Overview of nursing ethics teaching in Brazilian public higher education institutions.

OBJECTIVES: to outline the teaching of ethics in undergraduate Nursing programs in Brazilian public higher education institutions. METHODS: descriptive and exploratory study, carried out through the documentary analysis of pedagogical projects of undergraduate Nursing programs in Brazil. RESULTS: 153 active undergraduate Nursing programs were found, of which 106 provide the pedagogical project. In addition to deontological teaching, the teaching of ethics was identified in a transversal way associated with themes such as Social Context, Hospital and Community Care, Pharmacology, Systematization of Nursing Care, Surgical Nursing, Epidemiology, Palliative Care, Management in Nursing, Diversity, Women's, Children's, Adolescent's, Adult's and Older People's Health, and Mental Health. FINAL CONSIDERATIONS: the challenge in teaching nursing ethics is its integration with each action of caring, teaching and managing.

Ethics and Well-Being: The Health Professions and the COVID-19 Pandemic.

The COVID-19 pandemic has had a profound impact on health professionals, adding to the moral suffering and burnout that existed prepandemic. The physical, psychological, and moral toll of the pandemic has threatened the well-being and integrity of clinicians. The narrative of self-sacrifice and heroism bolstered people early on but was not sustainable over time. For health professions students, the learning environment changed dramatically, limiting opportunities in direct patient care and raising concerns for meeting training requirements. Learners lost social connections and felt isolated while learning remotely, and they witnessed ethical tensions between patient-centered care and parallel obligations to public health. Worries about transmission of the virus and uncertainty about its management contributed to their moral suffering. Educators adjusted curricula to address the changing ethical landscape. Preparing learners for the realities of their future professional identities requires creation of interprofessional moral communities that provide support and help develop the moral agency and integrity of its members using experiential and relational learning methods. Investing in the well-being and resilience of clinicians, implementing the recommendations of the National Academy of Medicine, and engaging learners and faculty as cocreators of ethical practice have the potential to transform the learning environment. Faculty need to be trained as effective mentors to create safe spaces for exploring challenges and address moral adversity. Ethics education will need to expand to issues related to health systems science, social determinants of health, and public health, and the cultivation of moral sensitivity, character development, professional identity formation, and moral resilience.

Essential components of midwifery ethics education: results of a Delphi study.

OBJECTIVE: Ethical dilemmas are an inevitable part of a midwife's experience in clinical care. Midwifery educational programs have an obligation to provide students the opportunities to acquire the skills and knowledge to recognize and negotiate ethical dilemmas. Implementation of strategies for imparting ethical competencies and clinical ethics decision-making skills in formal midwifery curricula have been challenging and inconsistent. The purpose of this study was to gather information and opinions from midwifery educators and clinical preceptors about the essential components of ethics education for midwifery students in the United States (U.S.), aiming for consensus on key content, competencies, learning outcomes, and teaching strategies. DESIGN: This is an online Delphi study conducted in three rounds. Round 1 consisted of open-ended questions to explore and identify key content, competencies, learning outcomes, and teaching strategies for midwifery ethics education. In Rounds 2 and 3, experts rated statements on a 1 to 7 Likert scale, with positive consensus defined as 70% or more of the experts scoring ≥6. PARTICIPANTS: The panel included midwifery educators (midwifery program directors, faculty, and clinical preceptors) from the United States. FINDINGS: Of the 12 statements on key content of ethics education, midwives emphasized that content promoting an understanding of shared decision-making is essential for inclusion. Of the statements regarding competencies, learning outcomes, and teaching strategies, 20 of 21 statements met consensus, including those related to shared decision-making and ethical decision-making, as well as attributes such as compassion and courage. Midwives did not agree that an essential teaching strategy includes a validated assessment tool for evaluating students on any component of ethics learning (knowledge, skills, behaviour). KEY CONCLUSIONS: This Delphi study reveals what midwifery educators consider essential components of ethics education for midwifery students, with a particular focus on the professional attributes of shared decision-making. IMPLICATIONS FOR PRACTICE: Initial insights about optimal ways to incorporate the essential ethics education components into midwifery program curricula are provided, and more research is needed.

Factors Affecting Nurses' Impact on Social Justice in the Health System.

