Ethical Decision-making Skills Research Articles

Interventions to improve ethical decision-making skills in nursing students: A systematic review.

Interventions to improve ethical decision-making are available in nursing education. Evidence of its effectiveness is essential. This review examined the effectiveness of interventions to improve nursing students' ethical decision-making skills. A structured search was performed in Google Scholar, Web of Science, Science Direct, Pubmed, Scopus, Cochrane Library, Elsevier, CINAHL EBSCO, and ULAKBIM. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments (JBI-MAStARI) was used to assess the quality of studies. Ethical approval was not required for this systematic review. The final review was composed of six studies of published between January 2013 and 2023. Nine different teaching methods applied to students. Although the importance of ethical decision-making skills in solving ethical problems that nurses may encounter at any time is known, it is thought that there is a lack of data in the literature in the last 10years. The last 10years were chosen as this aims to provide a review based on the most current, relevant and quality information. The review indicated that all of the teaching methods improved ethical decision-making. Different teaching methods can be used in the nursing education curriculum to meet the learning needs of nursing students in ethical decision-making.

Reframing Implications of Social Presence in Asynchronous Online Learning

The impact of social presence on virtual learning experiences is of increased interest in educational research as teaching and learning transitions from traditional classrooms to online learning environments. Educators need to know more about how to design asynchronous learning experiences that will results in students’ abilities to infer the mental states of others and participate in social conflict monitoring through perceptions of various social cues, as occurs in non-virtual instruction. Findings in the study showed that students’ age and satisfaction with online learning were the two main variables shaping participants’ mental states in online learning environments. Participants who expressed that online learning was sometimes a satisfying experience were more likely to believe that instructors could not resolve social conflicts. Otherwise, participants with some asynchronous learning experience tended to believe that social conflicts could be resolved by instructors teaching ethical decision-making skills and presenting and discussing multiple points of view. The outcomes of this study emphasize how instructors can work toward building social, cognitive, and teaching presence in online learning environments and can inform future social presence research.

CRIMINOGENIC BEHAVIOR WITHIN THE ACADEMIC COMMUNITY

This article explores the application of criminological theories to understand and mitigate academic dishonesty, with a focus on the outsourcing of assignments in higher education. Drawing on strain theory, social learning theory, the General Theory of Crime, neutralization theory, and control theory, we analyze the multifaceted roots of academic dishonesty. These theories shed light on the pressures, environmental influences, and rationalizations that lead students to engage in outsourcing behaviors. By integrating these criminological insights, the article provides a comprehensive framework for educators and academic institutions to develop targeted interventions. Recommendations include addressing academic strain, fostering a positive learning environment, enhancing self-control and ethical decision-making skills, countering rationalizations for dishonesty, strengthening institutional bonds, enforcing clear policies, and judiciously using technology. Ultimately, the article advocates for a holistic approach to promoting academic integrity, aiming to reduce the incidence of outsourcing and cultivate an ethical academic culture.

Using AAERs in Financial Accounting Courses: A Case Study to Integrate Ethical and Technical Competencies

ABSTRACT Using the Securities and Exchange Commission’s Accounting and Auditing Enforcement Releases, this assignment builds critical thinking and ethical decision-making skills in a financial accounting setting. It requires students to analyze a real-world fraud from the perspective of an employee, manager, or executive (a “case participant”) involved in the accounting impropriety. The case features individual and group components that may be customized to fit the instructor’s needs. The individual component examines a case participant’s choices in committing accounting improprieties using an ethical decision-making framework. The group component includes an analysis of the accounting, the fraud triangle, possible preventative measures, and takeaways applicable to students’ future careers. By requiring students to step into the shoes of a case participant, this assignment increases student awareness of deliberate choices leading to financial reporting fraud and equips students with an ethical decision-making framework should they encounter a financial reporting ethical conflict in the workplace.

Developing a Teaching Unit Based on Science, Technology, Society, and the Environment Approach, and Measuring its Effect on Developing Ethical Decision - Making Skills among Sakhnin College Students

The study aimed to uncover the effect of a teaching unit developed in accordance with science, technology, society and the environment approach in developing the ethical decision-making skills of Sakhnin College students. The quasi-experimental methodology was used, where the study sample consisted of (20) female students of a second year from Sakhnin College, who were randomly selected, as they underwent a pre-test on ethical decision-making, and then underwent the same test after they were taught two academic units according to science, technology, society and environment approach. The results of the study showed the existence of an impact of the developed teaching unit based on the approach of science, technology, society and the environment in developing the ethical decision related to the ethical decision-making skills of charity, justice, honesty, sincerity, and privacy, and on the tool as a whole, and it was found that there was an effect of the developed teaching unit based on the approach of science, technology, society and the environment in developing the ethical decision related to ethical principles as a whole, while it was evident that the developed teaching unit based on science, technology, society and the environment has no effect in developing the ethical decision related to the skill of (peace) and the principle of utility.

