Professional codes of ethics are regarded as elements of nurses' ethical knowledge base and consequently part of their ethics education. However, research focusing on these codes from an educational viewpoint is scarce. This study explored the need and applicability of nursing codes of ethics in modern health care, their importance in the nursing ethics curriculum, and the need for development of their teaching. A total of 183 Finnish nurse educators and 212 nursing students answered three structured questions, with an opportunity (...) to justify their responses, and one open-ended question. Descriptive statistics and content analysis were used to analyse the data. The results suggest that the existence of the codes was seen as important and their applicability mainly as appropriate, despite new challenges posed by modern health care. The codes were regarded as an important part of nurses' ethics education, but current integrated teaching methods require development. (shrink)

Nurses are encountering an increasing number of ethical dilemmas in clinical practice. Ethics courses for baccalaureate nursing students provide the opportunity for the development of critical thinking skills in order to deal with these effectively. The purpose of this descriptive qualitative study was to describe ethical reasoning in 70 baccalaureate nursing students enrolled in a nursing ethics course. Reflective clinical journals were analyzed as appropriate for qualitative inquiry. The overriding theme emerging from the data was `in the process of becoming', (...) which includes: practicing as a professional, lacking the confidence as a student nurse to take an ethical stand, advocating for patients, being just in the provision of care, identifying the spiritual dimensions of nursing practice, confronting the `real world' of health care, making a commitment to practice with integrity, and caring enough to care. The development of critical thinking and ethical reasoning within the framework of knowing and connecting is essential in nursing education. (shrink)

Professional codes of ethics are regarded as elements of nurses' ethical knowledge base and consequently part of their ethics education. However, research focusing on these codes from an educational viewpoint is scarce. This study explored the need and applicability of nursing codes of ethics in modern health care, their importance in the nursing ethics curriculum, and the need for development of their teaching. A total of 183 Finnish nurse educators and 212 nursing students answered three structured questions, with an opportunity (...) to justify their responses, and one open-ended question. Descriptive statistics and content analysis were used to analyse the data. The results suggest that the existence of the codes was seen as important and their applicability mainly as appropriate, despite new challenges posed by modern health care. The codes were regarded as an important part of nurses' ethics education, but current integrated teaching methods require development. (shrink)

Aims: To review the literature on perceptions of nursing students and/or educators on the contribution of ethics education to ethical competence in nursing students. Background: Nurses do not always demonstrate the competencies necessary to engage in ethical practice. Educators continue to debate about the best ways to teach ethics to nurses so that they can develop ethical competencies. Data sources: MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science. Review methods: A total of 15 articles with a quantitative, qualitative, or mixed-methods (...) design published between January 1992 and March 2012 were analyzed. Results: According to students and educators, ethics education increases ethical perception of nursing students and the development of reflective and analytical skills. However, its contribution to the development of ethical behavior was barely mentioned. The accounts of students and educators revealed essential features of effective ethics education: active involvement of students in case study discussions and use of ethical frameworks. The use of activating educational strategies requires a safe learning environment where students can openly reflect on values at stake in their care practice. Conclusion: A better understanding of how students learn to develop ethical skills and of influencing factors can guide educators to develop ethics courses for nursing curriculum. Future research needs to focus on the methodological accuracy of sampling and measuring instruments. (shrink)

To effectively train ethical decision-making of nursing students, a case-based computer program was developed using Flash animation. Seven ethical cases collected from practicing registered nurses’ actual clinical experiences and a six-step Integrated Ethical Decision-Making Model developed by the author were employed in the program. In total, 251 undergraduate students from three nursing schools used the program in their nursing ethics course. The usability of the program and its usefulness in improving 11 abilities needed in ethical decision-making were measured; it scored (...) higher than 4 on a 5-point scale. Of the students, 82% recommended the program as a valuable complementary tool in the teaching of a nursing ethics course. A variety of encouraging and positive experiences were reported by the students. The computer program is likely to be usefully practical in the training of abstract skills to nursing students, though certain challenges remain, such as the precise understanding of cognitive or affective responses to ethical issues. (shrink)

