Background:Moral courage is defined as courage to act according to one’s own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses’ career.Aim:To analyse graduating nursing students’ moral courage and the factors associated with it in six European countries.Research design:A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage (...) was assessed with a single question (visual analogue scale 0–100), the questionnaire also covered several background variables.Participants and research context:The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students’ moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires.Ethical considerations:Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent.Results:The mean of graduating nursing students’ self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0–100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students’ moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves.Discussion and conclusions:In all countries, the graduating nursing students’ moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research. (shrink)

Background Altruism is the core of nursing professionalism. Graduate nursing education in China started late and is still developing, exploring the current state of altruistic behavior and the perceived experience of altruism among graduate nursing students may have important implications for nursing education. Objective Explore the current state of altruistic behavior and the perceived experience of altruism among graduate nursing students in China. Research design This is a descriptive phenomenological qualitative research study, semi-structured in-depth interviews (...) were conducted. Seventeen graduate nursing students from three schools were selected to participate in the study. Colaizzi’s analysis method was performed with NVivo software to develop common themes from the data. Ethical considerations The research proposal was approved by the Research Ethic Committee of Yangzhou University, China. Results Four themes emerged from the analysis of the interviews of the 17 participants: “Definition of altruism,” “Altruism in the nursing profession,” “Altruism applied in practice,” and “Factors influencing altruistic behavior.” Conclusions Although participants indicated that the concept of “altruism” was relatively new to them, altruistic behavior is common in both their work and life. Many factors influence the altruistic behavior of graduate nursing students, including the environment, personal factors, education, recipient factors, occupational factors, and gains and losses. Families, schools, and hospitals should create favorable environments to foster altruistic tendencies in students. (shrink)

Canadian Schools of Nursing rest upon white, colonial legacies that have shaped and defined what is valued as nursing knowledge and pedagogy. The diversity that exists in clinical nursing and is emerging within the graduate student population is not currently reflected within nursing faculty and academic leadership. Black, Indigenous, and People of Color (BIPOC) nurse leaders, historically and presently, are repeatedly left unacknowledged as knowers and keepers of nursing knowledge. This lack of diversity persists (...) across nursing knowledge generation, research, and healthcare practices that ultimately aim to serve the increasingly diverse Canadian population. This narrative inquiry study examined the experiences of eight BIPOC graduate nursing students as they navigated white academic nursing spaces. The findings are presented to reflect their experiences of entrenched in whiteness, erasure of identity, and navigating belonging. These study findings highlight the importance of surfacing academic nursing history shaped by colonialism and racism, the need to diversify nursing faculty and the graduate nursing student population, and implementing nursing curricular and syllabi audits to ensure that they reflect the multitude of ways of knowing to expand dominant Eurocentric and Western knowledge in nursing education. (shrink)

Background Ethics communication has been described as a pedagogical form, promoting development of ethical competence among nursing students. The ‘one to five method’ was developed by this research group as a tool for facilitating ethical communication in groups among healthcare professionals but has not yet been evaluated. Aim To explore post-graduate nursing students’ experiences of practicing ethical communication in groups Research design The study design is qualitative. Participants and research context The study comprised 12 nursing students on (...) a post-graduate course for Registered Nurses focusing on palliative care. After education the students engaged as participants and facilitators in ethics communication in groups, with support from the ‘one to five method’. Data were derived from the students written reflections and subjected to thematic analysis. Ethical considerations The study was performed in accordance with the ethical standards in the 2013 Helsinki Declaration and approved by the Ethics Committee of the Medical Faculty at Umeå University Results An overall theme was identified, ‘being supported to achieve a democratic dialogue concerning ethical problems’ and five themes, related to each step of the ‘one to five method’. The themes concerned: putting the experience of an ethical dilemma into words; being confirmed by shared emotions; defining the value conflict using ethical principles; expressing virtues of empathy and raised awareness; jointly finding various action approaches. Discussion Regular ethics communication in groups encourages nursing students to actively seek understanding and clarification of ethically difficult situations. Conclusions The results indicate that ethics communication in groups could be a way of developing virtues during education. Interventions using the ‘one to five method’ need to be further studied among student groups from other healthcare contexts. (shrink)

The average age of women nursing students in Australia is rising. With this comes the likelihood that more now begin university with family responsibilities, and with their lives structured by the roles of mother and partner. Women with more traditionally gendered ideas of these roles, such as nurturing others and self‐sacrifice, are known to be attracted to nursing as a profession; once at university, however, these students can be vulnerable to gender role stress from the competing demands of (...) study. A qualitative research design, guided by Gadamer's hermeneutic philosophy, explored the gendered behaviours and experiences of 22 women nursing students, all of whom had children and began university in a heterosexual intimate relationship. The findings reveal traditional ideas of gender were almost universal among participants, and these ideas had a significant influence on the nursing degree experience. Participants commonly prioritised family over the university and practiced maternal gatekeeping (prevention of male partner involvement in domestic work). These traditionally gendered behaviours, coupled with experiences of gender role stress, had a detrimental impact on participants' capacity to study and their personal wellbeing. The importance of these findings to the burgeoning nursing workforce shortage nursing is considered in terms of student retention and the supply of graduates into the profession. The implications to the nursing profession are also explored against the evidence that nursing students with traditional gender beliefs are less likely to develop as autonomous, critical thinking nurses compared to their gender‐egalitarian peers. The introduction of gender theory via critical pedagogy in the undergraduate nursing degree curriculum is recommended to enlighten and empower women nursing students and promote the competence, agility, and sustainability of the nursing profession. (shrink)

ObjectivesTo examine implicit and explicit attitudes toward gay men and lesbian women among heterosexual undergraduate and graduate psychology and nursing students.MethodsImplicit attitudes were measured via the Implicit Association Test and explicit attitudes via the Attitudes Toward Lesbian Women and Gay questionnaire.Main resultsAll groups held negative implicit attitudes toward gay men and lesbian women. Among undergraduates, nursing students reported holding more negative explicit attitudes toward gay men and lesbian women than psychology students.ConclusionThe curricula in both nursing and psychology (...) studies need to address the medical and paramedical needs and issues of sexual minorities. (shrink)

Globalization is a part of modern life. Sharing a common set of professional nursing values is critical in this global environment. The purpose of this research was to examine the professional values of nursing students from two distinct cultural perspectives. Nurse educators in Taiwan partnered with nurse educators in the United States to compare professional values of their respective graduating nursing students. The American Nurses Association Code of Ethics served as the philosophical framework for this examination. (...) The convenience sample comprised 94 Taiwanese students and 168 US students. Both groups reported high scores on an overall measure of values. They did differ substantially on the relative importance of individual items related to advocacy, competence, education, self-evaluation, professional advancement, and professional associations. Global implications for the collaborative practice of nurses from different cultures working together can be improved by first recognizing and then attending to these differences in value priorities. (shrink)