A dialog on common morality in medical ethics in a pluralist setting in Iran: a qualitative content analysis.

The concept of common morality is fundamental in medical ethics, and lack of universal content and characteristics of common morality is a product of its multifaceted nature. This study aimed to identify the ideas and experiences of academic faculties regarding common morality in a pluralistic setting to promote conceptual knowledge and strengthen moral reasoning and ethical decision-making. The study was conducted using a qualitative method, employing semi-structured in-depth interviews with thirteen faculty members who were selected purposively. In order to assess their ideas and experiences, the transcripts of the interviews were analyzed using the content analysis method through directed and conventional approaches. The interviews were coded manually. Two themes were reflected in the interviews: ontology and epistemology of common morality. The study indicates that the debate about the subjective or objective dependence of common morality questions the coherence of Beauchamp and Childress' common morality (CM) theory, as common morality is the result of various individual and social factor that influence moral and decision -making in pluralistic environments. Additional studies are needed in order to investigate the effect of cultural, social, theoretical, ideological and individual factors on promoting clinical ethical reasoning and decision-making skills.

How to do the right thing

PurposeThis paper aims to make suggestions for addressing the apparent failure of business schools to communicate good ethical decision-making skills to students studying in postsecondary institutions.Design/methodology/approachAt the beginning of university management classes, a form is distributed to students outlining a short scenario that requires a course of action. The two questions asked, based on this decision context, are (i) is it ethical to offer bribes to secure construction contracts in countries where this practice is considered an acceptable way of conducting business and (ii) has the student completed an ethics course at the university?FindingsThe scenario described is what occurred at SNC Lavalin, a Canadian construction company that was charged and convicted with offering illegal inducements to foreign officials (in Libya) to secure large government construction contracts. Ethically, the “right” decision would be to not offer bribes; this is because they are illegal when offered both in the Canada and in foreign jurisdictions. The response results to the survey questionnaire showed that 21% of the students thought that bribery was acceptable, if it was a customary business practice in the country where the transaction occurred, and 93% of these students had taken an ethics course. It was interesting to note that almost all the students, who had not taken a business ethics courses, thought that bribery is not acceptable under the circumstances described.Originality/valueTo address the apparent failure to communicate good ethical decision-making skills, this essay suggests that when teaching business ethics, there should a clearer focus on (i) the distinction between morality and ethics; (ii) the problem posed by relativism; and (iii) the reasoning behind ethical standards. This approach is novel in that it makes sense from the perspective of both a business practitioner and university educator.

LEADERSHIP ETHICS PARADOX: ANALYSIS OF PARADOXES IN ETHICAL LEADERSHIP

The Leadership ethics paradox highlights the challenges faced by leaders in navigating the complexities of ethical decision-making. Leaders must balance their obligations to deliver results for their organizations and be mindful of the moral and ethical implications of their actions. Paradoxes in ethical leadership include paradoxes of power, transparency, loyalty, growth, integrity, risk and many more. To dissolve the paradoxes in ethical leadership, leaders must be proactive in developing their ethical decision-making skills as well as understanding the ethical implications of their decision and actions by thinking critically and creatively and seeking out diverse perspectives and solutions.

Using an avatar-based digital collaboration platform to foster ethical education for university students

When teaching business ethics, teachers often design collaborative learning activities that allow students to practice ethical decision-making skills with their peers. However, conventional asynchronous learning platforms do not provide real-time communication or collaborative learning functions, making it difficult for teachers to provide students with opportunities for continuous reflection on ethical decision-making and meet teaching objectives. The avatars-based digital collaboration platform addresses these limitations. The Gather Town platform allows students to engage in real-time interaction and ethical decision-making training missions with their peers in a virtual learning environment. In this study, 37 students from a local university were recruited for the experimental group and used the Gather Town platform, while 35 students in the control group used a different conventional asynchronous learning platform. Compared to the control group, the experimental group showed significantly higher levels of learning motivation, ethical decision-making, and significantly higher scores on post-tests. Through analysis of student performance and feedback, the authors found that the use of the Gather Town platform for synchronous collaborative learning missions that included peer discussions and continuous revision of mind map worksheets was effective in practicing ethical decision-making and improving learning outcomes.

