Moral dilemmas involving anthropological and ethical dimensions in healthcare curriculum.

BACKGROUND: Currently a variety of novel scenarios have appeared within nursing practice such as confidentiality of a patient victim of abuse, justice in insolvent patients, poorly informed consent delivery, non-satisfactory medicine outputs, or the possibility to reject a recommended treatment. These scenarios presuppose skills that are not usually acquired during the degree. Thus, the implementation of teaching approaches that promote the acquisition of these skills in the nursing curriculum is increasingly relevant. OBJECTIVE: The article analyzes an academic model which integrates in the curriculum a series of specific theoretical concepts together with practical skills to acquire the basic ethic assessment competency. RESEARCH DESIGN: The project includes designing two subjects, General Anthropology and Ethics-Bioethics, with an applied approach in the nursing curriculum. The sequential structure of the curriculum in both subjects is constituted by three learning domains (theoretical, practical, and communicative) with different educational strategies. ETHICAL CONSIDERATIONS: No significant ethical considerations as this is a discussion paper. FINDINGS: The model was structured from the anthropology's concepts and decision-making process, applied to real situations. The structure of the three domains theoretical-practical-communicative is present in each session. DISCUSSION: It is observed that theoretical domain fosters the capacity for critical analysis and subsequent ability to judge diverse situations. The practical domain reflected two significant difficulties: students' resistance to internalizing moral problems and the tendency to superficial criticism. The communicative domain has frequently shown that the conflicting points are in the principles to be applied. CONCLUSION: We conclude that this design achieves its objectives and may provide future nursing professionals with ethical competences especially useful in healthcare practice. The three domains of the presented scheme are associated with the same process used in decision making at individual levels, where the exercise of clinical prudence acquires particular relevance.

"Spinning Their Wheels "-Influences That Shape How Nurse Educators Teach Social Justice.

Despite institutional claims that social justice is a core professional nursing value, efforts to fulfill this claim remain uneven. The purpose of this study was to examine the circumstances that shape nursing educators' approaches to social justice. In-depth semi-structured interviews with 28 educators teaching theory courses in baccalaureate nursing programs shed light upon the influences that shape how educators integrate social justice. These include formative experiences, institutional factors, and curricular opportunities. Formative experiences include upbringing, educational background, and preparation to teach. Institutional factors consist of the type of institution, geographic location, and the specter of retention, promotion, and tenure. Finally, curricular opportunities and fit include the positioning of Community Health Nursing, fragmentation and tension between "content and context," and the "driving force" of the National Council Licensure Examination for Registered Nurses (NCLEX). Findings indicate that the capacity to uphold the value of social justice is shaped by experiences across the lifespan, institutional policies, and practices related to faculty hiring, development, career advancement, as well as curricular vision. This study calls for a concerted effort to enact social justice nursing education.

An analysis of nursing students' ethical conflicts in a hospital.

BACKGROUND: Education can be taken as a key factor in transmission of a value tradition in healthcare. In professional and educational contexts, transmission of values appears to be a kind of guarantee for an occupational group's professional identity, awareness and ethical integrity. Given the positives of such transmission of value traditions, one can also pay attention to conflicts between the professional tradition and individuals who are brought into that tradition. OBJECTIVES: How does mediation of value tradition in healthcare education appear out of the students' perspective based on their own narratives? RESEARCH DESIGN AND PARTICIPANTS: Students' texts were analysed through a combination of contrastive discourse analysis and sociohistorical description and then evaluated from an ethical perspective. Data were collected from the annual electronic feedback given by students after their clinical practice at a University Hospital. ETHICAL CONSIDERATIONS: Organizational approval was received. Information about the voluntary nature of participation was a part of the feedback tool. FINDINGS: The analysis points to the fact that there is a definite theme in the students' experiences that both the previous research has neglected and that stands in conflict with the current tradition of healthcare education in Finland. That theme can be summarized in the experience of 'losing one's identity', and it is expressed in a request to experience of 'losing one's identity' and it is expressed in a request to have a right to 'use one's own name' also as a healthcare professional. DISCUSSION AND CONCLUSION: Being addressed by one's name is to make the person directly involved and responsible, realizing that that person's perspective is of importance to the way the world is. We argue that this theme (my name) is of ethical importance and could have empowering potentiality when used in an ethically sound way.

Exploring the paradox: A cross-sectional study of academic dishonesty among Australian nursing students.

