Ethical Issues in Nursing Education: A Scoping Review of the Literature

Purpose: The purpose of this presentation is to present a synthesis of the literature highlighting ethical issues present in nursing education. The American Nurses Association designated 2015 as the "Year of Ethics". Although organizational efforts were undertaken during 2015, discussion of ethical issues present in nursing education has received less attention. Yet, nurse educators frequently encounter ethical issues while interacting with students, peers, and other individuals. A recent initial summary of evidence related to ethical issues in nursing education indicates that certain topics, such as unethical student behavior have been investigated. However, critical issues remain understudied. This scoping review extends this work, with special attention to literature published from 2006-2016.

Methods: Scoping review of CINAHL and Medline databases accessed using key words "ethics", "nursing education", "ethical", "dilemma", written in English, published in the United States and elsewhere. More than 1,300 hits were obtained using a combination of “ethical”, “issues” and “nursing education” for the years 2000 to 2016; fewer hits (N=142) were obtained using the same terms but limiting the years to 2013-2016. Once duplications were removed, 101 theoretical and research articles were reviewed. Level of evidence and quality of research were determined. Of these, 8 were published in 2013. 20 in 2014, 10 in 2015, and 8 in 2016. The reminder were published between 2000 and 2012.

Results: Results are similar to those obtained in the initial review. Unethical student behavior [bullying, academic misconduct, etc.], relationships between and among faculty, and moral distress among students continue to be reported in the literature. No literature was found that addressed ethical issues such as the impaired nurse educator nor faculty sexual misconduct, two issues highlighted in the earlier review. The majority of the research literature reviewed was descriptive in nature.

Conclusion: This review highlights continuing gaps in knowledge about ethical issues in nursing education. Implications for the science of nursing education include conducting more rigorous investigations so that faculty can have greater confidence in their approach to teaching ethics and in their development of safe work and learning environments.