How Do Chemistry Faculty and Graduate Students Engage in Decision Making on Issues Related to Ethical and Responsible Conduct of Research Including Authorship?

In the United States National Science Foundation and the National Institutes of Health have mandated training STEM doctoral students in the ethical and responsible conduct of research to improve doctoral students' ethical decision-making skills; however, little is known about the process and factors that STEM faculty and graduate students use in their decision-making. This exploratory case study examined how four triads of chemistry faculty and their doctoral students recruited from three research universities in the eastern United States engaged in ethical decision-making on issues of authorship, assignment of credit, and plagiarism. A mixed-methods approach involving the administration of an online survey consisting of three open-ended case studies followed by a think-aloud interview was utilized. Participants were found to use analogical reasoning and base their decision-making on a common core set of considerations including fundamental principles, social contracts, consequences, and discussion with an advisor, often using prior personal experiences as sources. Co-authorship did not appear to impact the doctoral students' ethical decision-making. Gender may play a role in graduate students' decision-making; female doctoral students appeared to be less likely to consider prior experiences when evaluating the vignettes. Graduate students' lack of knowledge of the core issues in the responsible conduct of research, coupled with their lack of research experience, and inability to identify the core considerations may lead them to make bad judgments in specific situations. Our findings help explain the minimal impact that the current responsible conduct of research training methods has had on graduate students' ethical decision-making and should lead to the development of more effective approaches.

Professional Dilemmas Experienced by Pharmacy Graduates in the United Kingdom When Transitioning to Practice

Objective. For many pharmacy students in the United Kingdom there are few opportunities during undergraduate education to learn, or be exposed to, different ways of dealing with ethical and professional dilemmas in real life practice. This study aimed to explore the experiences of graduates during their pre-registration year and early practice (up to two years post-qualification) on their perceived preparedness to make professional decisions when faced with problems or dilemmas once in practice.Method. Semi-structured interviews were undertaken with preregistration trainees and early careers pharmacists (up to two years qualified). Interviews were transcribed verbatim and analyzed thematically using the Framework Approach.Results. Eighteen interviews (nine preregistration trainees and nine qualified pharmacists) were conducted. Four key themes emerged: continued learning in practice, exposure to role-modelling, moral courage, and stress and moral distress.Conclusion. This study found that preregistration trainees and early career pharmacists perceive a need to be challenged and to receive further support and positive role-modelling to help them continue to develop their ethical and professional decision-making skills in the practice setting. The level and quality of support reported was variable, and there was a reliance on informal networks of peer support in many cases. This study suggests a need to raise awareness among preregistration tutors (preceptors) and line managers (supervisors) to improve and increase support in this area.

Ethical Judgments in the Trolley Dilemma and Ethical Decision-Making Levels of Nursing Students

Purpose: This study was aimed to investigate the effect of Decision-Making levels of nursing students on the ethical judgments in the Trolley Dilemma. Materials and Methods: It was carried out with 349 nursing students from the first, second, third, and fourth grades at a university's Nursing Department of the Faculty of Health Sciences during the 2020-2021 academic year. It was designed as a descriptive cross-sectional study. The data was collected online by using Trolley Dilemma scenarios and Nursing Dilemma Test. Results: The mean scores for nursing students' principled thinking (49.97±6.40) were found to be higher than the average, while the mean score for practical thinking (17.35±3.91) was close to the average. Most of the students (83.4%) responded ‘YES’ to the first trolley dilemma scenario, while 46.1% responded ‘YES’ to the second scenario. In the first trolley dilemma scenario, most students flipped a switch and saved the five workers; however, in the second scenario, more than half chose not to throw the fat man off the bridge to save five people, preferring to let five workers die instead. Female students were found to have a higher level of principled thinking, but students who had received ethics education and had previously experienced ethical dilemmas were found to be more familiar with dilemmas. Conclusions: To improve the ethical decisionmaking skills of nursing students', ethics classes should include compelling scenarios such as trolley dilemma scenarios as well as real-life scenarios, and students should be encouraged to discuss their ideas. Keywords: Nursing students; ethical dilemma, decision making; trolley dilemma

Experiences and Perceptions Gained by Student Nurse Externs Working During a Pandemic.

