Table 3

Selected codes: definitions and examples

CodeIdentifies parts of responses which include:
*Differences were found in these coding domains before and after the course.
CommunicationMention of communication between parties; for example the provider, patient, family or other individuals. Suggestion to share information, clarify the situation or attempt to reconcile opposing viewpoints.
 “Approach [the patient's] wife concerning the degree of injury and therefore permanent deficits, prognosis, and quality of life issues as well as [concerning] her feelings, concerns, and relationship with her husband.” (Brain haemorrhage case)
*ConflictingThe indication of a conflict existing between two or more principles, values, or interests in the analysis of the scenario.
 Recognition of interpersonal or intrapersonal conflicts.
 “In accordance with the principle of beneficence in a situation where grave harm could beset the patient ... the information might be withheld. However, this infringes upon the principle of veracity and patient autonomy.” (Lung tumour case)
DirectiveUse of a directive tone in stating a resolution. An authoritative, instructive statement that does not consider opposing viewpoints or other possible solutions.
 “Bring the patient into [the] hospital and evaluate her. Give her the best care available.” (Deteriorating health case)
HypotheticalUse of hypothetical reasoning. Presentation of conditional resolutions or identification of issues based upon supposition of various facts.
 “If there is significant evidence of incompetence, serious consideration must be given to ... beneficent intervention. If she appears competent, respect for her autonomy and choice should govern.” (Deteriorating health case)
*JustificationJustification of a proposed resolution or defence of how a resolution was decided upon. Explanation of consideration of various issues in the vignette.
 “The patient has the right to choose any ... therapy offered ... or to refuse treatment. He cannot make those choices if he does not know what is wrong with him.” (Lung tumour case)
PowerIdentification of a locus of power. Indication of who has decision making authority; for example patient, family, physician, ethics committee, the law, or others.
 “Absent any law requiring disclosure of the test results to the insurance company, I would comply with the patient's wishes.” (Huntington's test case)
*RankingAn attempt to choose between conflicting principles, values or interests. Ordering of or assignment of value to conflicting aspects of the vignette.
 “Given the fiduciary [physician-patient] relationship ... the patient's interests supersede those of third parties.” (Huntington's test case)