Investigating the Moral Development and Academic and Clinical Integrity in Nursing Students Using the Defining Issues Test and Hilbert’s Unethical Behavior Survey

This longitudinal study examined the development of moral judgement in 37 nursing students attending a university in Suwon, Korea. The participants completed the Korean version of the Defining Issues Test to allow analysis of their level of moral judgement. The development of moral judgement was quantified using ‘the moral development score’ at each stage (i.e. the six stages detailed by Kohlberg) and the ‘P(%) score’ (a measure of the overall moral judgement level). The results were as follows: (1) the moral development score for stage 5A was consistently the highest across the four years of the students’ course, showing significant differences in some sociodemographic factors including home, birth order and monthly income; and (2) the P(%) score was higher in fourth-year (47.47 ± 11.21) than in first-year (46.13±9.73) students. There was no significant difference in the P(%) score according to sociodemographic factors. Further studies will examine in detail the correlation between curriculum and moral judgement development. We suggest that courses in ethics education should be made more relevant.

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Moral development and unethical behavior among nursing students

Journal of Professional Nursing ◽

10.1016/s8755-7223(88)80133-9 ◽

1988 ◽

Vol 4 (3) ◽

pp. 163-167 ◽

Cited By ~ 25

Author(s):

Gail A. Hilbert

Keyword(s):

Nursing Students ◽

Moral Development ◽

Unethical Behavior

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The Empirical Performance of Cognitive Moral Development in Predicting Behavioral Intent

Business Ethics Quarterly ◽

10.2307/3857501 ◽

1996 ◽

Vol 6 (4) ◽

pp. 493-515 ◽

Cited By ~ 24

Author(s):

Donald P. Robin ◽

Gus Gordon ◽

Charles Jordan ◽

R. Eric Reidenbach

Keyword(s):

Moral Development ◽

Unethical Behavior ◽

Ethical Judgment ◽

Defining Issues Test ◽

Cognitive Moral Development ◽

Theoretical Level ◽

Behavioral Intent ◽

Multidimensional Ethics Scale ◽

Empirical Performance ◽

Better Than

AbstractThe substantial work on cognitive moral development (CMD) by Lawrence Kohlberg and James Rest popularized the use of this construct in the literature on business ethics. This construct has been prominently used in models attempting to explain ethical/unethical behavior in management, marketing, and accounting, even though Kohlberg did not intend for the construct to be used in that manner. As a predictor of behavior, CMD has been attacked on the theoretical level, and its empirical performance has been weak. This article uses another established construct, which seems to satisfy the central criticisms of CMD, as a means of testing those complaints. The comparative multidimensional ethics scale (MES) substantially outperforms CMD, operationalized using Rest's Defining Issues Test, in every test. These results seem to suggest that other options perform better than CMD when the purpose is to model ethical/unethical behavior or even ethical judgment.

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Student nurses’ unethical behavior, social media, and year of birth

Nursing Ethics ◽

10.1177/0969733015590009 ◽

2016 ◽

Vol 23 (8) ◽

pp. 910-918 ◽

Cited By ~ 7

Author(s):

Gloria Copeland Smith ◽

Troy Keith Knudson

Keyword(s):

Social Media ◽

Nursing Students ◽

Unethical Behavior ◽

Ethics Education ◽

Student Nurses ◽

Clinical Cohort ◽

Follow Up Study ◽

Significant Difference ◽

Use Of Social Media

Background: This study is the result of findings from a previous dissertation conducted by this author on Student Nurses’ Unethical Behavior, Boundaries, and Social Media. The use of social media can be detrimental to the nurse–patient relationship if used in an unethical manner. Method: A mixed method, using a quantitative approach based on research questions that explored differences in student nurses’ unethical behavior by age (millennial vs nonmillennial) and clinical cohort, the relationship of unethical behavior to the utilization of social media, and analysis on year of birth and unethical behavior. A qualitative approach was used based on a guided faculty interview and common themes of student nurses’ unethical behavior. Participants and Research Context: In total, 55 Associate Degree nursing students participated in the study; the research was conducted at Central Texas College. There were eight faculty-guided interviews. Ethical considerations: The main research instrument was an anonymous survey. All participants were assured of their right to an informed consent. All participants were informed of the right to withdraw from the study at any time. Findings: Findings indicate a significant correlation between student nurses’ unethical behavior and use of social media (p = 0.036) and a significant difference between student unethical conduct by generation (millennials vs nonmillennials (p = 0.033)) and by clinical cohort (p = 0.045). Further findings from the follow-up study on year of birth and student unethical behavior reveal a correlation coefficient of 0.384 with a significance level of 0.003. Discussion: Surprisingly, the study found that second-semester students had less unethical behavior than first-, third-, and fourth-semester students. The follow-up study found that this is because second-semester students were the oldest cohort. Conclusion: Implications for positive social change for nursing students include improved ethics education that may motivate ethical conduct throughout students’ careers nationally and globally for better understanding and promotion of ethics and behavior.

