A high standard of ethical conduct is a fundamental expectation of all professional engineers. Potentially all design and operational decisions have ethical implications so ethical thinking should be high in the minds of engineers in their operational as well as strategic thinking in their individual activities, team working and interactions with outside companies. Today organizations typically have a set standard of professional conduct and values expected of their engineers and many offer forms of ethical training and support as part of their professional development. Higher Education Institutes [HEIs] also have strategies to initiate ethical awareness and professional conduct among undergraduate engineers through specific training and curriculum interventions. There is however, some lack of clarity on the ethical development of engineering students. Can university curricula and ethics education influence the ethical decision making capabilities of students? Do students address difficult ethical situations with a refined professional approach after undertaking a course or workshop on ethics? This research study aims to address these issues by investigating the key factors that influence decision making competences of engineering students. Using two focus groups: one with students who have undertaken an ethics based workshop and a second, as a control group, with students who haven’t. This study explores the differences in their skills and approaches to decision making. According to Rest [1986], there are four key stages involved in the ethical decision making process: Recognising moral issues [ETHICAL AWARNESS]; Making a moral judgement [ETHICAL JUDGEMENT]; Prioritising moral issues ahead of other issues [ETHICAL INTENT]; and Acting on the moral concerns [ETHICAL BEHAVIOUR]. This study adopts this model as part of the analysis to determine what shapes the decision making capabilities and competences of the participants and whether distinct patterns are followed. The analysis shows no significant differences in the level of ethical awareness and intentions of the participants in the two focus groups. However, the findings do highlight that the factors influencing their responses did vary between the groups. Factors such as job and financial motivation, personal commitment to friendship, fear of academic punishment heavily influenced the decision making competences among these groups. The two key motivation themes that emerge are external and internal rewards. Participants from the group which had no experience of ethics education showed preference towards external rewards [money, salary and job] in their decision making whereas participants who had undertaken a workshop on ethics sought internal rewards [being happy and guilt-free]. The study makes a contribution to the literature of ethics education and curriculum design by bringing clarity on the factors influencing students’ decision making skills. It also reflects on the effectiveness of ethics education in HEIs. Educators can use the findings of this study to build and reform ethical awareness and professional conduct among student. Students can utilize this study to understand the ethical norms and expectations in a profession like engineering as part of their career development.
@InProceedings{ATESH2017ANA,
author = {Atesh, M. and Baruah, B. and Ward, A.},
title = {ANALYZING THE FACTORS INFLUENCING THE ETHICAL DECISION MAKING SKILLS AMONG ENGINEERING STUDENTS},
series = {11th International Technology, Education and Development Conference},
booktitle = {INTED2017 Proceedings},
isbn = {978-84-617-8491-2},
issn = {2340-1079},
doi = {10.21125/inted.2017.1364},
url = {//dx.doi.org/10.21125/inted.2017.1364},
publisher = {IATED},
location = {Valencia, Spain},
month = {6-8 March, 2017},
year = {2017},
pages = {5819-5825}}
TY - CONF
AU - M. Atesh AU - B. Baruah AU - A. Ward
TI - ANALYZING THE FACTORS INFLUENCING THE ETHICAL DECISION MAKING SKILLS AMONG ENGINEERING STUDENTS
SN - 978-84-617-8491-2/2340-1079
DO - 10.21125/inted.2017.1364
PY - 2017
Y1 - 6-8 March, 2017
CI - Valencia, Spain
JO - 11th International Technology, Education and Development Conference
JA - INTED2017 Proceedings
SP - 5819
EP - 5825
ER -
M. Atesh, B. Baruah, A. Ward [2017] ANALYZING THE FACTORS INFLUENCING THE ETHICAL DECISION MAKING SKILLS AMONG ENGINEERING STUDENTS, INTED2017 Proceedings, pp. 5819-5825.
1Dilek Sari, Associate Professor, Department of Fundamentals Nursing, Ege University School of Nursing, Izmir, Turkey
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Ebru Baysal
2Ebru Baysal, Research Assistant, Department of Fundamentals Nursing, Ege University School of Nursing, Izmir, Turkey
Find articles by Ebru Baysal
Gul Gunes Celik
3Gul Gunes Celik, Research Assistant, Department of Fundamentals Nursing, Ege University School of Nursing, Izmir, Turkey
Find articles by Gul Gunes Celik
Ismet Eser
4Prof. Ismet Eser, Department of Fundamentals Nursing, Ege University School of Nursing, Izmir, Turkey
Find articles by Ismet Eser
Author information Article notes Copyright and License information Disclaimer
1Dilek Sari, Associate Professor, Department of Fundamentals Nursing, Ege University School of Nursing, Izmir, Turkey
2Ebru Baysal, Research Assistant, Department of Fundamentals Nursing, Ege University School of Nursing, Izmir, Turkey
3Gul Gunes Celik, Research Assistant, Department of Fundamentals Nursing, Ege University School of Nursing, Izmir, Turkey
4Prof. Ismet Eser, Department of Fundamentals Nursing, Ege University School of Nursing, Izmir, Turkey
Correspondence: Dilek Sari, Associate Professor, Department of Fundamentals Nursing, Ege University School of Nursing, Izmir, Turkey. Email: moc.liamg@iraslid
Received 2018 Feb 23; Revised 2018 Apr 8; Accepted 2018 May 7.
Copyright : © Pakistan Journal of Medical Sciences
This is an Open Access article distributed under the terms of the Creative Commons Attribution License [//creativecommons.org/licenses/by/3.0], which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective:
The present study was conducted to determine nursing students’ levels of ethical decision-making.
Methods:
The sample of the descriptive study consisted of 240 nursing students. The data were collected using the Student Information Form and “Nursing Dilemma Test”.
