Ascertaining the thinking of professionals as they are confronted with ethical practice issues is a prerequisite to understanding ethical decision making. Before researchers or educators can examine the effectiveness of various approaches to ethics teaching and learning, there is a need for reliable and valid tools to assess practitioners' cognition. A potential problem with the few measuring instruments currently available is the fact that they ask subjects to rank order existing lists of issues. This says little about an individuals' own thinking about ethical issues and may prompt thinking or responses which would not otherwise have occurred. This paper reports the results of a study to test the psychometric properties of a new instrument, the Ethical Reasoning Tool (ERT) that measures ethical reasoning of nurses. The ERT demonstrates a promising way to reveal unprompted ethical thinking about a practice dilemma, thereby clarifying 'real' versus 'assumed' professional reasoning. The tool allows nurse educators to identify areas of student learning/reasoning deficiency that can be addressed by educational interventions. The ERT also allows nurse educators to evaluate the effectiveness of nursing ethics study units in a trustworthy way.
Background: This article discusses the course design, experiential findings, and evaluation of a Web-based course for graduate nurses examining professional health care practice and ethical issues. Method: Using course input and evaluative data, the article addresses student and teacher perceptions of use of a Web-based delivery mode for graduate level courses and the appropriateness of this ethics course for graduate level students. Results: Evaluative data supported existing knowledge concerning pros and cons of Webbased education. New insights concerning the Web's ability to foster critical thinking skills and supports for continuing ethics education for nurses are reported. All students assessed this ethics course as being of considerable value to their professional practice. Conclusion: Students evaluated the pros of Web use for the course as far outweighing the cons. The students' substantial interest in and critical thinking about appropriate knowledge bases to underpin effective ethical decision-making strongly supports the need for continuing ethics education for practicing nurses.
Increasingly, the professional literature reflects a call for the adoption of a (feminist) "ethic of caring" as a model for moral education in nursing. But what is not clear is the relationship between "care" and "ethics," or between an "ethic of caring" and "moral education." Has ethics, and the issue of ethics education for nurses, become entangled with what may be a separate issue of an "ethic of caring" for the nursing profession? This article presents an overview of evolving ethical stances of three professions, and shows how the dichotomous views within philosophy and psychology have strongly influenced ethical thought in nursing. Major questions concerning the stances are raised. Nurse educators need to have a critical awareness of the scope and complexity of the discussion, and the ability to closely scrutinize conclusions reached by each profession's theorists. Viewpoints concerning what should comprise ethics education in nursing will depend on the particular ethical stance adopted. Ethics education for nurses will continue in its present confused state until there is focused and directed critical reflection about what is currently known regarding moral development, ethical thought, and the role of education in both.
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