There are no data available presenting the experiences and perceptions of student nurse externs (SNEs) working during the COVID-19 pandemic. This qualitative study was conducted with 12 SNEs to determine their experiences and perceptions during the summer of 2020. The Colaizzi method was used to identify and analyze statements. Four main themes emerged from the data: 1) appreciating holistic compassionate care, 2) progressing from fear toward hope, 3) desiring ethical decision-making skills, and 4) recognizing communication barriers. Implications include emphasizing communication, ethical decision-making strategies, disaster preparedness, and externships as a way to bridge the gap between education and practice.

Emergency in Ethics: An innovative approach to game-based active learning in interprofessional ethics training

While the use of gaming in higher education has been shown to improve teamwork skills, data regarding the use of games in health sciences interprofessional ethics education is limited. The objectives of this learning activity were selected Interprofessional Education Collaborative (IPEC) core values/ethics sub-competencies (VE1, VE2, VE3, VE4, and VE8), in addition to the demonstration of cooperation with those who receive and provide care. The activity incorporated two gaming strategies, a “murder-mystery” style game and a branching decision-based game. Students from 12 health sciences degree programs participated in the event and were invited to complete a post-activity survey. Students perceived the game play elements of the activity to be effective in promoting teamwork; improving interprofessional ethical decision-making skills; embracing diversity that characterizes patients and the healthcare team; and respecting unique cultures, values, roles/responsibilities, and expertise of other health professions. Overall, use of interactive gaming strategies to promote teamwork skills and decision making were effective and well received by students across multiple degree programs.

Why 4-Year College Graduates are Not Reflecting the Best Ethical and Moral Leadership Behavior

In today's complex and ever-changing world, ethical and moral leadership is crucial for the development and progress of society. However, it has become increasingly evident that many 4-year college graduates are not reflecting the best ethical and moral leadership behavior. This article explores the reasons behind this phenomenon, including the shortcomings of the traditional college education system, the influence of external factors, and the lack of emphasis on character development. The conventional college education system often prioritizes technical skills over ethical development, leading to a gap in ethical leadership abilities among graduates. Moreover, external influences such as cultural and societal norms, media, and corporate impact on education can shape individuals' values and behaviors, potentially undermining ethical leadership qualities. Additionally, the limited exposure to real-world ethical challenges during college further hinders the development of ethical decision-making skills and moral reasoning abilities. To address these issues, the need for comprehensive reform in the college education system. This includes incorporating ethics education and character development programs into the curriculum, providing experiential learning opportunities that expose students to real-world ethical dilemmas, and promoting ethical role modeling and mentorship. Institutions should evaluate and assess the effectiveness of their ethical leadership development initiatives to ensure continuous improvement. The article also suggested strengthening ethical leadership development, equipping individuals with the necessary skills, knowledge, and values to navigate complex ethical challenges. This, in turn, will contribute to cultivating a new generation of ethical leaders who inspire trust, promote integrity, and foster a more honest and morally conscious world.

Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp

BackgroundIntegration of clinical skills, ethical decision-making, and reflection skills have emerged as cornerstones of clinical teaching in medical schools. This study aimed to detect whether a multimodal learning environment approach consisting of lectures, a drill, post-drill video debriefing, and written reflection in an emergency medicine rotation boot camp improves interns’ patient management skills, ethical decision-making, and reflection skills.MethodsA multimodal learning environment was created by the collaboration of emergency medicine, ethics, and medical education specialists. Multiple educational techniques involving lectures, case discussions, and role-playing a crisis scenario were applied. Pre-test and post-test, debriefing on performances on video records, video-recorded performance assessment, and reflective essays about their own and group’s performances were used to assess various aspects of the student performances. Additionally, a meeting was organized with the presence of the authors to create qualitative data obtained through the program evaluation meeting conducted on three themes: influences of teaching methods, students’ performances, and common achievements and mistakes of students.Results133 students participated. Post-test multiple-choice question (MCQ) test scores were slightly higher than pre-test. A low and medium correlation was detected among pre-test and post-test patient management problem (PMP) and reflection scores, which was more prominent for female students. Multiple linear regression showed that pre-test and post-test PMP scores significantly contributed to reflection scores. These results might support that better patient management predicts more robust reflective practice. Teachers observed that students appreciated being inspired by well-performing peers, particularly noting the empathic needs of patients, companions, and other health professionals. However, students overlooked summoning forensic or social services and were inhibited by the pressure of the contextual traits of the drill.ConclusionThe multimodal learning environment created by multidisciplinary collaboration contributed to the improvement of components of situational awareness of the interns: patient management skills, ethical decision-making, and reflective practice. During this research, we created a toolbox better to capture the richness and diversity of student interactions. Considering the scarcity of context-specific assessment methods and widespread use of MCQs or generic scales for higher-order thinking skills in medicine, this study might be regarded as a step forward in that context.