BACKGROUND: Social inequities in health systems are threats to global health. Considering the important role of nurses in establishing social justice, identification of factors affecting nurses' participation in this area can contribute to the development of social justice. OBJECTIVE: This study aimed to identify factors affecting nurses' participation in establishing social justice in the health system. RESEARCH DESIGN AND METHODS: The study was conducted using conventional qualitative content analysis approach. Purposive sampling was used to select 14 participants in 2019. The data were collected through semi-structured interviews and analyzed concurrently with data gathering. PARTICIPANTS AND RESEARCH CONTEXT: In total, six faculty members, five nursing managers, and three clinical nurses from three different universities were interviewed. ETHICAL CONSIDERATIONS: The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran. FINDINGS: Four main themes were found, including inadequate professional authority, insufficient attention to social justice in the area of education, clinical concerns as barriers to professional presence in society, and reflection of personality traits in the profession. These are the main factors affecting nurses' participation in establishing social justice in the health system. DISCUSSION: Authorities need to take effective steps to establish social justice through reforming the health system's policy-making and power-acquisition domains, promoting nurses' involvement in social factors in health issues, and adding professional values as a part of nursing curriculum. The clinical practice environment can also be helpful through providing quality, safe, and cost-effective services. In addition, fair and efficient recruitment process for new nurses can contribute to the establishment of social justice in the health system. CONCLUSION: Macro-level managerial factors such as policy, education, and clinical environment, along with personal factors, play a significant role in the participation of nursing profession in establishing social justice.

Findings from a mixed-methods pragmatic cluster trial evaluating the impact of ethics education interventions on residential care-givers.

There has been little previous research regarding the effectiveness of ethics education interventions for residential care-givers. The Researching Interventions to Promote Ethics in social care project responded to the question: Which is the most effective ethics education intervention for care-givers in residential social care? A pragmatic cluster trial explored the impact of three ethics education interventions for: (a) interactive face-to-face ethics teaching; (b) reflective ethics discussion groups; and (c) an immersive simulation experience. There was also a control arm (d). 144 trial participants were recruited from 39 residential care homes for older people in southern England. Change scores compared across intervention arms showed a significant reduction in work-related moral stress in the teaching arm compared with control group (p = .03); there were no significant differences between control and intervention arms in change scores for moral sensitivity, interpersonal reactivity (empathy) or ethical leadership. Qualitative data themes were as follows: ethical care; care challenges; and ethical care inhibitors. Overall findings stimulate reflection on the value of three different ethics education interventions and the most appropriate means to evaluate their impact. Findings suggest the complexity and diverse nature of ethical competence in care. We suggest a way forward for research evaluating ethics education.

Buenas prácticas éticas de los estudiantes de Enfermería ante el sida y la discapacidad / Good ethical practices of Nursing students when faced with aids and disability

INTRODUCCIÓN: Durante el curso 2017/2018 se realizó una intervención educativa sobre buenas prácticas éticas en el abordaje del sida y de la discapacidad. Los objetivos fueron: analizar, divulgar y concienciar a los estudiantes sobre los problemas éticos de estos colectivos y sobre las buenas prácticas. MÉTODOS: Participaron 185 estudiantes matriculados en la asignatura de Ética y Gestión de Enfermería. Los objetivos se abordaron mediante el trabajo autónomo de búsquedas de información y en 2seminarios presenciales, donde elaboraron pósteres, folletos y vídeos. Al finalizar la experiencia rellenaron un cuestionario de opinión. RESULTADOS: Se agruparon en 39 equipos de 4-5 estudiantes y entregaron 78 trabajos: 52 pósteres, 20 folletos y 6 vídeos. Los trabajos fueron expuestos, durante una semana, coincidiendo con el Día Mundial de la Lucha contra el Sida y con el Día Internacional de las Personas con Discapacidad. CONCLUSIONES: Esta experiencia ha servido para que los estudiantes tomen conciencia de los problemas de estos colectivos vulnerables, además de conseguir la divulgación de buenas prácticas éticas

