Nurses working in a clinic must be morally sensitive to identify unethical circumstances and act morally. Educational strategies that can effectively gain this sensitivity are a matter of curiosity.
Objective
This study aimed to examine if an interactive ethics training program would benefit (a) moral sensitivity and (b) knowledge.
Research Design
The present study was quasi-experimental based on a control group pretest/posttest.
Participants and Research Context
The study involved 53 nurses from 10 hospitals in Istanbul, Türkiye. The intervention group received the 5-week Interactive Ethics Training Program. Data were collected through the Personal Characteristics Form, Moral Sensitivity Questionnaire, and Nursing Ethics Knowledge Test.
Ethical Considerations
The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Non-Invasive Research Ethics Committee (No. 78/2022) from Istanbul Medipol University.
Results
There was a statistically significant difference between the two groups in the posttest for moral sensitivity (MD: −10.247; p = .010) and knowledge level (MD: 4178; p = .009).
Conclusion
An interactive ethics training program in nursing ethics education positively impacts nurses’ moral sense and knowledge. Improving nurses’ moral awareness can facilitate ethical decision-making. Therefore, it is advised that nurse educators design their curricula based on these results.
ChenQChenQMaC, et al.Moral sensitivity, moral courage, and ethical behaviour among clinical nurses. Nurs Ethics2025; 32(2): 665–677.
2.
SirillaJThompsonKYamokoskiT, et al.Moral distress in nurses providing direct patient care at an academic medical center. Worldviews Evidence-Based Nurs2017; 14(2): 128–135.
3.
BullockML. Not playing fair: deviant emotional intelligence, dark traits, and unethical behavior in the nursing profession. Ph.D. Thesis, Northcentral University, San Diego, CA, 2019.
4.
VagharseyyedinSA. Nurses’ perspectives on workplace mistreatment: a qualitative study. Nurs Health Sci2016; 18: 70–78.
5.
YeBLuoEZhangJ, et al.Moral sensitivity and emotional intelligence in intensive care unit nurses. Int J Environ Res Publ Health2022; 19(9): 5132.
6.
HaahrANorlykAMartinsenB, et al.Nurses experiences of ethical dilemmas: a review. Nurs Ethics2020; 27: 258–272.
7.
RainerJSchneiderJKLorenzRA. Ethical dilemmas in nursing: an integrative review. J Clin Nurs2018; 27: 3446–3461.
8.
AmiriEEbrahimiHNamdar AreshtanabH, et al.The relationship between nurses’ moral sensitivity and patients’ satisfaction with the care received in the medical wards. J Caring Sci2020; 9(2): 98–103.
9.
ChoeKKimSLeeC, et al.Effect of ethics seminar on moral sensitivity and ethical behavior of clinical nurses. Int J Environ Res Publ Health2021; 18: 241.
10.
SpekkinkAJacobsG. The development of moral sensitivity of nursing students: a scoping review. Nurs Ethics2021; 28(5): 791–808.
11.
MoreiraDAFerrazCMLCCostaIPD, et al.Professional practice of nurses and influences on moral sensitivity. Rev Gaúcha Enferm2020; 41: e20190080.
12.
BorhaniFKeshtgarMAbbaszadehA. Moral self-concept and moral sensitivity in Iranian nurses. J Med Ethics Hist Med2015; 8: 4.
13.
KamaliFYousefyAYamaniN. Explaining professionalism in moral reasoning: a qualitative study. Adv Med Educ Pract2019; 10: 447–456.
14.
SinclairJPappsEMarshallB. Nursing students’ experiences of ethical issues in clinical practice: a New Zealand study. Nurse Educ Pract2016; 17: 1–7.
Demir KarabulutSYalımNYŞahinoğluS. Evaluating the views and suggestions of educators on ethics education in nursing. TJOB2021; 8(2): 70–81.
18.
KovanciMSAtli ÖzbaşA. Moral distress and moral sensitivity in clinical nurses. Res Nurs Health2024; 47(3): 312–323.
19.
KhaghanizadeMMalakiHAbbasiM, et al.Faculty related challenges in medical ethics education: a qualitative study. Iran J Med Educ2012; 11(8): 903–916.
20.
InoueCYAValençaMM. Contribuições do aprendizado ativo ao estudo das Relações Internacionais nas universidades brasileiras. Merid 472017; 18: e18008.
21.
ÇulhaI. Active learning methods used in nursing education. Journal of Pedagogical Research2019; 3(2): 74–86.
22.
TorralbaKDDooL. Active learning strategies to improve progression from knowledge to action. Rheum Dis Clin N Am2020; 46(1): 1–19.
23.
