Abstract

This study evaluated the effectiveness of guided design as an instructional method in ethical decision-making of senior baccalaureate nursing students. One hundred forty-five students, enrolled in community health nursing in two different programs, received guided design instruction in three separate interventions. Each of the three groups attended a one-hour lecture followed by a one hour session using guided design. ;Data were collected on the following topics: entry level knowledge of moral reasoning and ethical decision-making as measured by the pretest using Ketefian's Judgment About Nursing Decisions ; demographic information; change in knowledge of moral reasoning and in the process of ethical decision-making by comparing pretest to posttest JAND one week following intervention; and specific relationships between moral reasoning and ethical decision-making and selected demographics based on factor changes within the JAND. Evaluation was based on student input of general comfort with the instructional tool. ;Analysis of data included multivariate analysis of variance, analysis of covariance, and subjective interpretation of descriptive evaluation feedback. Results indicated that a significant difference at the.05 confidence level existed in the ethical decision-making score following the instruction, but no difference in the mean moral reasoning scores. Specific factor changes appeared in regards to Taking Professional Initiatives. Demographic variables correlated with general or specific changes included individual group, marital status, professional status, exposure to an ethics course and experience in health care. Evaluations of written feedback from students indicated that while initial discomfort in the use of the instruction was experienced, an overall acceptance of the method prevailed