The Effects of Nursing Ethics Education through Case-Based Learning on Moral Reasoning among Nursing Students

Background: Despite their significant roles in patient care, most nursing students have limited ability to make wise ethical decisions in difficult situations. Objectives: This study aimed to examine the effects of nursing ethics education through case-based learning (CBL) on moral reasoning among nursing students. Methods: This controlled trial was conducted in 2016-2017 on 73 4th year nursing students recruited from Urmia Faculty of Nursing and Midwifery, Urmia, Iran. Participants were randomly allocated to an intervention (n = 37) and a control (n = 36) groups. Nursing ethics education to participants in the intervention and the control groups was provided through the case-based learning and the lecture methods, respectively. Using the Nursing Dilemma Test, participants' moral reasoning was assessed both before and 1 month after the intervention. Data were analyzed using the paired- and the independent-samples t and the Chi-square tests. Results: No statistically significant difference was found between the intervention and the control groups regarding the pretest mean score of moral reasoning (44.97 +/- 7.50 vs. 43.64 +/- 6.87, P = 0.44). However, the posttest mean score of moral reasoning in the intervention group was significantly greater than the control group (49.08 +/- 5.74 vs. 44.67 +/- 5.87, P = 0.002). Conclusion: Nursing ethics education through CBL is an effective strategy for improving moral reasoning among nursing students. Therefore, this method is recommended for ethics education to nursing students.