Developing Ethical Thinking in Clinical Settings: A Case Study

Carvalho Pinto, Cristina; Abreu, Wilson

http://hdl.handle.net/10400.26/34175

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Authors

Carvalho Pinto, Cristina

Abreu, Wilson

Abstract(s)

During their clinical learning, nursing students face complex realities. These require the mobilisation of scientific knowledge but also provide taxonomies of moral reasoning skills to develop ethical thinking. The main questions of the study were: how do students' clinical experiences affect the development of their ethical thinking? How can clinical teachers help students to overcome ethical tensions? The purposes were to explore students' experiences that might lead to ethical tensions and dilemmas; to identify opportunities to develop ethical thinking and ethical reasoning, and to evaluate the effectiveness of educational strategies that encourage students to value acting with good intentions and achieving the best outcome. An ethnographic study was conducted involving students from a nursing school in the North of Portugal. Data were collected using three methods. A questionnaire was used to identify the students’ moral orientation. Participant observation was carried out to identify tensions or ethical dilemmas. Semi-structured interviews were conducted to clarify and deepen the information gathered. Six dimensions emerged from the content analysis: the environment; learning styles; the influence of role models; mentorship processes; previous experience and the meaning of the ethical dilemmas to the students. These dimensions allowed us to understand the way students develop their ethical reasoning and show that educational strategies can improve the skills required to overcome moral dilemmas. Developing ethical thinking is an ecological process that takes place through processes of complex interactions between students, clinical teachers and patients. Students' ethical thinking is determined by what they experience in the settings they spend time in. Teachers should understand that clinical reasoning is dependent upon ethical thinking and is influenced by cultural experiences.