Development, implementation, and effects of an integrated web-based teaching model in a nursing ethics course

Background: Ethical competence, which is reflected in the ability to detect ethical challenges in clinical situations and engage in deliberate thinking on ethical actions, is one of the core competencies of nursing practice. Purpose: The purpose of this study was to develop and implement an interactive situational e-leaming system, integrating nursing ethical decisions into a nursing ethics course, and to evaluate the effects of this course on student nurses' ethical decision-making competence. Project design: The project was designed to be carried out in two phases. In the first phase, an interactive situated e-learning system was developed and integrated into the nursing ethics course. The second phase involved implementing the course and evaluating its effects in a quasi-experimental study. The course intervention was designed for 2 h per week over one semester (18 weeks). Participants: A total of 100 two-year technical college nursing students in their second year of the program participated in the study, with 51 in the experimental group and 49 in the control group. Results: After completing the course, the students in the experimental group showed significant improvement in nursing ethical decision-making competence, including skills in raising questions, recognizing differences, comparing differences, self-dialogue, taking action, and identifying the implications of decisions made, compared to their performance prior to the class. After controlling for factors influencing learning effects, students in the experimental group showed superiority to those in the control group in the competency of recognizing differences. The students in the experimental group reported that the course pushed them to search for and collect information needed to resolve the ethical dilemma. Conclusions: The interactive situational e-learning system developed by our project was helpful in developing the students' competence in ethical reasoning. The e-learning system and the situational teaching materials used in this study may be applicable in nursing and related professional ethics courses.