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J Acad Ethics (2008) 6:3350 DOI 10.

1007/s10805-007-9053-5

Using Creative Writing Techniques to Enhance the Case Study Method in Research Integrity and Ethics Courses
Timothy N. Atkinson

Published online: 23 January 2008 # Springer Science + Business Media B.V. 2007

Abstract The following article explores the use of creative writing techniques to teach research ethics, breathe life into case study preparation, and train students to think of their settings as complex organizational environments with multiple actors and stakeholders. Keywords Narrative . Ethics . Research integrity . Teaching . Creative writing . Organizational behavior Courses in research ethics and research integrity often use the case study method for teaching research ethics; however, as Cova et al. (1993) illustrated, given specific philosophical contexts, the case study method is often accused of excluding the students experiences. Linguistic scholars might classify case study as meta-narrative or reflexive representations of reality (Danesi 2007), but not the real thing. Scholars have further noted that the case study approach sidesteps the learning that emerges from actual encounters with real life problems (McCarthy and McCarthy 2006). Experience is the best teacher at times, but one would hope real-live cases of ethics violations are not abundantly available. Teachers are left with using the case study to simulate experience in order to get at the issues. Perhaps a little creativity is what is needed to enhance the method. The following article presents a way to breathe life into the case study method and begin to invite the student back into the narrative at a textual level. Creative writing techniques are a way to encourage the student to be both critically reflexive of the process of case study design and be attentive to the actual moral of the story by asking the student to engage the narrative, extend it and participate in it (Cunliffe 2002). The article provides a proposed method for using creative writing techniques in the classroom or in an online forum (without having to be a champion short story writer or novelist), and illustrates the impact these techniques had

T. N. Atkinson (*) University of Arkansas for Medical Sciences, 4301 West Markham, SLOT 812, Little Rock, AR 72205, USA e-mail: tnatkinson@uams.edu

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on the thought processes of an actual class by showing some illustrations of actual student work engaged in the process. Although, this was not a research project, the authors sought and obtained an IRB classification of exempt in order to illustrate the authors desire to maintain an ethical stance when using the student data. Absolutely no student names or identifiers were used; only the interesting applications of the creative writing techniques were used as illustrations. Creative writing techniques are interesting because of their focus on creating conflict, motive, action and suspense. Daily life is full of these elements. If students can think about what creates conflict for instance, they have to continuously consider how overall contexts (settings) are integrated with human nature when confronting ethical dilemmas. Stressing integration of basic ethical and normative concepts, I used a version of this method in my own course called Responsible Research Climate and Culture with some interesting outcomes. The students seemed to have fun with it. I hope others find it a refreshing approach as well. The article begins by examining the literature of using creative techniques and then assembles a conceptual framework and course ideas.

Background and Literature Case study has had a long history of use in the USA and Europe surviving various philosophical movements and perspectives (Cova et al. 1993). Prospectively, the primary critique of the case study is still its inability to engage students in experiential learning. Several scholars have tried to offer alternatives to the case study as an effective simulation of real-life problems. For instance, McCarthy and McCarthy (2006) suggested a program where students shadow a mentor in a real business setting. Many students found the job shadowing experience very helpful, and job shadowing was preferred by students over the case study method alone as a method for learning. The problem with this approach for teaching ethics, however, was that students were not in the field long enough to participate in the resolution of meaningful ethically charged experiences. For basic business life knowledge, the shadowing technique is a very good idea, but it is not a very effective technique for ethics cases. Also, if a real life ethics case did emerge in a business setting during a shadowing experience, it is hoped that the members of the organizations would have handled the case discretely for the sake of the actors who require due process. An intern or shadow learner should not be allowed to participate in these deliberations because they are usually private. McWilliams and Nahavandi (2006), on the other hand, described a method for engaging students in live-cases. The authors noted that a live case is different from a regular case in that students picked a current topic involving an ethical violation and wrote a case about it. This exceptional idea moved the use of case study closer to using creative writing techniques in that the student had to create a case based on actual happenings. The authors noted some success in implementing the method itself, engaging students in critical thinking, and creating relevance to the study of ethics and real life (McWilliams and Nahavandi 2006). They did not, however, attempt to use creative writing techniques to enhance the creation of the cases and/or as a method to deconstruct cases. Similarly, Laditka and Houck (2006) used the student-developed ethics case as a method for engaging students in the critical thinking process. Students created a case based on an actual ethically charged experience they encountered themselves, which again moved the use of case study closer to the experiential. Another exceptional idea, the method highlighted some of the cognitive processes involved in applying real life experiences to creative explanation. More

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of these ideas will be discussed below (See Ward 2001). However, the process did not appear to mention use of actual creative writing techniques in the development of the cases or discussion of the cases. Ward (2001) offered some interesting ideas concerning how the creative drama or narrative might work at a cognitive level, thereby enhancing the integration and learning of new ideas through creative writing. Ward (2001) produced an interesting discussion of what he called creative cognition and conceptual combination. Creative cognition is grounded in the study of the embedded cognitive processes instead of motivation, personality and other forms of socialization. The focus of this approach is what Ward (2001) referred to as a cluster of basic cognitive processes that has various configurations and effects on outcomes (p. 350). Cognitive science is the study of how peoples minds assemble solutions to problems, assemble language usage and react to certain stimuli. In studying ethics cases it is necessary for students to solve problems, but in order to get inside the thinking process I argue that a deconstruction or reverse creativity and that using creative writing techniques for student-developed cases would get inside the case on a cognitive level. Creative writing techniques allow one to go forward with constructing a new story; however, when presented with a story or case, the student can use the same techniques to deconstruct it and pull out many creative solutions to the case. Ward (2001) noted that within creative cognition lies preinventive forms of ideas that do not solve problems necessarily, but represent starting points to the creative process. I say reverse this by starting with a case, which is a meta-narrative or a story form, and have the student describe how it was constructed accounting for character, setting (context), conflict, etc. Further, Wards (2001) discussion of cognitive combination illustrates that previously separate concepts are merged to form new units that can differ in important ways from either of their constituent concepts (p. 351). When constructing a story we are told that character forms plot and character motivation drives the plot (Dibell 1988). In teaching research ethics, we need to explore what motivates actors to act against the rules. We ask ourselves; did the actor do it on purpose, did they do it to get ahead, did they do it simply because they were ignorant, was it the environment (setting) or did someone else (antagonist) use the perpetrator as an agent of evil? I think many decision makers in ethics today are too quick to find fault with individuals without exploring the myriad of contexts that could be causing the problems and prevent them. Are problems systemic or the result of a single-acting individual? Deconstructing or constructing cases using story methods gets down to the grain of the problem and at least asks the decision maker to avoid one dimensional decision making. Ward (2001) noted in laboratory tests, that the thoughts that are not in harmony produce emergent properties. He says, Having people consider completely imaginary conjunctions leads to a large number of emergent properties (Ward 2001). Examining divergent properties could also lead to creative solutions. Additional support for the narrative is found in an article by Hill (2004) who was primarily concerned with the limitations of the current models of teaching ethics in scientific and health-care settings. He noted that the standard of care model provides a framework for problems that one may encounter, but does not offer a mode of selfassessment and moral development. Hill supported creative forms by recommending that our methods of teaching ethics ought to consider the social environment, and to drop the student (or actor) into a creative drama or a narrative. Although there are many ways to do this, creative writing techniques come very close to this notion without requiring too much time from an instructor s already full calendar. In addition, Goodrich et al. (2005) noted that learning about various kinds of narratives help practitioners connect to the problems more readily. Goodrich et al. (2005) created a four stage curriculum around the narrative

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medicine literature: The first stage concerned how encounters with residents and patients are narrative in nature, in other words every patient has a story to tell about their lives; the second stage concerned narrative in general from both fictional accounts and actual patient accounts as value-added encounters; stage three was a session for residents to write about patient encounters and compare that with the what they wrote in the patients chart; and finally session four was a session to highlight the value in narrative based on the actual experiences (Goodrich et al. 2005). The article highlighted the contrast between lengths of chart narratives compared to the reflexive narratives. The reflexive narratives were long and more value laden, while the chart narratives were cold and business-like. Examining the contrasts, residents agreed that they were able to see that their medical decisions have ethical impact on more than just the individual, but on the individuals life-world (Goodrich et al. 2005). The literature concerning creative writing in formal teaching, on the other hand, is scattered throughout various disciplines within the social sciences, humanities, education and business. The following discussion focuses only on the most pertinent and provocative ones. Goma (2001) noted many benefits to creative writing, particularly in teaching economics. She noted that creative writing applied to a technical subject rounds the college educational experience by tapping into the imagination and helping students find solutions to problems to which they might not have thought. Likewise, Siegfried et al. (1991) noted with regard to Economic education, that creative skills leads to better problem solving and the ability to create new theoretical and conceptual frameworks that lead to better solutions. Combs (1946) on the other hand studied how plot construction allowed an individual to explore his or her own motivations. He noted that writers use personal experiences to create fictional plots. The plots were a version of the real-life self and a version of the lives of others. Those who study semiotics and discourses might label this weaving of personal discourses into fantasy as intertextuality where the narratives of experience merge with present day narratives or discourse moments as perhaps a representation of self and ones current thinking patterns (Chandler 2002; Chouliaraki and Fairclough 1999; Danesi 2007). In the Combs (1946) study, 46 students participated in the thematic apperception test where they wrote stories according to themes provided by the researcher, and they produced a one story autobiographical so the researcher had a baseline of comparison. In a manner similar to phenomenology, Combs condensed the narratives into significant statements from the stories and organized them into themes. He validated the themes by using another rater so he would not be the sole interpreter of the data. It is interesting to note Combs found that 36% of the stories contained themes and experiences from the participants own lives illustrating the inability to separate oneself from experience to create or generate new story material for fantasy. From this we know it takes life experiences to create new ones and thus we learn and make sense of life through retrospect (Weick 1995). It stands to reason that deconstructing a case using creative writing techniques might provide a useful method for creating the experience in the mind of the student by considering motive, plot and virtue. Another interesting project concerning the technique of point-of-view is found in Durgees (1986) study of the use of these techniques in conducting focus groups to generate information for advertising campaigns. Durgee (1986) noted that advertising brings life, spirit and personality to otherwise inanimate objects. In this phenomenological study, Durgee assembled a traditional focus group, taught them creative writing techniques and asked them to use these techniques to describe particular products. The notion was that peoples lived experiences are similar but people do not always have similar expressions of these experiences, so by giving the group new techniques to express themselves, the research team overcame the hurdles of group think and the intimate probing of individual

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perceptions that often accompany focus groups. (Durgee 1986). The results indicated that individuals were able to describe experiences in more condensed, evocative and effective ways and eliminated wordiness and bland face value descriptions. The value of this idea to teaching research ethics would perhaps appeal to the online course instructor. Online discussions often meander along various lines of thought and other students have the tendency to create the ditto effect where they write long descriptions of solutions very similar to discussions they have read from their colleagues a sub-par participation at best. By asking the discussants to use creative writing techniques and respond privately to the instructor, the instructor posts the discussion later and different views and solutions of the case emerge. Goma (2001) allowed students to choose their own creative format to solve problems in economics, but instructed them to strictly avoid making the answers sound appropriate for an economics professor. She noted that students generated short stories, plays and mock newspaper articles and noted a heightened level of imagination in reaching economic solutions. (p. 151) Goma trained students to look at problems from another point of view other than that of an economic analyst. She warned other instructors that grading the papers like this could take up more valuable time than one is willing to spend and cautioned not to use this technique as the sole method, but to use it along with other techniques.

Constructing the Method Examining Setting Case studies live in the setting. This is probably one of the most important aspects of ethical dilemmas. We know ethical dilemmas take place in complex organizational settings. Noble (1994) called this element of story construction stage setting. He noted that as a fictional device, the story moves along in this environment and story is affected by it. Case studies in research ethics often assume the setting is a given: University, laboratory or engineering firm. This is helpful, but students should begin to consider environmental cues that might affect character motivation. The research environment, for instance, has become the focus of the emergent field of research on research integrity (IOM 2002). The creative notion of setting translates into research environments, especially in the case study. Setting includes the organizational hierarchy, the politics, cultures, and human resources (Bolman and Deal 2003). If our case studies do not include some aspects of setting, they should. If our case studies are detailed enough to include setting then the student ought to be encouraged to use the settings in making a decision about the case. Research shows that tightly coupled hierarchies could result in a condition of anomie or alienation that could lead to misconduct (Braxton 1989, 1992, 1993; Braxton and Bayer 1994, 1999; Merton 1938). Anomie is a breakdown in the social support system that works toward a particular goal while alienation is the result of specialization and fragmentation, while alienation is isolation that could be due to high academic specialization. Examining Setting in the Assignment A solution to the problem might be: Create a new organizational system that promotes and supports research while making sure scientists and other creative faculty members have a place to go when their ideas do not seem fruitful. Under this rubric, we directly ask students to consider the broader contexts of ethical

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decision making and to describe the organizations or communities. We ask students to describe the setting, keeping the following questions in mind: We ask, can this type of setting encourage or discourage ethical decision making? What characteristics of the setting promote integrity? What characteristics discourage integrity?

Examining Plot Plot is commonly known as the events that take place during a story, but it is usually not recognizable until the story has already been constructed (Dibell 1988). This notion is excellent for case study analysis. Dibell noted that plot is more about what the characters do in a story, their motivations, feelings, thoughts, emotions that lead to particular consequences. Plot illustrates the values, the actions and the conflicts involved with the actors making it to a goal (Dibell 1988). Case studies have plots. Usually the conflict in an ethical case study involves a character who has acted morally wrong, and it is up to the reader to develop a solution, decide how the other characters should act, and ultimately decide the outcome of the story. Novakovich (1998) noted that character struggles are the primary engine for plots. The process of solving a case involves some sort of plotting based on character motivations, actions and conflicts. The reader of a case reads the story linearly in scenes (which contain settings or environments). As the case progresses, a representation of a problem is presented. It seems that plots are good for examining the contexts of a character s actions which leads us to a final solution. Examining Plot in the Assignment Examining plot is another way to consider deontological and consequential ethics. Are the characters in the case motivated to achieve a particular ends? What are they doing? What factors lead you to believe that the characters are plotting? Are they plotting good or evil? Are they intentionally plotting good or evil? Is someone else encouraging the main characters to plot good or evil? Are they breaking defined policies and regulations?

Examining Characters Bolman and Deal (2003) might call characters human resources. Each case study we review has characters. Some of them seem bad and some seem good. Characters cause the conflict. The characters have hopes, dreams and motivations, some hidden and some revealed in the texts. Without them, we would have no stories and much less case studies. Card (1988) said, The characters in your fiction are people. Human beings (p. 4). The primary conflict in an ethical case study involves matters of ethics. Card (1988) noted, Motive is what gives moral value to a character s acts. What a character does, no matter how awful or how good, is never morally absolute It is fair to note that we cannot read peoples minds. Their motivations are not always apparent. Case studies try to reveal these aspects to get us think about moral questions. Students of ethics should think about motive and intent of the actors in their case studies. Doing this helps us consider virtue ethics. Card noted that characters have a past, a reputation, stereotypes, networks, habits, and talents and abilities. All of these aspects should be considered when making moral judgments. Motivation is the primary purpose of character and movement in a story (Novakovich 1998). Their personalities and psychologies drive the plots and conflicts. Based on organizational theory, this notion coincides with the Bolman and Deal human resource

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frame. We analyze characters to consider virtue and the question to ponder is found in motive for breaking rules or violating norms. Examining Characters in the Assignment Ask the student to consider virtue and normative ethics. Do you believe the main characters are good or evil? If you believe the characters are highly virtuous, how will the setting and the plot affect their virtuousness? If the characters are not virtuous, how are they driving the plot and the conflict?

Examining Conflict Moral dilemmas involve conflict. Politics involve conflict (Bolman and Deal 2003). Our case studies in organizational ethics are about conflict. There would be no case without the conflict. Noble (1994) noted of creating conflict in stories that, a stream of complaints may develop insight into character (p. 5), but it also makes things interesting. Case studies as stories have what Noble calls immediacy because cases are short, quick, to the point and give you all the drama at once. Most stories involve conflict, unhappiness, tension, troubles and discord which are the elements of a good case study in ethics (Noble 1994). We ask our students to focus on the problems; often we get back very slim explanations that meet the goal of the exercise, but somehow miss the substance of the problem. Conflict is created in any kind of story and conflict arises out of character, plot, and setting (Noble 1994). Focusing on conflict as an element of the case encourages the student to bring in all aspects of the story together in a substantive solution to the problem. If we included political and structural elements in our cases, we could begin to examine some sources of conflict. Within the structure of Universities, for instance, there are parallel hierarchies and thus an automatic political tension between the faculty and the administration (Mintzberg 1979, 2000). Administration sometimes buckles to faculty demands and vice versa. Could this kind of behavior encourage moral failures? Bolman and Deal (2003) seem to think that the political frame is where most of our moral and virtuous dilemmas exist. We can encourage our students to look outside the text of a case and create new characters to solve problems (hire a compliance officer), modify characters (fire an employee), make characters work together (form a committee) or give characters new tools or organizations to work for (create a new division of research). All of these solutions could be reasonable resolutions to conflicts given the context, characters, settings and plots or motivations. Examining Conflict in the Assignment Integrate the elements of story construction. What is the primary conflict? Who is driving it? Who can prevent it? Are the people unknowingly causing conflict? Is their a specific character causing the conflict? Is the plot driving conflict? Is the setting driving the conflict? Describe the nature of the conflict.

Bringing It All Together in a Conclusion Ask the student to analyze all the elements of the story or case to come to a conclusion. Ask them to write the conclusion to the story by introducing characters that can help examine the moral development of the other characters, the consequences of the actions, and act to create a morally sound solution. Allow them to introduce an individual, a group, a committee, etc. Ask them to briefly describe their ethical decision making framework and

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how this framework will help them achieve a morally sound decision. Encourage them to be creative, but get to the point. Ask students to use the headings to construct a solution. Table 1 summarizes the previous discussion to illustrate what each creative writing element contributes to the overall examination of the case. Overlap is expected and encouraged because the elements work together to create a solution. Application of the Method About Word About the Students The students in this particular class were graduate students working on Master s degrees in Public Health and Physician Residents working on post-MD training in clinical-translational science. As an instructor, I admit I was very blessed with an articulate group of students who seemed to care about the subject matter and did not need much hand holding. Structure of the Course The course was offered online. The evaluation methods used were: (1) weekly online discussions in asynchronous format where the instructor posted a case or question of the week based on readings, (2) weekly reflective journaling on terminology learned during the previous weeks discussions and readings, (3) finally two creative writing papers, a mid-term and a final, where students used the knowledge from readings in previous weeks to analyze a case of their choice from the textbook. The assignment provided to students is illustrated by Table 2.
Table 1 Creative writing elements and their relationship to real life Element Setting Summary definition The stage The environment where the action takes place Plot Events that take place during a story A final view of the entire story, but is ongoing Related to character Who are the people in the story, what do they do, what are their hopes, dreams, and motivations? Related to plot Real life reflection/analysis What are the organizational culture and/or climate? What are the norms, laws, and rules of the organization? How does organization affect people? What are our values and the values of others? What actions affect my overall life? What causes conflict in my life and others? What are the human resources in the organization? Are we all virtuous? What are my motivations? Why do people do things they should not? What is human nature? Is a combination of all elements above

Characters

Conflict

Conclusion

What combination of elements above is causing the unhappiness, the tension, the trouble? Solves the problem presented by all elements

How do actions affect outcomes? Look back at the plot and decide what went wrong

Creative writing techniques for case studies Table 2 Assignment for story construction to analyze cases in scientific integrity Assignment

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Using story construction to examine cases in research integrity Course Number and Title Semester Basic story construction is used here as an alternate means to examining research integrity cases as opposed to traditional case study approach. The structure of the case analysis should be as follows 1. Setting: Consider the broader contexts of ethical decision making. Describe the organizations or communities. Can this type of setting encourage or discourage ethical decision making? What characteristics of the setting promote integrity? What characteristics discourage integrity? Describe the setting using the previous questions as described 2. Plot: Consider motive. Examining plot is another way to consider deontological and consequential ethics. Are the characters in the case motivated to achieve a particular ends? What are they doing? What factors lead you to believe that the characters are plotting? Are they plotting good or evil? Are they intentionally plotting good or evil? Is someone else encouraging the main characters to plot good or evil? 3. Character: Consider virtue and normative ethics. Do you believe the main characters are good or evil? If you believe the characters are highly virtuous, how will the setting and the plot affect their virtuousness? If the characters are not virtuous, how are they driving the plot? 4. Conflict: Integrate the previous elements. What is the primary conflict? Who is driving it? Who can prevent it? Are the people unknowingly causing conflict? Is their character causing conflict? Is the plot driving conflict? Is the setting driving the conflict? Describe the nature of the conflict 5. Conclusion: Analyze all the elements of the story or case to come to a conclusion. Write the conclusion to the story by introducing characters that can help examine the moral development of the other characters, the consequences of the actions, and act to create a morally sound solution. You can introduce an individual, a group, a committee, etc. Briefly describe their ethical decision making framework and how this framework will help them achieve a morally sound decision. Please feel free to be creative, but get to the point! Thanks Use the headings above to construct your project. Limit your analysis to two pages. I am not grading on page numbers, but I encourage you to be precise and concise. I am also not expecting you to write prose that matches that of your favorite authors. What am I looking for: Use of the vocabulary of ethics, integration of ideas from the readings and an overall sound conclusion to the problem. Please back up your assertions with references to the literature. Have fun!

During delivery of the course, the instructor stressed that grades would be affected by how well the student integrated the concepts learned during the sessions into their answers; therefore, many students used various technical terminologies in describing their ethics cases. Students used a case of their choice from Shamoo and Resnik (2003) to complete the exercise.

Results: Creative Writing Techniques in Action Students Examine Setting Some cases in the book did not necessarily describe the setting very well, but as we can see in the following examples, students used their creative writing freedom to further describe the setting based on the cues provided in the short cases: Student 1, Case 1: Setting The present conflict is taking place in a research setting probably at a University level institution. It involves the relationship between a post-doctoral fellow/principal investigator (PI) and her mentor. They had been working on a major project, designed

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by the mentor and utilizing the resources of his lab. Also, for her participation the post-doctoral fellow is receiving a salary that the mentor is providing through one of his other grant sources. In an environment like this several factors can sway the investigators toward unethical practices. Pressure to produce fast results would tempt the PI to falsify and cook data; lack of direct supervision can result in improper upkeep of the laboratory note book; personal and professional conflicts between the PI and the mentor can precipitate retaliatory actions; while mentor s overindulgence and stifling attitude can hinder productivity and PIs professional development. The following student did an excellent job integrating and applying the historical theories and relating them to current theories on deviant behavior: Student 2, Case 1: Setting The above incident took place in a university. In a university atmosphere there are some factors that can promote integrity and other factors that can foster misconduct. From the theories proposed by Robert K. Merton and Emile Durkheim the values and norms pertaining to the conduct of science ordinarily become internalized during the period of education and are reinforced later with a system of social control that includes both rewards and sanctions. Deviant behavior is likely to occur when values break down and an individuals aspirations and goals come into conflict with societys structure and controls. (Shamoo and Resnick page 104 2nd paragraph). The institution where the graduate student trained may have failed to instill appropriate values in the student during its training process. This could also be a result of the personal flaws of the graduate student- lack of morals. The institution could have contributed to this situation by providing inadequate training in research methodology, lacking adequate supervision of the graduate students work by his mentor and lack of accountability for the students behavior. The answers from students were not always copious, introspective or regularly integrated with ideas directly from the literature, but the common theme in describing the setting pointed to internal pressures to produce and achieve. As a matter of retrospect, it seems the readings and online discussions about the institutional environment (or setting) had an impact on the students thinking about setting in general: Student 3, Case 1: Setting The student was conducting this study in order to complete his Ph.D. and the findings supported his hypotheses. The student likely felt pressure and strong desire to successfully complete this research project and Ph.D. degree, as well as pressure to complete the project for the funding organization (NIH), and this desire and pressure were likely the motivating factors for fabricating data for the missing subjects. To make the case for creative writing to enhance the case study presentation, and depending on the case study presentation, the student descriptions of setting varied, emphasizing the need for a uniform method of constructing and analyzing cases with similar elements. Sometimes the descriptions of settings were cold and matter-of-fact (student 2s setting was very copious in Case 1): Student 2, Case 2: Setting The setting includes the institution NIH, regulatory body the FDA, the pharmaceutical industry interested in developing and marketing the new drug and the public who will be using the new drug on the market.

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But it is important not to base the final grade on an answer like this. As plot is examined, more elements are examined. All depends on how the original case was written. It is also important to remember that all the elements work together. In other words, a dry setting could still be popping with plotting, conflict and interesting characters. Students Examine Plot Upon examining the full case analysis from the student above, it was apparent that he/she believed the plot was more important than setting in the case, which is an advantage to the creative writing in case study design: Because each element overlaps, an overall story emerges. Please note the students interesting description of the plot: Student 2, Case 2: Plot The researcher who is interested in promoting the marketing of the new drug is the main character driving the plot. His motivation for this act lies in the financial gain that he is expecting to receive from the drug company manufacturing the drug. After the drug is approved for public use, the drug company, clearly advancing his career, promoted the researcher as the director of diabetic studies. The FDA selected this particular researcher to be on the advisory board in spite of the disclosure of his position as a consultant for the drug company. The potential for a conflict of interest exists in this case which was not critically appraised by the FDA. The plot is against the welfare of the public that will be using the drug who are at risk of experiencing the serious side effects listed by other researchers. When using creative writing techniques to explore a case, the case has to account for all the elements of the story to be complete. Following the same rubric for student responses above, plot is examined in the following paragraphs. Please refer back to the Setting as needed based on the code for students. As mentioned earlier, using creative writing techniques allows for different areas of critical thinking and explanation. The following plot descriptions illustrate interesting insights into the students thought processes about the overall case: Student 1, Case 1: Plot The main characters in the plot are working toward successful completion of a research project that can presumably score a major grant and publication in a reputable journal. More so, completion of fellowship training and gainful employment as a tenured faculty for the PI and additional honors and possible promotion for the mentor hinges on the successful completion of the project. Since the outcome of this endeavor affects both the PI and the mentor, presumably both are participating for its success but in different capacities. However, when a conflict forces the PI to seek employment elsewhere the motives change drastically. Now the PI could care less for her mentor and is more concerned about her well-being. Similarly perhaps the mentor also feels betrayed after seeing his invested resources and time go to waste. In the following example, it was a pleasant surprise to find the attempt to integrate basic normative ethical theories in a plot: Student 2, Case 1: Plot The graduate student has a motive to complete his thesis in a limited amount of time which is required for him to graduate and obtain his Ph.D. He wants to promote his

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career by graduating and getting a job. In this context, he made an effort to recruit the necessary sample size but failed. Applying the deontological theory which insists that how people accomplish their goals is usually more important than what people accomplish. (wikepedia.org, deontological ethics, paragraph 1) the student has not fulfilled his moral obligation to act the right way (sic) irrespective of the end he is trying to accomplish. His plot is to fabricate data to promote his academic career. The social worker involved with him, though has not contributed directly to the fabrication of data, was aware of the students misconduct, but has not brought the issue to the attention of appropriate authority for her personal gain. This makes her an accomplice in an act of misconduct. Still other students, depending on the case, were more direct about the plot in order to describe other elements of the case which perhaps seemed more important to the overall solution: Student 3, Case 1: Plot The scientific misconduct, fabricating and falsifying data, was in fact intentional and premeditated in this case. The student needed additional subjects but could not attain them, and therefore made up the additional subjects. (See students description of the setting above). Again, the packaged cases used in the class had varying information. Student 3 integrated historical-normative behavioral concepts in the plot description for his/her chosen case 2, which involves a problem with an animal activist group requesting information about his study: Student 3, Case 2: Plot Dr. Gribnick is faced with the decision to provide or not provide the requested information to a potentially threatening party. Refusing to provide this information would be illegal since the Freedom of Information Act requires him to do so because his research is funded by NIH. Refusing to provide the information also constitutes a breach of ethics, since the scientific norm of communism requires researchers to share data with colleagues and the public. As a government funded researcher, Dr. Gribnick has a responsibility to the public. Dr. Gribnick is concerned, and reasonably so, about the potential negative consequences of providing the data. The animal rights group poses a potential threat to his work and his lab. Another advantage of framing a case analysis with creative writing techniques is that it is difficult to talk about plot without also talking about character (as in student 3, case 2: plot above). Character is examined next with some interesting student responses. Students Examine Character At this point it should be noticeable that all the elements of a story work together. The following examples illustrated how conflict and character work together, and how it is difficult to talk about one without the other. This is acceptable. In the first example, student 1 does a good job of trying to integrate normative ethical theories into an interesting description of character: Student 1, Case 1: Character It is only after the conflict erupts that the essential elements of the PI and mentor s respective characters come to light. By taking all the three laboratory notebooks

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without mentors permission with her, the PI can be considered to have acted in a consequentialist manner and not worry about the deontologic or the virtue ethics of research. The PI may have started off as a virtuous person but the suffocating environment and hindrance in her professional development forced a consequentialist approach. The mentor, though virtuous, may not realize that his attitude is unbearable. However, by insisting on having the lab notebooks returned, he is exercising a deontologic approach, as that action of the PI was morally wrong. This transformation of character also results in another ethically unjust action by the PI, namely not including the mentor as an author in her publication of the project two years later. So, the main characters are driving the plot in antagonistic directions; the PI in a consequentialist and the mentor in a deontologic, each in turn serving the individuals current needs. It is interesting that both student 2 and student 3 also considered and integrated ethical theory in some interesting discussions of character: Student 2, Case 1: Character Virtue ethics focuses on what makes a good person, rather than what makes a good action. (Wikipedia Virtue ethics, paragraph 1). The student in this act failed to demonstrate integrity and strength of character. Since data from the 44 subjects was adequate to draw conclusions he could have discussed the issue of inability to recruit the remaining subjects, with his mentor. In performing an act such as fabrication, he is not showing virtuousness. Instead it is lack of honesty and integrity. The social worker being aware of the students acts could have been a whistleblower sooner, but remained quiet until their relationship went sour which indicates her selfishness and lack of virtue. Student 3, Case 1: Character This students point of view was likely one of consequentialism. Since the conclusions from the statistical data were basically the same whether he used 50 or 44 subjects, (p. 113) he believed that no negative consequences would be produced by fabricating the additional subjects, i.e., the findings of the study were not altered. Further, he thought that this action would produce the positive consequences of allowing him to complete his Ph.D., as well as satisfying NIH and therefore favorably impacting the possibilities for funding in the future Conflict Upon examination of the other answers, students chose to examine normative ethics in their descriptions of character almost all the time. This was an interesting discovery where abstract concepts are applied to simulations just by using the basics of character in a story. As the discussion moves toward discussion of conflict and conclusions, student examples continue to show the integration of all the elements of the case with other abstract concepts, theories and behaviors. Conflict is examined in the following paragraphs. Student 1 expounds on his/her entire case when discussing conflict and how this conflict drove the entire case from start to finish. Although some of the answers may seem repetitive, the exercise appears to cause retrospective review of the other elements in order to analyze conflict: Student, 1, Case 1: Conflict The primary conflict appears to be that of principles. At first glance it appears that the mentor initiated the conflict but a careful dissection of the facts reveals that his

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intentions remain virtuous even after the PI leaves to start a new job. He is angry not at the PI leaving his lab after he invested time, money and resources in her, but because she has taken the lab notebooks that are truly the labs property and that amounts to theft. Even at this inflammatory state of affairs, he is willing for her to keep copies of the lab notebooks, something that she should have done in the first place. The PI makes the first ethically questionable action by taking all 3 original lab notebooks with her. To some extent this appears to have happened knowingly as the PI might consider the work as her property and that she has a right to benefit from it in a different context. Had she pursued the right way, the entire conflict might have been avoided. Then again the conflict would have ceased upon her returning the originals but she propagates the conflict further by not including the mentor as an author in a publication based on her work at his lab. So, it can be deduced that the PI is knowingly driving the conflict by her disregard for the rule in the first instance and attempt at retaliation in the latter instance, both ethically unjust actions. It also appears that the PI lost the opportunity to prevent the conflict and mend bridges when she knowingly denied him due credit for his contribution in her publication. It is interesting to note how student 2 asks a question and reflects on character and setting in describing conflict: Student 2, Case 1: Conflict The primary conflict in this situation is should the student fabricate data that he was unable to obtain? Should the social worker be reporting this case now, long time after the student obtained his Ph.D.? Both the student and the social worker knowingly caused the conflicts. Their individual characters and ulterior motives seem to have largely contributed to the conflicts. The presence of a mentor or supervisor who has the responsibility to supervise and guide the students actions could have prevented this. The university is responsible in the sense that it has failed to detect an act such as this, either due to lack of adequate staff or lack of stringent supervision and documentation of research work. Student 3 continues the integration of normative ethical concepts in analyzing the conflict and working toward the solution. Student 3, Case 1: Conflict The students need and desire were to complete this research project. The student was unable to obtain the required number of subjects, therefore making it impossible for him to complete the project and preventing him from obtaining the Ph.D. degree. This was unacceptable given the strong desire and pressure the student felt. Given the students consequentialist point of view and the fact that adding the fabricated subjects would not only allow completion of the project and obtaining the degree, but also would not altar the data, he decided to proceed with this action. At this point of the analysis, it seems the students have done all they can do to break down the elements of the pre-packaged cases from the textbook. It is time to draw a conclusion and create other characters, settings, committees or acts. Students Examine Conclusions Like the examination of conflict, students become very retrospective and creative in developing solutions. Student 1 has an interesting solution to his problem and engages in a

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form of benchmarking, finding a policy that might be relevant to the case. Professionals in the field do this kind of thing all the time. Note the students final few sentences: Student 1, Case 1: Conclusion Perhaps a small committee comprising of the mentor s peers, including the division director, could have intervened in the initial stages before the discontentment propagated into a conflict. The PI would have had an opportunity to air her concerns and some compromise could have been reached possibly by setting guidelines or consulting preset protocols. Though the mentor is under no obligation to follow this route, can terminate her employment as he is providing the salary, but he could have also benefited in terms of his investment from such an intervention. If a conflict arises between a junior scientist and a senior scientist, experts recommend that the disagreement should first be addressed within the group of authors and the project leader. Should that not lead to a satisfactory solution; the junior scientist can seek guidance from other members of the department, student organizations, representatives in an office of postdoctoral affairs, or the ombudsperson at the institution. (Columbia Universitys policy on authorship and peer review: http://www.ccnmtl. columbia.edu/projects/rcr/rcr_authorship/foundation/index.html). When the PI moved to a new lab, the lab director or the new mentor should have been cognizant of the fact that a conflict is inevitable given the lab notebooks status. The latter could have guided the PI to return the originals and ask permission to obtain copies from her previous employer. Conversely, the new mentor could have denied continuation of her work along the same lines in the new lab, an action that would not have prevented the conflict but surely would have contained it. Then again at the time of submitting her manuscript, the co-authors or the new mentor should have raised the issue of proper authorship. From a virtue ethics stand point this action was necessitated, and even a deontologic point of view would have helped prevent the conflict. In short, even good- natured and well meaning people could, under stressful circumstances, revert to ethically questionable practices leading inevitably to conflict and potential for great harm to self and others. Rational thinking can obviate such actions in the first place and provide avenues to contain and minimize the damage. Student 2 delves into the textbook and the literature to justify his/her conclusions. Student 2, Case 1: Conclusion To tackle the present situation the university can appoint a committee consisting of independent researchers with no conflicts of interest. It should make sure that the complaint made by the social worker is in fact true before proceeding with further action. After the due process of investigation, the student should be provided with an opportunity to appeal the decision of the committee. The purpose of the investigation should be to test if the student has been guilty and take appropriate actions if the case of scientific misconduct is proven. It is essential that the institution conducts an investigation to promote accountability and integrity in the conduct of research. As a general measure, the university can incorporate empirical research and professional education in its curriculum. It can assign committees to investigate issues of scientific misconduct, ensure that the investigations take place in a timely and efficient manner. Role modeling also plays a key role in ethics education: beginning scientists learn about ethics and integrity in research by following the examples set by their teachers, advisors, mentors, and peers(Shamoo and Resnick, page 110, paragraph 2).Research

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institutions, such as universities, have ethical and legal obligations and policies that can either foster or hinder integrity in research (Shamoo and Dunigan 2000) (Shamoo and Resnick, page 21 paragraph 3). Sometimes the solution is not always obvious, but the exercise encourages retrospective thought about bigger picture concerns such as culture, climate and environment: Student 3, Case 1: Conclusion Given the definition of scientific misconduct, which includes fabrication and falsification of data, this student is in fact guilty of misconduct. Since the decision to fabricate and falsify the data was likely due to the student feeling pressure and a strong desire to complete the project, its possible that addressing this issue would have prevented the decision the student made. The institutional culture in many universities places a high value on advancement, accomplishment, achievement, acquiring doctoral level degrees, and publishing research findings. In the long term, shifting the focus to place more value on completing a research project properly rather than obtaining a degree, being published, or being awarded tenure would prevent these kinds of actions. In the short term, if the student felt comfortable seeking his mentor s advice and the mentor advised the student to simply postpone completion of the project until the additional subjects could be obtained and the project could be completed properly and honestly, perhaps this would have prevented the decision to fabricate and falsify data.

Enhancing the Case Study Narrative After examining student responses, it seems that some uniformity would enhance the overall process. It might be beneficial for case designers to use the techniques to create the case studies used in the classroom. When constructing case studies it might be a good idea to describe settings to better enhance our overall decision making repertoire for the case. Our settings are almost always organizational settings with different people, goals, coalitions and cultures. The exercise is reflexive for both student and teacher. Perhaps the best place to get ideas for the setting would be from Bolman and Deals (2003) four frames model of organizations which describes the structural, human resource, political and symbolic frames of reference for leaders. Bolman and Deal note that the structural frame involves rules, regulations, and lines of authority and assumes that goals are explicit and well defined. Rules are also a source for deontological thinking in ethics. If someone breaks a rule, they are reprimanded. In reality, we know that organizations do not work this way every day; that is why Bolman and Deal indicate that the structural frame of organizations is balanced by the human resource frame which dictates that human beings in organizations are treated as vital resources and are motivated to work because the organization treats them well. Likewise, this frame is balanced by the political frame which dictates that organizations are sets of coalitions, each trying to achieve a goal and battle over resources both monetary and human. The political arena might indeed be grounds for considering the nature of consequentiality and human virtue contained in ethical dilemmas. Finally, we might be compelled by the fact that Bolman and Deals symbolic frame is where people in organizations find symbols, rituals and myths around which they derive meaning in their work. Perhaps there are some myths or histories in an organizational

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setting that keep people from making appropriate ethical decisions. A case study charged with symbolic narrative might help derive creative solutions to problems. To avoid writing a novel, it might be a good idea to learn how to inject quick plot points such as an aside concerning motivation, conditions surrounding employment, conditions surrounding funding or grants. Describe specific policies or rules that might actually be overly burdensome to investigators and scientists. In the end, the overall case study approach would be enhanced with these techniques. I am not suggesting that you go back and rewrite all your cases when a paragraph will do, but if that paragraph can have a little more impact, consider using some of these elements to increase creativity and encourage creative solutions. Overall, case study methods should be enhanced by considering these techniques.

Case Study Scrub Checklist 1. Is your setting clearly described with policies, procedures, hierarchies and atmosphere? What is the culture or climate? 2. Is there a clear plot? Enhance the plot with background information. Is someone intentionally trying to break the rules or is it not so clear? 3. Are the characters realistic? Enhance characters with markers such as quick histories, past conflicts, personalities, etc. 4. Is the conflict believable and does it invite solution?

References
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