ETHICS EDUCATION in MSN Programs: A Study of National Trends

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ABSTRACT

The aim of this study was to determine the manner in which master's of science in nursing programs, accredited by either the National League for Nursing Accrediting Commission or the Commission on Collegiate Nursing Education, conduct ethics education. A survey method was employed to obtain requisite data. Among the main variables investigated were: the percentage of programs that require a course with formal ethics content; the average number of class hours a program or track dedicates to ethics education; required and actual credentials of instructors who teach ethics; and objectives, topics, teaching methods, and grading methods of required courses with formal ethics content. Results indicated that most programs do not require instructors to have completed formal ethics training. In terms of content, few common trends exist and there are important gaps in clinical ethics topics. Comparisons between school of medicine ethics content reported in the literature and MSN ethics content reported in this study indicate that medical schools are more exacting of their students. The study concludes with a call for the establishment of guidelines or standards relevant to ethics content in MSN curricula in the United States.

Key Words Ethics Education - Nursing Curricula - Nursing Education Master's Degree in Nursing

SINCE THE 1977 STUDY BY AROSKAR on ethics in the nursing curriculum (1), a growing number of nurse educators have called attention to the importance of ethics education for nurses (2-8). They underscore that nurses cannot appropriately interact with their patients and other health care professionals without the knowledge and skills necessary for ethical decision-making in their profession. Studies suggest that students are responsive to formal courses in nursing ethics. Such courses contribute to the development of nursing students' moral judgment (9,10), and students perceive ethics courses to be a major source of their ethical decision-making skills (11).

While recognition of the need for ethics in nursing education is widespread, there are diverse views on content and teaching methods (12). These views variously emphasize the value of:

* Interdisciplinary ethics courses (13)

* Discipline-specific ethics (2,14-16)

* Distinct or stand-alone ethics courses (8-10,17,18)

* Nursing courses that integrate ethical concepts and frameworks (19,20)

* Both distinct or stand-alone ethics courses and nursing courses that integrate ethical content (2).

A variety of recommendations are made with regard to the objectives and topics to be included in nursing ethics instruction (8,13,17,19-23).

At present, no reliable data exist on the state of ethics education in master's of science in nursing programs. Stone, in 1989, was the last to report on ethics education in MSN programs (24). Since then, growth in advanced practice nursing education makes it appropriate to reexamine the trends in related ethics education. Such information will provide educators with a basis for evaluating their ethics offerings, content areas, and teaching methods relative to those of other schools.

The primary aim of this study was to determine the manner in which MSN programs accredited by either the National League for Nursing Accrediting Commission (NLNAC) or the Commission on Collegiate Nursing Education (CCNE) conduct their ethics education. While the standards of these accrediting agencies indirectly refer to ethics education, no specific guidelines about the inclusion of ethics are provided (25,26).

Method INSTRUMENT AND PARTICIPANTS Program directors of the 345 master's level programs listed in the NLNAC or CCNE directories were sent a letter in November 2003 describing the study and inviting them to participate by taking part in a five- to ten-minute telephone survey. The telephone survey was conducted by the principal investigator (an instructor of a graduate-level nursing ethics course) and by trained doctoral students who had taken courses in health care ethics and had completed institutional review board training on protection of human subjects of research. …