Wihlborg Jonas, Andersson Ulf, Sterner Anders, Sandman Lars, Kängström Anna, Boysen Gabriella N
Dalarna University.
University of Borås.
Nurs Ethics. 2025 Jun;32(4):1197-1209. doi: 10.1177/09697330241291162. Epub 2024 Oct 15.
Ethical competence in professional practice can be considered essential among nurses and nurses in ambulance care encounter ethical dilemmas frequently. To enhance ethical competence among students in the ambulance specialist nursing program, high-fidelity simulation scenarios including ethical dilemmas were introduced as a learning activity. The research aim was to investigate the usefulness of high-fidelity simulation in ambulance specialist nurse education to teach ethical reasoning when caring for children. This study was conducted as a qualitative interview study, complemented with observations and using field notes and qualitative interviews for data collection. Data was analysed using deductive qualitative content analysis based on a care ethical model. Participants ( = 35) were recruited from an ambulance nurse educational program at a Swedish university. Data was collected after the students took part in two high-fidelity simulations involving children in an ambulance care setting. The study has been vetted and approved by the ethical council at the University of Borås, Sweden. The study follows the Helsinki Declaration's advice on ethical principles. The results showed that most of the students expressed some form of ethical reasoning during the simulation sessions, which were elaborated and reflected upon during the debriefing part of the sessions. The simulation design seemed to have a great impact on the outcome of the student's ethical reasoning, where increased immersion led to deeper emotional engagement among the students which increased awareness of their personal preconceptions. This study aimed to investigate whether high-fidelity simulations could be useful to stimulate ethical reflections and contribute to increased ethical competence among students. In conclusion, a well-designed high-fidelity simulation can be useful as an educational tool to learn and enhance ethical competence among specialist ambulance nursing students.
在专业实践中，道德能力对于护士而言至关重要，而从事急救护理的护士经常会遇到道德困境。为了提高急救专科护理项目学生的道德能力，引入了包含道德困境的高仿真模拟场景作为一种学习活动。研究目的是调查高仿真模拟在急救专科护士教育中对培养照顾儿童时的道德推理能力是否有用。本研究作为一项定性访谈研究开展，辅以观察，并使用实地记录和定性访谈进行数据收集。基于护理伦理模型，采用演绎定性内容分析法对数据进行分析。参与者（n = 35）从瑞典一所大学的急救护士教育项目中招募。在学生参与了两次涉及急救护理场景中儿童的高仿真模拟后收集数据。该研究已通过瑞典博拉斯大学伦理委员会的审查和批准。该研究遵循了《赫尔辛基宣言》关于伦理原则的建议。结果表明，大多数学生在模拟过程中表达了某种形式的道德推理，并在模拟后的汇报环节进行了详细阐述和反思。模拟设计似乎对学生道德推理的结果有很大影响，更高的沉浸感会使学生产生更深的情感投入，从而提高他们对个人先入之见的认识。本研究旨在调查高仿真模拟是否有助于激发道德反思，并促进学生道德能力的提高。总之，精心设计的高仿真模拟作为一种教育工具，对于学习和提高急救专科护理专业学生的道德能力可能是有用的。
