آموزش و اخلاق در پرستاری
Education and Ethics In Nursing ISSN: 2322-5300

بررسی تأثیر یادگیری تأملی مبتنی بر سناریوهای بالینی بر حساسیت اخلاقی دانشجویان پرستاری

https://doi.org/10.22034/ethic.2022.700734
دوره 11، شماره 1
فروردین 1401
صفحه 39-46
آموزش و اخلاق در پرستاری

نویسندگان

مریم باقری 1
اکرم محمدی پلارتی 2
شهناز کریمی 3

1 استادیار پرستاری، مرکز تحقیقات مراقبت های پرستاری و مامایی، گروه پرستاری سلامت بزرگسالان، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 کارشناسی ارشدپرستاری، بیمارستان تخصصی شفا، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 استادیار آموزش پزشکی، دانشگاه علوم پزشکی فسا، فسا، ایران

چکیده
مقدمه: پرستاران در ارائه مراقبت به بیماران، با چالش­ های اخلاقی متعددی رو به رو می ­شوند. یادگیری مبتنی بر سناریو همراه با به کارگیری تأمل می‌تواند، یک استراتژی مهم در یاددهی یادگیری تعاملی، پویا و گسترده در آموزش اخلاق باشد که مهارت­ های تصمیم ­گیری و توانایی­ های خودآموزی دانشجویان را افزایش می­دهد. پژوهش حاضر، با هدف بررسی تأثیر یادگیری تأملی مبتنی بر سناریوهای بالینی بر حساسیت اخلاقی دانشجویان در واحد درسی ارتباط حرفه‌ای و اخلاق پرستاری انجام شد.
روش کار: این پژوهش از نوع نیمه تجربی پیش آزمون – پس آزمون تک گروهی بود که بر دانشجویان پرستاری دانشگاه علوم پزشکی فسا، در طول سال تحصیلی 98-97 و در سه مرحلۀ طراحی، اجرا و ارزشیابی و به منظور سنجش میزان حساسیت اخلاقی دانشجویان انجام گردید. در این تحقیق تمامی دانشجویان پرستاری ترم 2  شامل 48 نفر در بررسی شرکت کردند. جهت جمع‌آوری داده‌ها، از پرسشنامۀ نسخۀ فارسی حساسیت اخلاقی لوتزن (2006) استفاده گردید. داده‌ها در محیط نرم افزار SPSS نسخۀ 21 در سطح آمار توصیفی و تحلیلی، بررسی شدند.
یافته­ ها: در این مطالعه تفاوت معناداری بین میانگین کل نمرۀ حساسیت اخلاقی قبل و بعد از مداخله مشاهده نشد( 0.05< p value). همچنین نتایح آزمون تی زوجی نیز قبل و بعد از مداخلۀ آموزشی در زیر مقیاس­ های حساسیت اخلاقی (حسن بار اخلاقی، قدرت اخلاقی، مسئولیت اخلاقی) تفاوت معناداری نشان نداد (0.05< p value).
نتیجه‌گیری: پژوهش حاضر با توجه به معنادار نشدن تفاوت نمرۀ حساسیت اخلاقی دانشجویان قبل و بعد از مداخله، پیشنهاد می‌کند که علی رغم جایگاه فعالیت‌های تأملی در توسعۀ یادگیری دانشجویان به خصوص در مطالعات غرب و همچنین به کارگیری این­ گونه رویکردهای نوینی به ویژه با در نظرگرفتن پداگوژی فرهنگی متفاوت می‌تواند ابعاد پیچیده تری را در برگیرد تا اثربخشی مناسبی داشته باشد. بنابراین انجام تحقیق ­های بیشتر در زمینۀ اثربخشی و ابعاد به کارگیری فعالیت‌های تأملی در آموزش اخلاق، به دانشجویان کارشناسی پرستاری در ایران پیشنهاد می‌گردد.

