ABSTRACT

Background: As a critical discipline within the healthcare field, nursing students inevitably encounter complex ethical dilemmas during their clinical internships in hospitals. These dilemmas test not only their professional knowledge and skills but also their ethical sensitivity. To effectively enhance nursing students’ ability to address ethical dilemmas in clinical practice, fostering their ethical sensitivity is crucial. Ethical sensitivity is the awareness of ethical issues even in situations where there are no obvious moral conflicts. A high level of ethical sensitivity helps nursing students make more morally appropriate decisions in their actual work, thereby improving the quality of nursing services and patient satisfaction. Situational case study teaching is a method that simulates real clinical situations, allowing students to enhance their ethical sensitivity through the analysis and discussion of specific cases. Based on this, the present study aims to explore the impact of situational case study teaching on the ethical sensitivity of nursing students who have not yet started their hospital clinical internships. Methodology: Between April 2024 and June 2024, this study implemented an educational intervention using the situational case study teaching method at the faculty of Nursing, Lincoln University College, Malaysia, after obtaining permission from Muramatsu (the author of the ESQ-NS) and approval from the institutional Ethical Committee of Lincoln University College. A convenience sampling method was used to select a total of 55 nursing students who had not yet begun their clinical internships. First, an initial questionnaire survey was conducted with all 55 nursing students to assess their level of ethical sensitivity before the educational intervention. Subsequently, the situational case study teaching intervention was conducted, involving the analysis and discussion of specific cases aimed at enhancing the students’ ethical sensitivity. After the intervention, a follow-up questionnaire survey was conducted with these students to assess the effect of the educational intervention and the changes in their level of ethical sensitivity. Results: After the intervention, the total ESQ-NS score of nursing students was 38.5±13.5, which was higher than the pre-intervention score of 33±19. Statistical analysis showed that the difference was significant (t=4.109, P<0.05). After the intervention, the per-item score rate on the ESQ-NS was 82.05%±6.59%, higher than the pre-intervention per-item score rate of 66.59%±5.68%, with an increase observed in each item’s score rate. Conclusion: The study results indicate that the situational case study teaching method has a positive effect on enhancing the ethical sensitivity of nursing students. Statistical analysis revealed that the improvement was highly significant (p<0.01). Specific scenario discussions effectively promote deep engagement and critical thinking among nursing students in the classroom, thereby improving their ethical sensitivity.