Investigating the Impact of Scenario-Based Moral Concepts Training on the Professional Moral Courage of Nursing Students: A Protocol for a Randomized Controlled Trial Publisher



A Akbari ALI ; A Mirshahi ARVIN ; F Mehravar FATEMEH ; Ak Karimi Rozveh Ali KARIMI ; An Nasrabadi Alireza NIKBAKHT
Source: Health Science Reports Published:2025

Abstract

Background and Aims: Moral courage is vital in nursing, enabling professionals to make ethical decisions and uphold values, even in challenging situations. Nursing students often struggle with moral decision-making due to limited experience and insufficient ethical training. This study proposes a randomized controlled trial (RCT) to evaluate the effectiveness of scenario-based ethics training compared to traditional methods in improving professional moral courage among nursing students. Methods and Analysis: This RCT involved a 3-month scenario-based ethics training program delivered under faculty supervision, targeting sixth-semester undergraduate nursing students. Participants (n = 48) were randomly assigned to either the intervention group or the control group. Both groups received traditional ethics education, however, the intervention group also participated in two workshops focused on core and derived ethical concepts (e.g., autonomy, confidentiality) utilizing a scenario-based approach. This was followed by weekly online follow-ups and discussions conducted via WhatsApp Messenger. The outcomes will be assessed using the Sekerka Professional Moral Courage Questionnaire at four time points: immediately before, immediately after, and at 1 and 3 months postintervention. The questionnaire has demonstrated acceptable validity and reliability in previous studies, with Cronbach's α exceeding 0.8, and a value of 0.977 reported in an Iranian validation study. In this study, face validity was confirmed by ten nursing faculty members. The data will be analyzed using t-tests, χ2 tests, and ANCOVA to evaluate changes in professional moral courage (SPSS v22, p < 0.05). Conclusion: This protocol outlines a trial to evaluate the impact of scenario-based training on enhancing nursing students' professional moral courage and improving ethics education in clinical settings. Trial Registration: Iranian Clinical Trials Registry: IRCT20240319061338N1. © 2025 Elsevier B.V., All rights reserved.