Defense Date


Graduation Date

Spring 5-8-2020


Immediate Access

Submission Type


Degree Name



Health Care Ethics


McAnulty College and Graduate School of Liberal Arts

Committee Chair

Dr. Henk ten Have

Committee Member

Dr. Gerard Magill

Committee Member

Dr. Joris Gielen


Quality in All Levels, Bioethics Education, Quality Measurement, Defining Quality, Quality Standards


Due to the lack of academic studies in the quality assessment of bioethics education, this dissertation aimed to propose a normative model, Quality in All Levels (QAL), to define and measure quality in bioethics education. The QAL model described quality in bioethics education as conformance to the goals and determined these goals as (1) increasing ethical knowledge, (2) improving ethical skills to strengthen ethical sensitivity, awareness, and judgment, (3) developing ethicalbehavior, and (4) promoting cultural competence. The dissertation utilized Avedis Donabedian’s three approaches: structure, process, and outcome to formulate quality standards and indicators in bioethics education. In respect of data collection, QAL suggested using mixed research methods and different data collection techniques, such as document reviews, surveys, interviews, and observations. Additionally, QAL advised employing a Likert scale-based method with an analytic hierarchy process in order to analyze data and reach a conclusion concerning the overall quality of a bioethics program or course. QAL assumes that it is not possible to ensure long-standing, deliberate, and sustainable quality without simultaneously fulfilling certain standards in each level of bioethics education. In this view, QAL regards the structure, process, and outcome as the three levels of bioethics education and requires attributing equal importance to all these levels.

Even though encompassing some limitations due to its normative aspect, the QAL model has high potential to fill the gap in the intersection of bioethics education and quality by indicating the first comprehensive study defining and assessing quality in this emerging field. Furthermore, the emphasis of the model on promoting cultural competence inquires the feasibility of reconciling differences in bioethics and integrating distinct values without causing assimilation or marginalization.