BACKGROUND: Universities' responsibility to ensure academic integrity is frustrated by software and communication tools that facilitate content reuse coupled with a growing international essay writing economy. A wide range of behaviours constitute academic dishonesty and while a complex phenomenon to examine, existing evidence suggests that there is sufficient proliferation (both in volume and variety) of these behaviours among Australian university students to warrant concern. This proliferation presents faculty and staff with new challenges in ensuring academic integrity. OBJECTIVES: This paper reports findings of a nationwide cross-sectional survey of 361 students enrolled in an Australian nursing degree program and describes the extent of academic dishonesty among those surveyed. DESIGN: An online survey adapted from previous work was used to collect data on academic dishonesty, professional dishonesty and social desirability bias. Analysis of this data enabled identification of the prevalence of dishonesty, relationships between individual characteristics and dishonest behaviours, associations between academic and professional dishonesty, and the impact of deterrents to such behaviour. RESULTS: Plagiarism was the most frequently reported form of academic misconduct. Most participants indicated that threat of severe punishment and signing of verification statements would deter undesirable academic behaviour. Despite this, a relatively high proportion of students reported engaging in at least one form of academic misconduct, the likelihood of which was higher among younger age groups. Of concern was that a correlation was found between academic and professional misconduct, the most common being the recording of inaccurate or fabricated vital signs and breaching client privacy. CONCLUSION: In health professional education, there is a tendency to assume that the nobility of these disciplines would result in a lower incidence of cheating behaviours. The findings of this study support existing literature that refutes this assumption. This study found troubling rates of academic and professional misconduct among the surveyed population.

Plagiarism governance in nurse education; dispositions, dimensions and tensions.

The reality of managing plagiarism in nurse education is indicative of multilayered and cumulative governance processes, which exist to fit with the needs of both the higher education institution and that of the Professional Statutory and Regulatory Body. However, the relationship between these entities is diffuse, particularly when this involves major plagiarism by post-qualified learners. This study sought to explore the strategic governance of plagiarism in Scottish higher education institutions offering nurse education and its articulation with the professional requirements of nurse education. The design involved a retrospective quantitative documentary analysis of plagiarism policies within 11 Scottish higher education institutions and a national on-line survey involving nurse educators with an active teaching role (n = 187). The documentary analysis demonstrated deficits and variations in how Scottish higher education institutions communicated the dimensions of plagiarism, and its subsequent management. Statistically significant findings from the on-line survey provided a clear mandate for educational providers to make visible the connectivity between organisational and professional governance processes to support responsive and proportional approaches to managing plagiarism by nurse learners. Significant findings also confirmed role implications and responsibilities, which nurse educators in this study, viewed as primarily pedagogical but crucially remain professionally centric.

Fairness and respect in nurse educators' work- nursing students' perceptions.

This study describes how the ethical principles of fairness and respect come true in the work of nurse educators from the perspective of nursing students. Nurse educators' competence of professional ethics is important in providing an ethical role model to nursing students and to professionals in the field of health care. The descriptive cross-sectional study design was used. The data were collected from graduating nursing students (n = 202) in Finland with an internet-based questionnaire consisting of 22 structured questions with 5-point Likert scale. The data were analyzed by descriptive and inferential statistics. The findings revealed that educators' fairness and respect towards others (colleagues, superiors, mentors, nursing leaders) was good but towards students their fairness did not achieve as good a level. Also, according to the students' assessment, the educators did not respect the students' individual opinions in all cases. Educators' fairness and respect towards their colleagues was satisfactory. The appreciation of educators in the society was reasonably good, but in the opinion of the students the views of educators were not respected very much. As a conclusion, can be said that educators need to put more emphasis on their action.

Nursing students' attitudes toward persons who are aged: An integrative review.

OBJECTIVES: To analyze empirical studies from the United States and Canada to gain an understanding on how nursing education affects nursing students' attitudes toward persons who are aged. DESIGN: An integrative literature review was completed using Garrard's (2011) Matrix Method. DATA SOURCES: Articles were identified through the electronic database search engines of CINAHL, Pub Med, and Academic Search Complete. Only peer reviewed research articles from 2009 to 2015 were reviewed. REVIEW METHODS: A review matrix was created to abstract information from 11 studies so that synthesis could occur. Information in the columns of the review matrix was used to compare the studies. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 27 item check list was used to help with reporting the findings. Studies were graded using the American Association of Critical Care Nurses' (AACN) level of evidence. RESULTS: A key finding is student engagement with gerontological content in the classroom or clinical setting results in improving nursing students' attitudes toward persons who are aged. CONCLUSIONS: Several gaps exist in the literature. Further research including longitudinal studies and large scale, multi-site samples would add to the existing knowledge.

