Trinity Western University, Langley, British Columbia, Canada.
University of Victoria, Victoria, British Columbia, Canada.
Nurs Philos. 2024 Jan;25(1):e12427. doi: 10.1111/nup.12427. Epub 2023 Feb 27.
Moral imagination is a central component of moral agency and person-centred care. Becoming moral agents who can sustain attention on patients and their families through their illness and suffering involves imagining the other, what moral possibilities are available, what choices to make, and how one wants to be. This relationship between moral agency, moral imagination, and personhood can be effaced by a focus on task-driven technical rationality within the multifaceted challenges of contemporary healthcare. Similarly, facilitating students' moral agency can also be obscured by the task-driven technical rationality of teaching. The development of moral agency requires deliberate attention across the trajectory of nursing education. To prepare nursing students for one practice challenge, workplace violence, we developed a multimodal education intervention which included a simulated learning experience (SLE). To enhance the realism and consistency of the educational experience, 11 nursing students were trained as simulated participants (SP). As part of a larger study to examine knowledge acquisition and practice confidence of learners who completed the SLE, we explored the experience of being the SP through interviews and a focus group with the SP students. The SP described how their multiple performances contributed to imagining the situation 'on both sides' prompting empathy, a reconsideration of their moral agency, and the potential to prevent violence in the workplace beyond technical rational techniques, such as verbal de-escalation scripts. The empirical findings from the SP prompted a philosophical exploration into moral imagination. We summarise the multimodal educational intervention and relevant findings, and then, using Johnson's conception of moral imagination and relevant nursing literature, we discuss the significance of the SP embodied experiences and their professional formation. We suggest that SLEs offer a unique avenue to create pedagogical spaces which promote moral imagination, thereby teaching for moral agency and person-centred care.
道德想象力是道德主体和以患者为中心的护理的核心组成部分。成为能够在患者及其家属患病和受苦期间关注他们的道德主体,需要想象他人、思考有哪些道德可能性、做出何种选择以及希望自己成为什么样的人。道德主体、道德想象力和人的身份之间的这种关系可能会因关注当代医疗保健多方面挑战中的任务驱动技术理性而被抹杀。同样,在教学中强调任务驱动的技术理性,也会使学生的道德主体地位变得模糊不清。道德主体的发展需要在护理教育的整个过程中给予刻意关注。为了使护理学生能够应对实践挑战之一的工作场所暴力,我们开发了一种多模式教育干预措施,其中包括模拟学习体验 (SLE)。为了提高教育体验的真实性和一致性,我们培训了 11 名护理学生作为模拟参与者 (SP)。作为一项更大的研究的一部分,该研究旨在检查完成 SLE 的学习者的知识获取和实践信心,我们通过对 SP 学生的访谈和焦点小组探讨了他们作为 SP 的体验。SP 描述了他们的多次表演如何有助于想象“双方”的情况,从而引发同理心、重新思考他们的道德主体地位,以及超越言语降级脚本等技术理性技术,在工作场所预防暴力的潜力。SP 的经验发现促使我们对道德想象力进行哲学探讨。我们总结了多模式教育干预措施和相关发现,然后,使用约翰逊的道德想象力概念和相关护理文献,我们讨论了 SP 体现的经验及其专业形成的意义。我们认为,SLE 为创造促进道德想象力的教学空间提供了独特途径,从而为道德主体和以患者为中心的护理教学。