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Examination of Nursing Students' Moral Sensitivity and Its Relationship with Demographic Characteristics
Maryam Sina, Zahra Keshtkaran, Zinat Mohebbi, Naeimehossadat Asmarian,
Volume 17, Issue 0 (12-2024)
Abstract
Nurses, as the largest healthcare provider group, play a crucial role in patient care and treatment teams. To provide professional and appropriate care, nursing students must possess both clinical and moral competencies. Moral sensitivity, defined as the ability to recognize and understand moral situations, is paramount. It fosters trust and responsiveness to individual patient needs while equipping nurses to navigate ethical challenges within clinical settings. This study aimed to assess the moral sensitivity of nursing students and investigate its relationship with demographic characteristics. This descriptive-cross-sectional study involved 112 third- and fourth-year nursing students. Data were collected using demographic questionnaires and Lutzen's moral sensitivity scale. Data analysis was performed using SPSS version 23, employing descriptive and analytical statistical tests. The highest mean score for moral sensitivity was observed in the area of "honesty in decision-making" (14.71 ± 6.25), while the lowest mean was found in the area of "professional knowledge" (3.70 ± 2.12). The overall mean score for moral sensitivity was 15.87 ± 8.54, indicating a moderate level. Analysis of the relationship between demographic variables, including age, GPA, gender, marital status, living situation, current semester, family financial status, and parental education, revealed a significant positive correlation between moral sensitivity and family economic status only in the area of "experience with moral issues" (P=0.046). The findings of this study underscore the critical need for the development and implementation of structured programs designed to enhance the moral sensitivity of nursing students. Furthermore, this study highlights the importance of considering influential social factors, such as economic conditions, in fostering moral experiences and strengthening ethical sensitivity.

Explaining Nursing Students’ Experiences of Professional Ethics in Relation to Psychiatric Clients: an Analysis Based on Narrative Writing-Reflection
Mina Gaeeni, Hamid Asayesh, Ahmad Parizad, Zahra Abedini,
Volume 17, Issue 0 (12-2024)
Abstract
Clinical education constitutes the cornerstone of nursing education. Enhancing students' theoretical and practical knowledge within the psychiatric department is crucial for improving their attitudes, acceptance, and delivery of care. The outcomes of effective clinical learning encompass the development and refinement of professional competencies, including communication and professional ethics, the cultivation of critical thinking for clinical judgment and decision-making, the enhancement of ethical sensitivity, and the fostering of effective team and group performance. Recognizing the significance of these factors, this study aimed to "explain the experiences of nursing students based on narrative writing-reflection during their first encounter with psychiatric clients." This qualitative study was conducted during the psychiatric nursing internship at the Faculty of Nursing, Qom University of Medical Sciences, over two consecutive semesters. Purposive sampling was employed, and data were collected through 10 semi-structured individual interviews and 2 face-to-face and virtual focus groups (n=5 per group). Data collection continued until data saturation was reached. Data analysis was conducted using a qualitative content analysis approach with the assistance of MAXQDA20 software. The clinical experiences of students during their initial psychiatric nursing training course, as reflected in their narrative writing-reflections, revealed a primary theme: "encouraging ethical and spiritual communication in nursing." This overarching theme encompassed four sub-themes: "enhancing empathetic communication," "enhancing ethical sensitivity," "respecting the dignity of clients," and "listening to the voice of clients' feelings." The experiences gained through the reflective method within the clinical education setting, particularly in specialized clinical environments such as psychiatric wards and during initial encounters with clients in these departments, can provide valuable insights into students' attitudes and perspectives towards these clients and their families. These rich experiences can be effectively utilized to cultivate and strengthen communication and professional ethics among medical science students.

