Ethical Challenges and Strategies in Nursing Doctoral Supervision: A Systematic Mixed-Method Review

Area of Science:

• Health Sciences
• Nursing Education
• Doctoral Studies

Background:

• Doctoral supervision in nursing and health sciences faces unique ethical challenges.
• These challenges impact student adjustment, supervisor roles, and institutional support structures.

Purpose of the Study:

• To systematically review and synthesize ethical challenges in doctoral supervision within nursing and health sciences.
• To propose evidence-based strategies for overcoming these ethical challenges.

Main Methods:

• A mixed-method systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Searched CINAHL, Education Source, ERIC, PubMed, Scopus, and Web of Science Core Collection (2014-2025).
• Assessed methodological quality using STROBE and COREQ frameworks, followed by thematic synthesis.

Main Results:

• Eleven studies (4 quantitative, 4 qualitative, 3 mixed-methods) met inclusion criteria.
• Ethical challenges identified at individual (e.g., expectations, feedback), institutional (e.g., ratios, support), and cultural levels.
• Strategies include enhanced communication, supervision agreements, institutional support, and supervisor training.

Conclusions:

• Ethical supervision issues stem from individual, institutional, and cultural factors.
• Multi-level strategies are crucial, emphasizing clear expectations, feedback, training, and cultural sensitivity.
• Ethical principles foster transparency and support, improving doctoral outcomes.