A Case-Centered Approach to Nursing Ethics Education: A Qualitative Study
Open accessAbstract
Nurses deal with ethical decisions as they protect patients' rights, but a consensus on effective approaches to nursing ethics education is lacking. The "four topics" method can facilitate decision-making when nurses experience ethical dilemmas in practice. This study aimed to describe nursing students' perspectives on and experiences of a case-centered approach to nursing ethics education using the four topics method. This qualitative study consisted of two phases. First, we delivered case-centered nursing ethics education sessions to nursing students using the four topics method. Then, we conducted two focus group discussions that explored students' perspectives on and experiences of nursing ethics education. Data were analyzed using conventional content analysis. Four themes were identified: the importance of ethics education as perceived by nursing students, problems in current nursing ethics education, the experience of case-centered nursing ethics education using the four topics approach, and suggestions for improving nursing ethics education. The case-centered approach using the four topics method is effective in enhancing nursing students' nursing ethics ability. It is crucial to understand that nursing students would like to set up their own ethical standards and philosophy. Continuous efforts to encourage students' participation and to provide ethical reflection opportunities during clinical practice are needed to better connect theory with clinical practice.
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The long-term stability of teaching outcomes and the efficiency of translating knowledge comprehension into clinical decision-making capabilities remain critical challenges to be addressed in nursing ethics education.
“These studies indicate that the long-term stability of teaching outcomes and the efficiency of translating knowledge comprehension into clinical decision-making capabilities remain critical challenges to be addressed [11–21].”
From Exploring the integration of AI and national quality courses in China: a study on teaching practices in nursing smart education (2025) · cites this paper as [18]
The Results (section 3.2.2; page not provided) report that students struggled to apply classroom ethics knowledge and judge ethical issues in clinical practice, supporting the knowledge-to-decision-making challenge. Students also said course content was not memorable, but the study did not assess the long-term stability of teaching outcomes or measure how efficiently knowledge became clinical decision-making capability. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSmall group discussions are appropriate when healthcare professionals or students are unwilling to stand out by asking questions or giving individual opinions in learning situations with many participants.
“Small group discussions are appropriate when healthcare professionals or students are unwilling to stand out by asking questions or giving individual opinions in learning situations in which many people participate [63].”
From Ethics education to support ethical competence learning in healthcare: an integrative systematic review (2022) · cites this paper as [63]
Section 3.2 reports that participants recommended small-group education to encourage participation, especially in a Korean cultural setting where people dislike standing out by asking questions or offering opinions. The claim extends that recommendation beyond the paper’s nursing-ethics education context to healthcare professionals or students generally; the cited passage does not establish that broader scope. (LLM, conf=0.85)
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- Authors
- Lee, W., Choi, S., Kim, S., & Min, A.
- Affiliations
- Chung-Ang University (KR)
- Yonsei University (KR)
- Catholic University of Korea (KR)
- Corresponding author
- Min, Ari
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2020-10-23
- Volume
- 17
- Issue
- 21
- Pages
- 7748
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC7660290
- OpenAlex
- W3093844245
- Cited by
- 46
- References
- 46
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 16 · 2023: 9 · 2022: 3 · 2021: 3
- FWCI
- 3.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
- Funders
- Chung-Ang University Research Scholarship Grants (not applicable)
- Korea National Institute for Bioethics Policy (not applicable)
- Topics
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Social Sciences › Decision Sciences › Information Systems and Management › Ethics in Business and Education
- Keywords
- nursing ethics education, nursing students' perspectives, ethical decision-making, ethical dilemmas, ethical reflection, clinical practice, student participation
- MeSH terms
- Adult, Education, Nursing, Ethics, Nursing, Female, Humans, Male, Students, Nursing, Focus Groups, Qualitative Research, Young Adult
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