Investigating the Relationship Between Moral Intelligence and Clinical Competence of Nurses and Nursing Students: A Systematic Review
Zahra Abdollahi, Marzieh Barahooei Noori, Mohammad Hossein Khani, Mohammad Hossein Taklif, Negin Farid,
Volume 17, Issue 0 (12-2024)
Abstract
Moral intelligence encompasses an individual's ability to discern right from wrong, possess ethical values, and demonstrate ethical behavior in practice. Clinical competence, a crucial aspect of nursing practice, encompasses a combination of knowledge, skills, and attitudes, including adherence to ethical principles. This systematic review aimed to investigate the relationship between moral intelligence and clinical competence among nurses and nursing students. A comprehensive literature search was conducted using keywords related to "moral intelligence," "clinical competence," "nurses," and "nursing students" in major international databases, including Web of Science Core Collection, PubMed/Medline, Scopus, and Google Scholar, as well as national databases such as Irandoc, SID, and Magiran. The search included publications in Persian and English with no time limitations. After removing duplicates and screening the initial 150 identified studies, five studies met the inclusion criteria. Ethical considerations, including minimizing bias in the selection, extraction, and analysis of evidence, were adhered to throughout the review process. The abstract adheres to PRISMA guidelines for reporting systematic reviews. The review revealed a significant positive correlation between moral intelligence and clinical competence across various dimensions. Studies demonstrated that higher levels of moral intelligence were associated with improved clinical competence, including ethical reasoning and clinical self-efficacy. Factors such as age, work experience, educational status, and individual rank were found to influence this relationship. Additionally, some studies indicated that moral intelligence could predict clinical competence scores, while others demonstrated that it could be a significant predictor of clinical competence alongside other factors such as Grade Point Average (GPA). This systematic review provides evidence for a significant positive relationship between moral intelligence and clinical competence among nurses and nursing students. Enhancing moral intelligence through targeted educational interventions can contribute to improved clinical competence and ultimately enhance the quality of patient care. Future research should focus on developing and evaluating educational programs designed to enhance moral intelligence in nursing education and practice.

Educational Strategies to Enhance Moral Sensitivity in Nursing Students: A Systematic Review
Pooriya Samadzadehshahri, Reza Mohammadpourhodki, Zahra Delir,
Volume 17, Issue 0 (12-2024)
Abstract
Nursing students, as future healthcare professionals, must develop not only clinical competencies but also ethical competencies to deliver appropriate and professional care. Moral sensitivity is a critical aspect of professional competence, enabling nurses to recognize and respond sensitively to ethical situations as patient advocates. Consequently, fostering moral sensitivity should be prioritized from the beginning of nursing education to ensure quality care. This study aimed to examine the characteristics and effectiveness of educational interventions designed to improve the moral sensitivity of nursing students. In this systematic review, articles were retrieved using Persian and English keywords from international databases, including PubMed, Web of Science, and Scopus, as well as Persian databases such as SID and Magiran, from inception until October 2024. Keywords used in the search included "moral sensitivity," "ethical sensitivity," "nursing students," "ethics," and "moral sensitivity in nursing students." A total of 2,321 articles were identified in the initial search. References for each study were also manually reviewed. Based on inclusion criteria, experimental and quasi-experimental studies published in Persian and English focusing on effective interventions to improve the moral sensitivity of undergraduate nursing students were selected for analysis. Ultimately, six articles met the criteria for thorough review, and relevant data were extracted. Two researchers independently extracted the data and assessed the quality of the studies using the Joanna Briggs Institute (JBI) checklist. A total of 190 nursing students from six selected studies participated in the research, with 60% in intervention groups. The six educational interventions identified included:
  1. Two studies on nursing ethics workshops.
  2. A nursing ethics workshop conducted through a seminar.
  3. A motivational ethical education program.
  4. A virtual narrative ethics workshop.
  5. Problem-based learning.
However, the nursing ethics workshop conducted through a seminar was not effective in improving the moral sensitivity of nursing students. Evidence suggests that while the positive effects of educational interventions on the moral sensitivity of nursing students are limited, they are nonetheless encouraging. This review highlights various approaches to ethics education and moral sensitivity development. The findings can be utilized to enhance students' preparedness and ability to navigate ethically challenging work situations. However, further research is necessary to confirm the effectiveness of these interventions in fostering moral sensitivity among nursing students.

