Clinical ethics observation embedded in nursing ethics education: Nursing students' experiences

Nursing ethics is foundational to the provision of quality nursing care. Teaching methods such as in-class case analysis and standardised patient interactions may fail to fully replicate the complexity and dynamic nature of real-world clinical practice. Clinical ethics observation engages students in real-world clinical settings to reflect on nursing ethics through guided observation. Given that understanding student perspectives is crucial for quality assessment and enhancement in higher education, qualitative research is necessary to evaluate this teaching method.

This study aimed to explore the experiences and perspectives of baccalaureate nursing students who participated in a clinical ethics observation module embedded in a nursing ethics course.

A qualitative descriptive design was used, involving five focus groups conducted in December 2024.

Participants were recruited from the second-year cohort of an undergraduate nursing programme at a medical university in China.

Twenty-nine second-year baccalaureate nursing students (mean age: 19.34 years) participated.

The clinical ethics observation module consisted of three phases: preparatory, observation, and reflection. The 90-min observation phase was conducted in the patient wards of a tertiary care teaching hospital. Focus groups were conducted by two moderators using a semi-structured interview guide. Data were analysed using latent content analysis with an inductive approach.

The qualitative analysis revealed four key themes: (1) reflecting on the gap between 'ideal' ethical decisions and 'real' ethical behaviours, (2) impact on knowledge application and competence building, (3) inspiring future self-improvement in nursing professionalism, and (4) suggestions for future improvement.

This study is among the first to report findings on the use of clinical ethics observation in nursing ethics education. The module facilitated students' knowledge application and competence building and motivated them to pursue professional growth. Students' suggestions provided valuable insights for refining and implementing this teaching method in future curricula.