Results:
It was found that Principled Thinking [PT] mean score [48.38±7.97] of nursing students was above average while their Practical Consideration [PC] mean score [17.87±4.13] was close to average. It was also determined that the nursing students participated in the study were not familiar [17.75±2.77] with the dilemmas included in the Nursing Ethical Dilemma Test.
Conclusion:
The students paid attention to consider ethical principles when making decisions about ethical dilemmas; however, they are also affected by environmental factors as well. Sex and class level were found to be influential in the process of ethical decision making.
Keywords: Nursing, nursing students, Ethical decision making, Ethical dilemma, Ethics education
INTRODUCTION
Advances in science and technology have made patient care more and more complicated.1,2 As a result decision making responsibilities in nursing care to increase as well. Thus, nurses have begun to face many ethical problems such as initiating heart-lung resuscitation, ending a life-supporting treatment and patients rejecting treatment.2 Ethical decision making is a logical process which involves making the best moral decisions through systematic reasoning in a situation that brings about conflicting choices.3
Professional decisions of nurses affect their ethical problem solving skills and professional development of nursing students as well as the quality of patient care.4,5 If nurses fail to act in accordance with the principles taught at school in their practical applications, nursing students may fall into ethical conflict.6 Nursing students attend practical applications in the guidance of nurses and professors and make decisions in care. Therefore, nurses and professors must be role models for nursing students in clinical practices.4,5 Ethics education cannot be effective alone unless students have good role models. Practical norms and hierarchical structures may adversely affect new-graduates’ enthusiasm for ethical behavior.7
Studies conducted on nurses’ ethical sensitivity and ethical decision making levels have shown that they are not at the desired levels in ethical decision making.8,9 Likewise, studies carried out with student nurses have presented similar results.3,10,11 It has been found by studies on the ethical dilemmas experienced by nursing students and ethical decision making that the most frequent ethical dilemmas are telling the truth to incurable patients and their relatives,4 euthanasia, privacy,10,11 tapering of therapy,4,11 resuscitation of patients and patient rights.11
In order to improve nurses’ ethical decision making skills, they have to be undergo through basic education.2 Courses on ethics need be included within nursing curriculum. In-service training should cover ethical thinking skills and decision making process after graduation.1,12 It will enable them to identify when faced with an ethical problem, make the decisions in conflicts of ethical principles and develop solutions.13
It has been seen that the related literature includes few studies on the ethical decision making levels of nursing students.5,11,12,14,15 Considering the importance and necessity of ethical decision making, we believe that our study in which we measured nursing students’ levels of moral reasoning and ethical decision making will contribute to the literature.
METHODS
The present descriptive cross-sectional study was consisted of the 637 students receiving education and training in the second and fourth years of the College of Nursing in the academic year 2016-2017. The formula [n=[Nx2xpxq]/[d2x[N-1]+t2xpxq]] was used to calculate the size of the sample over the population.16,17 The calculation showed that the appropriate sample size would be minimum 240 students [105 students from second year and 135 students from fourth year]. A stratified random sampling method was used in selecting the students to be taken in the sample according to class.16
Data Collection Student Information Form
The form included four questions on students’ personal characteristics [class level, age, sex] and six questions about ethics and ethical dilemmas.
Nursing Dilemma Test
Nursing Dilemma Test was developed by Patricia Crisham in 1981. The Turkish version of the test was analyzed for validation and reliability by Cerit [2010]. The test formulated six scenarios. In each scenario, a situation is presented to possibly generate moral confusion for nurses offering care to the patient and family. The ethical dilemmas include: [a] newborn with anomalies considering the issue of defining and promoting the quality of life; [b] forcing medication; [c] adults’ requests to die; [d] orientation of a new nurse; [e] medication errors and [f] terminally ill adults. Each of the ethical dilemmas consists of three sections. The first section asks about the necessary action to be taken in case of the ethical dilemma given in the scenario and wants the answerer to mark one of the three options provided for each ethical dilemma. In the second section, six statements are presented which could be taken into consideration in the approach to the given scenario including the ethical dilemma. The participants are asked to choose the most important statement among these six and to put the statements in order of importance for themselves. The responses given in this section of the test aim at determining the levels of Principled Thinking” [PT] and “Practical Consideration” [PC]. The possible minimum PT score on the test is 18, while the maximum PT score is 66. The lowest PC score that could be obtained on the test is 6 and the highest PC score is 36. PT shows the importance attached to considering moral principles when making a moral decision in nursing. PC, on the other hand, measures the importance given to environmental factors such as the number of patients, the number of available resources, institutional policies, the degree of nurses’ perception of the support given by the administration and the doctor’s control when making decisions about ethical problems. In the third section, the participants are asked to state whether they have any past experience with a similar dilemma or not. Based on the answers given to the question in this section, the state of having experience with a similar dilemma was assessed on a likert type scale and the “Familiarity” score was obtained. A familiarity score between 6 and 17 shows that the participants are familiar with a similar dilemma, while a score falling within the 18-30 range reveals no familiarity with a similar dilemma.8
Ethical Considerations
Prior to data collection, an approval was obtained from X University College of Nursing Ethics Committee. Permission to use the Turkish version of the Nursing Dilemma Test was obtained from Birgül Cerit. Written approval was taken from school administrators to conduct the study. The study was conducted according to the Helsinki Declaration. Verbal consent was obtained from each student who agreed to participate after they were informed about the study content.
Statistical Analysis
Statistical analysis was performed by using SPSS [version 17.0, SPSS Inc, Chicago, Illinois]. General subject characteristics were analyzed using descriptive analysis through frequency, percentage, and means. Categorical variables were tested with Student t test and p