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The ethical development of undergraduate nursing students: A longitudinal parallel mixed methods study / ADRIENNE GRECH
Swansea University Author: ADRIENNE GRECH
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Copyright: The Author, Adrienne Grech, 2023. Distributed under the terms of a Creative Commons Attribution Non Commercial 4.0 License (CC BY-NC 4.0).
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DOI (Published version): 10.23889/SUthesis.64037
Abstract
There is significant support for the teaching of ethics in health care and nursing education. However, currently there is limited knowledge of how students studying in these areas apply ethics in their professional practice, and how this is influenced by what they experience during their education....
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Swansea, Wales, UK
2023
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| Institution: | Swansea University |
| Degree level: | Doctoral |
| Degree name: | Ph.D |
| Supervisor: | Calder, Gideon. J. and Upton, Hugh. R |
| URI: | https://cronfa.swan.ac.uk/Record/cronfa64037 |
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| Abstract: |
There is significant support for the teaching of ethics in health care and nursing education. However, currently there is limited knowledge of how students studying in these areas apply ethics in their professional practice, and how this is influenced by what they experience during their education. Undergraduate education shapes the kind of nurses that will work in health care, hence the importance of developing good nursing students cannot be ignored. This research study aims to evaluate and explore how students develop ethically over a three-year degree program. The study’s outcomes intend to guide the development and delivery of nursing curricula in the future.A three-year longitudinal, prospective, parallel mixed methods research approach was adopted to explore the perceptions of ethics and evaluate the ethical development of nursing students, during a Bachelor of Science (Honours) in Nursing at the University of Malta, from their first year to their third year of studies. Ten semi-structured interviews were carried out over three years and 36 (Year 1) and 39 (Year 3) Defining Issues Tests (DIT2), were eligible for analysis. Quantitative and qualitative data were converged at the end of the three years.Survey data showed significant (N2 score p=0.04) development of students related to an increase in their education level. However, the mean N2 scores were lower than expected, with the highest scores attributing moral reasoning based on personal interests. DIT2 developmental scores showed no significant differences when correlated with sociodemographic variables. Qualitatively, students understood ethics from a perspective of character, humanity, and professional issues. Although there is an understanding of ethical principles, students are often unaware of how this understanding occurs and how it can be applied to nursing practice. Practice was considered to have the highest impact on their development, with a focus on role models and relationships. Furthermore, students perceive ethics to be a complex and ambiguous subject.This study shows that students ethically developed during their undergraduate studies. Overall, moral development mean scores were lower than expected for university students. There was a discrepancy between the lower quantitative moral reasoning scores and reference to ethical principles during interviews. Students expressed an understanding of ethics predominantly in relation to nursing practice. Their development was highly influenced by contextual, social and environmental factors. This study highlighted the impact of continuous ethics education through the academic years and beyond, providing opportunities for decision-making in practice, supportive educational environments and adopting a positive active learning approach to ethics education with a focus on day-to-day ethical issues that were relevant to students. Moreover, ethics education should equip students with the necessary tools to confidently voice their ethical concerns. Thus, an integrated student-centred nursing curriculum based on a multifaceted approach along the whole programme that supports positive ethical education environments and opportunities for decision-making in practice should be adopted. |
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| College: |
Faculty of Medicine, Health and Life Sciences |