The Relationship Between Ethical Courage and Moral Distress in Nursing Students of Mashhad University of Medical Sciences in 2023
Sepide Ghavidel, Sajedeh Ghaani, Seyedehghodsieh Bahreinitousi, Mohaddeseh Mohsenpour,
Volume 17, Issue 0 (12-2024)
Abstract
Moral distress is a common topic in medical ethics, referring to a state where individuals, despite possessing knowledge and the ability to act ethically, are unable to perform the right ethical actions due to external constraints. Ethical courage is a crucial virtue for conscientious performance by healthcare providers, particularly nurses and nursing students. It facilitates the delivery of nursing care and is especially important in today’s healthcare environment, where factors such as increased patient awareness, evolving health needs, social justice issues, and access to healthcare services have contributed to heightened levels of moral distress among nurses and nursing students. This study aims to investigate the relationship between ethical courage and moral distress in nursing students. This descriptive, cross-sectional study was conducted in 2023 in Mashhad, Iran. The study population consisted of third-semester nursing students at Mashhad University of Medical Sciences. A total of 40 third-semester nursing students, both male and female, participated in the study. Data were collected using two questionnaires: the Moral Distress Scale (Corley) and the Ethical Courage Questionnaire (designed by Sekerka and colleagues). The data were analyzed using SPSS version 25, employing descriptive statistics and Pearson correlation tests. The majority of the students were female (51.2%), while 36.6% were male. The average age of the participants was 21.14 years. Among the students, 75.6% were single, and 4.9% were married. The findings revealed a weak, non-significant negative correlation between moral distress and ethical courage (r = -0.055, p > 0.05). The average moral distress score was 75.34 ± 10.81 (range: 12–16), while the average ethical courage score was 85 ± 9.33 (range: 60–103). The study found a weak, non-significant negative correlation between moral distress and ethical courage among nursing students. Based on these findings, it is recommended to implement workshops focused on ethical motivation and educational programs designed to reduce moral distress and enhance ethical courage among nursing students. Additionally, the non-significant correlation may be attributed to the small sample size. Therefore, future studies with larger sample sizes are suggested to validate these findings.

Strategies for the Promotion and Development of Socio-Cultural Indicators Affecting Professional Commitment in Nursing Students
Mandana Arash, Nadergholi Ghourchian, Parivash Jafari, Akhtar Jamali ,
Volume 17, Issue 0 (12-2024)
Abstract
Professional commitment is a key indicator of success in the nursing profession. Nursing schools play a critical role in fostering this commitment by instilling the values and responsibilities associated with the profession. Developing a culture of commitment and integrating it as a societal value is essential for cultivating professional behavior in students. This study aimed to identify strategies for enhancing and developing socio-cultural factors that influence professional commitment among nursing students. This applied research employed a qualitative approach. Twenty professional experts were selected through purposive sampling in 2021. Data were collected using semi-structured interviews, guided by the principle of theoretical saturation, and analyzed using content analysis. Six major components were identified as influential strategies: 1. Participation of communication media in the cultural and scientific advancement of the profession; 2. Attention to cultural differences between universities and healthcare centers; 3. Promotion of a culture of commitment in universities and clinical settings; 4. Attention to the alignment between individual culture and professional culture; 5. Attention to ensuring the profession benefits from social support; 6. Attention to the promotion of a culture of work and effort in society. These components were reflected in 20 specific indicators, including: raising awareness, instilling a sense of need, fostering concern among academic communities, educating nurses, resolving cultural conflicts, creating conducive educational environments, employing committed faculty, embedding commitment in the culture and as a duty, aligning individual and professional cultures, promoting social prestige and recognition of the profession, addressing local cultural aspects and gender roles, and enhancing flexibility and participation in social interactions.
The development of professional commitment in nursing students can be significantly enhanced through the promotion of ethical and professional principles and the establishment of a supportive socio-cultural environment. Embedding professional commitment within cultural frameworks contributes to students’ sense of responsibility and its sustainability in professional practice.
 

Identifying Factors Influencing Upholding Research Ethics from the Perspective of Postgraduate Students: A Qualitative Study
Mitra Bahrami, Mohadeseh Shaygan Jamal, Maryam Afshari, Omid Najm Roshan,
Volume 17, Issue 1 (3-2024)
Abstract
Research ethics is a branch of professional ethics that deals with the ethical principles guiding the research process from the beginning to the end. Ignoring ethical issues in research sometimes occurs unintentionally and simply due to a lack of awareness regarding professional research ethics. Therefore, this study aimed to identify facilitators and inhibitors of adherence to ethics in research conducted by postgraduate students at Hamadan University of Medical Sciences. This qualitative study was conducted using an inductive content analysis approach. The target population included postgraduate students at Hamadan University of Medical Sciences. Data were collected through semi-structured interviews with 29 students who were selected using purposive sampling. Data were analyzed using the method proposed by Diekelmann et al. For data validation, Strauss and Corbin’s method was utilized. Factors influencing adherence to research ethics included individual and personality traits (accuracy and ethical conduct of students and professors and having sufficient information about research ethics) and environmental factors (information dissemination and familiarity with research methods, the professors’ interactions with students, confidentiality of information, strictness of professors, having a clear framework from the university, respecting students’ rights, and establishing deterrent regulations). Strengthening facilitators and mitigating inhibitors of adherence to research ethics requires joint efforts from students, professors, and the university. Students need to develop accuracy and awareness, and professors should serve as ethical role models. University officials are required to create and propose clear frameworks for adhering to ethics, to be followed by all individuals involved in research.

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