"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.

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.

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.

Moral Professional Personhood: ethical reflections during initial clinical encounters in nursing education

Moral agency is an important constituent of the nursing role. We explored issues of ethical development in Greek nursing students during clinical practice at the beginning of their studies. Specifically, we aimed to explore students’ lived experience of ethics, and their perceptions and understanding of encountered ethical conflicts through phenomenological analysis of written narratives.

The process of developing an awareness of personal values through empathizing with patients was identified as the core theme of the students’ experience. Six more common themes were identified. Development of the students’ moral awareness was conceptualized as a set of stages, commencing with empathizing with patients and nurses, moving on to taking a moral stand and, finally, concluding by becoming aware of their personal values and showing evidence of an emerging professional moral personhood. The notions of empathy, caring and emotion were in evidence throughout the students’ experience. Implications for practice and nurse education are discussed.

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.

Perceptions of academic integrity among nursing students

PURPOSE

Academic dishonesty is growing among nursing students. Reasons for this growth can be categorized into student, faculty, and system factors. Nursing faculty designed a study to explore this problem.

CONCLUSIONS

We identified three themes: characteristics of students with academic integrity, patient safety, and professional outcomes. Exploring student perceptions of academic integrity can help faculty design measures to prevent dishonesty in these three areas.

PRACTICE IMPLICATIONS

We recommend fostering culture change through strategies that target students, faculty, and systems. These strategies include peer mentoring, role modeling integrity, enhancing awareness of what constitutes cheating, and developing policies that promote honesty.

A study of an ethics education topic for undergraduate nursing students

The study aims to explore nursing students' perceptions of the relative value of various aspects of the ethical component of the undergraduate topic, 'Ethics and Law applied to Nursing' (topic NURS2104). To enable time for reflection on ethics in nursing, sampling occurred 1 year after successful completion of the above-mentioned topic and after successful completion of all but the final clinical experience components of the Bachelor of Nursing (BN) degree. A significant proportion of respondents perceived ethics education as relevant to professional practices. It is also noteworthy that the ethical decision-making strategies that had been incorporated into the topic (NURS2104) became transformed by the clinical experience of each particular student. While results of this study are not conclusive, they nevertheless provide important information for future nursing students on the evolutionary development of ethics education.

The ethical basis of teaching spirituality and spiritual care: a survey of student nurses perceptions

BACKGROUND

There is a professional requirement for student nurses to achieve competence in the delivery of spiritual care. However, there is no research exploring students nurses perceptions of being educated in these matters.

AIM

This paper explores the ethical basis of teaching student nurses about the concepts of spirituality and spiritual care by reporting the findings from the first year of a 3 year investigation.

DESIGN

An exploratory longitudinal design was used to obtain student nurses perceptions of spirituality and spiritual care as they progressed through a 3 year programme.

METHOD

A questionnaire incorporating the Spirituality and Spiritual Care Rating Scale was distributed to 176 pre-registration nursing students undertaking either the Advanced Diploma or Bachelor of Science degree programmes.

RESULTS

A response rate of 76.7% was obtained. Findings reveal that the majority of student nurses perceived spirituality to be a universal phenomenon of a type that can be associated with existentialism. Some students were very uncertain and apprehensive about being instructed in spiritual matters.

CONCLUSION

A cohort of student nurses held similar understandings of spirituality to those presented in the nursing literature. However the results also suggest an overwhelming majority felt it was wrong for spirituality to imply that some people are better than others and most were uncertain whether spirituality was related to good and evil. RELEVANCE TO NURSE EDUCATION: The investigation reveals that there are a number of ethical concerns surrounding the teaching of spirituality to student nurses that need to be resolved.

On being of good character: nurse education and the assessment of good character

The Nursing and Midwifery Council sets good character as a condition not only of entry to the UK register of nurses but also for entry to and continuation on pre-registration nursing programmes in the UK. This requires education providers to assess the character of potential and actual nursing students yet the guidance offered by the NMC for making such assessments is insufficiently developed and serves to provide criteria by which determination can be made of good character only in a narrow sense. Assessment of character requires making value judgements about others and lends support to the idea that nurse education has an explicit moral component. This paper outlines some of the difficulties in assessing character, explores the idea that good character can be assessed in both a thin and a thick sense, and considers some of the consequent implications for nurse educationalists.