INTRODUCTION: During the academic year 2017/2018, an educational intervention on good ethical practices was carried out about AIDS and Disability. The objectives were, to analyse, divulge and sensitise students about the ethical problems of these patient groups and about good practices. METHODS: The study included a total of 185 students enrolled in the subject of Ethics and Management of Nursing. The objectives were addressed using independent information searches and attending 2seminars, where they produced posters, brochures and videos. At the end of the experience they produced an opinion questionnaire. RESULTS: They were grouped into 39 teams of 4-5 students, and delivered 78 works, 52 of which were posters, 20 brochures, and 6 videos. The works were presented for a week, coinciding with the World AIDS Day and with the International Day of Persons with Disabilities. CONCLUSIONS: This experience has served to make students aware of the problems of these vulnerable groups, and also for the divulgation of good ethical practice

Teaching Ethics in Classroom Settings: Nursing Faculty Perceptions in Baccalaureate Programs.

BACKGROUND: The complexity of the current health care system has resulted in increasing demands on nurses to act as patient advocates and moral agents. Understanding faculty's experiences teaching ethics is instrumental to deliver ethically competent care. The purpose of this study was to explore the experiences of nursing faculty teaching ethics content in the classroom setting to prelicensure baccalaureate nursing students. METHOD: This qualitative, descriptive phenomenological design asked 11 nursing faculty with recent experience teaching ethics within prelicensure baccalaureate nursing programs to complete qualitative interviews. RESULTS: Participants expressed the importance of teaching ethics in undergraduate nursing curricula but experienced significant challenges. Three main themes were identified in the data analysis: Lacking Prior Preparation, Difficult Content, and No Place Holder for Ethics Content. CONCLUSION: Intentional curriculum design incorporating ethics content is necessary for the preparation of prelicensure nursing students, along with formal and informal opportunities for faculty to explore ethics including philosophical underpinnings. [J Nurs Educ. 2020;59(9):506-509.].

The Effectiveness of Teaching Nursing Ethics via Scenarios and Group Discussion in Nurses' Adherence to Ethical Codes and Patients' Satisfaction with Nurses' Performance.

BACKGROUND: There are shortcomings in nurses' adherence to ethical principles in practice. The present study aims to investigate the effectiveness of teaching nursing ethics via scenario-based learning and group discussion in nurses' adherence to codes of ethics and patients' satisfaction with nurses' performance. METHODS: Using a quasiexperimental design, the present study employed questionnaires which measure nurses' compliance with nursing codes of ethics and patients' satisfaction with nursing care before, immediately after, and one month after intervention. The collected data were analyzed using the independent t-test, ANOVA, and chi-square test in SPSS v.22. The level of significance was set at p < 0.05. The nurses (n = 80) and patients (n = 160) from various units of two university hospitals in the south-west of Iran participated in the present study. RESULTS: The pretest mean scores of the intervention and control groups in patient rights and patients' satisfaction with nursing care were not significantly different (p=0.07, p=0.21). Yet, there were statistically significant differences between the groups' mean scores as calculated immediately after (p < 0.001, p < 0.001) and one month after intervention (p < 0.001, p < 0.001). CONCLUSION: Employment of new approaches to teach nursing ethical principles improves compliance with nursing ethical codes and patients' satisfaction with nurses' performance.

Analysis of Undergraduate Nursing Students' Sensitivity to Microethical Dilemmas During Simulation.

BACKGROUND: Simulation can extend ethics education in undergraduate nursing programs beyond the cognitive domain. However, the degree to which nursing students recognize and respond to microethical dilemmas in simulation is unknown. METHOD: Using a mixed-methods convergent parallel design, 68 third- and fourth-year undergraduate nursing students completed a sensitivity questionnaire. Twelve students also participated in an interview. Data were compared to create meaning. RESULTS: Many students reported having a high level of ethical sensitivity toward microethical dilemmas during simulation. However, some students expressed uncertainty in their ability to identify microethical dilemmas during nurse-patient interactions. Students also reported limited confidence in being able to transfer their ethical knowledge to the practice setting. CONCLUSION: Nurse educators must be moral agents during simulated learning experiences by helping students learn what microethical dilemmas are and strategies to manage them. [J Nurs Educ. 2020;59(2):88-92.].

Relationships between organizational and individual support, nurses' ethical competence, ethical safety, and work satisfaction.