Introduction Ethical climate in medical contexts is referred to the organizational environment consisting of medical staff interpersonal relationships regarding patient care. This element affects staff behavior in an organization. The investigation and comparison of the effects of the interventions promoting ethical climate are among important nursing challenges that should be considered by researchers. The present study was conducted to compare the effect of nurses’ ethical decision-making skills and interpersonal communication training on their ethical climate. Materials and methods This experimental study (...) was performed on 90 nurses working in the general teaching hospitals of Mashhad, Iran. The sampling process was conducted in two stages. Nurses were divided into three groups: intervention 1 (ethical decision-making skills group), intervention 2 (interpersonal communication skills group) and control group. The intervention was separate 12-h workshops for each of the intervention groups. The ethical climate questionnaire by Victor and Cullen was used to assess the score of ethical climate in the three groups both at the beginning and 4 weeks after the workshop. The data were analyzed in Statistical Package for Social Sciences software (version 16) using descriptive statistics, analysis of variance, Kruskal–Wallis, paired sample t-test, Wilcoxon test, and post hoc Tukey’s test. Ethical considerations were as follows: The study design was approved by the Research Ethics Committee of Mashhad University of Medical Sciences. Informed consent was obtained from all subjects, and they were ensured about the confidentiality terms. Results The mean scores of the ethical climate test at the first stage were obtained as 66.0 ± 5.5, 67.8 ± 6.9, and 67.7 ± 7.2 in the ethical decision-making, interpersonal communication, and control groups, respectively. Accordingly, the three groups were not significantly different in terms of this variable (df = 87, f = 0.70, P = 0.005). However, after the intervention (i.e. second stage), a significant difference was observed among the three groups regarding the mean scores of the ethical climate test In this regard, the calculated mean scores in the ethical decision-making, interpersonal communication, and control groups were 99.3 ± 6.3, 90.4 ± 7.7, and 67.4 ± 7.9, respectively (df = 87, f = 152.00, P < 0.001). Conclusion Training workshops about ethical decision-making skills and interpersonal communication on the ethical professional climate of nurses was effective. Nonetheless, the effect of ethical decision-making skill training was found to be higher than interpersonal communication skill training. Therefore, it is recommended that nursing managers hold training workshops to improve the ethical climate for nurses. (shrink)

BackgroundEthical decision-making of nurses could affect patients’ recovery and also decrease medical costs. To make ethical decisions, ICU nurses experience complicated ethical conflicts. Considering the multi-dimensional process of ethical decision-making, the present study was conducted to describe the experiences of ICU nurses regarding ethical decision making.MethodThe present research is a qualitative study with conventional content analysis approach that was done in 2020. Fourteen ICU nurses were interviewed using a semi-structured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed (...) using Granheim and Landman approach.ResultsBeing torn by inevitable moral dilemma was defined as the main category which contained the categories of conflict with professional self, feeling squeezed between self-authority and demands of others, and Surrounded by organizational limitations.ConclusionsResults of the present study showed that moral dilemma is a situation in which the nurses are forced to choose between two options based on their equipment and facilities. In these situations, the nurses would hesitate between their internal conflicts and confusion between choosing their own benefits and patients’ benefits. To prevent ethical challenges in decision making, it is necessary to educate healthcare team about ethical dilemmas and empower the personnel for encountering ethical challenges. (shrink)

In the UK, higher education and health care providers share responsibility for educating the workforce. The challenges facing health practice also face health education and as educators we are implicated, by the way we design curricula and through students’ experiences and their stories.

The vast majority of research in nursing ethics over the last decade indicates that nurses may not be fully prepared to ‘deliver the good(s)’ for their patients, or to contribute appropriately in the wider current health care climate. When suitable research projects were evaluated for this article, one key question emerged: if nurses are educationally better prepared than ever before to exercise their ethical decision-making skills, why does research still indicate that the expected practice-based improvements remain elusive? Hence, a number (...) of ideas gleaned from recent research about the current nature of nursing ethics, and especially teaching nursing ethics to student nurses, are analysed and critiqued in this article, which concludes with a cluster of ideas and conclusions based on that analysis. It is hoped that such a review may serve as a catalyst for nurse educators to re-examine their teaching practices with a view to enhancing good (i.e. ethical) nursing practice through educational means. (shrink)

