Lecture-based versus problem-based learning in ethics education among nursing students
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Updated: Feb 11, 2026

Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 21, 2010
Mahnaz Khatiban1, Seyede Nayereh Falahan2, Roya Amini3
1Associate Profssor, Mother and Child Care Research Center, Dept. of Medical Surgical Nursing, School of Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran.
Background:
Moral reasoning is a vital skill in the nursing profession. Teaching moral reasoning to students is necessary toward promoting nursing ethics.
Objectives:
The aim of this study was to compare the effectiveness of problem-based learning and lecture-based methods in ethics education in improving (1) moral decision-making, (2) moral reasoning, (3) moral development, and (4) practical reasoning among nursing students.
Research Design:
This is a repeated measurement quasi-experimental study.
Participants And Research Context:
The participants were nursing students in a University of Medical Sciences in west of Iran who were randomly assigned to the lecture-based (n = 33) or the problem-based learning (n = 33) groups. The subjects were provided nursing ethics education in four 2-h sessions. The educational content was similar, but the training methods were different. The subjects completed the Nursing Dilemma Test before, immediately after, and 1 month after the training. The data were analyzed and compared using the SPSS-16 software.
Ethical Considerations:
The program was explained to the students, all of whom signed an informed consent form at the baseline.
Findings:
The two groups were similar in personal characteristics (p > 0.05). A significant improvement was observed in the mean scores on moral development in the problem-based learning compared with the lecture-based group (p < 0.05). Although the mean scores on moral reasoning improved in both the problem-based learning and the lecture-based groups immediately after the training and 1 month later, the change was significant only in the problem-based learning group (p < 0.05). The mean scores on moral decision-making, practical considerations, and familiarity with dilemmas were relatively similar for the two groups.
Conclusion:
The use of the problem-based learning method in ethics education enhances moral development among nursing students. However, further studies are needed to determine whether such method improves moral decision-making, moral reasoning, practical considerations, and familiarity with the ethical issues among nursing students.
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