BACKGROUND: Organizations and nurse leaders do not always effectively support nurses' ethical competence. More information is needed about nurses' perceptions of this support and relevant factors to improve it. PURPOSE: The aim of the study was to examine relationships between nurses' perceived organizational and individual support, ethical competence, ethical safety, and work satisfaction. METHODOLOGY: A cross-sectional questionnaire survey was conducted. Questionnaires were distributed to nurses (n = 298) working in specialized, primary, or private health care in Finland. Descriptive statistics, multifactor analysis of variance, and linear regression analysis were used to test the relationships. RESULTS: The nurses reported low organizational and individual support for their ethical competence, whereas perceptions of their ethical competence, ethical safety, and work satisfaction were moderate. There were statistically significant positive correlations between both perceived individual and organizational support, and ethical competence, nurses' work satisfaction, and nurses' ethical safety. CONCLUSIONS: Organizational and individual support for nurses' ethical competence should be strengthened, at least in Finland, by providing more ethics education and addressing ethical problems in multiprofessional discussions. Findings confirm that organizational level support for ethical competence improves nurses' work satisfaction. They also show that individual level support improves nurses' sense of ethical safety, and both organizational and individual support strengthen nurses' ethical competence. PRACTICE IMPLICATIONS: These findings should assist nurse leaders to implement effective support practices to strengthen nurses' ethical competence, ethical safety, and work satisfaction.

Professional values and ethical ideology: Perceptions of nursing students.

BACKGROUND: Moral philosophical positions and professional values have been shown to influence nurses' practice behaviours. Understanding nursing students' professional values and ethical ideologies, therefore, is important as they may help inform evidence-informed curriculum decisions and education strategies to develop students' professional reflective competencies. However, there is a dearth in current empirical data on Canadian nursing students' perceptions of professional values and ethical positions. OBJECTIVES: This study's purpose was to examine undergraduate nursing student's perceptions of professional values and ethical ideology and explore relationships in data and selected participant demographic variables. RESEARCH DESIGN, PARTICIPANTS AND CONTEXT: A descriptive cross-sectional research design was conducted with a convenience sample of undergraduate nursing students recruited from a university in Canada. An online encrypted survey consisting of two validated instruments was administered to participants who met study eligibility criteria. Descriptive and inferential statistics were employed to analyse the data and classify nursing students' ethical ideologies into four categories based on mean scores for idealism and relativism. ETHICAL CONSIDERATIONS: This study received ethical approval from the institutional Behavioural Research Ethics Board and was executed in-line with ethical principles for research involving humans. FINDINGS: Nursing students scored high on professional values and ethical idealism and differed significantly on a measure of ethical relativism in terms of age and year of study. Professional values were significantly associated with ethical idealism. Based on mean scores for idealism and relativism, most nursing students in the study were classified as situationists. DISCUSSION AND CONCLUSION: Findings suggest that faculty pay attention to influences of moral philosophical positions in facilitating nursing students' professional values development. Implications for future research and curriculum are highlighted to strengthen nursing students' professional values.

Nursing Students' Professional Value Development: Can We Do Better?

AIM: The purpose of this study was to identify whether differences exist in nursing professional values based on program type and/or geographic location. BACKGROUND: Deliberate inclusion of values formation is critical to nursing education and high-quality nursing care. There is limited research comparing professional values development among students in all types of prelicensure RN programs and no research comparing students' professional values between geographic regions. METHOD: A secondary analysis was completed of original data collected in three descriptive studies using the Nursing Professional Value Scale-Revised®. RESULTS: Findings indicate prelicensure nursing students are educated with the values integrated within the American Nurses Association Code of Ethics. Significant differences (p < .05) were found when comparing geographic locations, program types, and Nursing Professional Value Scale-Revised factor scores. CONCLUSION: Additional research is needed to identify best practices for overall values formation in all program types.

The effects of debate-based ethics education on the moral sensitivity and judgment of nursing students: A quasi-experimental study.