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Socializing for Authentic Caring Engagement in Nursing Practice: Nursing Student Moral Development in Preceptorship

Canadian Journal of Nursing Research ◽

10.1177/0844562118809258 ◽

2018 ◽

Vol 51 (2) ◽

pp. 63-71 ◽

Cited By ~ 3

Author(s):

Jill Vihos ◽

Florence Myrick ◽

Olive Yonge

Keyword(s):

Nursing Students ◽

Moral Development ◽

Nursing Student ◽

Nursing Practice ◽

Moral Identity ◽

Theory Approach ◽

Moral Issues ◽

Undergraduate Nursing ◽

Patient’S Experience ◽

Authentic Caring

Background The purpose of this study was to explore the basic psychosocial process of undergraduate nursing student moral development in clinical preceptorship. Method A grounded theory approach was used to explore the process within the context of clinical practice and the student–preceptor–faculty member relationship. Results Socializing for authentic caring engagement in nursing practice emerged from the data as the basic psychosocial process of nursing student moral development in preceptorship. This process included four key categories: (a) distinguishing nursing and moral identity in practice, (b) learning to recognize the patient’s experience, (c) identifying moral issues in practice and creating meaning of practice encounters, and (d) becoming an advocate and reconciling moral issues in practice. Conclusion Findings emerging from this study illustrate the processes of how nursing students work through moral issues and the role of faculty and preceptors in engaging students with moral encounters in the context of preceptorship.

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Collectivism in Moral Development

Psychological Reports ◽

10.2466/pr0.1997.80.3.967 ◽

1997 ◽

Vol 80 (3) ◽

pp. 967-975 ◽

Cited By ~ 2

Author(s):

Chang-Ho C. Ji

Keyword(s):

Graduate Students ◽

Moral Development ◽

Moral Reasoning ◽

Defining Issues Test ◽

T Test ◽

Regression Analyses ◽

Asian People

This study investigated the relations among ethnicity, moral reasoning, and collectivism by administering the Defining Issues Test and the Individualism-Collectivism Scale to 165 Euro-American and Asian graduate students. To the data were applied analyses of variance, correlation, t test, and regression analyses. The analysis indicated that the Asian subjects had lower P scores on the Defining Issues Test so Kohlberg's model may not incorporate the concerns and experience of Asian people. The study also showed that scores on collectivism were not necessarily associated with low P scores.

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Differences in Moral Reasoning Among Medical Graduates Compared With Graduates of Other Degrees and Adults Without Professional Degrees

10.21203/rs.3.rs-936255/v1 ◽

2021 ◽

Author(s):

Maria Guadalupe Jean-Tron ◽

Diana Ávila-Montiel ◽

Horacio Márquez-González ◽

Gina del Carmen Chapa-Koloffon ◽

José Antonio Orozco-Morales ◽

...

Keyword(s):

Moral Development ◽

Moral Reasoning ◽

Education Level ◽

Defining Issues Test ◽

Master's Students ◽

Social Construct ◽

Medical Graduates ◽

Education Levels ◽

Natural Characteristic ◽

Professional Degrees

Abstract Background. When we talk about morality, a question arises as to whether it is a natural characteristic of humans—that is, whether it is what people should pursue as individuals or whether it is a social construct. Kohlberg established six progressive stages of moral judgment that form three levels of moral development, showing the development of people’s thinking on moral issues that is characterized by the aforementioned criteria. Methods. This study’s objective was to compare the level of moral reasoning among graduate students in medicine with a group of young graduates from other degrees and a group of non-professional adults.The moral reasoning questionnaire (Defining Issues Test, DIT) designed by James Rest based on Kohlberg’s theory (Rest 1979) was applied. In total, 304 questionnaires were completed. Results. Depending on the population studied, differences have been found in the profile of moral development. The profile of family clinic users showed a very high predominance of subjects in category 1 at 70%, but only 4.5% in category 3, while in the group of pediatric specialty students, 37.5% were found in category 1 and 34% in category 3. They were the group with the highest percentage in this category. This vast difference could be because the differences in the age and socio-education levels of the beneficiaries are much wider than that of the residents. However, differences are also found if the profiles of residents are compared with those of master’s students because the latter comprised 56% in category 1 and 19% in category 3. We also found differences in the profiles of moral development based on the highest education level. Conclusions. Based on the results of this study, the population could be classified into three levels of moral development, the first level being the predominant one and the third the least common, as we expected prior to the study. The reason why some individuals reach the highest level while others do not remains a question to be addressed. The results show us that there is a difference in some populations depending on education level and even the type of degree pursued.

