Investigating the Impact of Scenario-Based Moral Concepts Training on the Professional Moral Courage of Nursing Students: A Protocol for a Randomized Controlled Trial

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports Pub Date : 2025-07-13 DOI:10.1002/hsr2.71021

Ali Akbari, Arvin Mirshahi, Fatemeh Mehravar, Ali Karimi Rozveh, Alireza Nikbakht Nasrabadi

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Abstract

Background and Aims

Moral courage is vital in nursing, enabling professionals to make ethical decisions and uphold values, even in challenging situations. Nursing students often struggle with moral decision-making due to limited experience and insufficient ethical training. This study proposes a randomized controlled trial (RCT) to evaluate the effectiveness of scenario-based ethics training compared to traditional methods in improving professional moral courage among nursing students.

Methods and Analysis

This RCT involved a 3-month scenario-based ethics training program delivered under faculty supervision, targeting sixth-semester undergraduate nursing students. Participants (n = 48) were randomly assigned to either the intervention group or the control group. Both groups received traditional ethics education, however, the intervention group also participated in two workshops focused on core and derived ethical concepts (e.g., autonomy, confidentiality) utilizing a scenario-based approach. This was followed by weekly online follow-ups and discussions conducted via WhatsApp Messenger. The outcomes will be assessed using the Sekerka Professional Moral Courage Questionnaire at four time points: immediately before, immediately after, and at 1 and 3 months postintervention. The questionnaire has demonstrated acceptable validity and reliability in previous studies, with Cronbach's α exceeding 0.8, and a value of 0.977 reported in an Iranian validation study. In this study, face validity was confirmed by ten nursing faculty members. The data will be analyzed using t-tests, χ² tests, and ANCOVA to evaluate changes in professional moral courage (SPSS v22, p < 0.05).

Conclusion

This protocol outlines a trial to evaluate the impact of scenario-based training on enhancing nursing students' professional moral courage and improving ethics education in clinical settings.

Trial Registration

Iranian Clinical Trials Registry: IRCT20240319061338N1.

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基于场景的道德观念训练对护生职业道德勇气的影响：一项随机对照试验方案

道德勇气在护理中是至关重要的，它使专业人员即使在充满挑战的情况下也能做出道德决定并坚持价值观。护理专业的学生由于经验有限，缺乏道德培训，经常在道德决策方面挣扎。本研究提出一项随机对照试验（RCT）来评估基于场景的伦理训练与传统方法在提高护生职业道德勇气方面的效果。方法与分析本随机对照试验包括在教师监督下进行为期3个月的基于场景的道德培训计划，目标是六学期的本科护理学生。参与者（n = 48）被随机分为干预组和对照组。两组都接受了传统的伦理教育，然而，干预组还参加了两个研讨会，重点是核心和衍生的伦理概念（例如，自主性，保密性），利用基于场景的方法。之后每周通过WhatsApp Messenger进行在线跟进和讨论。在干预前、干预后、干预后1个月和3个月四个时间点使用Sekerka职业道德勇气问卷对结果进行评估。问卷在既往研究中具有可接受的效度和信度，Cronbach’s α值超过0.8，伊朗验证研究报告的值为0.977。在本研究中，10名护理教师对面孔效度进行了验证。数据将采用t检验、χ2检验和ANCOVA分析，以评估职业道德勇气的变化（SPSS v22, p < 0.05）。本方案概述了一项试验，以评估基于场景的培训对提高护理学生的职业道德勇气和改善临床环境中的伦理教育的影响。伊朗临床试验注册中心：IRCT20240319061338N1。

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