Background: Moral sensitivity is a life-long cognitive ability. It is expected that nurses who work in a professional purpose at “curing human beings” should have a highly developed moral sensitivity. The general opinion is that ethics education plays a significant role in this sense to enhance the moral sensitivity in terms of nurses’ professional behaviors and distinguish ethical violations. Aim: This study was conducted as intervention research for the purpose of determining the effect of the ethics training on fourth-year students (...) of the nursing department recognizing ethical violations experienced in the hospital and developing ethical sensitivity. Methods: The study was conducted with 50 students, with 25 students each in the experiment and control groups. Students in the experiment group were provided ethics training and consultancy services. The data were collected through the data collection form, which consists of questions on the socio-demographic characteristics and ethical sensitivity of the students, Moral Sensitivity Questionnaire, and the observation form on ethical principle violations/protection in the clinic environment. The data were digitized on the computer with the SPSS for Windows 13.0 program. The data were evaluated utilizing number, percentile calculation, paired samples t-test, Wilcoxon test, and the McNemar test. Results: The total Moral Sensitivity Questionnaire pre-test score averages of students in the experiment group were determined to be 93.88 ± 13.57, and their total post-test score averages were determined to be 89.24 ± 15.90. The total pre-test score averages of students in the control group were determined to be 91.48 ± 17.59, and their total post-test score averages were determined to be 97.72 ± 19.91. In the study, it was determined that the post-training ethical sensitivity of students in the experiment group increased; however, this was statistically not significant. Furthermore, it was determined that the number of ethical principle protection/violation observations and correct examples provided by students in the experiment group were higher than the control group and the difference was statistically significant. Ethical considerations: Written permission and ethical approval were obtained from the university where the study was conducted. Written consent was received from students accepting to participate in the study. Conclusion: As a result, ethics education given to students enables them to distinguish ethical violations in a hospital and make a proper observation in this issue. (shrink)

This descriptive study investigated the current status of ethics instruction in Turkish nursing education programs. The sample for this study comprised 39 nursing schools, which represented 51% of all nursing schools in Turkey. Data were collected through a postal questionnaire. The results revealed that 18 of these nursing schools incorporated an ethics course into undergraduate and three into graduate level programs. Most of the educators focused on the basic concepts of ethics, deontological theory, ethical principles, ethical problems in health care, (...) patient rights and codes of ethics for nurses. More than half of the educators believed that students' theoretical knowledge of ethics is applied to their clinical experiences. The teaching methods used included discussion in class, lectures, case studies, small group discussion, dramatization and demonstration. Assessment was carried out by means of written essays and written examinations. (shrink)

Background: The advances in science and technology increasingly lead to the appearance of ethical issues and to the complexity of care. Therefore, it is important to define the ethics position of students studying in health departments so that high quality patient care can be achieved. Objectives: The aim of this study was to examine the ethics position of the students at Shool of Health of an University in western Turkey. Methods: The study design was descriptive and cross-sectional. The study population (...) included 540 first, second, third, and fourth year students from the Departments of Nursing, Midwifery, and Rescue and Disaster Management in the 2013–2014 academic year. Data were collected with a Personal Identification Form and The Ethics Position Questionnaire. Obtained data were analyzed with Chi-square test, Confirmatory Factor Analysis, and Nested Analysis of Variance. Ethical considerations: Before conducting the research, approval was obtained from Ege University Clinical Research Ethics Committee in İzmir and written informed consent was taken from all the participants. Findings: There was no significant difference in the mean scores for the Ethics Position Questionnaire between the students in terms of years and fields of study. Although the mean scores for the subscale idealism did not differ between fields of study, the mean scores significantly differed between years of study. However, the mean scores for the subscale relativism did not differ in terms of years and fields of study. Discussion: Whether students are idealistic or relativistic in terms of ethical judgment will be effective in ethical decision-making skills during patient care. Therefore, we need to define the factors that influence students’ ethics position in the future. Conclusion: It is suggested that the courses and practices that teach students to be aware of their ethics position to create an ethical outlook can be placed in the curriculum in health schools. (shrink)

Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional (...) nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg’s Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p < 0.05) was found between nursing students’ professional nursing values and levels of self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses. (shrink)

