The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.
Narrative writing as a strategy for nursing ethics education in Japan
Open accessAbstract
OBJECTIVES: The purpose of this study was to explore the effectiveness of learning ethics of nursing practice using narrative writing. METHODS: Study design was qualitative descriptive research. The participants were 90 graduate students who took nursing ethics classes, of whom 86 graduate students (4 males and 82 females) agreed to this study. The data gathered for analysis were their narratives described as feeling uncomfortable in clinical settings and their comment sheets after narrative group work in nursing ethics classes. We used qualitative content analysis to identify graduate students' awareness gained through narrative writing and narrative group work. RESULTS: As a feature of the scenes described by graduate students, there were often conflicts that patients' autonomy were not respected, or that they were not able to engage in sincere engagement. The narrative writing was effective to make graduate students aware of the following two aspects: 1) habits and trends in one's own thoughts and 2) organizational and administrative issues related to ethical issues. CONCLUSIONS: Learning ethics of nursing practice using narrative writing that focused on nurses' sentiments helped reveal nurses' thoughts as well as their attitudes and approaches to patients. These findings suggest that narrative writing in nursing ethics education could lead to ethical practice. Additionally, our results indicate that narrative writing in research may be helpful as a strategy to clarify ethical issues and the awareness of nurses in clinical settings.
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“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 [11]
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“Sometimes, it is difficult to express one’s critical thoughts about ethical problems in everyday healthcare work, since relationships with others and cohesion between individuals can be affected and compromised [45, 57].”
From Ethics education to support ethical competence learning in healthcare: an integrative systematic review (2022) · cites this paper as [57]
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“Understanding one’s own values and attitudes can be facilitated through, for example, role-play or simulation activities [54–56], narratives [40, 57, 58], storytelling [42] and discussions in small groups [38, 43–45, 47, 59–62].”
From Ethics education to support ethical competence learning in healthcare: an integrative systematic review (2022) · cites this paper as [57]
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“Using narrative writing, one’s own or others’ attitudes and approaches to everyday healthcare work situations where ethical problems occur can be made visible [57].”
From Ethics education to support ethical competence learning in healthcare: an integrative systematic review (2022) · cites this paper as [57]
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“One way of designing ethics education that facilitates the visualisation of ethical problems is to use a narrative approach [40, 57, 58].”
From Ethics education to support ethical competence learning in healthcare: an integrative systematic review (2022) · cites this paper as [57]
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“Narrative groupwork is another way of highlighting and processing ethical problems [57].”
From Ethics education to support ethical competence learning in healthcare: an integrative systematic review (2022) · cites this paper as [57]
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“Through such training, an increased understanding of ethical problems can be gained [54, 72], for example, regarding the ways in which certain patients, events, and situations are to be viewed [37, 57, 65].”
From Ethics education to support ethical competence learning in healthcare: an integrative systematic review (2022) · cites this paper as [57]
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Cites
Narrative Medicine: Form, Function, and Ethics
Charon, R. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-1-200101020-00024 · Cited by 363
Levine, R. B., Kern, D. E., & Wright, S. M. (2007) · Advances in Health Sciences Education · doi:10.1007/s10459-007-9079-x · Cited by 121
Organizational ethics: A literature review
Suhonen, R., Stolt, M., Virtanen, H., et al. (2011) · Nursing Ethics · doi:10.1177/0969733011401123 · Cited by 111
Facilitating reflective practice and self-assessment of competence through the use of narratives
Levett-Jones, T. L. (2006) · Nurse Education in Practice · doi:10.1016/j.nepr.2006.10.002 · Cited by 110
Storytelling as a Teaching Technique
Davidhizar, R., & Lonser, G. (2003) · Nurse Educator · doi:10.1097/00006223-200309000-00008 · Cited by 103
Narrative Pedagogy: Rethinking Nursing Education
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Emotions, Narratives, and Ethical Mindfulness
Guillemin, M., & Gillam, L. H. (2015) · Academic Medicine · doi:10.1097/acm.0000000000000709 · Cited by 58
Enhancing Reflection: An Interpersonal Exercise in Ethics Education
Verkerk, M. A., Lindemann, H., Maeckelberghe, E. L. M., et al. (2004) · The Hastings Center Report · doi:10.2307/3528175 · Cited by 54
Guillemin, M. N., McDougall, R. J., & Gillam, L. H. (2009) · Cambridge Quarterly of Healthcare Ethics · doi:10.1017/s096318010909032x · Cited by 49
Create a Tradition: Teach Nurses to Share Stories
Heinrich, K. T. (1992) · Journal of Nursing Education · doi:10.3928/0148-4834-19920301-13 · Cited by 49
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Cited by
Sorted by citations
Andersson, H., Svensson, A., Frank, C., Rantala, A., Holmberg, M., & Bremer, A. (2022) · BMC Medical Ethics · doi:10.1186/s12910-022-00766-z · Cited by 338
“Narrative groupwork is another way of highlighting and processing ethical problems [57].”
BackgroundInfluentialJing, Z., & Mouhong, Z. (2025) · BMC Medical Education · doi:10.1186/s12909-025-08289-y · Cited by 4
“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].”
Metadata
- Authors
- Tsuruwaka, M., & Asahara, K.
- Affiliations
- St. Luke's International University (JP)
- Corresponding author
- Tsuruwaka, Mari
- ORCID
- Tsuruwaka, Mari
- Venue
- International Journal of Medical Education
- Published
- 2018-07-19
- Volume
- 9
- Pages
- 198-205
- ISSN
- 2042-6372 (ISSN-L)
- PMC
- PMC6129168
- OpenAlex
- W2884164493
- Cited by
- 22
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 6 · 2023: 4 · 2022: 1 · 2021: 5 · 2020: 2 · 2019: 2
- FWCI
- 3.44
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- International Journal of Medical Education (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (24790514)
- Topics
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- narrative writing, nursing ethics education, nursing ethics, patient autonomy, nurses' attitudes, moral consciousness, graduate nursing students, clinical ethics
- MeSH terms
- Data Anonymization, Education, Nursing, Emotions, Ethics, Nursing, Female, Humans, Japan, Learning, Male, Students, Nursing, Writing, Narration
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