BACKGROUND: While ethics education in undergraduate nursing education can be developed using a variety of teaching and learning strategies, consensus on the content and teaching modules for these ethics courses has still not been established and the effect of ethics education has rarely been evaluated. OBJECTIVES: The purpose of this study is to compare the effect of debate-based ethics education and lecture-style ethics education on the moral sensitivity and moral judgment of nursing students.. METHODS: This was a pre-test and post-test quasi-experimental study with a control group. A total of 64 senior-year nursing students in Korea participated in the study (35 in the debate group and 29 in the lecture group). The debate-based ethics education lasted for eight weeks with one two-hour session per week. The debate-based ethics education consisted of 16 rounds of affirmative and negative sides. Each debate lasted a total of 40 min and consisted of the introduction, cross-examination, rebuttal, conclusion, operation time, and wrap-up. The outcomes were measured by moral sensitivity and moral judgment questionnaires. RESULTS: There was a significant improvement in idealistic moral judgment and realistic moral judgment in the debate group compared to the lecture group. However, no statistically significant difference was found for moral sensitivity between the two groups. CONCLUSION: Based on this study's findings, it can be concluded that the debate-based ethics education for undergraduate nursing students is very effective in promoting moral judgment and the ability to take ethical decisions.

A comparison of inquiry-oriented teaching and lecture-based approach in nursing ethics education.

BACKGROUND: With developing nursing ethics education, the traditional methods of teaching could not meet the learning needs of undergraduates. Improving ethical decision-making to undergraduates is necessary toward promoting nursing ethics. OBJECTIVE: The aim of study is to compare the effect of inquiry-oriented teaching and lecture-based approach on nursing ethics education for undergraduates. DESIGN: A quasi-experimental study was conducted for undergraduate nursing students. SETTINGS: Two nursing schools participated in the study in mainland China. PARTICIPANTS: A total of 97 undergraduate nursing students participated in the study. METHODS: The study adopted a quasi-experimental design. RESULTS: The inquiry-oriented teaching group was significantly higher on average scoring than the lecture-based group after intervention in 2 aspects including: professional relationship (P = 0.015) and ethical decision making (P = 0.021). Contrarily, this study also showed that in the lecture-based group the score of foundational theories of nursing ethics was higher than Inquiry-oriented group (P = 0.038). A statistically significant difference was not found between the two groups in 3 scenarios: ethics related to nursing practice, ethics related to nursing research and necessity of learning nursing ethics. CONCLUSION: Combination of inquiry-oriented teaching and lecture-based approach is suggested as part of design for curriculum of nursing ethics education.

Nurses' professional values: Influences of experience and ethics education.

AIMS AND OBJECTIVES: To measure the professional values of registered nurses and determine whether these values are significantly related to postlicensure ethics education and years of experience. BACKGROUND: Nursing guilds in many countries reference the American Nurses Association's code of ethics to define expected professional nursing values. Strong professional values contribute to high-quality patient care and are influenced by complex practice environments. DESIGN: Causal-comparative design. METHODS: A convenience sample of actively licensed registered nurses in Washington State, United States of America, participated in an electronically administered survey (N = 2,439). Analyses were conducted using descriptive statistics, analysis of variance and correlation. Reporting utilised the STROBE checklist. RESULTS: Results suggested values of highest and lowest importance to nurses. Scores varied significantly based on years of nursing experience; a higher score indicated stronger orientation toward professional nursing values. Nurses with experience of 10 years or more had the highest scores. There was a modest, positive relationship between professional values and amount of time spent in postlicensure ethics education. CONCLUSIONS: Professional values of Washington State nurses are similar to other nurses in national and global workforces. Results suggest key areas of strength in nurses' professional values and areas needing additional focus and support. Professional values are highest among nurses with longer practice experience and among nurses who have had increased ethics education. RELEVANCE TO CLINICAL PRACTICE: Knowledge of nurses' priority values can assist leaders and educators to identify areas of needed support among nursing staff members. Organisational commitment to support of nurses' professional values through investment in ethics education may produce positive enduring consequences, such as workplace retention and high-quality patient care. Healthcare leaders and clinical educators who promote ethics education may help to mitigate negative effects of morally challenging situations, such as moral distress and work leaving.