Professional values are standards for action and provide a framework for evaluating behavior. This study examined changes in the professional values of nursing students between their entrance to and graduation from an undergraduate nursing program. A pre- and post-test design was employed. A convenience sample of 94 students from a university in Taiwan was surveyed. Data were collected from students during the sophomore and senior years. Total scores obtained for the revised Nurses Professional Values Scale during the senior (...) year of the nursing program were significantly higher than upon program entry. The ‘caring’ subscale was scored highest at both program entry and graduation, but the pre- and post-test scores were not significantly different from each other. The students scored significantly higher on the ‘professionalism’ and ‘activism’ subscales at post-test than they did at pre-test. Professional values changed in a positive direction between the beginning of the student nurses’ educational experience and their graduation. The results supported the premise that education had a positive effect on these students’ professional values but causality could not be assumed. (shrink)

There is no co-ordinated focus on liabilities arising from nurses’ medical interventions in terms of occupational, administrative, civil legal and criminal activities. However, the Turkish Criminal Code, the Turkish Medical Ethics Code of Practice, and guidelines for patients’ rights offer some framework for the relevant ethical principles and responsibilities of nurses. The aim of this study was to investigate the evaluation of nursing students’ training in their legal liabilities. The sample consisted of 309 students who were taking a course (...) entitled ‘Nurses’ legal liabilities under Turkish criminal and civil law arising from medical interventions’. Data were obtained by means of self-administered questionnaires and McNemar’s test was used to evaluate the answers. In conclusion, after their training, a great majority of the students demonstrated an improvement in terms of their percentage of correct answers relating to malpractice. This does not, however, mean that they will not face malpractice charges after graduating, but their increased awareness of the issue may encourage them to make more effort to reduce the risk of mistakes. It is recommended that nursing faculty carry out studies into medical malpractice, that they focus more on this subject in nursing education, and that all nursing schools review their curricula from the point of view of malpractice. (shrink)

This longitudinal study (1994-1996) used the Gordon Personality Inventory to measure nursing students’ self-image (Gordon A), self-values (Gordon B) and interpersonal values (Gordon C). It was performed with students from three colleges of health in the south of Sweden: Jönköping (n = 54), Växjö (n = 24) and Kristianstad (n = 38). The null hypothesis of the study was that the new academic three-year programme did not have the power to change significantly the students’ self-image and professional values. The (...) hypothesis was tested by paired sample Student’s t-test. The result was that, at Jönköping, self-image changed and increased significantly in the dimensions of ‘cautiousness’ and ‘personal relations’, and decreased in ‘sociability’, and increased in the self-value ‘order’. At Växjö the self-image dimensions of ‘original thinking’ and ‘personal relations’ increased, and, at Kristianstad, the students increased their self-image scores in ‘responsibility’. (shrink)

This longitudinal study used the Gordon Personality Inventory to measure nursing students’ self-image, self-values and interpersonal values. It was performed with students from three colleges of health in the south of Sweden: Jönköping, Växjö and Kristianstad. The null hypothesis of the study was that the new academic three-year programme did not have the power to change significantly the students’ self-image and professional values. The hypothesis was tested by paired sample Student’s t-test. The result was that, at Jönköping, self-image (...) changed and increased significantly in the dimensions of ‘cautiousness’ and ‘personal relations’, and decreased in ‘sociability’, and increased in the self-value ‘order’. At Växjö the self-image dimensions of ‘original thinking’ and ‘personal relations’ increased, and, at Kristianstad, the students increased their self-image scores in ‘responsibility’. (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)

Graduate nursing students should have a strong ethical theoretical foundation to identify and explore scientific and technological ethical issues impacting nursing care, to assume leadership positions in practice and education, and to conduct research contributing to nursing’s knowledge base. This paper reports the implementation and evaluation of a new ethics course at Turkish doctoral nursing programs. The first section describes course design and implementation. The second section evaluates the course and discusses results. Students’ evaluations indicated that (...) the concept of caring in key ethical theories, particularly care ethics, was vital to course content. The most preferred teaching method was case analysis. Students suggested increase in course length and credits, content inclusion of feminist ethics, and real-world knowledge application by other teaching strategies such as clinical practice visits and hospital ethics committee member participation. (shrink)

This paper describes the first phase of an ongoing education and research project guided by three main intentions: (1) to create opportunities for phronesis in the classroom; (2) to develop new understandings about phronesis as it relates to nursing care generally and to caring for specific groups, like formerly incarcerated adults; and (3) to provide an opportunity for formerly incarcerated adults and graduate nursing students to participate in a dialectical conversation about ethical knowing. Gadamer's writings on practical philosophy, (...) phronesis, and the Socratic dialectic provide the philosophical foundation and framework for the project. The first phase in the project was a 4‐h class within a graduate‐level health promotion course during which 30 nursing students and three formerly incarcerated panelists engaged in a dialectic conversation about what it means to care for formerly incarcerated adults in a meaningful way. After the class, two focus groups were conducted, one with the students and one with the formerly incarcerated panelists. Findings articulated participants' prejudices and assumptions prior to the class, expanded sense of phronesis, and ability to consider nursing practice within a larger ethical framework. Panelists and students left the class with a deeper understanding of one another and expressed an openness towards continued dialectic conversations together. Use of the Socratic dialectic within nursing curricula reflects a current and critical trend in nursing education to bring non‐epistemologic forms of knowledge into the classroom. (shrink)

This historical study aims to explain how the transition from student nurse service to fully qualified “graduate nurse” service in the United States in the 20th century affected assumptions about fundamental patient care in hospital wards and provide historical context for current apprenticeship programs. Through analysis of documents from 1920 when student nurse service, a nurse apprentice model, was the norm to 1960 when the nurse apprentice model was waning in favor of registered nurse service, this study found (...) that the replacement of student nurses with registered nurses led to weakened standardization of fundamental bedside care and the introduction of large numbers of unlicensed nursing assistants. While student nurses could perform all the functions of fully qualified graduate nurses, nursing assistants could not, resulting in a separation of fundamental nursing care from the professional nurse role and changes in assumptions and attitudes toward fundamental care. These changes had a negative effect on fundamental nursing care. New apprenticeship programs provide opportunities for improvement. (shrink)