Comparison of ethical decision-making and interpersonal communication skills training effects on nurses’ ethical climate

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.

Pharmacy graduates' perceived impact of long-term undergraduate use of an ethical decision-support tool on their early practice

IntroductionValues-based practice is an important concept within healthcare decision-making that sits alongside evidence-based practice. Values Exchange (Vx) (http://www.vxcommunity.com) is an online tool that supports the development of ethical and professional decision-making skills through values transparency. The aim of this research was to explore the perceived impact of long-term use of the tool during undergraduate study on pharmacy graduates' early practice. MethodsAlumni in their pre-registration year or up to two years qualified were invited to participate via a question at the end of a survey, with additional students invited prospectively during an undergraduate lecture. All had completed three cases per year on Vx during the four-year master of pharmacy course. Semi-structured interviews were audio-recorded and transcribed verbatim, and framework analysis was applied. Ethical approval was obtained. ResultsA total of 18 interviews (nine pharmacists and nine pre-registration tutees) were conducted between May 2015 and March 2016. Thirteen participants were female, 13 were based in community pharmacy, and 10 were Caucasian. Interviews ranged from 50 min to 2 hours. Three themes emerged from the data: (1) the Vx learning environment, (2) learning and reflection, and (3) potential enhancements for learning. Participants perceived Vx to be an effective teaching tool supporting the development of skills necessary to exercise professional judgement in pharmacy practice. ConclusionsVx appears to be a worthy addition to the armoury of teaching methods necessary to support future pharmacists in their preparedness to deal with ethical and professional dilemmas in practice.

A 4-tier rubric for evaluating engineering students’ ethical decision-making (EDM) skills: EDM model as a tool for analysing and assessing ethical reasoning

ABSTRACT Ethical decision-making (EDM) is an important element in the engineering profession. This paper explores the use of an ethical decision-making model (EDMM) as a tool for analysing and assessing the ethical reasoning skills of student engineers and their ability to apply the rationale of EDM process for ethical vignettes. The tool, distilled from several existing EDMMs, was tested against interview data collected from 12 graduating students at one private university in Malaysia. The students were asked to examine two ethical vignettes of varying scenarios and difficulty levels. This was followed by a semi-structured, face-to-face interview (corresponding to the first four steps of EDMM) to gauge their ethical reasoning behind their decision for each vignette. Their verbal responses were analysed and categorised into a four-tier rubric developed in accordance with the four steps of EDMM. Findings revealed that generally, students were able to identify the underlying issue (step 1) and the affected parties and the consequences (step 2), but they did not give much thought to potential course of action (step 3) or to testing available options (step 4). Levels of development of ethical reasoning provided by students varied between the first and second vignette. Findings suggest that the EDMM holds promise as a way to better understand and diagnose students’ readiness to face ethical challenges in their profession.

Academic Ethical Awareness and Moral Sensitivity of Undergraduate Nursing Students: Assessment and Influencing Factors

IntroductionNursing students are exposed to ethically challenging conditions in their future workplaces; hence, they must be ethically knowledgeable and morally sensitive to provide patients with holistic care based on sound ethical decision-making skills. Objectives: This study aimed to assess nursing students’ perception of their academic ethical awareness and moral sensitivity and determine the relationship between these variables. Methods: We conducted a descriptive correlational research study with a convenient sample of nursing students (N = 246) in a Saudi University nursing college. Data were collected using the Academic Ethical Awareness Questionnaire and Moral Sensitivity Questionnaire. We used descriptive statistics, ANOVA, and regression analyses. Results: Nursing students exhibited moderate academic ethical awareness and moral sensitivity. The regression analysis showed that academic ethical awareness can substantially predict 28.8% of the explained moral sensitivity variance (p < 0.001). Nursing students were aware that the violation of patients’ respect or confidentiality and cheating in examinations were unethical behaviors. However, they showed low ethical awareness toward plagiarism behaviors. Furthermore, they reported higher moral sensitivity for patient-oriented care and professional responsibility and did not experience conflict. Academic level and integrated classroom and clinical learning experiences seemed to positively impact students’ academic ethical awareness. Conclusion: The findings provide a basis for monitoring nursing students’ professional misconduct so that they maintain integrity and adhere to academic ethics guidelines. Constant exertions for fostering nursing ethics courses with inspiring learning content and innovative instructional material are vital in improving nursing students’ academic integrity and ethical care.