Nursing students' ethical decision-making: a review of the literature

Research into education in ethical decision-making in nursing is scarce. This review is an overview of empirical literature published between 1980 and September 2006. The literature was retrieved from the Medline and CINAHL databases. The focus is on the methodology and findings of these studies for identifying knowledge gaps for further research. The methodological approaches and foci of the studies varied rendering the comparison and generalization of the findings difficult. The findings indicate that education has a positive impact on students' moral development. Future research should focus on educators and clinical instructors, and on the cooperation between theoretical and clinical instruction. A review of the theoretical scientific literature would provide valuable knowledge as well. Research in this area might also benefit from more context appreciating qualitative research as well as from the use of longitudinal research designs. Research projects at national and international level should be considered.

Group clinical supervision for mental health nursing students

Clinical supervision is recognized as important for developing safe professional practice in nursing. Although attention has been given to the development of training and education in clinical supervision for registered nurses, less discussion exists regarding these issues for pre-registration mental health nursing student to the theory and practice of group clinical supervision. In particular, this article raises awareness and promotes discussion of the practical issues involved in such an initiative.

Promoting Integrity Among Nursing Students

Unethical practices among college students are concerning for any profession, but especially for nursing because these students will become health care providers after graduation. Studies have found correlations between unethical practices as a student with future professional behavior; therefore, it is important to instill a sense of ethics in all nursing students. Honor codes facilitate communication about behavioral expectations between faculty and students and emphasize the importance of ethical behavior. The HIRRE (honesty, integrity, respect, responsibility, and ethics) program at Pasco-Hernando Community College is an example of a modified honor code. Through the use of faculty and student situation reports, this program has enabled faculty to monitor the integrity status of the nursing program and establish policy protocols for unethical behaviors.

Student plagiarism and professional practice

With the ever-increasing availability and accessibility of the Internet, students are able to access a multitude of resources in support of their studies. However, this has also led to an increase in their ability to cheat through plagiarising text and claiming it as their own. Increased pressures of balancing work and study have contributed to this rise. Not only confined to the student population, some academics are also guilty of engaging in this practice providing a less than favourable role model for their students. Of increasing concern is the links of this practice to professionalism or indeed in this case unprofessionalism. Both pre- and post-registration nursing students who plagiarise risk bringing the reputation of the profession into disrepute. There are a number of methods that may be used to detect plagiarism but often the penalties are menial and inconsistently applied. Overall it is essential that academic institutions foster a culture of honesty and integrity amongst its academic community. A culture that clearly emphasises that plagiarism in any form is unacceptable.

Teaching Spiritual Care in a Public Institution: Legal Implications, Standards of Practice, and Ethical Obligations

This article reviews the status of teaching spiritual care in a public institution of higher education. The resurgence of interest in spiritual care across the United States has spurred interest and expanded theories of spirituality within the nursing profession. Nursing education rose to the challenge of teaching spiritual care theories and interventions to students, despite the absence of policy to guide educators. However, differences between public and private educational institutions have led to variations in the teaching of spiritual care. In addition to the legal implications stemming from the need for separation of church and state, nurses must also be aware of their ethical obligations in order to teach spiritual care concepts appropriately. The accrediting agencies for nursing education programs and hospitals, as well as state licensure boards, foster high expectations for nurses to provide spiritual care. A call for research and policy development to guide nurse educators is also addressed in this article.

High tech cheating

The use of technology has enhanced the convenience, flexibility, and efficiency of both preparatory and continuing education. Unfortunately, academic dishonesty, including plagiarism, has shown a positive correlation with the increased use of technology in education. A review of the literature related to unintended outcomes of the use of technology in nursing education and continuing education was conducted to determine the ethical implications for the nursing profession. Although nursing research dealing with academic and professional misconduct is sparse, evidence suggests that academic dishonesty is a predictor of workplace dishonesty. Given this correlation between unethical classroom behavior and unethical clinical behavior, efforts to staunch academic dishonesty may help allay professional misconduct. A combination of high tech and low tech methods may be used to minimize unethical behaviors among students and practicing professional nurses in order to maintain the integrity of the profession.