College students have become more representative as blood donors, mainly to help other people. This study ascertained the association between spirituality and adherence or intention to donate blood in post-graduate students. In this quantitative and cross-sectional study, participants were 281 students from a post-graduate programme at a Brazilian public university. After complying with ethical requirements, data were collected through a questionnaire for sociodemographic characterization and identification of blood donation practices, followed by the Spiritual Well-Being Scale. Descriptive statistics and parametric tests (...) were used for data analysis. A total of 74% of the participants were female and 26% were male. Previous experience and/or intention to donate blood were found in 75.3%; 14.3% donated blood periodically. In addition, 12.2% were not adept to donation and 12.5% were inapt. Spiritual Well-Being scores were similar between individuals who are not adept and those who donate periodically. In conclusion, in the sample, spirituality and blood donation are not associated, but spiritual well-being and gender are. To enhance blood donation, further research is needed. (shrink)

Background Nursing students must graduate prepared to bravely enact the art and science of nursing in environments infiltrated with ethical challenges. Given the necessity and moral obligation of nurses to engage in discourse within nursing ethics, nursing students must be provided a moral supportive learning space for these opportunities. Situating conversations and pedagogy within a brave space may offer a framework to engage in civil discourse while fostering moral courage for learners. Research Objective The aim of (...) this research is to explore the influence of a structured self-assessment tool called the ESA “Engagement Self-Assessment” on the alignment and creation of a brave space in a nursing ethics course. Research Design This study used an exploratory, cross-sectional survey design. Participants and Study Setting Data from 39 undergraduate nursing students enrolled in a nursing healthcare ethics & law course using the ESA were recruited. Ethical Considerations Participation was voluntary and informed without coercion. Written consent was obtained prior to participation. Research ethics approval was obtained by the Institutional Research Ethics Board of the recruited participants (Ethics # 2022-23-03). Findings The ESA provided structured self-reflection on the impact of shared vulnerability within a brave space. However, commitment to a brave space was not strongly influenced by the ESA, but rather by a mutual “commitment to others.” Conclusion A teaching tool such as an ESA can be used to facilitate instructor expectations of civil discourse and discussion of difficult topics. Rules of engagement such as those found in brave spaces can help transform fear of vulnerability into authentic growth for learners. A morally supportive learning space can support critical opportunities for ethical development. This study provides insight into how self-assessment and the use of a brave space in nursing ethics education can facilitate a morally supportive learning space. (shrink)

Background Improving the competencies of nurses requires improving educational methods through the use of novel methods in teaching and learning. We aim to explore the perceptions of stakeholders (including nursing education directors, faculty members and nursing students) of the requirements of implementing innovative educational approaches in nursing. -/- Methods In this qualitative descriptive study, 19 participants, including educational directors, faculty members, and undergraduate and graduate nursing students, were selected through the purposeful sampling method. Achieving the theoretical (...) saturation in extracted categories was considered as a criterion for determining the sample size and the completion of sampling. The data were collected from December 2019 to May 2020 in nursing schools of Tehran, Iran, through in-depth semi-structured individual face-to-face interviews and were then analyzed based on the Graneheim and Lundman method. -/- Results Using qualitative content analysis, eight sub-themes and three themes were extracted. The extracted themes were ‘novel educational policymaking’, ‘Innovative education-oriented platform’, and ‘managing barriers of innovative educational approaches’. -/- Conclusions Developing and implementing innovative educational approaches entail providing appropriate context, structure, and required facilities by the policymaking system and educational authorities. In addition, developing capacity and related competencies of faculty members and students as the major stakeholders in employing these approaches is crucial. (shrink)

Canada is an immigrant‐receiving nation and many graduate students in nursing and other disciplines pursue immigrant health research. As these students often start with inadequate understanding of the policy, theoretical, and research contexts in which their work should be situated, we became concerned that the theses and dissertations were less sophisticated than were both possible and desirable. This led to development of a PhD‐level course titled Migration and Health in the Canadian Context. In this study, we provide an analytic (...) overview including course description, objectives, assignments, and specific class topics. Areas of focus include historical and theoretical considerations; determinants of immigrant health; refugee health; cultural competence and cultural safety; research challenges, approaches, and skills; policy‐relevant research; and educational imperatives in the health and related disciplines. Salient research is introduced in each of these classes. While Canada is the main focus, comparative data are provided and there is relevance for nurse‐researchers in other immigrant‐receiving countries. (shrink)

Although thousands of articles and books appear annually in the field of nursing ethics, the sheer volume of scholarly publications points to the need to provide assessment and focus, and that is what this book offers. Nursing and Healthcare Ethics documents the work of nurse scholars in ethics, and goes well beyond a mere documentation of what has transpired and a list of what can be done in the future. It creatively looks back to assess previous accomplishments and (...) forward to find new directions and strengthen future scholarly contributions in nursing ethics. Critical thinking activities, organized by the book s themes (such as vulnerability, care and caring, diversity and disparity, and pain and suffering) are examples of applying these scholarly insights into practice. This book is intended not only for undergraduate and graduate students in academic settings, but also for those in professional development programs. (shrink)

This paper challenges nurses to join together as a collective in order to facilitate ongoing analysis of the issues that arise for nurses and patients when nursing care is harnessed for health care efficiencies. It is a call for nurses to respond with a collective strategy through which we can ‘talk back’ and ‘act back’ to the powerful rationality of current thinking and practices. The paper uses examples from an institutional ethnographic (IE) research project to demonstrate how dominant approaches (...) to understanding nursing position nurses to overlook how we activate practices of reform that reorganize how we nurse. The paper then describes two classroom strategies taken from my work with students in undergraduate and graduate programs. The teaching strategies I describe rely on the theoretical framework that underpin the development of an IE analysis. Taken into the classroom (or into other venues of nursing activism) the tools of IE can be adapted to inform a pedagogical approach that supports nurses to develop an alternate analysis to what is happening in our work. (shrink)

Nursing is a complicated and multifaceted profession that sets high demands in preparing nursing students for the profession. In today's education, the emphasis is often on knowledge and skills, that is, epistemology. In caring science another approach is sought, an approach based on human sciences in which knowledge will serve a more profound understanding, that is, the ontology. Consequently, the question of what this ‘understanding’ in clinical education is and how it is promoted in clinical nursing education (...) becomes important to clarify. Therefore, the aim here is to explicate the phenomenon of understanding in clinical education as experienced by third‐year undergraduate nursing students ready for graduation. This study, with a hermeneutic approach, is based on a secondary analysis of focus group interviews with undergraduate nursing students. The analytical expansion of the original material suggests three interrelated themes that illuminate the phenomenon of understanding in clinical education. These findings are deepened and enriched through philosophical abstraction. In the process of understanding, episteme, techne and phronesis can be viewed as inherent parts of the structure of thought in nursing. The perspective advanced in this study adds new aspects to the phenomenon of understanding and its meaning and significance in the dynamic process of formation and becoming in clinical education. The focus in clinical nursing education should be on learning reflective, critical thinking and the ways of being a nurse, rather than drilling students on particular skills. In the rapidly changing world of the 21st century, an understanding‐based education is needed as a more meaningful and authentic approach. Therefore, an ontological turn in nursing education, through which the main focus shifts from a traditional epistemology to an epistemology in the service of ontology, is suggested. Further studies are needed in the development and implementation of an understanding‐based, interpretative education in nursing. (shrink)

