Nursing students' ethical challenges in the clinical settings: A mixed-methods study

Nurs Ethics. 2019 Nov-Dec;26(7-8):1983-1991. doi: 10.1177/0969733018810766. Epub 2018 Nov 14.

Abstract

Background: Nursing students experience ethical conflicts and challenges during their clinical education. These may lead to moral distress and disturb the learning process.

Objectives: This study aimed to explore and to evaluate the nursing students' ethical challenges in the clinical settings in Iran.

Research design: This was a mixed-methods study with an exploratory sequential design.

Participants and research context: A total of 37 and 120 Iranian nursing students participated in the qualitative and quantitative phases, respectively.

Ethical considerations: The ethical committee of Kerman University of Medical Sciences, Iran, approved the protocol of the study.

Findings: Three main categories were extracted from qualitative data including Low attention of nurses to the patients' preferences; Lack of authority; and Inadequate support. A total of 97% of the students had more than one ethical challenge in clinical settings and 48% of them stated that their challenges did not resolve. The total score of perceived ethical challenges was 62.03 ± 9.17, which was moderate. The highest mean score related to the "Low attention of nurses to the patients' preferences" subscale.

Discussion: The finding confirmed most of the existing results of other international researches about the frequency and kinds of baccalaureate nursing students' ethical challenges.

Conclusion: Identifying student ethical challenges helps teachers to manage their clinical learning process better. This study may provide a view for the nurses, clinical educators, and managers toward nursing students' ethical challenges and their impact on nursing students' clinical experiences.

Keywords: Clinical setting; Iran; ethical challenge; mixed-methods study; nursing students.

MeSH terms

  • Adult
  • Analysis of Variance
  • Ethics, Nursing*
  • Female
  • Humans
  • Interviews as Topic / methods
  • Iran
  • Male
  • Psychometrics / instrumentation
  • Psychometrics / methods
  • Qualitative Research
  • Students, Nursing / psychology*
  • Students, Nursing / statistics & numerical data