Nursing Ethics Education Research Articles

The present status of nursing ethics education in Japanese nursing colleges and schools: a survey

The present status of nursing ethics education in Japanese nursing colleges and schools: a survey

Narrative and ethics education for nurses

This article illustrates the unique role of narrative medicine in the education of nursing students. Thirty-two students attending the university course for nursing were asked to describe in writing their clinical experience when prompted with the statement “from that event, in relation to treatment ethics, I learnt that …”. Thanks to narrative, the themes have gained a personal meaning as they emerged from a situation which involved the students emotionally. The students became endowed with the ability to face ethical dilemmas in different context and to deliver personalized care with empathy and compassion.

Response to Commentary. 1: Effectiveness of nursing ethics education: much more research needed.

Response to Commentary. 1: Effectiveness of nursing ethics education: much more research needed.

Effectiveness of ethics education as perceived by nursing students: development and testing of a novel assessment instrument.

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. 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. Content validity, comprehensibility and usability of the SPEEES were assessed. Reliability was assessed by means of a quantitative descriptive non-experimental pilot study. 86 third-year baccalaureate nursing students of two purposefully selected university colleges answered the SPEEES. Formal approval was given by the ethics committee. Informed consent was obtained and anonymity was ensured for both colleges and their participating students. 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. 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.

Effects of a Blended Learning Program on Ethical Values in Undergraduate Nursing Students

Purpose: This study was performed to investigate the effects of a blended learning program on ethical values in undergraduate nursing students. Methods: This study was a one group pretest-posttest design. Seventy-one undergraduate nursing students who were taking a nursing ethics course at K University in S city were conveniently selected. The blended learning program was undertaken for 120 minutes one day weekly for 15 weeks. It consisted of case-based learning through an online method combined with problem-based learning offline. Scores for ethical value were measured using the ethical values scale. Results: The ethical values score increased significantly in the students after the blended learning (p=.004). Of the subgroup of ethical values human-life, relationship with collaborator, and nursing job scores increased significantly in students after the blended learning, respectively (p=.034; p<.001; p<.001), the score for area as relationship with nursing clients decreased significantly in the students after the blended learning (p<.001). Conclusion: The blended learning program was identified as an educational program which induces a positive effect on the development of ethical values in undergraduate nursing students, and in future it can be utilized in nursing ethics education.

Understanding and Future Issues in Educational Content for the Development of a Nursing Ethics Education Program

Understanding and Future Issues in Educational Content for the Development of a Nursing Ethics Education Program

간호윤리교육에서 간호윤리상황극과 찬반토론이 간호대학생의 도덕지능, 도덕적 민감성과 도덕 판단력에 미치는 영향*

This study was designed to compare the effects of two teaching methods, i.e., ‘Theatre of Situations’ and ‘Pro-Con Debate’ on moral intelligence, moral sensitivity and moral judgment of students taking nursing ethics classes. Two-group pretest-posttest design was used. The subjects, 87 nursing students, were randomly allocated to two groups, i.e., experimental group A, ‘Theatre of Situations’ consisting 45 students and experimental group B, ‘Pro-Con Debate’ consisting 42 students. The same four nursing hypotheticals dealing with ethical issues or dilemmas were used for both groups. Each of ‘Theatre of Situations’ and ‘Pro-Con Debates’ was conducted for 150 minutes after 450 minutes of regular nursing ethics lectures. Data were collected before and after the classes to measure moral intelligence, moral sensitivity and moral judgment of the subjects. The data were analyzed by a paired t-test using SPSS. The findings from this study are as follows: (1) in group A, moral meaning perceived by the subjects (a sub-domain of moral sensitivity) was significantly improved; (2) in group B, kindness and tolerance (sub-domains of moral intelligence) were significantly improved. Both methods are recommendable for enhancing nursing ethics education.