Background: Double degrees in nursing and midwifery have evolved in Australia as a proposed solution to possible impending shortages of qualified midwives in the healthcare workforce. The double degree is seen as a more acceptable option in non-metropolitan areas in particular. Concern has been expressed however, about dilution of midwifery philosophy and graduates opportunities in respect of future clinical practice. Aim: This study aimed to provide a better understanding of motivations and intentions of students who undertake the Bachelor of (...) Nursing Science/Bachelor of Midwifery double degree. Methods: A cross-sectional survey design was employed at four universities that offered double degrees in nursing and midwifery in three states of Australia. Students enrolled in first and fourth year of a double degree and graduates of a double degree were invited to complete an online survey comprised of Likertscales and items requiring free text responses. Quantitative data was analysed using SPSS and thematic analysis was used to analyse the qualitative data. Findings: Participants indicated a clear preference for midwifery as a career with this preference increasing for each cohort at each stage of study. Discussion: Primary reasons for selecting a double degree were perceived increased opportunity for employment and use of nursing skills to enhance midwifery practice in a population with growing co-morbidities. A strong identification with midwifery philosophy and identity was also demonstrated.Conclusion: An understanding of motivations and career intentions of students undertaking double degree studies can inform future program development and workforce planning. (shrink)

Con el objetivo de diseqar una propuesta de modificacisn al programa de la formacisn de enfermeros y sugerir la inclusisn de temas sobre la discapacidad infantil, que permitan instruir al personal en formacisn, se realizs un estudio descriptivo cualitativo, en dos etapas, en la primera, mediante entrevistas se recogis la opinisn del claustro de profesores de la Licenciatura en Enfermerma de la Universidad de Ciencias Midicas de Camag|ey, en una segunda etapa se aplics el mitodo de Panel de Expertos, en (...) el que participaron diez expertos seleccionados de manera intencional a partir de su prestigio, experiencia y vinculacisn a la docencia, en lo referido al tema. Se analizaron los programas rectores de la carrera de formacisn en Enfermerma. El analisis de los mismos permitis apreciar aspectos tan importantes como el trabajo con la familia del discapacitado, o los procedimientos propios del manejo en el domicilio del discapacitado, los cuales no son objeto de estudio en la carrera. Se diseqs una estrategia curricular teniendo en cuenta los objetivos pedagsgicos a cumplimentar con las modificaciones propuestas. Se impone la necesidad de incluir en los programas de estudios aspectos relacionados con esta compleja tematica. Constituye un reto entonces para la universidad continuar desarrollando estrategias que permitan el desarrollo del proceso docente educativo y garanticen calidad en el egresado. In order to design a modification proposal to the nurses training program and suggest the inclusion of topics on the child disability, enabling to instruct staff in training, a qualitative descriptive study was carried out in two stages. In the first stage, opinions through interviews to the staff of the Nursing Faculty of the University of Medical Sciences of Camag|ey were collected. In the second stage, the method of Experts Panel was applied. Ten experts were chosen intentionally taking into account their prestige, experience and links to teaching in regard to the subject. Guiding programs of the career of nursing training were analyzed. This analysis gave the possibility to appreciate important aspects, such as the work with the family of disabled children, and management procedures in their home, which are not the object of study in the career. A curricular strategy was designed taking into account the educational objectives to be fulfilled with the proposed modifications. It is necessary to include those aspects related to this complex subject in the programs. To continue developing strategies that allow improving the educational teaching process and ensuring the quality of graduated students represents a challenge to the University. (shrink)

Teaching graduate students how to do research can be a challenge for many instructors because "research education" is not an established field of research like other areas of teaching such as mathematics education, nursing education, science education, and statistics education. There are no scholarly journals devoted solely to teaching research methods; these sources are instead scattered across disciplines and journals (e.g., Nurse Researcher, Volume 13, Number 2, 2005; Sociology, Volume 15, Issue 4, 1981; and Scandinavian Journal of Educational Research, (...) Volume 49, Issue 1, 2005). Furthermore, even though research methods courses are a staple in most graduate training programs, instructors were rarely taught how to teach research methods as part of their own graduate programs. Left to their own devices, instructors of research courses must rely on a network of peers, scattered research literature, and much trial-and-error as they develop and improve upon their own research methods courses. (shrink)

