Cultivating a moral sense of nursing through model emulation

Optimistic Fiction as a Tool for Ethical Reflection in STEM

Greater emphasis on ethical issues is needed in science, technology, engineering, and mathematics (STEM) education. The fiction for specific purposes (FSP) approach, using optimistic science fiction texts, offers a way to focus on ethical reflection that capitalizes on role models rather than negative examples. This article discusses the benefits of using FSP in STEM education more broadly, and then explains how using optimistic fictions in particular encourages students to think in ethically constructive ways. Using examples of science fiction texts with hopeful perspectives, example discussion questions are given to model how to help keep students focused on the ethical issues in a text. Sample writing prompts to elicit ethical reflection are also provided as models of how to guide students to contemplate and analyze ethical issues that are important in their field of study. The article concludes that the use of optimistic fictions, framed through the lens of professional ethics guidelines and reinforced through ethical reflection, can help students to have beneficial ethical models.

Effects of using standardized patients on nursing students’ moral skills

Background:

Nurses and nursing students increasingly confront ethical problems in clinical practice. Moral sensitivity, moral reasoning, and ethical decision-making are therefore important skills throughout the nursing profession. Innovative teaching methods as part of the ethics training of nursing students help them acquire these fundamental skills.

Aim:

This study investigated the effects and potential benefits of using standardized patients in ethics education on nursing baccalaureate students’ moral sensitivity, moral reasoning, and ethical decision-making by comparing this method with in-class case analyses.

Research design:

This is a quasi-experimental study.

Participants and research context:

The sample comprised 89 students in Hacettepe University’s Faculty of Nursing. Following lectures describing the theoretical components of ethics, students were randomly assigned to two working groups, one using standardized patients and the other using in-class case analyses. Data were collected using the Moral Sensitivity Questionnaire, Rest’s Defining Issues Test, and the Nursing Dilemma Test. All data were analysed using IBM SPSS Statistics Version 23.

Ethical considerations:

Ethical approval and official permission were obtained. All participating students completed informed consent forms.

Findings:

According to the results, the moral sensitivity of students in the standardized patient group significantly improved over time compared to those in the case analysis group, while the mean scores of students in both groups for moral reasoning and ethical decision-making were not statistically significant.

Conclusion:

Based on our results, we recommend the use of both standardized patients and case analysis as appropriate teaching methods in ethics education.

Implications of Confucian learning on nurse education in the UK: a discussion

This paper explores and discusses the increasing presence of international recruitment in higher education in the UK with a particular focus on nurse education and the implications of this growth in student population with regards to teaching and learning. It draws attention to the noted differences in learning styles of Confucian learners from the East to that of Socratic learners in the West. Addressing these two dimensions and cultural differences in learning for international students is important if educators are to fully understand the student learning behaviours. Owing to a lack of information regarding these learning behaviours in the nursing domain, comparisons have been drawn from other disciplines. Recurrent themes are presented and analysed in terms of the educational paradigm and their possible influence on the educational interaction is postulated. From this analysis it is apparent that although quite disparate, both learning behaviours could benefit from each other's intellectual tradition. Emic differences between learning styles have been highlighted in this paper, it would in future be useful to identify etic commonalities within learning groups and use those as a foundation for further research, so that the full potential of confusion learners can be achieved within a Westernised academic arena.

Ethical practice in end-of-life care in Japan

Nurses are obliged to provide quality nursing care that meets the ethical standards of their profession. However, clear descriptions of ethical practice are largely missing in the literature. Qualitative research using a phenomenological approach was conducted to explicate ethical nursing practice in Japanese end-of-life care settings and to discover how ethical practices unfold in clinical situations. Two paradigm cases and contrasting narratives of memorable end-of-life care from 32 Japanese nurses were used to reveal four levels of ethical practice: ethical, distressed, uncertain, and unethical. Having the ability to actualize, justify, and recognize what is the good and/or right differentiated between these levels of ethical practice, empirical descriptions of which are given, followed by discussion of how nurses gain the skilled knowledge necessary for ethical practice.

Nursing ethics education: are we really delivering the good(s)?