Moral content and assignment marking: an exploratory study

This small scale exploratory survey investigates the relation between the moral content of student assignments and potential marking behaviour by lecturers. A questionnaire containing a number of deliberately discriminatory statements was sent to a sample of nurse academics, and participants were asked to indicate whether the inclusion of these statements might affect the mark awarded. The sample was too small to undertake tests of statistical significance. However, the results tentatively suggest that a majority of participants would penalise assignments that contain morally questionable statements, and many would cite the code of professional conduct in justification. There appeared to be little difference in the response to statements that offered opinions (normative) or described actions (descriptive). However, differences between responses to statements discriminating against different groups were apparent, with racist statements being penalised more often and with greater severity than other categories. Qualitative data support the quantitative data. Several areas for discussion are identified, including the academic status of nursing, the use of the code of professional conduct, the moral claims made for nurses, a potential 'hierarchy of wrongness', student self censorship, and inconsistency in marking. Further research is justified.

Using an Ethical Decision-Making Model to Determine Consequences for Student Plagiarism

The incidence of plagiarism, intentional or unintentional, in the professional nursing arena has increased in recent years, as has the occurrence of plagiarism among nursing students. Strategies for cheating have become very sophisticated with the use of aids such as personal digital assistants, camera phones, and instant messaging. Cheating on written papers has also increased. The Internet provides students with ready-made research and academic papers, and access to Web sites on a plethora of topics. In this article, I describe my experience with plagiarism of ethics papers during students' final semester before graduation. How I discovered the plagiarized work and used the A-B-C-D-E ethical decision-making model in determining the student consequences for the event are presented.

A Q-methodological study on nursing students' attitudes toward nursing ethics

PURPOSE

Professional nursing ethics is a living, dynamic set of standards for nurses'professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decision-making that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients'care.

METHODS

Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software.

RESULTS

Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes.

CONCLUSION

This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.

Researching students: an ethical dilemma

Students may be perceived as an accessible source for research, but their use as research subjects is not without ethical problems. These difficulties are increased when the researchers are also responsible for teaching the students they are researching. In this paper, Eileen Clark and Terence McCann reflect on the ethics of conducting research on their own students. They identify sources of ethical concern and discuss how these may be managed. Their experience is that lecturers can carry out research on their own students, even at small campuses, in an ethical manner They highlight the importance of opening a dialogue with the ethics committee at the institution.

The development of moral judgment during nursing education in Finland

This study describes moral judgment among first- and last-year nursing students in Finland and examines the effects of ethics teaching on the development of moral judgment. The data for this quantitative cross-sectional study were collected using the Defining Issues Test (DIT), which is based on Kohlberg's theory of moral reasoning stages. The questionnaires were sent to four polytechnics, which offer nursing education in southern Finland. A total of 52 first-year students and 54 last-year students participated. The results showed that students who had had to deal with ethical dilemmas in their practical training had higher moral judgment than students who did not. Last-year students had higher moral judgment than first-year students. Last-year students resorted to principle-based thinking more often than first-year students in resolving DIT dilemmas. The differences between the two groups were statistically significant. The results indicate that nursing education may has an effect upon students' moral judgment.

Ethics Content in Nursing Education: Pondering with the Possible

Accrediting bodies of nursing as well as other healthcare organizations require that nursing ethics content be incorporated in programs of study. How does nursing define the termnursing ethics? How is it distinguished or viewed in various levels of higher degree nursing education? What is the role of codes for nursing? These are but a few of the questions pondered in the following article that includes personal correspondence with two distinguished authors, educators, and consultants for biomedical ethics, Dr. Sara T. Fry and Dr. Nancy Berlinger of the Hastings Center.

The use of critical reflection in baccalaureate nursing education

Leaders in nursing education are incorporating innovative educational strategies, including reflection, which will more fully develop student nurses' intellectual capacities to conceptualize knowledge to better meet patients' needs (Boud, Keough, & Walker, 1998; Duraghee, 1996; Hallett, 1997). This article examines the theoretical basis for reflective practice and explores its usefulness in the development and transmission of nursing knowledge in baccalaureate nursing education. Critical reflection can be effectively utilized by leaders in baccalaureate nursing education in classrooms, clinical settings, service learning experiences, experiential learning activities, and in the instruction of ethical decision-making.

Ethical debates: enhancing critical thinking in nursing students

The use of classroom debates can be helpful in teaching ethical content that is often nebulous and difficult for students to comprehend and apply. Debates enhance critical thinking skills through researching issues and developing a stance that can be supported in scientific literature. The authors describe a student debate project involving ethical issues with chronically ill clients. Many students changed their views during the debates. Students evaluated the debates as a positive learning experience.