Júri simulado no ensino da ética/bioética para a enfermagem / Simulated jury in the teaching of ethics/bioethics for nursing

Objetivo: relatar a experiência docente com o emprego da técnica do júri simulado no ensino da ética/bioética para a graduação em Enfermagem. Método: trata-se de um estudo descritivo, tipo relato de experiência, empregando metodologia alternativa no ensino para a graduação em saúde. Utiliza-se a técnica do júri simulado desde 2008, no 4º período, na disciplina "Interagindo com as Pessoas". Refere-se esse relato à implementação da técnica no segundo semestre de 2018. Ocorre-se a estratégia de ensino/aprendizagem em quatro momentos distintos, sequenciais e complementares. Resultados: observou-se o envolvimento dos estudantes com a técnica do júri por meio da aplicabilidade dos conteúdos teóricos na resolução das questões discutidas com a técnica. Subsidiou-se o aprendizado com as aulas expositivo-dialogadas, que foi aprimorado e alcançado pelos próprios estudantes ao realizarem estudos complementares direcionados e colocados em prática com situações do cotidiano exposto por meio dos filmes. Conclusão: revela-se que docente e discentes aprendem a aprender, a fazer, a conviver e são sensibilizados a assumir uma postura profissional comprometida com a responsabilidade social e ética que a profissão requer.(AU)

Objective: to report the teaching experience with the use of the simulated jury technique in ethics/bioethics teaching for the undergraduate nursing course. Method: it is a descriptive study, of experience report type, using an alternative methodology in teaching for health graduation. The simulated jury technique is used since 2008, in the 4th period, in the subject "Interacting with the People". This report refers to the implementation of the technique in the second half of 2018. The teaching/learning strategy occurs in four distinct, sequential and complementary moments. Results: the students' involvement with the jury technique was observed through the applicability of the theoretical contents in the resolution of the issues discussed with the technique. It subsidized the learning with the expository-dialoged classes, which was improved and reached by the students themselves when carrying out complementary studies directed and put into practice with daily situations exposed through the films. Conclusion: it is revealed that teachers and students learn to learn, to do, to live together and are sensitized to take a professional position committed to the social and ethical responsibility that the profession requires.(AU)

Objetivo: relatar la experiencia docente con el empleo de la técnica del jurado simulado en la enseñanza de la ética / bioética para la graduación en Enfermería. Método: se trata de un estudio descriptivo, tipo relato de experiencia, empleando metodología alternativa en la enseñanza para la graduación en salud. Se utiliza la técnica del jurado simulado desde 2008, en el 4º período, en la asignatura "Interactuando con las Personas". Se refiere este relato a la implementación de la técnica en el segundo semestre de 2018. Se produce la estrategia de enseñanza / aprendizaje en cuatro momentos distintos, secuenciales y complementarios. Resultados: se observó la participación de los estudiantes con la técnica del jurado por medio de la aplicabilidad de los contenidos teóricos en la resolución de las cuestiones discutidas con la técnica. Se apoyó el aprendizaje con las clases expositor-dialogadas, que fue perfeccionado y alcanzado por los propios estudiantes al realizar estudios complementarios dirigidos y puestos en práctica con situaciones del cotidiano expuesto por medio de las películas. Conclusión: se revela que docentes y alumnos aprenden a aprender, a hacer, a convivir y ser sensibilizados a asumir una postura profesional comprometida con la responsabilidad social y ética que la profesión requiere.(AU)

Lecture-based versus problem-based learning in ethics education among nursing students.

BACKGROUND: Moral reasoning is a vital skill in the nursing profession. Teaching moral reasoning to students is necessary toward promoting nursing ethics. OBJECTIVES: The aim of this study was to compare the effectiveness of problem-based learning and lecture-based methods in ethics education in improving (1) moral decision-making, (2) moral reasoning, (3) moral development, and (4) practical reasoning among nursing students. RESEARCH DESIGN: This is a repeated measurement quasi-experimental study. PARTICIPANTS AND RESEARCH CONTEXT: The participants were nursing students in a University of Medical Sciences in west of Iran who were randomly assigned to the lecture-based (n = 33) or the problem-based learning (n = 33) groups. The subjects were provided nursing ethics education in four 2-h sessions. The educational content was similar, but the training methods were different. The subjects completed the Nursing Dilemma Test before, immediately after, and 1 month after the training. The data were analyzed and compared using the SPSS-16 software. ETHICAL CONSIDERATIONS: The program was explained to the students, all of whom signed an informed consent form at the baseline. FINDINGS: The two groups were similar in personal characteristics (p > 0.05). A significant improvement was observed in the mean scores on moral development in the problem-based learning compared with the lecture-based group (p < 0.05). Although the mean scores on moral reasoning improved in both the problem-based learning and the lecture-based groups immediately after the training and 1 month later, the change was significant only in the problem-based learning group (p < 0.05). The mean scores on moral decision-making, practical considerations, and familiarity with dilemmas were relatively similar for the two groups. CONCLUSION: The use of the problem-based learning method in ethics education enhances moral development among nursing students. However, further studies are needed to determine whether such method improves moral decision-making, moral reasoning, practical considerations, and familiarity with the ethical issues among nursing students.

