Ethical challenges for children undergoing surgery: Evaluation of graduate nursing students' learning

Ariane Gautrin, A. Tsimicalis, Yi Wen Wang, Raíssa Passos dos Santos, Franco A. Carnevale, Amanda Cervantes, Katherine Logue
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Abstract

Background Multiple barriers can impede the holistic care of children and their meaningful involvement in their healthcare in the context of surgery. These include lack of clinician knowledge of the ethical concerns impacting children and scarce educational resources. Our team created an open-access training module (https://childsxethics.net) to enhance clinicians’ understanding of ethical challenges for children undergoing surgery.  Objective To evaluate the level of Bloom’s Taxonomy cognitive, affective, and psychomotor learning reached by graduate nursing students after completing the module.  Methods A qualitative descriptive study was conducted. Data sources comprised of participants’ course assignments. Data were analysed inductively and deductively using Bloom’s Taxonomy and the Childhood Ethics Framework. Results Nineteen participants wrote online reflections and peer responses. Two subgroups completed group assignments. The module and associated class assignments successfully promoted high levels of cognitive and affective learning of ethical challenges impacting children undergoing surgery. The type of assignment influenced participants’ level of learning and achievement of learning objectives. Cognitive and affective learning processes were enhanced when integrating reflections and fostering dialogue/interaction among peer learners.  Implications Study findings will be used to improve the module. Future iterations will include collaborations with international clinicians to enhance the global relevance of the module contents, which will be evaluated with other clinicians/trainees. Providing educational resources for clinicians on ethical challenges in children’s surgery will help facilitate the recognition of children as active moral agents and improve their surgical experiences by promoting holistic patient care.
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接受手术的儿童面临的伦理挑战:护理研究生的学习评估
背景 在外科手术中,多种障碍可能会阻碍对儿童的整体护理以及儿童对其医疗保健的有意义参与。这些障碍包括临床医生对影响儿童的伦理问题缺乏了解以及教育资源匮乏。我们的团队创建了一个开放访问的培训模块 (https://childsxethics.net),以提高临床医生对接受手术的儿童所面临的伦理挑战的理解。目标 评估护理研究生在完成该模块后在布卢姆分类法认知、情感和心理运动学习方面达到的水平。方法 进行定性描述研究。数据来源包括参与者的课程作业。使用布卢姆分类法和儿童伦理框架对数据进行归纳和演绎分析。结果 19 名学员撰写了在线反思和同行回复。两个小组完成了小组作业。该模块和相关的课堂作业成功地促进了对影响接受手术儿童的伦理挑战的高水平认知和情感学习。作业类型影响了参与者的学习水平和学习目标的实现。在整合反思和促进同伴间的对话/互动时,认知和情感学习过程得到了加强。 启示 研究结果将用于改进该模块。未来的迭代将包括与国际临床医生的合作,以提高模块内容的全球相关性,并与其他临床医生/学员一起进行评估。为临床医生提供有关儿童外科伦理挑战的教育资源,将有助于促进对儿童作为积极的道德主体的认识,并通过促进全面的患者护理来改善他们的手术体验。
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