The vast majority of research in nursing ethics over the last decade indicates that nurses may not be fully prepared to 'deliver the good(s)' for their patients, or to contribute appropriately in the wider current health care climate. When suitable research projects were evaluated for this article, one key question emerged: if nurses are educationally better prepared than ever before to exercise their ethical decision-making skills, why does research still indicate that the expected practice-based improvements remain elusive? Hence, a number of ideas gleaned from recent research about the current nature of nursing ethics, and especially teaching nursing ethics to student nurses, are analysed and critiqued in this article, which concludes with a cluster of ideas and conclusions based on that analysis. It is hoped that such a review may serve as a catalyst for nurse educators to re-examine their teaching practices with a view to enhancing good (i.e. ethical) nursing practice through educational means.

An Action Research on the Development of a Caring Curriculum in Taiwan

The purpose of this study was to plan, develop, implement, and evaluate the effectiveness of the first-year course of a 5-year nursing caring curriculum. An action research method involving participant observation investigated how 18 instructors in a junior college nursing program implemented caring in the course. Data gathered through observation, interviews, and questionnaires were used for evaluation and revision of the course. Results included development of the framework for the caring curriculum and the contents of the first-year course, Introduction to Caring. Course content included the concepts of caring ("love and sincerity," "caring communication," "empathy and respect," "acceptance and trust," and "offering of self"), performance of caring actions ("care of self," "care of family members," and "care of peers"), and caring motivations ("caring reinforcing factors" and "caring restraining factors"). Teaching strategies included role modeling, dialogue, reflection, journaling, and caring groups. Evaluation showed that student caring knowledge, attitudes, and behavior improved after course implementation.

A comparative study of Chinese, American and Japanese nurses' perceptions of ethical role responsibilities

This article reports a survey of nurses in different cultural settings to reveal their perceptions of ethical role responsibilities relevant to nursing practice. Drawing on the Confucian theory of ethics, the first section attempts to understand nursing ethics in the context of multiple role relationships. The second section reports the administration of the Role Responsibilities Questionnaire (RRQ) to a sample of nurses in China (n = 413), the USA (n = 163), and Japan (n = 667). Multidimensional preference analysis revealed the patterns of rankings given by the nurses to the statements they considered as important ethical responsibilities. The Chinese nurses were more virtue based in their perception of ethical responsibilities, the American nurses were more principle based, and the Japanese nurses were more care based. The findings indicate that the RRQ is a sensitive instrument for outlining the embedded sociocultural factors that influence nurses' perceptions of ethical responsibilities in the realities of nursing practice. This study could be important in the fostering of partnerships in international nursing ethics.

Drawing a qualitative distinction of caring practices in a professional context: the case of Chinese nursing

How to draw a qualitative distinction between nursing work and the work of a servant has been a major concern for nurses in China. This article explains the ways in which nurses in China articulate the meaning of caring in practice situations. Seventy nurses in Beijing were invited to share their experience about what caring meant to them as nurses and examples of caring in practice situations. Van Kaam's phenomenologic method of controlled explication was used to analyze the data. The findings reveal that these Chinese nurses are able to articulate the cheng and jing versions of caring practices that emphasize flexible, pluralist, contextualized, individualized, and subjectively informed practices. To further this study, we would suggest nurses be more proactive in starting a dialogue with society so as to seek nursing's legitimate practice that can foster responsive care to patients and society on the one hand and the professional integrity of nursing on the other.

Holism and caring: nursing in the Chinese health care culture

This article examines the concepts of holism and caring within the historical and cultural context of the development of nursing in China. Data were collected in two research projects on the cultural construction of caring in nursing within different Chinese communities. Grounded in the theory of "systematic correspondence" and in Chinese medical tradition, illness is perceived as a state of disharmony between the individual and the natural and social environment. The interplay of caring and curative processes is seen as pertinent to health maintenance. In Chinese culture, it is the moral duty of family members to take care of their sick. Because of this, questions are posed about ways in which the nurse can relate to patients and their family members. Although lay people view nursing as servant's work, nurses cherish "treating the patient as their own family member." The authors contend that these versions of nursing are inappropriate. It is the intention of this article to stimulate discourse on a third version focusing on the patient and the family as the unit of care within their dynamic, natural, and social environments.