Dignity in nursing care: What does it mean to nursing students?

BACKGROUND:: Despite growing interest in the potential of nursing education to enhance dignity in nursing care, relatively little is known about what dignity means to nursing students. RESEARCH QUESTION:: What meaning does dignity in nursing care have for nursing students? RESEARCH DESIGN:: Photo-elicitation was embedded within a Nominal Group Technique and responses were analysed by qualitative and quantitative content analysis. PARTICIPANTS AND RESEARCH CONTEXT:: Participants were recruited from each year of a 3-year undergraduate preregistration adult nursing programme in Scotland. In total, 31 nursing students participated in the study. ETHICAL CONSIDERATIONS:: The study was approved by the Ethics Committee of the School of Health, Nursing and Midwifery, University of the West of Scotland. FINDINGS:: Participants articulated the meaning of dignity in nursing care in terms of the relationships and feelings involved. A total of 10 categories of meaning were identified. DISCUSSION:: The significance of the nature of the nurse-patient interaction to preserving dignity in nursing care is highlighted. CONCLUSION:: Understanding the meaning of dignity for nursing students may help prepare future nurses more able to preserve dignity in nursing care.

Teaching ethics using games: Impact on Iranian nursing students' moral sensitivity.

This study seeks to develop a method of teaching ethics to nursing students using games. We used the one-group pretest-posttest design with 30 undergraduate nursing students as participants. Professional ethics education was provided for 17 weeks in 90-minute sessions. The Lutzen ethical sensitivity questionnaire and a checklist of the satisfaction levels of games used measured the effects of training. Repeated-measures ANOVA and the Greenhouse-Geisser correction were used to measure ethics game satisfaction. After training, total moral sensitivity questionnaire scores increased significantly (p = 0.02). The score on awareness of the relationship with the patient and the application of ethics concepts in ethical decisions from the subdomain of moral sensitivity increased significantly. Card sorting and drawing or art production earned the highest scores of satisfaction. The results show that playing games is a useful approach to developing moral sensitivity among nursing students to make them more sensitive toward ethics issues in their professional environment.

Academic ethical awareness among undergraduate nursing students.

BACKGROUND: Academic ethical awareness is an important aspect especially for nursing students who will provide ethical nursing care to patients in future or try to tread the path of learning toward professional acknowledgement in nursing scholarship. PURPOSE: The purpose of this study was to explore academic ethical awareness and its related characteristics among undergraduate nursing students. METHODS: This study commenced the survey with cross-sectional, descriptive questions and enrolled convenient samples of 581 undergraduate nursing students from three universities in South Korea. It was investigated with structured questionnaires including general characteristics and academic ethical awareness related. ETHICAL CONSIDERATIONS: This study was reviewed and approved by the Institutional Review Board at National University. FINDINGS: Academic ethical awareness was the highest regarding behaviors violating the respect or confidentiality of patients and cheating on exams, while it was the lowest for inappropriate behaviors in class. From the result of general characteristics difference, male students showed higher score than female students in relative; first-year students showed higher score than other year students; the higher score was rated from students who were highly satisfied with their major than the other not satisfied with their major; and students with low academic stress showed higher ethical awareness score than persons with higher stress. CONCLUSION: Personal behaviors were rated with low ethical awareness in relative, but items related to public rules and actual effects on patients or others were rated with higher score. Nursing satisfaction and academic stress are main factors on ethical awareness. To improve overall ethical awareness level of nursing students, it is required to provide more education about the importance of personal behaviors in class and need to improve the understanding of how it will be connected with future situation and effect.