کلیدواژه‌ها

یادگیری تأملی
سناریوهای بالینی
حساسیت اخلاقی
دانشجوی پرستاری

عنوان مقاله English

Investigating the effect of reflective learning based on clinical scenarios on the moral sensitivity of nursing students

نویسندگان English

Maryam Bagheri 1
Akram Mohammadi pelarti 2
Shahnaz karimi 3
1 Assistant Professor of nursing, Nursing and Midwifery Care Research Center, Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2 MSc in nursing, Shafa specialized hospital, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor of Medical Education, Fasa University of Medical Sciences, Fasa, Iran
چکیده English

Introduction: Nurses face many ethical challenges in providing care to patients. Scenario-based learning along with
the use of reflection can be an interactive, dynamic, and expansive learning strategy in ethics education that enhances students' decision-making skills and self-learning abilities. The aim of this study was to investigate the effect of reflective learning based on clinical scenarios on students' moral sensitivity in the course of professional communication and nursing ethics.
Materials and Methods: This study was a semi-experimental pre-test-post-test single group study that was performed on nursing students of Fasa University of Medical Sciences during the academic year of 2018-2019 in three stages of design, implementation and evaluation to assess students' moral sensitivity. In this study, all second semester nursing students including 48 people participated in the study. To collect data, the Persian version of the Lutzen Ethical Sensitivity Questionnaire (2006) was used. Data were analyzed in SPSS software version 21 at the level of descriptive and analytical statistics (paired t).
Results: In this study, there was no significant difference between the mean of the total score of moral sensitivity before and after the intervention (p value> 0.05). Also, the results of paired t-test did not show a significant difference before and after the educational intervention in the subscales of moral sensitivity (Sense Of Moral Burden, Moral Strength, Moral Responsibility) (p value> 0.05).
Conclusion: The present study, considering the non-significant difference between students 'moral sensitivity scores
before and after the intervention, suggests that despite the place of reflective activities in the development of students' learning, especially in Western studies, and also applying such new approaches, especially by considering different cultural pedagogies, can take on more complex dimensions in order to be effective. Therefore, further studies on the effectiveness and dimensions of using reflection activities in ethics education are recommended to undergraduate nursing students in Iran.