The professions of nursing and nurse education are currently experiencing a crisis of confidence, particularly in the UK, where the Francis Report and other recent reviews have highlighted a number of cases of nurses who no longer appear willing or able to ‘care’. The popular press, along with some elements of the nursing profession, has placed the blame for these failures firmly on the academy and particularly on the relatively recent move to all‐graduate status in England for pre‐registration (...) student nurses. This has come to be known in the UK as the ‘too‐posh‐to‐wash’ argument, that there is an incommensurability between being educated to degree level and performing basic nursing tasks. I will argue in this paper that the diagnosis of the problem is substantively correct, but the formulation and the prescription are misguided and dangerous. I will suggest that the growing emphasis on research‐based and evidence‐based practice is the logical conclusion of an inappropriate scientific paradigm for nursing which is underpinned by the social sciences, by technical rationality, and by a focus on people. In contrast, I will suggest that a more fruitful way of thinking about and practising nursing and nurse education is to consider it as a human science with a focus on persons in which evidence for practice derives largely from practice itself. The history of the idea of a human science is traced from its roots in nineteenth century hermeneutics to the work of Gadamer and R.D. Laing in the 1960s, and I attempt to imagine a paradigm for nursing practice, scholarship, and education based on Laing's ‘existential–phenomenological’ approach with a focus on the endeavour to understand and relate to individual persons rather than to make broad prescriptions for practice based on statistical and other generalizations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:To Nurse BetterJaime HenselWhen things were quiet again I asked him what training he’d had to become the director of hospital security. “I worked for 20 years in corrections,” he answered proudly, and I was saddened but not surprised.In September 2010 I started an accelerated graduate entry nurse practitioner program to become a family nurse practitioner. Accelerated programs leave little time for preamble, since the idea is to take (...) a total novice and turn her first into a nurse and then into a nurse practitioner in just three years. While the classroom information was vital, it was our clinical experiences that really initiated us into the profession. In just the second week of school, we were divided into small groups and assigned to clinical preceptors—hands–on teachers who introduced us to our first patients, curbed our mistakes, quelled our fears, and pushed and pulled and cajoled us into being nascent healthcare providers. In showing us how to give bed baths, suction secretions, insert Foley catheters, and hang IV bags, our preceptors really began showing us how to use our hands as healers.In that first semester my patients also proved to be invaluable instructors. Talking to them, administering their medication, washing their bodies made me keenly aware of the delicate balance of vulnerability and power and trust and respect and intimacy that underlies all healthcare relationships. I hope, wherever those patients are now, they know how deeply I appreciate their patience and good humor and their collusion in my education.In December, the first semester and the first clinical rotations ended. Four months into nursing school I had a basic understanding of what it means to be a nurse. Frankly, most days I still felt like an impostor in blue pajamas sporting a stethoscope I didn’t really know how to use and new Dansko clogs that squeaked with every step. But in an accelerated program, fast and furious is the name of the game. We went away for winter break—a much needed breather—and came back to something completely different: psychiatric nursing.In preparation for these new clinicals, we were taught in class that we should not wear dangly jewelry or stethoscopes. That we should never let the patient get between us and the door. That psychiatric (psych) patients could escalate quickly; psych patients could have surprising triggers; psych patients could be very unpredictable. And psych patients could be violent. We were taught about physical and chemical restraints, and about show of force. We were cautioned, as students, to stay out of the way if things got tense on the floor. In stark contrast to medical patients, psych patients were made to sound less like people who had diseases and more like adversaries. I drove to my first day on the floor with trepidation.My new preceptor had spent her entire career in psych. She loved her job, loved the care of psychiatric patients. She set up a rotation because she wanted our entire clinical group to get full exposure to the breadth of psychiatric services offered by this medium–sized community hospital. We would each get to spend shifts on the locked psych floor, observing outpatient group therapy sessions, and in the psych emergency department (ED).I rotated to the psych ED for the first time on a Friday night. The first couple hours of the shift were very slow. I started talking to the mustachioed guard on duty, who looked as bored as I felt. He told me about his kids, I told him about nursing school. He seemed nice.When our conversation flagged, I explored the psych ED. It didn’t take long—just a short hallway with a bathroom, the social workers’ office, and two patient rooms without doors. The majority of the designated psych beds were actually around the corner in the main room of the medical ED—stretchers lined against the wall, without curtains or any [End Page 98] other attempt at privacy. I noticed that from where the guard stood at the corner of the psych hall he had a pretty good view of all the beds. Then again, so did most of the other patients... (shrink)

In nursing, expectations of honesty and integrity are clearly stipulated throughout professional standards and codes of conduct, thus the concept of academic integrity has even more impetus in preparing students for graduate practice. However, a disparity between policy and practice misses the opportunity to instil the principles of academic integrity, and at its core honesty, a pivotal trait in the nursing profession. This study draws upon the experience of the nursing faculty to explore how academic integrity policy (...) of deterrence operate in nursing education.While participants deplored cheating behaviours, they expressed frustration in having to ‘police’ large numbers of students who had little awareness of the academic standards to meet policy requirements. In addition, they were cynical because of a perceived lack of severity in sanctions for students who repeatedly breached integrity. Participants expressed a moral obligation as educators to meet student learning needs and preferred to engage with students in a more meaningful way to uphold academic integrity. The ambivalence to detect and report breaches in integrity undermines the effectiveness of policy. Therefore, faculty must recognise the importance of their role in detecting and escalating cases of dishonesty and execute deterrence in a more consistent way. To do this, greater support at an institutional level, such as smaller class sizes, inclusion in decision making around sanctions and recognition of additional workload, will enable faculty to uphold policy. Although policing was not their preferred approach, the role of faculty in detecting and reporting cases of misconduct is crucial to increase the certainty of students getting caught, which is essential if policy is to be effective in deterring dishonest behaviour. (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: Nurses who provide aggressive care often experience the ethical challenge of needing to preserve the hope of seriously ill patients and their families without providing false hope. -/- Research objectives: The purpose of this inquiry was to explore nurses’ moral competence related to fostering hope in patients and their families within the context of aggressive technological care. A secondary purpose was to understand how this competence is shaped by the social–moral space of nurses’ work in order to capture (...) how competencies may reflect an adaptation to a less than ideal work environment. -/- Research design: A critical qualitative approach was used. -/- Participants: Fifteen graduate nursing students from various practice areas participated. -/- Ethical considerations: After receiving ethics approval from the university, signed informed consent was obtained from participants before they were interviewed. -/- Findings: One overarching theme ‘Mediating the tension between providing false hope and destroying hope within biomedicine’ along with three subthemes, including ‘Reimagining hopeful possibilities’, ‘Exercising caution within the social–moral space of nursing’ and ‘Maintaining nurses’ own hope’, was identified, which represents specific aspects of this moral competency. -/- Discussion: This competency represents a complex, nuanced and multi-layered set of skills in which nurses must be well attuned to the needs and emotions of their patients and families, have the foresight to imagine possible future hopes, be able to acknowledge death, have advanced interpersonal skills, maintain their own hope and ideally have the capacity to challenge those around them when the provision of aggressive care is a form of providing false hope. -/- Conclusion: The articulation of moral competencies may support the development of nursing ethics curricula to prepare future nurses in a way that is sensitive to the characteristics of actual practice settings. (shrink)

In Australia, debates over the appropriate length of undergraduate nursing programs have a long history. Submissions from both universities and industry to key government reports have consistently argued that the current minimum entry level of practice, a three‐year program, is too short to enable students to gain the knowledge and skills necessary for the contemporary nursing role. Despite these submissions, the established entry level for nursing practice in Australia remains a three‐year undergraduate bachelor degree. However, there is (...) a small group of high‐achieving students who will begin practice at the end of a four‐year program. Little is known about these programs, or the students who are currently enrolled in them. Designed as a collaborative endeavour, based on co‐operative inquiry, the study discussed in this article aimed to provide an insight into aspects of a four‐year undergraduate nursing program. Potentially, the broader theoretical and clinical preparation that is possible in a four‐year program provides students with enhanced learning opportunities that will enable them to graduate with more confidence and greater ability. In this study a four‐year program provided an opportunity for a regional university to prepare students for the demanding realities of a complex area of practice, rural nursing. (shrink)

