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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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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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Published: Swansea, Wales, UK 2023
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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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.</abstract><type>E-Thesis</type><journal/><volume/><journalNumber/><paginationStart/><paginationEnd/><publisher/><placeOfPublication>Swansea, Wales, UK</placeOfPublication><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic/><keywords/><publishedDay>11</publishedDay><publishedMonth>7</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-07-11</publishedDate><doi>10.23889/SUthesis.64037</doi><url/><notes/><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><supervisor>Calder, Gideon. J. and Upton, Hugh. 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spelling v2 64037 2023-08-04 The ethical development of undergraduate nursing students: A longitudinal parallel mixed methods study 9b28a76fa1fd3271742256e916c54a73 ADRIENNE GRECH ADRIENNE GRECH true false 2023-08-04 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. E-Thesis Swansea, Wales, UK 11 7 2023 2023-07-11 10.23889/SUthesis.64037 COLLEGE NANME COLLEGE CODE Swansea University Calder, Gideon. J. and Upton, Hugh. R Doctoral Ph.D Endeavour Scholarship Scheme-Malta 2023-10-05T15:15:17.9933384 2023-08-04T16:07:07.3336065 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing ADRIENNE GRECH 1 64037__28247__b5f761573b2d483a9dd41f72a19a40eb.pdf 2023_Grech_A.final.64037.pdf 2023-08-04T16:15:40.6510917 Output 4664987 application/pdf Redacted version - open access true 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). true eng https://creativecommons.org/licenses/by-nc/4.0/
title The ethical development of undergraduate nursing students: A longitudinal parallel mixed methods study
spellingShingle The ethical development of undergraduate nursing students: A longitudinal parallel mixed methods study
ADRIENNE GRECH
title_short The ethical development of undergraduate nursing students: A longitudinal parallel mixed methods study
title_full The ethical development of undergraduate nursing students: A longitudinal parallel mixed methods study
title_fullStr The ethical development of undergraduate nursing students: A longitudinal parallel mixed methods study
title_full_unstemmed The ethical development of undergraduate nursing students: A longitudinal parallel mixed methods study
title_sort The ethical development of undergraduate nursing students: A longitudinal parallel mixed methods study
author_id_str_mv 9b28a76fa1fd3271742256e916c54a73
author_id_fullname_str_mv 9b28a76fa1fd3271742256e916c54a73_***_ADRIENNE GRECH
author ADRIENNE GRECH
author2 ADRIENNE GRECH
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publishDate 2023
institution Swansea University
doi_str_mv 10.23889/SUthesis.64037
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
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description 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.
published_date 2023-07-11T15:15:19Z
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score 11.016235

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