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Enhancing professionalism using ethics education as part of a dental licensure board's disciplinary action. Part 2. Evidence of the process.

Pretest scores were analyzed for 41 professionals referred for ethics assessment by a dental licensing board. Two were exempt from instruction based on pretest performance on five well-validated measures; 38 completed an individualized course designed to remediate deficiencies in ethical abilities. Statistically significant change (effect sizes ranging from .55 to 5.0) was observed for ethical sensitivity (DEST scores), moral reasoning (DIT scores), and role concept (essays and PROI scores). Analysis of the relationships between ability deficiencies and disciplinary actions supports the explanatory power of Rest's Four Component Model of Morality. Of particular interest is the way the model helped referred professionals deconstruct summary judgments about character and see them as capacities that can be further developed. The performance-based assessments, especially the DEST, were particularly useful in identifying shortcomings in ethical implementation. Referred practitioners highly valued the emphasis on ethical implementation, suggesting the importance of addressing what to do and say in ethically challenging cases. Finally, the required self-assessments of learning confirm the value of the process for professional renewal (i.e., a renewed commitment to professional ideals) and of enhanced abilities not only to reason about moral problems, but to implement actions.