Introduction: Nurses and nursing students in emergency departments face numerous ethical challenges. Adherence to ethical principles depends, in part, on strengthening moral sensitivity and moral courage.
Objective: This study aimed to determine the effect of implicit ethics education on nursing students’ moral sensitivity and moral courage in caring for a standardized patient with substance use disorder at a selected hospital in Tehran.
Materials and Methods: This randomized controlled trial used a pretest–posttest design and was conducted during 2023–2024. The 36 nursing students were recruited through census sampling and randomly assigned to intervention and control groups. The intervention group received implicit ethics education on caring for a patient with substance use disorder during a single two-hour session in the emergency department of a selected hospital. Data were collected using a demographic questionnaire, a standardized moral sensitivity questionnaire, and a professional moral courage questionnaire before the intervention, immediately afterward, and one month later. Data were analyzed using SPSS.
Results: In the intervention group, mean moral sensitivity scores (mean±SD) at baseline, immediately after the intervention, and one month later were 60.06±7.46, 53.94±8.12, and 59.29±6.22, respectively (F=3.292, df=2, P= 0.050). The corresponding scores in the control group were 60.78±5.60, 59.56±5.58, and 61.11± 6.71 (F=0.623, df= 1.131, P = 0.459). After controlling for the effect of time, the groups did not differ significantly in moral sensitivity across the three assessments (P=0.835). In the intervention group, mean moral courage scores at the three assessments were 58.72±6.11, 60.77±6.36, and 59.44±6.59, respectively (F=1.405, df=2, P=0.259). The corresponding scores in the control group were 59.72±7.67, 58.05±6.75, and 57.33± 6.82 (F=2.645, df=1.030, P=0.121). After controlling for the effect of time, no significant between-group difference in moral courage was found across the three assessments (P=0.093).
Conclusion: Given these findings, future studies should consider extending the intervention, incorporating richer scenarios, and using other active teaching methods.