Identifying and Prioritizing the Moral Virtue Indicators for Undergraduate Nursing Students: Measurement Invariance Testing across Class Levels.

Abstract

Purpose: This study aimed to identify and prioritize the importance of the moral virtue indicators for undergraduate nursing students and to test the non-invariant indicators across class levels.

Methods: Secondary data from a sample of 1,000 Thai undergraduate nursing students from two nursing education institutes (one university nursing school and one nursing college of the Ministry of Public Health) was split into the first-, second-, third-, and fourth-year student groups (n = 247, 229, 246, and 278, respectively). A confirmatory factor analysis was conducted to identify and prioritize the importance of the moral virtue indicators in four student groups separately. The non-invariant indicators testing across the four class levels was employed using multiple-group analysis.

Results: The ten indicators were crucial for nursing students' moral virtue across the first to fourth years. The most important indicator for the first- and second-year student nurses was cooperation, while honesty was the most crucial for the third-year student nurses, and caring was the most dominant for the fourth-year student nurses. The testing of non-invariant indicators confirmed that each indicator contributed differently to the moral virtue of junior and senior students.

Conclusions: The findings spotlight the importance of the ten moral virtue indicators for undergraduate nursing students. Besides, the junior and senior student nurses prioritized the importance of the ten indicators measuring moral virtue differently. Therefore, administrators and nurse educators should provide the ethical scenarios and issues for classroom discussion and implement clinically authentic case-based simulations with timely feedback in laboratories for junior students. A regulatory process on moral virtues, using critical reflection, assessment criteria, and multi-rater assessors, should be deliberated in clinical training for senior students so that they adhere to moral virtues. These tailored strategies may help student nurses recognize their ethical behavior and gain personal and professional development as future nurses.