Effects of an ethical decision-making reasoning scheme in nursing students: A randomized, open-label, controlled trial

BACKGROUND

Previous research suggests that, to design a program to help students to develop ethical decision making, competence and courage to confront ethical dilemmas should be critical components.

PURPOSE

This study examines the effect of an ethical decision-making reasoning scheme in ethical decision making and communication self-efficacy in nursing students.

METHODS

This study was a prospective and randomized, open-label, controlled trial design. Nursing students from a medical university served as participants. Students were randomly assigned to an intervention group (IG), which received the ethical decision-making reasoning scheme intervention, or a control group (CG), which received a standard general course. The effect was measured with the Ethical Decision-Making Scale-Revised and the Self-efficacy for Communication Scale. Analysis of covariance (ANCOVA) was used to measure between-group differences, and paired t-tests were used to measure pre- and post-IG/CG differences.

RESULTS

A total of 101 nursing students were included and randomly assigned to the IG (n = 50) and CG (n = 51), and 41 IG and 43 CG students completed all aspects of the study. The findings show that there was significant improvement in self-efficacy in communication (t = 2.341, p = .024) and a decrease in difficulty in communication (t = 2.330, p = .025) in the IG. Ethical decision-making competencies improved more in the IG compared to the CG (F = 4.856, p = .034). Ethical decision-making competencies increased in both males and females, but there were no significant differences between males and females at the end of study (F = 0.264, p = .610).

CONCLUSION

These findings suggest that ethical decision-making training can improve students' confidence in communicating with patients and may help to improve students' more complex ethical decision making.

Principals’ knowledge of school law in Kuwait: implications for professional development

Purpose

The purpose of this study is to examine a principal's knowledge of school law in Kuwait. It further aims to examine the relationship between a principal's knowledge of school law and other variables.

Design/methodology/approach

The study employed a quantitative research paradigm. Data for this study, collected via survey, were collected from a sample of 369 public school principals.

Findings

Using descriptive and inferential statistical methods, the findings indicated that school principals have only limited knowledge about the legal rights of teachers and students. Furthermore, the results revealed a significant difference in knowledge of school law relative to a principal's gender, school level, years of experience, knowledge source and the number of completed school law training courses.

Practical implications

The implications for professional development programs which prepare all school leaders to serve the needs of students’ and teachers’ rights are included.

Originality/value

Studies showed that there is a lack of research regarding a principal's legal knowledge in the Arab countries. As such, this study examined a school principal's knowledge of school law in Kuwait and discussed the associated implications for principal professional development programs.

Exploring Rehabilitation Counseling Supervisors’ Role in Promoting Counselor Development of Ethical Fluency

Clinical supervision plays an integral role in the professional development of counselors, particularly for developing their awareness of ethical service delivery and decision making. This grounded theory study queried eight rehabilitation counseling supervisors, four from a state rehabilitation agency and four from a nonprofit community rehabilitation organization. The purpose of the study was to determine supervisor perspectives regarding their role in the development of ethical decision making in their supervisees. The emergent construct from the data is termed ethical fluency. Ethical fluency is a cognitive ability representing the interaction between acculturation knowledge, fluid reasoning, and the speed and accuracy with which ethical dilemmas are recognized and processed. Supervisors in this study reported playing a key role in developing ethical fluency in counselors, and the supervisory working alliance was an integral platform from which to approach discussions on ethics. Recommendations for improved practice and future research are provided.

The emotional wellbeing of lay HIV counselling and testing counsellors

The HIV testing, treatment and care programme of the South African public healthcare system depends on HIV counselling and testing (HCT) that is primarily delivered by lay counsellors. Lay counsellors are expected to educate clients about HIV/AIDS, advocate behaviour change, convey test results and support those infected and affected to cope with the emotional and social challenges associated with HIV/AIDS. This research focuses on the emotional wellbeing of lay HCT counsellors because this influences the quality of services they provide. A mixed methods approach was used. The emotional wellbeing, level of burnout, depression and coping style of 50 lay HCT counsellors working at the City of Tshwane clinics were assessed. Additionally, five focus group discussions were conducted. The results showed that HCT counsellors reported average emotional wellbeing, high levels of emotional exhaustion and depression. They had a sense of personal accomplishment and positive coping skills. The results revealed that they may have difficulty dealing with clients' emotional distress without adequate training and supervision. This creates a dilemma for service delivery. In the light of the important role they play in service delivery, the role of the lay HCT counsellor needs to be reconsidered. HCT should develop as a profession with specific training and supervision to develop their emotional competencies to conduct effective counselling sessions.