Latent profiles of nursing students' moral courage, moral sensitivity, and moral resilience: a cross-sectional study

Growing scholarly attention has been directed toward moral courage in nursing, particularly among students confronting complex ethical challenges; however, existing research often neglects the diverse characteristics of interns' moral courage and its associations with moral sensitivity and resilience.

In addition to using a cross-sectional design, we employed latent profile analysis (LPA) with bootstrapped likelihood ratio test for model fit differences, followed by unordered multicategory logistic regression analysis using the LPA results as the dependent variable. We recruited 302 nursing students from a single school between January and March 2024.

The LPA results revealed three distinct moral courage profiles: moderate (50.00%), low (30.13%), and high (19.87%) moral courage groups. These groups differed in professional knowledge, skills, and perceptions of the ethical atmosphere in internship hospitals. However, there were no significant differences in moral resilience scores among the different moral courage profiles. Higher moral sensitivity scores were associated with an increased likelihood of moderate and high levels of moral courage compared to lower scores.

Our study confirmed three distinct clusters of moral courage among nursing students and provided a detailed analysis of the variations in moral sensitivity and resilience within these clusters. This novel understanding contributes significantly to the literature and lays the foundation for targeted interventions that focus on individual moral courage characteristics. These findings can inform educational strategies and institutional policies aimed at enhancing ethical competencies and fostering moral courage among nursing students in clinical settings.