Abstract
Objectives: With rapid advancements in medical care, nurses are confronted with ethical issues on a daily basis. If new nurses are introduced to the clinical setting without having acquired sufficient ethical judgment skills in basic nursing education, they are unable to respond to the ethical dilemmas they face. This results in learned helplessness, which can lead to burnout and turnover. Therefore, it is imperative to develop educational programs where there is a natural progression from basic to continuing nursing. Therefore, in this study, we conducted a nationwide survey using the Nursing Student Care Ethical Competence Scale to present a benchmark for the assessment of this skill and facilitate continuity in nursing education. Methods: From February to March 2019, we conducted a questionnaire survey of 4930 final-year nursing students enrolled in nursing colleges, junior colleges, and technical schools nationwide. The survey consisted of 29 items on ethical behavior, 26 items on ethics knowledge, and seven items on personal attributes. For the analysis, we calculated percentiles for the five standards of nursing students’ ethical care competence: safe care provision, respecting self-determination, protecting personal information, providing the best care, and upholding patients’ dignity. Results: Responses were obtained from 1505 nursing students (collection rate 30.5%, valid response rate 30.5%). The 80th percentile (minimum value-maximum value) was 128 (38 - 145) points for the ethical competence of nursing students, 37 (11 - 40) points for safe care provision, 28 (4 - 31) points for respect for self-determination, 23 (5 - 25) points for protection of personal information, 23 (5 - 25) points for best care provision, and 13 (3 - 15) points for respect for personal dignity. Discussion: The 80th percentile was established as the benchmark for ethical care competence. Conclusion: Based on these criteria, nursing students can objectively assess their ethical behavior, allowing them to understand their strengths and weaknesses, articulate their challenges, and learn autonomously.
Highlights
With advancements in medical care and the development of comprehensive community care systems, there has been an inevitable increase in the complexity of medical situations
From February to March 2019, we conducted a questionnaire survey of 4930 final-year nursing students enrolled in nursing colleges, junior colleges, and technical schools nationwide
The participants were 177 (11.8%) nursing students enrolled in nursing colleges and junior colleges, and 1328 (88.2%) nursing students enrolled in vocational schools
Summary
With advancements in medical care and the development of comprehensive community care systems, there has been an inevitable increase in the complexity of medical situations. In the context of ethics, “Basic Nursing Practice Core Abilities and Achievement at Graduation” presents five core competencies [2]. In this group of skills, “Ability to defend the dignity and rights of people to be nursing” and “Ability to explain the necessary nursing care and obtain consent” regarding continuing nursing education for new nurses, as per the “Nursing Staff Training Guidelines,” it is imperative to defend the human rights of patients, act based on ethics, obtain consent, and ensure confidentiality and privacy [3]. According to the Japan Nursing Association [4], it is necessary to develop a clinical ladder to establish indicators of nursing practice skills that are common to all nurses, and demonstrate the actual as well as desired positions of individual nurses with regard to practical skills [4]
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