Se presenta una revisión bibliográfica en la que se valora la implementación de las estrategias curriculares en la Licenciatura en Enfermería, a partir de las asignaturas impartidas en el segundo año de la carrera. Se destaca la importancia de estos recursos pedagógicos en la formación de los estudiantes, su desarrollo y contribución a la solución de situaciones relacionadas con el cuidado, la calidad de la atención de salud, la disminución de eventos adversos y la seguridad del paciente. Las estrategias curriculares (...) vinculadas a la carrera de Enfermería constituyen una forma particular de desarrollar el proceso docente, caracterizadas por una direccionalidad coordinada que responde al perfil de salida del egresado, en la que se imbrican los contenidos y métodos teóricos y prácticos de las unidades curriculares correspondientes al plan de estudio, a partir de una estructura metodológica que garantiza su funcionamiento. Ello contribuye a la formación integral de un profesional competente. A bibliographic revision is presented in order to assess the implementation of curricular strategies in Nursing 2nd year subjects. The importance of teaching aids in students' training, their development and contribution to solve issues related to care and quality of the health system, the lowering of adverse events and the patient´s safety are pointed out. Curricular strategies related to Nursing represent a particular way to develop the teaching process, characterized by a coordinated direction which responds to the graduate's experience, in which theoretical and practical methods and contents of the curricular units that belong to the syllabus are interwoven, starting from a methodological structure that ensures these strategy functions. It contributes to the comprehensive formation of a competent professional. (shrink)

Background There is continued need for enhanced medical ethics education across the United States. In an effort to guide medical ethics education reform, we report the first interprofessional survey of a cohort of graduate medical, nursing and allied health professional students that examined perceived student need for more formalized medical ethics education and assessed preferences for teaching methods in a graduate level medical ethics curriculum. Methods In January 2018, following the successful implementation of a peer-led, grassroots medical ethics (...) curriculum, student leaders under faculty guidance conducted a cross-sectional survey with 562 of 1357 responses received among students enrolled in the School of Medicine, College of Nursing, Doctor of Physical Therapy and BS/ MD Professional Scholars programs at The Medical College of Georgia at Augusta University. An in person or web-based questionnaire was designed to measure perceived need for a more in-depth medical ethics curriculum. Results The majority of respondents were female, white and mid-20s in age. Almost half of respondents reported no prior medical ethics exposure or training in their previous educational experience, while 60% of students across all degree programs reported an interest in more medical ethics education and 92% noted that an understanding of medical ethics was important to their future career. Over a quarter of students were interested in pursuing graduate-level training in medical ethics, with case-based discussions, small group peer settings and ethics guest lectures being the most desired teaching methods. Conclusions The future physician, nursing and physical therapist workforce in our medical community demonstrated an unmet need and strong interest for more formal medical ethics education within their current coursework. Grassroots student-driven curricular development and leadership in medical ethics can positively impact medical education. Subsequent integration of interprofessional training in medical ethics may serve as a vital curricular approach to improving the training of ethically competent healthcare professionals and overcoming the current hierarchical clinical silos. (shrink)

The population of most non-dominant ethnic groups in the USA is growing dramatically. Faculty members are challenged to develop curricula that adequately prepare our future nurses. An increased focus on clinical ethics has resulted from the use of sophisticated technology, changes in health care financing, an increasing elderly population and the shift of care from inpatient to outpatient settings. Nurses frequently face situations demanding resolution of ethical dilemmas involving cultural differences. Nursing curricula must include content on both ethics and (...) cultural sensitivity. Active student participation is an important element providing a foundation for ethical practice. A proposed educational format was introduced with graduating baccalaureate students. In a pilot study, curricular content on cultural sensitivity and ethical practice was taught in separate modules. Students were then asked to identify and problem solve an ethical dilemma involving patients and professional caregivers from vastly different cultures. Course faculty members provided discussion questions to guide the students' thinking. (shrink)

This article examines trigger warnings, particularly the call for trigger warnings on university campuses, and from a Levinasian and Kantian ethical perspective, and addresses the question: When, if ever, are trigger warnings helpful to student's learning? The nursing curriculum is developed with key stakeholders and regulatory bodies to ensure graduate nurses are competent to deliver a high standard of care to patients and clients. Practical teaching practice and published research has uncovered an increasing use of ‘Trigger Warnings’ before (...) a topic is discussed, or used as warnings on core module texts. It is appreciated that some students have personal experience of psychological or physical trauma. However, apart from identifying these students through Mitigating Circumstances committees, or when the student feels confident to share this information with a personal tutor, this information remains strictly confidential. There is the potential for covert skills such as critical analysis and skilful discussion not being attained by the student. With the assistance of Kants moral theory, an argument will develop that the insidious use of Trigger warnings and the embargo of recommended reading, requires critical discussion with the public. This would involve the rationale and pedagogical justification for the use of texts, and the necessity within nursing education to address challenging clinical topics. To support students with PTSD this may involve the research discussed on personal educational needs analysis. (shrink)

One of the career options Ede Christian University for higher professional education offers is nursing. As a Christian professional school, the ECU provides learning environments for nursing students to become professionals who are to exhibit a Christian life style, values and professional ethics. Nursing graduates of our school in general may have a Christian disposition regarding major issues in health care like displaying respect for patients, having a correct attitude, practising informed consent, displaying confidentiality, and avoiding euthanasia (...) etc. A worrying development for educators, though, is that often within a year after their graduation these young nursing professionals may adopt the secularized behaviour predominant in their workplace, even when that behaviour in some respects contrasts with the values they internalized during their nursing education. . Apparently, the shaping force of the social context of a professional practice can be stronger than the personal beliefs young professionals adopt before their graduation. (shrink)

Background:Horizontal violence, defined in the literature as ‘interpersonal conflict between two nurses at the same hierarchical levels in organizations’, often associated with bullying, affects the well-being of nurses, care recipients and the professional image of nursing and the organization due to increased turnover. One in every three newly graduated nurses is a victim of horizontal violence, although they do not always know how to define it.Aim:To investigate the direct and indirect experiences of horizontal violence in newly graduated nurses as (...) well as to shed light on the phenomenon, on its awareness and recognition.Methods:A qualitative phenomenological study was conducted between September and October 2018 with newly graduated nurses, with a work experience ranging between 6 months and 3 years. The interviews were conducted face-to-face, consisting of a first open general question, followed by semi-structured questions.Ethical considerations:The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Institution Review Board.Results:From the analysis of the interviews of the 21 participants, four main themes were identified: the ‘enemies’, that is those who exercised violence, the ‘weapons’ used by them to exercise violence, the ‘effects’ and the types of ‘armor’ identified to protect themselves.Discussion:Horizontal violence is rarely recognized by newly graduated nurses, even though our sample had directly or indirectly experienced horizontal violence. Tackling the phenomenon starting from the undergraduate degree courses, focusing on effective support and more protection by the organization leaders were the silent requests that emerged from this study.Conclusion:Preventing horizontal violence is important for nurses’ professional and private well-being, for professional conduct and for the quality of care provided to patients. (shrink)

