Competencies in nursing students for organized forms of clinical moral deliberation and decision-making

Abstract

Bachelor-prepared nurses are expected to be competent in moral deliberation and decision-making (MDD) in clinical practice. It is unclear, however, how this competence develops in nursing students. This study explores the development of nursing students’ competence for participating in organized forms of MDD in clinical practice, with an eye to improve nursing education.

A cross-sectional descriptive survey was conducted by a questionnaire among first and fourth year bachelor nursing students and two cohorts of novice nurses of one bachelor program in nursing. Items included the variables knowledge, attitude and skills in relation to the nurse as professional, to the nursing process, and to the organization. Data collection took place in March 2009.

Across 179 respondents, scores in MDD knowledge and skills are significantly higher for students later in nursing education, especially with regard to the variable ‘nursing process’. Attitudes towards MDD score significantly higher after completing nursing training, but lower scores appeared for MDD knowledge and skills, particularly in relation to the organization.

Results suggest nursing education should reinforce students’ attitudes to structural forms of MDD, and clinical practice should reinforce nurses’ MDD knowledge and skills. Both education and practice should reinforce nurses’ MDD competence in relation to the organization.