Assessing educational needs of nurses' ethical competence based on the four components model of moral behaviour: a cross-sectional study using the Borich needs assessment and locus for focus models.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.