Current situation and issues in nursing ethics education for new graduate nurses: A questionnaire survey in the five prefectures in Central Japan Area

Current situation and issues in nursing ethics education for new graduate nurses: A questionnaire survey in the five prefectures in Central Japan Area

Changes in Nursing Students' Moral Judgment and Ways to Evaluate the Effect of Ethics Education

Purpose: This study was done to investigate changes in nursing students' moral judgment throughout their professional education, and to identify more suitable ways to evaluate ethics education by using P (%) scores only and P (%) scores with 4th scores. Methods: The study consisted of cross-sectional and longitudinal surveys as well as a study using a nonequivalent control group pre-post experimental design. The participants were nursing students attending a university in Gyeongju, Korea. The data were collected from September 1, 2006 to October 31, 2009 using the Korean version of the Defining Issues Test. Results: In the cross-sectional survey, there was no significant difference in the nursing students' moral judgment scores according to their school grades. In the longitudinal survey, nursing students' moral judgment scores did not change significantly over the duration of their education. In the nonequivalent control group study, the effectiveness of nursing ethics education was identified by P (%) scores only. Conclusion: The evidence indicates that nursing professional education does not influence the development of nursing students' moral judgment, and using P (%) scores only seems to be a better way compared to other ways to evaluate the effects of nursing ethics education.

Qualitative Assessment of a Blended Learning Intervention in an Undergraduate Nursing Course

Nurses are experiencing new ethical issues because of global developments and changes in the healthcare environment. Blended learning is one of the various methods used to deliver meaningful learning experiences. Well-designed, properly administered nursing ethics education is essential for nursing students to visualize the role of professional nurses. However, a literature review shows that only a few existing studies have touched on the subject of nursing student experiences with blended learning in a nursing ethics course. This study examines how undergraduate nursing students respond to a blended learning approach in a nursing ethics course and how blended learning affects the learning process. We used a qualitative research design with in-depth interviews. Participants included 28 female undergraduate nursing students who had completed the nursing ethics course. Each interview lasted 50-100 minutes. The researcher conducted all interviews in 2009. The researcher identified six major themes and 13 subthemes from the data. The six themes included (a) enhancing thinking ability, (b) improving problem-solving skills, (c) reflecting in and on practice, (d) perceiving added workload, (e) encouraging active learning, and (f) identifying the value of nursing. Participants felt that the blended learning experience was a generally positive experience. Most participants appreciated the opportunity to take a more active role in the learning process, think about issues profoundly and critically, and exercise metacognitive powers in the thinking and decision-making process. Study findings may suggest productive ideas for fine-tuning blended learning models.

간호윤리 수업에서의 CEDA 토론학습이 간호대학생의 도덕 판단력과 윤리적 가치관에 미치는 효과

Purpose: The purpose of this study was to compare the effects of CEDA (Cross Examination Debate Association) debate with those of traditional lecture education on moral judgment and ethical values using the Korean version of DIT and the ethical values. Methods: The experiment was performed for 9 weeks, from September 2 to November 12, 2010. Participants were 71 undergraduate nursing students in a nursing college, assigned to an experimental group (36 students) or a control group (35 students). The design of this study was a non equivalent control group pretest-posttest design. Results: The experimental group reported significantly higher scores of the 4 stage scores of moral judgment (t=-2.19, p=.036) and ethical values (t=3.04, p=.004) than the control group. However, no significant differences were found in the P score of moral judgment between the two groups. Conclusion: The findings of this study showed the benefits of providing a CEDA debate course for nursing ethics education. Therefore, in further studies, it is necessary to develop various teaching strategies or educational programs to improve nursing ethical values and moral judgment.

Nursing Ethics Education and Level of Mastery Specific Ethical Content Needed by Newly Hired Nurses

Nursing Ethics Education and Level of Mastery Specific Ethical Content Needed by Newly Hired Nurses

Nurse Ethicist: Innovative Resource for Nurses

Nurses are challenged with ethical problems on a daily basis, yet when they are students, nurses may have never had an opportunity to explore the complexities of how ethics will influence every facet of their nursing practice. This article describes how a large health care system, through collaboration between academic and clinical partners, developed a nurse ethicist role to serve both the patient care environment and students in academic programs. The nurse ethicist is charged with creating and sustaining programs in ethics and nursing ethics education with the goal of improving the capacity of nurses to manage the ethical issues inherent in the care of patients in a contemporary, technology-driven health care system. The Program in Nursing Ethics includes staff education, consultation and support, and research. The addition to the faculty of a nurse ethicist who is active in clinical ethics consultation has strengthened the baccalaureate nursing curriculum by providing an instructor who creates and shares a clear vision for how ethics is central to quality nursing care. This article describes the central role of a nurse ethicist in promoting ethical nursing practice.