GhezziJFSAHigaEFRLemesMA, et al.Strategies of active learning methodologies in nursing education: an integrative literature review. Rev Bras Enferm2021; 74(1): e20200130.
24.
VerkuylMAtackLMastrilliP, et al.Virtual gaming to develop students’ pediatric nursing skills: a usability test. Nurse Educ Today2016; 46: 81–85.
25.
NamadiFHemmati MaslakpakMMoradiY, et al.The effects of nursing ethics education through case-based learning on moral reasoning among nursing students. Nurs and Mid2019; 8: 2.
26.
BaşakTCeritB. Comparing two teaching methods on nursing students’ ethical decision-making level. Clin Simul in Nurs2019; 29: 15–23.
27.
KhaliliABehzadHAlmasiS, et al.Nursing professional ethics education using a superior method- lecture or multimedia. J Res Med Dent Sci2017; 5: 61.
28.
NyumbaTOWilsonKDerrickCJ, et al. The use of focus group discussion methodology: insights from two decades of application in conservation. Methods Ecol Evol. 2018; 9(1): 20–32.
29.
SchallenbergerCDTomaschewski-BarlemJGBarlemELD, et al.Moral sensitivity components identified among nurses from intensive care units. Rev Bras Enferm2019; 72: 2–8.
30.
KhaghanizadehMKoohiAEbadiA, et al.The effect and comparison of training in ethical decision-making through lectures and group discussions on moral reasoning, moral distress and moral sensitivity in nurses: a clinical randomized controlled trial. BMC Med Ethics2023; 24(1): 58.
31.
BahrieniFAzodiPHajivandiA, et al.The effect of durability of knowledge transfer through reminiscence on the moral sensitivity of nurses. BMC Nurs2022; 21(1): 305.
32.
JamshidianFShahriariMAderyaniMR. Effects of an ethical empowerment program on critical care nurses’ ethical decision-making. Nurs Ethics2019; 26(4): 1256–1264.
33.
Des JarlaisDCLylesCCrepazNTREND Group. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Publ Health2004; 94: 361–366.
34.
LützénKEvertzonMNordinC. Moral sensitivity in psychiatric practice. Nurs Ethics1997; 4(6): 472–482.
35.
TosunH. Moral sensitivity questionnaire (MSQ): Turkish adaptation of the validity and reliability. J Contemp Med2018; 8(4): 316–321.
36.
MunkebyHMoeABratbergG, et al.Ethics between the lines’ - nurses’ experiences of ethical challenges in long-term care. Glob Qual Nurs Res2021; 8: 23333936211060036.
37.
ChenXLFei HuangFZhangJ, et al.Tertiary hospital nurses' ethical sensitivity and its influencing factors: a cross-sectional study. Nurs Ethics2022; 29(1): 104–113.
38.
NoraCRZoboliELVieiraM. Ethical problems experienced by nurses in primary health care: integrative literature review. Rev Gaucha Enferm2015; 36: 112–121.
39.
ParchamiFJacksonACSharifiF, et al.Written and computer simulation on the moral sensitivity of nurses. Nurs Ethics2022; 29(7–8): 1739–1749.
40.
KraaijeveldMISchildermanJHvan LeeuwenE. Moral sensitivity revisited. Nurs Ethics2021; 28(2): 179–189.
41.
QuZSunJLiL, et al.The effect of simulated problem learning in nursing ethics on moral sensitivity, empathy and critical thinking of nursing students: a quasi-experimental study. Nurse Educ Pract2024; 80: 104119.
42.
Gil-LacruzMGracia-PerezMLGil-LacruzAI. Learning by doing and training satisfaction: an evaluation by health care professionals. Int J Environ Res Publ Health2019; 16(8): 1397.
43.
MomennasabMGhanbariMRivazM. Improving nurses’ knowledge, attitude, and performance in relation to ethical codes through group reflection strategy. BMC Nurs2021; 20(1): 222.
44.
OzgonulLAlimogluM. Comparison of lecture and team-based learning in medical ethics education. Nurs Ethics2019; 26(3): 903–913.
45.
KhatibanMFalahanSAminiR, et al.Lecture-based versus problem-based learning in ethics education among nursing students. Nurs Ethics2019; 26(6): 1753–1764.
46.
KudaibergenovaTDzhusupovKJainN. Fostering public health ethics awareness among medical students through interactive web-based values exchange learning: a cross-sectional study. Medicine2023; 102(43): e35808.
47.
WardLA. Engaging nurses through active and experiential learning. Nursing2022; 52(8): 31–35.
48.
KaluFWolseyCEnghiadP. Undergraduate nursing students’ perceptions of active learning strategies: a focus group study. Nurse Educ Today2023; 131: 105986.