Nursing students' experiences of ethical issues in clinical practice: A New Zealand study.

Nursing students experience ethical problems in clinical practice in a different way from registered nurses. In order to develop ethical reasoning and competence in nursing students, nurse educators must recognise the unique issues students face. This research described the occurrence of ethical issues in clinical practice for 373 undergraduate nursing students who responded to a national questionnaire investigating the frequency of pre-determined ethical issues and the corresponding level of distress. Over two thirds of respondents experienced breaches of a patient's right to confidentiality, privacy, dignity or respect and 87% experienced unsafe working conditions. The most distressing issues were those that compromised patient safety, including unsafe healthcare practices, working conditions and suspected abuse or neglect. Themes that emerged from an open-ended question included lack of support and supervision, bullying and end of life issues. This research found the frequency at which ethical issues are experienced was highest in year three participants. However, the overall distress levels were lower for the majority of issues for those participants in the later part of their degree. Recommendations from this research include developing ethics education around the main concerns that students face in order to enhance students' understanding, resilience and ability to respond appropriately.

Gossamer Threads: Commentary on the Impact of Digital Technology on the Developing Brain and the Capacity for Empathy.

This essay explores the impact of digital technology on brain development and other areas of human growth including the capacity for empathy, which is fundamental to successful relationships, is an essential survival skill, and is an important source of moral knowledge. Reflections on a teenaged daughter's immersion in technology, coupled with evidence for the mixed consequences of such, weave together the gossamer threads of disparate, sometimes conflicting information about the explosion of digital technology over the past few decades, the impossibility of multitasking, the mixed effects of digital technology on brain development, and what it all might mean for human development generally and the moral capacity for empathic response in particular. While the essence of the commentary is intentionally interdisciplinary and weaves together disparate threads of multidisciplinary knowledge, it has important implications for nursing-with its relational core, unique as well as shared bodies of moral and scientific knowledge, and interprofessional health care goals to maximize human growth and well-being across the life span in both health and illness.

Moral distress in undergraduate nursing students: A systematic review.

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.

Dealing with academic dishonesty: a redemptive approach.

Studies reveal that as many as 80% of college students cheat; over half do not think cheating is a serious transgression. Developing integrity in nursing students is crucial, as their later actions impact patients' lives. How can educators foster academic integrity? Two educators from a Christian university relay how they approached a student's cheating and the transformative lessons they learned.

Privacidade e confidencialidade em saúde na vigilância epidemiológica: relato de experiência sob o olhar bioético / Privacy and confidentiality in health in epidemiological surveillance: experience report on bioethical look

Durante experiência de trabalho em vigilância epidemiológica, na Bahia, entre as atividades desenvolvidas, destaca-se a notificação compulsória de agravos e doenças. O estudo da disciplina Bioética em Ciência da Saúde, do Programa de Pós Graduação em Enfermagem e Saúde, nível de Mestrado, mobilizou-nos à retomada de vivências cotidianas nos serviços de saúde que envolve questões bioéticas e que merece reflexão crítica. O presente estudo teve como objetivo desenvolver uma reflexão, segundo a perspectiva bioética, sobre a experiência vivenciada, envolvendo privacidade e confidencialidade em saúde, no contexto da vigilânciaepidemiológica. Trata-se de estudo descritivo da vivência em atividade de notificação compulsória no serviço de vigilância epidemiológica da Secretaria Municipal de Saúde de município da Bahia, no período de novembro de 2011 a março de 2013. Permitiu-nos perceber que a negligência na aplicação de princípios bioéticos no âmbito da notificação compulsória pode interferir na saúde do usuário, pois não garante a integridade de seus direitos e reflete a inadequação da ambiência para os atendimentos e o despreparo dos profissionais, no que se refere ao conhecimento teórico-prático de bioética

During work experience in epidemiological surveillance, Bahia, between the activities, there is mandatory reporting of injuries and Illnesses. The study of the discipline of Health Scienc and in Bioethics, the Graduate Program in Nursing and Health, Master level, mobilized us to the resumption of daily experiences in health services Involving bioethical issues que deserve critical reflection. The present study Aimed to develop the reflection, According to bioethical perspective on the lived experience Involving privacy and confidentiality in health, in the context of epidemiological surveillance. This is a descriptive study of the experience of Mandator y reporting on activity in the epidemiological surveillance service of the Municipal Health Secretariat of the state of Bahia, in the period november 2011 to march 2013.Allowed us to perform que negligence in the application of bioethical principles under compulsory notification may interfere with the health of the user, it does not guarantee the integrity of Their Rights and Reflects the inadequacy of ambience for consultations and the unpreparedness of professionals, with regard to the theoretical and practical knowledge of bioethics.