A comparison of problem-based learning and conventional teaching in nursing ethics education

The aim of this study was to compare the learning effectiveness of peer tutored problem-based learning and conventional teaching of nursing ethics in Taiwan. The study adopted an experimental design. The peer tutored problem-based learning method was applied to an experimental group and the conventional teaching method to a control group. The study sample consisted of 142 senior nursing students who were randomly assigned to the two groups. All the students were tested for their nursing ethical discrimination ability both before and after the educational intervention. A learning satisfaction survey was also administered to both groups at the end of each course. After the intervention, both groups showed a significant increase in ethical discrimination ability. There was a statistically significant difference between the ethical discrimination scores of the two groups (P < 0.05), with the experimental group on average scoring higher than the control group. There were significant differences in satisfaction with self-motivated learning and critical thinking between the groups. Peer tutored problem-based learning and lecture-type conventional teaching were both effective for nursing ethics education, but problem-based learning was shown to be more effective. Peer tutored problem-based learning has the potential to enhance the efficacy of teaching nursing ethics in situations in which there are personnel and resource constraints.

Cultural and hierarchical influences: ethical issues faced by Taiwanese nursing students

OBJECTIVES Improving nurses' competence in resolving clinical ethical issues must start with ethics education in training and clinical practice. However, many students complain that they cannot apply classroom learning to actual clinical scenarios. This study explored ethical issues and dilemmas, and their impact experienced by student nurses in clinical practice. METHODS Focus groups were conducted with 44 first-year student nurses from a 2-year college course in northern Taiwan. Interviews were tape-recorded and verbatim transcripts were analysed using content analysis. RESULTS Students expressed and discussed their views in eight focus groups. Analysis of interviews revealed five themes: frustration at inability to help some patients; oppression caused by lower status; lack of honesty and ethical courage; powerlessness, and self-encouragement in adversity. CONCLUSIONS Taiwanese nurse ethics training was only recently introduced and the curriculum has not addressed the clinical reality in Taiwan. This reality includes limitations arising from the medical hierarchy and the socio-cultural role of families in medical decision making, which may inhibit ethical judgements and decision making. In clinical dilemmas, the most common problems faced by Taiwanese nursing students involved not knowing how to handle some situations, inability to abide by principles, and a lack of appropriate role models. Hence, we suggest that nursing ethics education should: (i) integrate scenarios involving ethical dilemmas into daily routines; (ii) give students opportunities to discuss their feelings about their experiences; (iii) allow teachers and students to talk about scenarios with ethical implications, and (iv) provide students with opportunities to reflect on clinical scenarios in order to clarify their values and learn how to respect the value of life.

Ethics Education for Professionals in Japan: A critical review

Ethics education for professionals has become popular in Japan over the last two decades. Many professional schools now require students to take an applied ethics or professional ethics course. In contrast, very few courses of professional ethics for teaching exist or have been taught in Japan. In order to obtain suggestions for teacher education, this paper reviews and examines practices of ethics education for engineers and nurses in Japan that have been successfully implemented. The paper concludes that difficulties in professional ethics education in Japan are caused by the fact that both teachers and students lack experience in leading and participating in discussion‐based classes and misunderstand the effectiveness of a case‐based pedagogy. It also suggests that we need to offer teachers systematic opportunities to be trained to be proficient in enabling students to be active and critical in class.

Issues in evaluating ethics education for nurses and their competency in matters involving ethical judgment and behavior : based upon quantitative surveying of the actual state of clinical nurse&apos;s ethics education and moral sensitivity

Issues in evaluating ethics education for nurses and their competency in matters involving ethical judgment and behavior : based upon quantitative surveying of the actual state of clinical nurse&apos;s ethics education and moral sensitivity

The Legal Basis of Nursing Ethics Education

The Legal Basis of Nursing Ethics Education

우리나라 간호윤리 교육의 현황 및 전망

In today’s rapidly changing and technologically sophisticated health-care environment, nurses frequently encounter ethical issues in caring for patients. While ethical values have always been a part of nursing education, the resources needed for ethics education have not always been readily available to nursing students and practicing nurses. This review aims to describe the state of nursing ethics education in Korea and provide insights into its requirements and priorities. In order to train nurses to participate in ethical decision making, more contemporary models of ethics education are being implemented in nursing programs. It is important for nurse educators to understand that ethics education should provide students with ways of conceptualizing ethical dilemmas and arriving at practical solutions. Furthermore, we argue that there is a need to develop Web-based continuing-education courses to enhance nurses’ ethical decision-making and advocacy roles.

An Urgent Call for Ethics Education

The target article by Grady and colleagues (2008) is a valuable and exciting contribution to the debate about the importance of ethics education for nurses. The findings indicated that ethics educa...