Background Euthanasia is a controversial practice in many countries. Since Spain’s Euthanasia Law came into effect on March 24, 2021, healthcare providers have faced a new challenge since they must inform patients, provide care, accompany them, and implement the law. It also represents a new stumbling block at universities, which must adapt to regulatory changes and educate future professionals accordingly. Little is known about the attitude of nursing students in Spain toward euthanasia since this law was implemented. Objective This (...) study aims to answer the following research questions: What is the attitude of nursing students toward euthanasia? What factors influence this attitude? Research design A cross-sectional study was conducted using an online questionnaire. Participants and research context The study population comprised all nursing students at a public university in Barcelona ( n = 444), Spain, during the 2022–2023 academic year. The validated Spanish version of the Euthanasia Attitude Scale was employed. A bivariate analysis was performed. Ethical considerations The university Ethics Committee (CEEAH 6247) approved this study. All participating students signed an informed consent form. Participation was voluntary, and data anonymity and confidentiality were guaranteed. Results Two hundred and forty-four nursing students responded to the questionnaire. The mean total score was 79.64. Participants with religious beliefs presented lower scores, indicating a more negative attitude toward euthanasia. Participants in their second, third, or fourth year of the nursing degree scored higher, demonstrating a more positive attitude. Conclusions The attitude of nursing students toward euthanasia was remarkably positive. Working on ethical content during the degree course and clinical practice are factors that help to develop a more positive attitude. In addition, nursing education should encourage professional aspects to prevail over religious beliefs in euthanasia situations. (shrink)

Background: Nursing students experience ethical conflicts and challenges during their clinical education. These may lead to moral distress and disturb the learning process. Objectives: This study aimed to explore and to evaluate the nursing students’ ethical challenges in the clinical settings in Iran. Research design: This was a mixed-methods study with an exploratory sequential design. Participants and research context: A total of 37 and 120 Iranian nursing students participated in the qualitative and quantitative phases, respectively. Ethical considerations: (...) The ethical committee of Kerman University of Medical Sciences, Iran, approved the protocol of the study. Findings: Three main categories were extracted from qualitative data including Low attention of nurses to the patients’ preferences; Lack of authority; and Inadequate support. A total of 97% of the students had more than one ethical challenge in clinical settings and 48% of them stated that their challenges did not resolve. The total score of perceived ethical challenges was 62.03 ± 9.17, which was moderate. The highest mean score related to the “Low attention of nurses to the patients’ preferences” subscale. Discussion: The finding confirmed most of the existing results of other international researches about the frequency and kinds of baccalaureate nursing students’ ethical challenges. Conclusion: Identifying student ethical challenges helps teachers to manage their clinical learning process better. This study may provide a view for the nurses, clinical educators, and managers toward nursing students’ ethical challenges and their impact on nursing students’ clinical experiences. (shrink)

This article portrays the unique aspects of ethics education in a multicultural, multireligious and conflict-based atmosphere among Jewish and Arab nursing students in Jerusalem, Israel. It discusses the principles and the methods used for rising above this tension and dealing with this complicated situation, based on Yoder's `bridging' method. An example is used of Jewish and Arab students together implementing two projects in 2008, when the faculty decided to co-operate with communities in East Jerusalem, the Arab side of the (...) city. The students took it upon themselves to chaperon the teachers who came to watch them at work, translate, and facilitate interaction with a guarded and suspicious community. This approach could also be relevant to less extreme conditions in any inter-religious environment when trying to produce graduates with a strong ethical awareness. (shrink)

Nursing education is a dynamic process that is constantly changing. Currently, we want the profile of a professional who not only has technical-scientific skills, but also adopts a critical-reflexive and humanistic approach based on ethics. O aprender a cuidar em Enfermagem perpassa por questões que vão além do saber teórico, exigindo outras formas de agir, no que tange à formação e prática apoiadas na humanização. This study aimed to understand the senses of humanization in the teacher-student relationship during (...) the supervised internships in Tertiary Health Care services of a graduation. Nursing course in the interior of Pernambuco. This study aimed to understand the senses of humanization in the teacherstudent relationship during the supervised internships in Tertiary Health Care services of a graduation. Nursing course in the interior of Pernambuco. And as specific objectives: To investigate what is the perception about human relationship between teacher and student during supervised internships; identify how the relationship between teachers and students is developed during such activities and; To analyze how this relationship can affect and or impact on the development and performance of pairs. We emphasize that the study was approved by the Research Ethics Committee, with the Certificate of Presentation for Ethical Appreciation of n. 05009218.4.0000.5208. The research in question was characterized by a qualitative approach, of an exploratory nature and to obtain the data, we conducted semistructured and audio-recorded interviews, from March to May 2019, with seven supervising professors from a Private Higher Education Institution in Agreste de Pernambuco, who fallowed the Supervised Internships in the Tertiary Care to Health. Data analysis took place from the perspective of Bardin and the obtained results showed that both teachers and students understood and recognized that a humanized relationship, in the context of supervised internships, is based on respect for beliefs, values and principles, aiming at the comprehensiveness of the human being. Besides, the studies show us that the type of relationship established between this binomial can impact in various ways on the development of its activities. This research made it possible to identify and understand the meanings of humanization in the teacher-student relationship during the exercise of Supervised Internship, through a practice based on the integrality of being. Keywords: Human Formation. Nursing. Humanization. Education. Supervised Internship. (shrink)

This Korean study replicated a previously published American study. The conceptual framework and method combined ethical enquiry and phenomenology. The research questions were: (1) What is nursing students’ experience of ethical problems involving nursing practice? and, (2) What is nursing students’ experience of using an ethical decision-making model? The participants were 97 senior baccalaureate nursing students, each of whom described one ethical problem and chose to use one of five ethical decision-making models. From 97 ethical problems, (...) five content categories emerged, the largest being health professionals (69%). The basic nature of the ethical problems was the students’ experience of conflict, resolution and rationale. Using an ethical decision-making model helped 94% of the students. A comparison of the Korean and American results yields important implications for nursing ethics education, practice and research. (shrink)

Background Previous research mainly focuses on how to support nursing students in caring for the patient and on educators’ views of students’ development as professional caring nurses. Against this background, it is important to further investigate nursing students’ perspectives on what it means to become a professional caring nurse. Research aim This qualitative systematic review study aims to identify and synthesize nursing students’ perceptions on the meaning of becoming a caring nurse. Research design and data sources Systematic (...) data searches were conducted by using the electronic databases MEDLINE (Ovid), CINAHL (EBSCO), Academic Search Premiere (EBSCO), and Philosopher`s Index. In total, 13 studies met the inclusion and quality criteria. The articles were analyzed by a systematic review and a thematic synthesis according to Thomas and Harden. Ethical consideration The study followed good ethical practice guidelines outlined in the Northern Nurses’ Federation. Findings The analysis resulted in eight descriptive themes and finally in three analytical themes: Becoming is to get in touch with one’s inner ethic or ethos, Becoming is a movement between courage, understanding, and being touched, and Becoming is strengthened through caring role models and a learning culture. Conclusions Becoming a professional caring nurse is seen as an ongoing movement toward a deeper understanding of oneself and one’s being and bearing. This movement is enabled when nursing students have a sense of self-awareness, courage to stand in their vulnerability, and reflect on their responsibility, caring attitude, and inner values and ethics. The force of becoming is that the attention is directed beyond self to care for and feel empathy for others in a caring manner. Becoming is released through a caring relationship, external confirmation, and good role models. A lack of external support in the movement can potentially prevent the students from becoming a professional caring nurse. (shrink)

