Educational programmes improving nurses' ethical competence: A scoping review

Abstract

Enhancing ethical competence in nursing has become a crucial educational focus due to growing ethical challenges in clinical settings. However, systematic knowledge about the design and impact of relevant educational programs remains limited. This scoping review seeks to address that gap by examining the scope, variety, and characteristics of such programs, highlighting their educational strategies and content, and proposing directions for future research to inform more effective ethical competence development in nursing. The review was conducted using the Arksey and O'Malley framework and reported in accordance with PRISMA-ScR guidelines. A systematic search was performed across five international databases including PubMed, Scopus, Web of Science, EMBASE, and Google Scholar between 2000 and 2024. Of 25,868 initial sources, 35 studies were selected for final analysis. The findings revealed four main educational approaches utilized: e-learning, simulation and role-playing, group discussions, and traditional lectures. Ethical content focused on fundamental ethical principles, professional codes, ethical reasoning, and ethical challenges. Although most studies reported improvements in ethical sensitivity or ethical decision-making, significant gaps persist in the design, implementation, and evaluation of the effectiveness of these programs. While ethics education can facilitate ethical development in nurses, the absence of standardized evaluations and evidence-based frameworks limits the generalizability of findings. This review outlines the current state of ethics education in nursing, highlighting the crucial need for future research to develop robust, culturally appropriate, and evidence-based programs that truly enhance nurses' ethical competence. All stages of this review adhered to valid scientific research principles.