The objective of this historical control trial is to evaluate the effectiveness of an Ethics and Moral Course, based on the Ashridge training model, in newly graduated nurses. The primary questions it aims to address are: (1) What is the impact of integrating moral education into the standardized training of newly employed nurses on their professional outlook? (2) Can this study enhance the humanistic care abilities and overall competencies of newly graduated nurses? Researchers compared two groups of newly employed nurses (without work experience) at a specific hospital. The control group received conventional training, while the intervention group underwent a moral education curriculum designed in three stages based on the Ashridge training model, in addition to traditional training. Post-training, the two groups were compared in terms of their sense of professional mission, perceived professional benefits, humanistic care abilities, theoretical knowledge, and practical skills performance.
With the continuous development of the healthcare sector, nursing personnel face increasingly higher professional demands. Newly graduated nurses, lacking work experience, are particularly prone to ethical dilemmas during their transition from nursing students to clinical practitioners. Ophthalmology and otolaryngology diseases often affect patients' sensory functions and quality of life, imposing higher competency requirements on Eye, Ear, Nose, and Throat (EENT) nurses. Standardized training, as a crucial transitional period for new nurses, presents an optimal opportunity to integrate ethical education, thereby fostering their professional outlook and moral qualities. This study underscores the importance of structured ethical and moral education during this critical transition period. The investigators first developed an ethics and morality curriculum tailored for new EENT nurses based on the Ashridge training model, followed by a non-randomized controlled trial to evaluate its effectiveness. Newly employed nurses (new graduates without work experience) at a tertiary specialized hospital in Shanghai were selected as study subjects. Sixty new nurses employed between January 2022 and December 2022 served as the control group and received conventional training. Between January 2023 and December 2023, sixty newly employed nurses served as the intervention group, receiving an ethics and morality curriculum designed in three phases based on the Ashridge training model, in addition to conventional training. A mixed-methods research design was adopted. The investigators surveyed the sense of professional mission, professional benefit perception, humanistic care ability, theoretical knowledge, practical skills, and scenario-based case simulation performance in both groups post-training. The qualitative component used purposive sampling to conduct semi-structured interviews with 18 new nurses. Thematic framework analysis was employed to extract viewpoints, categorize reasoning, and summarize themes. The results indicated that the intervention group outperformed the control group across all measured parameters (P \< 0.05). The results highlight the effectiveness of our course in enhancing the professional identity, ethical decision-making, and humanistic care abilities of newly graduated nurses. Our qualitative interviews further complemented the quantitative findings, providing valuable insights for the development of ethical and moral education courses for new nurses.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
120
Based on the three-stage characteristics of the Ashridge training model, the developed the content of this ethics course. (1) Discrete stage (within 3 months of employment): This stage aims to initially cultivate the professional identity of new nurses, stimulating humanistic awareness. It primarily involves self-study, supplemented by instructor supervision and implicit positive guidance. (2) Integrated stage (4-6 months of employment): This stage combines professional identity with actual work, enhancing humanistic care abilities in practice. It emphasizes mutual sharing between instructors and new nurses, utilizing diverse training methods to promote experience and reflection. (3) Cumulative stage (7-12 months of employment): This stage develops critical thinking and ethical problem-solving abilities. It focuses on assessing comprehensive abilities in complex nursing situations, providing feedback on the teaching plan, and evaluating training effectiveness.
EYE & ENT Hospital, Fudan University
Shanghai, China
Professional Calling
Evaluation was conducted using the Professional Calling Scale. This scale consists of 12 items and is a unidimensional scale. It uses a Likert 5-point scale, ranging from 1 (strongly disagree) to 5 (strongly agree), resulting in a total score range of 12 to 60, with higher scores indicating a stronger sense of professional calling.
Time frame: Within 7 days after the completion of the training program
Professional Benefits
Evaluation was conducted using the Nurse Professional Benefits Scale. This scale comprises 29 items across five dimensions: Positive Professional Perception (5 items), Family and Friends' Recognition (7 items), Team Belongingness (5 items), Good Nurse-Patient Relationship (6 items), and Personal Growth (6 items). It uses a Likert 5-point scale, ranging from 1 (strongly disagree) to 5 (strongly agree), with a total score range of 29 to 145. Higher scores indicate a higher level of professional benefits for nurses.
Time frame: Within 7 days after the completion of the training program
Humanistic Caring Ability
Evaluation was conducted using the Nursing Students' Humanistic Caring Ability Scale. This scale consists of 45 items across eight dimensions: Instilling Beliefs and Hope (9 items), Humanitarian Altruistic Values (6 items), Health Education (7 items), Promoting Emotional Communication (5 items), Scientifically Solving Health Problems (4 items), Assisting in Meeting Basic Needs (4 items), Helping Solve to Difficulties (5 items), and Providing a Good Environment (5 items). It uses a Likert 5-point scale, with positive items scored from 4 (completely agree) to 0 (completely disagree), and 10 reverse-scored items from 0 (completely agree) to 4 (completely disagree), providing a total score range of 0 to 180. Higher scores indicate stronger humanistic caring abilities.
Time frame: Within 7 days after the completion of the training program
Theoretical Knowledge and Practical Skills, and Scenario Simulation Exam Scores
Two groups of newly graduated nurses were assessed on fundamental nursing theory, practical nursing skills, and scenario-based case examinations. Standardized patients were portrayed by three nurses who had undergone rigorous standardized training and passed competency evaluations. The scenario-based case examinations included assessments of ophthalmology and otolaryngology workflows, evaluating the new nurses' abilities in nurse-patient communication, clinical judgment, emergency response, and practical skills.
Time frame: During the last seven days of the training program
Qualitative Research
A semi-structured interview method was used to gain in-depth insights into their perceptions of the Ethics and Moral Course, thereby complementing the quantitative research.
Time frame: Within 7 days after the completion of the training program
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