Failing a student nurse: a new horizon of moral courage.

The factors preventing registered nurses from failing students in practice are multifaceted and have attracted much debate over recent years. However, writers rarely focus on what is needed to fail an incompetent pre-registration nursing student in their final placement. This hermeneutic study explored the mentor experience of failing a pre-registration nursing student in their final placement. A total of 19 mentors were recruited from 7 different healthcare organisations in both inner city and rural locations in the southeast of England. Participants took part in individual reflective interviews about their experience of failing a pre-registration nursing student in their final placement. These experiences were interpreted through a hermeneutic discovery of meaning. The new horizon of understanding which developed as a result of this research is framed within the context of moral stress, moral integrity and moral residue with the overall synthesis being that these mentors' stories presented a new horizon of moral courage.

Perspectives on academic misconduct: implications for education and practice.

From Harvard to high school, concern related to academic misconduct, specifically cheating and its impact on societal issues, has become a great concern for educational communities. While a significant number of studies on ethical behaviors in practice in other professions such as business have been published, little research exists on registered nurses in practice. Even fewer studies have, for registered nurses, addressed if there is an association between perceived academic misconduct as students and perceived unethical behaviors in the workplace. The purpose of this study was to determine the relationship between perceptions of registered professional nurses' (RNs) current workplace behaviors and the RNs' retrospective perceptions of their academic misconduct as students. A convenience sample of 1 66 RNs enrolled in master's degree programs at four university schools of nursing completed questionnaires regarding their beliefs and behaviors. The outcome of this study was significant. Results revealed a strong relationship between unethical behaviors of the RN in practice and their prior academic misconduct when they were students.

Uncovering nurse educators' beliefs and values about grading academic papers: guidelines for best practices.

Fair and consistent assessment, specifically grading, is crucial to teaching and learning scholarship and is a professional responsibility of nurse educators. Yet, many would agree that assessment is one of the most challenging aspects of their role. Despite differing beliefs, values, and meanings attributed to grading and grades, teachers' grading practices should be guided by principles and supported by policies. Inconsistent grading practices among educators, students' unrealistic expectations of grades, and a trend toward grade inflation may be contributing to both educators' and students' concerns. A teaching scholarship project that led to a research study explored nurse educators' beliefs, values, and practices related to the grading of written academic work. The purpose of this article is to share the findings and the resulting grading guidelines that were developed to support nurse educators' endeavors to enact equitable grading practices.

Nursing students' perceptions toward the nursing profession from clinical practicum in a baccalaureate nursing program-a qualitative study.

The purpose of this study was to explore senior nursing students' perceptions toward the nursing profession and their experiences in clinical practicum in Taiwan. This study used semistructured interview guides and unstructured face-to-face dialogue with the participants based on a qualitative method. A purposive sample with a snowball method from a baccalaureate nursing program in Southern Taiwan was used to recruit participants. A total of 30 senior nursing students participated in this study. Data were collected from February to May 2011. The interviews were transcribed verbatim, and data were analyzed based on the phenomenological approach of qualitative methodology. Data were categorized into three major themes: in-depth recognition of nursing, recognition of the meaning and value of life, and decision conflicts for being a nurse. The findings of the study not only help nursing educators further understand the educational effects of clinical practicum, but also provide information for managers of medical organizations to recruit and train newly graduated nurses.

Bioethics education of nursing curriculum in Korea: a national study.

The aim of this study is to examine the current profile of bioethics education in the nursing curriculum as perceived by nursing students and faculty in Korea. A convenience sampling method was used for recruiting 1223 undergraduate nursing students and 140 nursing faculty in Korea. Experience of Bioethics Education, Quality of Bioethics Education, and Demand for Bioethics Education Scales were developed. The Experience of Bioethics Education Scale showed that the nursing curriculum in Korea does not provide adequate bioethics education. The Quality of Bioethics Education Scale revealed that the topics of human nature and human rights were relatively well taught compared to other topics. The Demand for Bioethics Education Scale determined that the majority of the participants believed that bioethics education should be a major requirement in the nursing curriculum. The findings of this study suggest that bioethics should be systemically incorporated into nursing courses, clinical practice during the program, and during continuing education.