کلیدواژه‌ها English

  • Reflective learning
  • Clinical Scenarios
  • Ethical Sensitivity
  • Nursing Student
1. Shayestehfard M, Torabizadeh C, Gholamzadeh S, Ebadi A. Ethical sensitivity in nursing students: Developing a context–based education. Electronic Journal of General Medicine. 2020;17(2(.(Persian) 2. Lützén K, Blom T, Ewalds-Kvist B, Winch S. Moral stress, moral climate and moral sensitivity among psychiatric professionals. Nursing Ethics. 2010;17(2):213-24. 3. Hoseini M, Ebadi M, Farsi Z. The effect of moral motivation training on moral sensitivity in the nurses of Military Hospitals. Military Caring Sciences Journal. 2018;4(4):249-57. (Persian) 4. Chen XL, Fei Huang F, Zhang J, Li J, Ye BY, Chen YX, et al. Tertiary hospital nurses’ ethical sensitivity and its influencing factors: A cross-sectional study. Nursing Ethics. 2021:09697330211005103. 5. Baykara ZG, Demir SG, Yaman S. The effect of ethics training on students recognizing ethical violations and developing moral sensitivity. Nursing ethics. 2015;22(6):661-75. 6. Bahrieni F, Azodi P, Hajivandi A, Jahanpour F. The effect of education in nurse’s moral sensitivity. Journal of Pharmaceutical Sciences and Research. 2017;9(10):1817-21. (Persian) 7. Azizi A, Sasanpour M. Effectiveness of nursing ethics training on nurses' moral sensitivity in 2014. Journal of Clinical Nursing and Midwifery. 2018;7(1):1-8. (Persian) 8. Park M, Kjervik D, Crandell J, Oermann MH. The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing students. Nurs Ethics. 2012;19(4):568-80. 9. Lee W, Choi S, Kim S, Min A. A Case-Centered Approach to Nursing Ethics Education: A Qualitative Study. International Journal of Environmental Research and Public Health. 2020;17(21):7748. 10. Azim S, Shamim M. Educational theories that inform the educational strategies for teaching ethics in undergraduate medical education. JPMA. 2020;70(1):123-8. 11. Ahmed DH. Adopting Scenario Based Learning in Critical Care Nursing Education: Students’ Achievement and Feedback. 2019;7. 12. Haugland VL, Reime MH. Scenario-based simulation training as a method to increase nursing students' competence in demanding situations in dementia care. A mixed method study. Nurse education in practice. 2018;33:164-71. 13. Sandars J. The use of reflection in medical education: AMEE Guide No. 44. Medical teacher. 2009;31(8):685-95. 14. Bagheri M, Taleghani F, Abazari P, Yousefy A. Development of Reflection in Clinical Education: Developing a Manual for Nursing Educators [Dissertation]. Iran: Isfahan University of Medical Sciences; 2019. (Persian) 15. Sullivan BT, DeFoor MT, Hwang B, Flowers WJ, Strong W. A novel peer-directed curriculum to enhance medical ethics training for medical students: A single-institution experience. Journal of medical education and curricular development. 2020;7:2382120519899148. 16. Dhaliwal U, Singh S, Singh N. Reflective student narratives: honing professionalism and empathy. Indian J Med Ethics. 2018;3(1):9-15. 17. Choperena A, Oroviogoicoechea C, Zaragoza Salcedo A, Olza Moreno I, Jones D. Nursing narratives and reflective practice: a theoretical review. Journal of Advanced Nursing. 2019;75(8):1637-47. 18. Campbell TD, Penz K, Dietrich-Leurer M, Juckes K, Rodger K. Ways of knowing as a framework for developing reflective practice among nursing students. International Journal of Nursing Education Scholarship. 2018;15(1). 19. Milliken A, Grace PJ. Developing Ethical Awareness and Ethical Sensitivity. Clinical Ethics Handbook for Nurses: Springer; 2022. p. 21-33. 20. LAM CM, PAN Z. BLENDED LEARNING IN SOCIAL WORK PRACTICE COURSES: A REFLECTIVE LEARNING MODEL. The Hong Kong Journal of Social Work. 2021;55(01n02):53-68. 21. Hariri G. Correlation between ethical climate and moral sensitivity of turnover in nurses of educational hospitals of Shahid Beheshti University of Medical Sciences [Thesis]. Tehran, Iran: Shahid Beheshti University of Medical Sciences. 2012. Persian) 22. Hassanpoor M, Hosseini M, Fallahi Khoshknab M, Abbaszadeh A. Evaluation of the impact of teaching nursing ethics on nurses' decision making in Kerman social welfare hospitals in 1389. Iranian Journal of Medical Ethics and History of Medicine. 2011; 58-64:4(5);11. (Persian) 23. Wocial LD, Bledsoe P, Helft PR, Everett LQ. Nurse ethicist: innovative resource for nurses. Journal of professional nursing : official journal of the American Association of Colleges of Nursing. 2010;26(5):287-92. 24. Hoseini M, Ebadi M, Farsi Z. The Effect of Moral Motivation Training on Moral Sensitivity in the Nurses of Military Hospitals. Military Caring Sciences. 2018;4(4):249-57. (Persian) 25. Bulman C, Schutz S. Reflective practice in nursing: John Wiley & Sons; 2013. 26. Fernández-Peña R, Fuentes-Pumarola C, Malagón-Aguilera MC, Bonmatí-Tomàs A, Bosch-Farré C, Ballester-Ferrando D. The evaluation of reflective learning from the nursing student's point of view: A mixed method approach. Nurse Education Today. 2016;44:59-65. 27. Namadi F, Hemmati-Maslakpak M, Moradi Y, Ghasemzadeh N. The effects of nursing ethics education through case-based learning on moral reasoning among nursing students. Nursing and Midwifery Studies 2019. 2019;8(2): 85-90. (Persian) 28. Baykara ZG, Demir SG, Yaman S. The effect of ethics training on students recognizing ethical violations and developing moral sensitivity. Nursing ethics. 2015;22(6):661-75. 29. Nasiriani K, Fazlojoo SE, Dehghani Tafti A, Mobari Y. The Effect of Virtual Narrative Ethics Education on Moral Sensitivity in Critical Care Nurses. Medical Ethics and History of Medicine. 2020;13(1):168-79. (Persian) 30. Yeom HA, Ahn SH, Kim SJ. Effects of ethics education on moral sensitivity of nursing students. Nurs Ethics. 2017;24(6):644-52. 31. Lee C, Kim S, Choe K, Kim S. Effect of Ethics Seminar on Moral Sensitivity and Ethical Behavior of Clinical Nurses. Int J Environ Res Public Health. 2020;18(1). 32. Wanda D, Wilson V, Fowler C. East meets West in reflective practice. Nurse education today. 2014;34(12):1417-9. 33. Ip WY, Lui MH, Chien WT, Lee IF, Lam LW, Lee D. Promoting self-reflection in clinical practice among Chinese nursing undergraduates in Hong Kong. Contemporary nurse. 2012;41(2):253-62. 34. Lu H, Kitt-Lewis E. Pedagogical differences: A comparative reflection between American and Chinese nursing education. Nurse Educ Today. 2018;63:108-11. 35. Bagheri M, Naseri N, Haghani F. Take on Issues and uses of Reflection and Reflective Practice in Nursing Education. Journal of Medical Education and Development. 2019; 14(2); 12 3 -135. (Persian)

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