Using a conceptual framework and method combining ethical enquiry and phenomenology, we asked 73 senior baccalaureate nursing students to answer two questions: (1) What is nursing students’ experience of an ethical problem involving nursing practice? and (2) What is nursing students’ experience of using an ethical decision-making model? Each student described one ethical problem, from which emerged five content categories, the largest being that involving health professionals (44%). The basic nature of the ethical problems consisted (...) of the nursing students’ experience of conflict, resolution and rationale; 85% of the students stated that using an ethical decision-making model was helpful. Although additional research is needed, these findings have important implications for nursing ethics education and practice. (shrink)

The purpose of this study was to compare nursing students' perceptions of self-determination in elderly patients before and after clinical training in long term care institutions as a part of their course in gerontological nursing. A pre- post-test design was employed. The data were collected by questionnaires completed by students at one nurse education organization college in Finland (pre-test n ± 120, response rate 95%; post-test n ± 115, response rate 91%). The students' perceptions of elderly patients' self-determination (...) were more positive after their clinical training period concerning to what extent elderly patients are able to control their treatment and what kind of support they received from nurses to exercise their self-determination. The students' perceptions remained stable concerning how important self-determination is to elderly patients, and how willing and knowledgeable they are about using their self-determination. Ethics teaching, together with high quality clinical training placements, should be assured early during nursing studies. (shrink)

Background:Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety.Objectives:The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors (...) contribute to moral distress in undergraduate student nurses during their clinical experience and professional education.Research design:The research design was a systematic literature review.Method:The search produced a total of 157 articles published between 2004 and 2014. These were screened with the assessment sheet designed by Hawker and colleagues. Four articles matched the search criteria (one quantitative study and three qualitative), and these were separately read and analyzed by the researchers. The process of review and analysis of the data was supervised by a colleague experienced in moral distress who provided an independent quality check.Ethical consideration:Since this was a systematic review, no ethical approval was required.Findings:From the analysis, it emerged that inequalities and healthcare disparities, the relationship with the mentor, and students’ individual characteristics can all impact negatively on the decisions taken and the nursing care provided, generating moral distress. All these factors condition both the clinical experience and learning process, in addition to the professional development and the possible care choices of future nurses.Conclusion:Few studies dealt with moral distress in the setting of nurse education, and there is a knowledge gap related to this phenomenon. The results of this review underline the need for further research regarding interventions that can minimize moral distress in undergraduate nursing students. (shrink)

BackgroundWhile academic dishonesty among nursing students is becoming a global problem, the instruments used in studies on this topic are heterogeneous and, in many cases, not even validated. This...

In literature as well as in nursing practice a growing concern about nurses’ ethical competence can be observed. Based on the cognitive theory of moral development by Kohlberg, this research examined nursing students’ ethical behaviour in five nursing dilemmas. Ethical behaviour refers not only to the ethical reasoning of nursing students but also to the relationship between reasoning and behaviour. Kohlberg’s definition of morality was refined by adding a care perspective. The results show that the majority (...) of students can be located in the fourth moral stage according to Kohlberg’s theory, that is, the conventional level of moral development. This finding implies that students are still guided by professional rules, norms and duties, and have not (yet) succeeded in making personal ethical decisions on the basis of their own principles and acting according to such decisions. (shrink)

Background:Through education, individuals acquire knowledge, skill and attitudes that facilitate professional socialization; it involves intellectual, emotional and psychomotor skill development. Teachers are role models for behaviour modification and value development.Objective:To examine students’ perceptions of faculty members’ ethical and unethical attitudes during interactions in undergraduate nursing.Research design:This descriptive study consisted of two phases. In Phase I, we developed an instrument, which was administered to nursing students to assess validity and reliability. Exploratory factor analysis yielded 32 items. Cronbach’s α was (...) 0.83, and test–retest reliability was good. In Phase II, a 32-item version of the instrument was administered to nursing students from another university.Participants and research context:Participants included 219 nursing students from one university in Phase I and 196 from another university in Phase II. The study was conducted at the universities attended by the participants.Ethical considerations:Ethical approval was granted by the institutions involved, and all participants provided informed consent.Findings:In Phase I, the instrument demonstrated good psychometric properties for measuring nursing students’ perceptions of faculty members’ ethical and unethical behaviours. In Phase II, students considered certain professional and personal qualities, including respecting confidentiality and students’ private lives and assuming an impartial stance during interactions in the classroom, examinations, or clinical practice, ethical. They considered using obscene examples or unprofessional speech during teaching, selling textbooks in class, using university facilities for personal interests, engaging in romantic relationships with students, and humiliating students in front of patients or staff in clinical settings unethical.Conclusion:Results of this study suggest that nurse educators should be aware of their critical role in the teaching–learning process, and they must scrutinize their attitudes towards students from an ethical point of view. (shrink)

Background:Moral distress is considered to be the negative feelings that arise when one knows the morally correct response to a situation but cannot act because of institutional or hierarchal constraints.Objectives:To analyze moral distress and its relation with sociodemographic and academic variables in undergraduate students from different universities in Brazil.Method:Quantitative study with a cross-sectional design. Data were collected through the Moral Distress Scale for Nursing Students, with 499 nursing students from three universities in the extreme south of Brazil answering (...) the scale. The data were analyzed in the statistical software SPSS version 22.0, through descriptive statistical analysis, association tests (t-test and analysis of variance), and linear regression models.Ethical considerations:Approval for the study was obtained from the Research Ethics Committee at Universidade Federal do Rio Grande.Findings:The mean intensity of moral distress in the constructs ranged from 1.60 to 2.55. As to the occurrence of situations leading to moral distress in the constructs, the frequencies ranged from 1.21 to 2.43. The intensity level of moral distress showed higher averages in the more advanced grades of the undergraduate nursing course, when compared to the early grades of this course (between 5 and 10 grade, average = 2.60–3.14, p = 0.000).Conclusion:The demographic and academic characteristics of the undergraduate nursing students who referred higher levels of moral distress were being enrolled in the final course semesters, were at a federal university, and had no prior degree as an auxiliary nurse/nursing technician. (shrink)