Background: The effectiveness of ethics education continues to be disputed. No studies exist on how nursing students perceive the effectiveness of nursing ethics education in Flanders, Belgium. Objectives: To develop a valid and reliable instrument, named the ‘Students’ Perceived Effectiveness of Ethics Education Scale’ (SPEEES), to measure students’ perceptions of the effectiveness of ethics education, and to conduct a pilot study in Flemish nursing students to investigate the perceived efficacy of nursing ethics education in Flanders. Research design: Content validity, comprehensibility (...) and usability of the SPEEES were assessed. Reliability was assessed by means of a quantitative descriptive non-experimental pilot study. Participants and research context: 86 third-year baccalaureate nursing students of two purposefully selected university colleges answered the SPEEES. Ethical considerations: Formal approval was given by the ethics committee. Informed consent was obtained and anonymity was ensured for both colleges and their participating students. Findings: The scale content validity index/Ave scores for the subscales were 1.00, 1.00 and 0.86. The comprehensibility and user-friendliness were favourable. Cronbach’s alpha was 0.94 for general effectiveness, 0.89 for teaching methods and 0.85 for ethical content. Students perceived ‘case study’, ‘lecture’ and ‘instructional dialogue’ to be effective teaching methods and ‘general ethical concepts’ to contain effective content. ‘Reflecting critically on their own values’ was mentioned as the only ethical competence that, was promoted by the ethics courses. The study revealed rather large differences between both schools in students’ perceptions of the contribution of ethics education to other ethical competences. Discussion and conclusion: The study revealed that according to the students, ethics courses failed to meet some basic objectives of ethics education. Although the SPEEES proved to be a valid and reliable measure, the pilot study suggests that there is still space for improvement and a need for larger scale research. Additional insights will enable educators to improve current nursing ethics education. (shrink)

This descriptive study was conducted to determine nursing students’ observation of ethical problems encountered in their clinical practice. Data were collected through a questionnaire from 153 volunteer nursing students at a university-based nursing school in Ankara, Turkey. The students reported that some patients are either physically or psychologically mistreated by doctors and nurses; they were not given appropriate information; they were subjected to discrimination according to their socio-economic situation; and their privacy was ignored. The findings reveal that nurses’ own unethical (...) behaviors contribute to a rise in ethical problems. It is argued that nurses should internalize their professional and ethical roles in order to provide safe and ethical care and be good role models for students. (shrink)

This longitudinal study examined the development of moral judgement in 37 nursing students attending a university in Suwon, Korea. The participants completed the Korean version of the Defining Issues Test to allow analysis of their level of moral judgement. The development of moral judgement was quantified using ‘the moral development score’ at each stage (i.e. the six stages detailed by Kohlberg) and the ‘P(%) score’ (a measure of the overall moral judgement level). The results were as follows: (1) the moral (...) development score for stage 5A was consistently the highest across the four years of the students’ course, showing significant differences in some sociodemographic factors including home, birth order and monthly income; and (2) the P(%) score was higher in fourth-year (47.47 ± 11.21) than in first-year (46.13±9.73) students. There was no significant difference in the P(%) score according to sociodemographic factors. Further studies will examine in detail the correlation between curriculum and moral judgement development. We suggest that courses in ethics education should be made more relevant. (shrink)

This study describes the level of moral sensitivity among nursing students enrolled in a traditional baccalaureate nursing program and a master’s nursing program. Survey responses to the Modified Moral Sensitivity Questionnaire for Student Nurses from 250 junior, senior, and graduate students from one nursing school were analyzed. It was not possible to draw conclusions based on the tool. Moral category analysis showed students ranked the category structuring moral meaning highest and interpersonal orientation second. The moral issue ranking highest was honesty, (...) respect for the patient second, and third was responsibility to know the patient’s situation. Seniors agreed more often about the need to focus on patient safety. As students progress through the baccalaureate program and into the graduate program, their perspectives increasingly recognize the contextuality of moral issues. The results show a need to further develop a tool to measure moral sensitivity, using student understanding and perceptions of moral issues. (shrink)

The aim of this study is to examine the current profile of bioethics education in the nursing curriculum as perceived by nursing students and faculty in Korea. A convenience sampling method was used for recruiting 1223 undergraduate nursing students and 140 nursing faculty in Korea. Experience of Bioethics Education, Quality of Bioethics Education, and Demand for Bioethics Education Scales were developed. The Experience of Bioethics Education Scale showed that the nursing curriculum in Korea does not provide adequate bioethics education. The (...) Quality of Bioethics Education Scale revealed that the topics of human nature and human rights were relatively well taught compared to other topics. The Demand for Bioethics Education Scale determined that the majority of the participants believed that bioethics education should be a major requirement in the nursing curriculum. The findings of this study suggest that bioethics should be systemically incorporated into nursing courses, clinical practice during the program, and during continuing education. (shrink)