Design and Psychometrics of the Nursing Educators' Moral Sensitivity Scale: A Mixed-Methods Study

Background and Purpose: Educators play a central role in enhancing students' moral competence by internalizing professional norms, values, attitudes, and skills. Moral sensitivity is a key competency for nursing educators and significantly influences their professional practice. Assessing this construct requires a valid and reliable measurement scale. This study aimed to design and psychometrically evaluate a questionnaire to measure moral sensitivity among nursing educators. Methods: This mixed-methods study used a sequential exploratory design for instrument development. In the qualitative phase, a hybrid concept analysis was conducted through a systematic literature review and in-depth, semistructured interviews with 10 purposively selected experts (8 nursing educators and 2 specialists in ethics and Islamic studies). Data were analyzed using conventional content analysis with MAXQDA 21. Based on the findings, an initial pool of questionnaire items was developed. In the quantitative phase, psychometric evaluation included face, content, and construct validity (exploratory factor analysis), as well as reliability testing through internal consistency and test-retest methods. Results: Qualitative findings identified attributes, antecedents, and consequences of moral sensitivity. Exploratory factor analysis revealed five factors: recognition of the situation, accuracy in decision-making, civic-benevolent behavior, student-centeredness, and attention to human dignity. The initial 80-item questionnaire was reduced to 31 items. The questionnaire showed excellent reliability (coefficient alpha = .92; intraclass correlation coefficient = .91). Conclusion: The Moral Sensitivity Questionnaire for educators demonstrates strong psychometric properties and provides a culturally grounded scale for assessing and promoting ethical sensitivity among nursing educators.