Ethics of nursing in the digital age: perceptions and challenges among Korean nursing students.

Abstract

Background: The advancement of digital technologies has brought transformative changes across the healthcare sector, and nursing is no exception. However, existing research has largely overlooked the ethical challenges nursing students face in real-world clinical settings, including dilemmas arising from the integration of artificial intelligence, patient privacy, and digital communication. This study explored nursing students' perceptions and challenges regarding nursing ethics in the digital age, focusing on the ethical dilemmas they face and their strategies for resolution.

Methods: We conducted two focus group interviews with 13 nursing students from two universities in Seoul, South Korea. Discussions centered on their experiences with ethical conflicts in digital healthcare environments.

Results: Nursing students frequently experienced ethical tensions between utilizing digital information and protecting patient privacy, including concerns about photographing EMR screens and using patient data without explicit consent. Many reported confusion in ethical decision-making due to unclear institutional guidelines and insufficient practical guidance. A notable gap existed between theoretical ethics education and its application in digital contexts. Introducing AI in clinical settings further complicates ethical reasoning, raising questions about trust, accountability, and verification of AI-driven decisions. Students also highlighted ethical risks in digital communication, such as improper use of hospital messaging systems and social media, which threaten professionalism and confidentiality. These findings emphasize students' strong demand for enhanced digital ethics education through case-based learning, simulations, and experiential training.

Conclusions: Nursing students stressed the need for practical ethics education that bridges the gap between theory and real-world application. This study underscores the importance of mandatory, practice-focused training linked to clinical environments, reinforced patient privacy protections, and ongoing education addressing ethical issues posed by emerging technologies like AI. To develop ethically competent nurses, digital ethics education must adopt a comprehensive, practice-oriented framework grounded in the realities of modern healthcare.