues to be a more complete prescription for the design of instruction, determining the level of ethical issue awareness of healthcare professionals, and investigating the meaning of efficient, effective and appealing instruction in a hospital environment.