moral reasoning development; educational interventions, DIT, Defining Issues test, Neo-Kohlbergian theory, community pharmacists, Intermediate concept measures


Research indicates that appropriately designed educational interventions may impact positively on moral reasoning competencies development (MRCD) as measured by a psychometric measure known as the Defining Issues Test (DIT). However, findings include that educational interventions intended to impact on MRCD do not consistently promote measurable pre-post development. This paper reviews the theoretical background to the use of educational interventions to impact on MRCD, and spotlights how underpinning Neo-Kohlbergian theory might inform the design of an intervention in order to optimise impact on MRCD.

Findings indicate that peer debate - regarding ethical concepts in profession-specific dilemma scenarios, what action(s) might be taken and how ‘less than ideal’ action options might be justified - is essential. Five examples of an adapted format of ‘Neo-Kohlbergian’ profession-specific ‘intermediate concept measures’ (ICMs) are included and were integrated into a 16 week blended learning educational intervention in a manner that promoted repeated exposure to peer debate regarding dilemmas, and the educational intervention design was trialled in a study with 27 volunteer community pharmacists in Ireland. An overview of the design, development and delivery of the intervention is provided. The paper concludes with recommendations for further development of the ‘idea’.

Conflict of Interest

We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties