The best results obtained in the PIIT classes have been when the technique has been used in tutorial groups, rather than have students submit individual reflections on particular cases. Individual reflection yields significant results and students have voiced their delight at being able to work through difficult situations using this technique, but even so, further insights and better solutions are derived when it is used in a group situation. Solving scenarios collaboratively also adds credibility to the process, in that much of the professional development takes place in multidisciplinary teams. And that creates new a problem - which ethical standard should one adopt? In multidisciplinary teams, professionals often belong to different professional societies, each with similar, but not identical, codes of ethics. In a student context this leads to interesting discussions, in a professional setting it may lead to conflicting standards that are difficult to resolve.

Another limitation is objectivity. One advantage of thinking through cases, such as those below, before being confronted with real situations, is that it becomes easier to be objective. When confronted with an ethical dilemma in real life, subjectivity can prevent one from being able to make the most appropriate judgments. This is where reference to one's peers, co-workers or members of one's professional society can be helpful. Such people can use this technique to work objectively through the issues and advise the person in the situation of the most appropriate course of action