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Lecture-based versus problem-based learning in ethics education among nursing students

Nursing Ethics ◽

10.1177/0969733018767246 ◽

2018 ◽

Vol 26 (6) ◽

pp. 1753-1764 ◽

Cited By ~ 3

Author(s):

Mahnaz Khatiban ◽

Seyede Nayereh Falahan ◽

Roya Amini ◽

Afshin Farahanchi ◽

Alireza Soltanian

Keyword(s):

Decision Making ◽

Nursing Students ◽

Moral Development ◽

Moral Reasoning ◽

Ethics Education ◽

Problem Based Learning ◽

Nursing Ethics ◽

Moral Decision ◽

Moral Decision Making ◽

The Mean

Background: Moral reasoning is a vital skill in the nursing profession. Teaching moral reasoning to students is necessary toward promoting nursing ethics. Objectives: The aim of this study was to compare the effectiveness of problem-based learning and lecture-based methods in ethics education in improving (1) moral decision-making, (2) moral reasoning, (3) moral development, and (4) practical reasoning among nursing students. Research design: This is a repeated measurement quasi-experimental study. Participants and research context: The participants were nursing students in a University of Medical Sciences in west of Iran who were randomly assigned to the lecture-based (n = 33) or the problem-based learning (n = 33) groups. The subjects were provided nursing ethics education in four 2-h sessions. The educational content was similar, but the training methods were different. The subjects completed the Nursing Dilemma Test before, immediately after, and 1 month after the training. The data were analyzed and compared using the SPSS-16 software. Ethical considerations: The program was explained to the students, all of whom signed an informed consent form at the baseline. Findings: The two groups were similar in personal characteristics (p > 0.05). A significant improvement was observed in the mean scores on moral development in the problem-based learning compared with the lecture-based group (p < 0.05). Although the mean scores on moral reasoning improved in both the problem-based learning and the lecture-based groups immediately after the training and 1 month later, the change was significant only in the problem-based learning group (p < 0.05). The mean scores on moral decision-making, practical considerations, and familiarity with dilemmas were relatively similar for the two groups. Conclusion: The use of the problem-based learning method in ethics education enhances moral development among nursing students. However, further studies are needed to determine whether such method improves moral decision-making, moral reasoning, practical considerations, and familiarity with the ethical issues among nursing students.

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Self-Perception and Value System as Possible Predictors of Stress

Nursing Ethics ◽

10.1177/096973309800500203 ◽

1998 ◽

Vol 5 (2) ◽

pp. 103-121 ◽

Cited By ~ 5

Author(s):

Bengt Sivberg

Keyword(s):

Nursing Students ◽

Principal Component ◽

Defining Issues Test ◽

Moral Judgement ◽

T Test ◽

Principal Component Factor Analysis ◽

Coping With Stress ◽

Swedish Version ◽

Value System ◽

Paired Samples

This study was directed towards personality-related, value system and sociodemographic variables of nursing students in a situation of change, using a longitudinal perspective to measure their improvement in principle-based moral judgement (Kohlberg; Rest) as possible predictors of stress. Three subgroups of students were included from the commencement of the first three-year academic nursing programme in 1993. The students came from the colleges of health at Jönköping, Växjö and Kristianstad in the south of Sweden. A principal component factor analysis (varimax) was performed using data obtained from the students in the spring of 1994 ( n = 122) and in the spring of 1996 ( n = 112). There were 23 variables, of which two were sociodemographic, eight represented self-image, six were self-values, six were interpersonal values, and one was principle-based moral judgement. The analysis of data from students in the first year of a three-year programme demonstrated eight factors that explained 68.8% of the variance. The most important factors were: (1) ascendant decisive disorderly sociability and nonpractical mindedness (18.1% of the variance); (2) original vigour person-related trust (13.3% of the variance); (3) orderly nonvigour achievement (8.9% of the variance) and (4) independent leadership (7.9% of the variance). (The term ‘ascendancy’ refers to self-confidence, and ‘vigour’ denotes responding well to challenges and coping with stress.) The analysis in 1996 demonstrated nine factors, of which the most important were: (1) ascendant original sociability with decisive nonconformist leadership (18.2% of the variance); (2) cautious person-related responsibility (12.6% of the variance); (3) orderly nonvariety achievement (8.4% of the variance); and (4) nonsupportive benevolent conformity (7.2% of the variance). A comparison of the two most prominent factors in 1994 and 1996 showed the process of change to be stronger for 18.2% and weaker for 30% of the variance. Principle-based moral judgement was measured in March 1994 and in May 1996, using the Swedish version of the Defining Issues Test and Index P. The result was that Index P for the students at Jönköping changed significantly (paired samples t-test) between 1994 and 1996 ( p = 0.028), but that for the Växjö and Kristianstad students did not. The mean of Index P was 44.3% at Växjö, which was greater than the international average for college students (42.3%); it differed significantly in the spring of 1996 (independent samples t-test), but not in 1994, from the students at Jönköping ( p = 0.032) and Kristianstad ( p = 0.025). Index P was very heterogeneous for the group of students at Växjö, with the result that the paired samples t-test reached a value close to significance only.

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