Definition of the problem Clinical ethics consultants are required to provide specialized guidance, care, and support on ethics issues in healthcare settings. They need to develop a varied set of competencies ranging from clinical and ethics knowledge, critical thinking and decision-making, difficult conversation and conflict management skills, cultural competence, professionalism, adaptability, educational skills, and the ability to respectfully handle conflicting priorities in high-stakes situations. How to teach and learn ethics consultation skills is a nuanced and evolving process. It is often unexpectedly hindered not just by external pressures but by educators’ blind spots. These blind spots prevent them from detecting subtle but important inconsistencies between the care and curiosity they bring to their interactions with clients versus the way they treat their learners. These mismatches, though common and documented, can unintentionally weaken or threaten the quality and consistency of learning environments, limiting learners’ opportunities for deep, experiential growth. Arguments Drawing on the literature of behavior change, development, and simulation-based medical education, we identify three challenges to developing ethics consulting skills and the implications of these challenges for educational settings. The intention-versus-impact challenge highlights the mismatch between a consultant’s intentions—such as fostering dialogue or reducing moral distress—and the actual effects of their interventions, which may inhibit dialogue and exacerbate learners’ distress as they seek to learn new skills. The feedback challenge captures the common difficulty of giving and receiving feedback that is meaningful, honest, and timely yet does not harm; instead, it strengthens the relationship between ethics instructor and ethics consultation learner. Ethics consults often occur in emotionally charged contexts, and when these are replicated in training, ethics consultants-in-training may be reluctant or unable to take in critiques or reflect critically on their performance. In parallel, ethics instructors may struggle to “tell it like it is” with their learners in the same way they must with their ethics consult clients. Learners’ struggles to tolerate feedback and instructors’ struggles to lead conversations that are neither harsh nor judgment-hiding can limit opportunities for professional growth and quality assurance. Third, the walk-your-talk challenge highlights the mismatch between the ethics ideals consultants espouse and promote and how they enact these espoused values when they interact with ethics consultants-in-training. Institutional and interpersonal constraints ethics instructors face often make upholding the transparency, respect, and moral courage they espouse difficult to carry out in their teaching practice. We propose the use of reflective practice—the systematic examination of one’s actions, assumptions, and impacts—as a lens for exploring these challenges and identifying a pathway for faculty development. Applying the Learning Pathway Grid—a reflective practice tool—to illuminate how educators can surface and realign the invisible frames that shape their education behaviors. This approach strengthens educational integrity by helping ethics educators more consistently embody the values they teach, thereby fostering safer, more authentic, and more effective learning environments. Conclusion The particular challenges for developing ethics consulting skills provide guidance for targeting reflective practice and faculty development efforts.

Walking the talk when teaching ethics consulting skills: A pathway for faculty development

期刊论文
发表日期：

2026年3月6日

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Michaela Kolbe,
Jenny W. Rudolph

摘要

Definition of the problem

Clinical ethics consultants are required to provide specialized guidance, care, and support on ethics issues in healthcare settings. They need to develop a varied set of competencies ranging from clinical and ethics knowledge, critical thinking and decision-making, difficult conversation and conflict management skills, cultural competence, professionalism, adaptability, educational skills, and the ability to respectfully handle conflicting priorities in high-stakes situations. How to teach and learn ethics consultation skills is a nuanced and evolving process. It is often unexpectedly hindered not just by external pressures but by educators’ blind spots. These blind spots prevent them from detecting subtle but important inconsistencies between the care and curiosity they bring to their interactions with clients versus the way they treat their learners. These mismatches, though common and documented, can unintentionally weaken or threaten the quality and consistency of learning environments, limiting learners’ opportunities for deep, experiential growth.

Arguments

Drawing on the literature of behavior change, development, and simulation-based medical education, we identify three challenges to developing ethics consulting skills and the implications of these challenges for educational settings. The intention-versus-impact challenge highlights the mismatch between a consultant’s intentions—such as fostering dialogue or reducing moral distress—and the actual effects of their interventions, which may inhibit dialogue and exacerbate learners’ distress as they seek to learn new skills. The feedback challenge captures the common difficulty of giving and receiving feedback that is meaningful, honest, and timely yet does not harm; instead, it strengthens the relationship between ethics instructor and ethics consultation learner. Ethics consults often occur in emotionally charged contexts, and when these are replicated in training, ethics consultants-in-training may be reluctant or unable to take in critiques or reflect critically on their performance. In parallel, ethics instructors may struggle to “tell it like it is” with their learners in the same way they must with their ethics consult clients. Learners’ struggles to tolerate feedback and instructors’ struggles to lead conversations that are neither harsh nor judgment-hiding can limit opportunities for professional growth and quality assurance. Third, the walk-your-talk challenge highlights the mismatch between the ethics ideals consultants espouse and promote and how they enact these espoused values when they interact with ethics consultants-in-training. Institutional and interpersonal constraints ethics instructors face often make upholding the transparency, respect, and moral courage they espouse difficult to carry out in their teaching practice. We propose the use of reflective practice—the systematic examination of one’s actions, assumptions, and impacts—as a lens for exploring these challenges and identifying a pathway for faculty development. Applying the Learning Pathway Grid—a reflective practice tool—to illuminate how educators can surface and realign the invisible frames that shape their education behaviors. This approach strengthens educational integrity by helping ethics educators more consistently embody the values they teach, thereby fostering safer, more authentic, and more effective learning environments.

Conclusion

The particular challenges for developing ethics consulting skills provide guidance for targeting reflective practice and faculty development efforts.