Ha Kyunghee, Oh Younjae
Graduate School of Nursing Science, Hallym University, Gangwon-do, Republic of Korea.
College of Nursing and Research Institute of Nursing Science, Hallym University, Hallymdaehakgil 1, Chuncheon, Gangwon-do, 24252, Republic of Korea.
BMC Nurs. 2025 May 30;24(1):615. doi: 10.1186/s12912-025-03269-5.
Ethical competence is an essential attribute for professional nurses. Before designing ethics education programmes for nurses, it is crucial to conduct a systematic and accurate analysis of the needs of nurses to optimise the effectiveness of such programmes. This study performed an educational-needs analysis aimed at assessing and prioritising ethical competence requirements among nurses.
We developed a 35-item questionnaire based on the Four Components Model of moral behaviour and adjusted it according to findings from a review of the pertinent nursing literature and input from expert panel discussions. The questionnaire, which comprised questions across four ethical competencies (ethical sensitivity, ethical judgment, ethical motivation, and ethical implementation) was distributed to 400 nurses working in three general hospitals in Seoul and Gyeonggi Province, Republic of Korea. Of the 400 questionnaires returned, 307 met our inclusion criteria. The responses were analysed with the aim of determining in which areas nurses needed more training to achieve the required competence. The three-step educational-needs analysis first employed paired t-tests to determine where reliable differences lie between the nurses' present competence level and required competence level, and then we employed Borich Needs Assessment and the Locus for Focus models to rank and prioritise the identified educational needs.
Our analysis revealed significant differences between the nurses' present competence levels and the required competence levels in all 35 items (p < .001) of the questionnaire. Borich Needs Assessment and the Locus for Focus models identified four items in the questionnaire that had the highest priorities for educational needs in ethical competence: three ethical judgment items and one ethical implementation item. These items deal with ethical judgment grounded in ethical theories such as virtue ethics and the principle of justice within principlism; and ethical implementation that specifically addresses issues related to the concealment of clear medical errors.
This study suggests that specific ethical competencies, identified as high-priority needs through the educational-needs analysis, should be included in student and post-graduate nursing education and in institutional policies in order to foster good nursing practices in daily care.
道德能力是专业护士的一项基本特质。在为护士设计道德教育项目之前，对护士的需求进行系统且准确的分析，以优化此类项目的效果至关重要。本研究进行了一项教育需求分析，旨在评估护士的道德能力要求并确定其优先次序。
我们基于道德行为的四要素模型编制了一份包含35个条目的问卷，并根据对相关护理文献的综述结果以及专家小组讨论的意见进行了调整。该问卷涵盖了四种道德能力（道德敏感性、道德判断、道德动机和道德实施）方面的问题，发放给了韩国首尔和京畿道的三家综合医院的400名护士。在回收的400份问卷中，有307份符合我们的纳入标准。对这些回复进行分析，目的是确定护士在哪些领域需要更多培训以达到所需能力。三步教育需求分析首先采用配对t检验来确定护士当前能力水平与所需能力水平之间的可靠差异所在，然后我们使用博里奇需求评估法和聚焦点模型对已确定的教育需求进行排序和确定优先次序。
我们的分析显示，问卷中所有35个条目（p <.001）的护士当前能力水平与所需能力水平之间均存在显著差异。博里奇需求评估法和聚焦点模型确定了问卷中四个在道德能力教育需求方面优先级最高的条目：三个道德判断条目和一个道德实施条目。这些条目涉及基于诸如美德伦理学和原则主义中的正义原则等道德理论的道德判断；以及专门处理与隐瞒明显医疗差错相关问题的道德实施。
本研究表明，通过教育需求分析确定为高优先需求的特定道德能力，应纳入本科和研究生护理教育以及机构政策中，以促进日常护理中的良好护理实践。
