IAJPS 2017, 4 (12), 4454-4458 Ali Mansouri et al ISSN 2349-7750

CODEN [USA]: IAJPBB ISSN: 2349-7750

INDO AMERICAN JOURNAL OF

PHARMACEUTICAL SCIENCES
http://doi.org/10.5281/zenodo.1116187

Available online at: http://www.iajps.com Research Article

EVALUATION OF KNOWLEDGE AND PERFORMANCE OF STUDENTS

OF NURSING AND MIDWIFERY FACULTY IN CLINICAL
ENVIRONMENT BEFORE AND AFTER HOLDING TRAINING
WORKSHOP OF PROFESSIONAL ETHICS IN ZABOL CITY, 2017
Aziz Shahraki vahed1, Hossein Shahdadi1, Ali Mansouri1*, Mohammadreza Firouzkouhi2,
Abdolghani Abdollahimohammad3
1
MSc in Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Science, Zabol, Iran.
2
Phd in Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Science, Zabol, Iran.
3
Phd of Medical Education, , Faculty of Nursing and Midwifery, Zabol University of Medical Science,
Zabol, Iran.
Abstract:
Introduction and Objective: The topic of professional ethics has been considered in different countries and professional groups and different
languages. It is necessary for the medical profession students to increase their skills in this area, while being aware of the principles of
professional ethics. Therefore, the current research was conducted due to the importance of this issue and since no study has been conducted
regarding nursing & midwifery faculty students’ knowledge of the principles of professional ethics in Zabol.
Materials & Methods: This is a semi-experimental study conducted in in the form of group trail with pre-workshop and post-workshop method
on Nursing and Midwifery Faculty students of Zabol University of Medical Sciences, with cooperation of professors of the Nursing and
Midwifery students for four months. After coordinating with the education department and professors of the faculty and announcing the holding
the workshop for each academic level, subjects received the training and film for 21 days from 8am to 12am in 20-subject groups and each group
in two days for four hours in the Faculty of Nursing and Midwifery. Data were analyzed by SPSS software.
Results: The results showed that out of 300 participants in the training workshop of professional ethics, majority of people (66%) were female,
and 60% stated that they did not have information about training and guiding the patients, and after the workshop, 97% of them stated that
patient training is one of the requirements for patient knowledge. Before the workshop, the students' knowledge of stating the professional errors
report was 30%, while it as 100% after the workshop. The results showed that there was no significant relationship between the variables of
academic semester and ethnicity and the mean score of knowledge of professional ethics.
Conclusion: The findings of the research indicate that it is necessary to increase the training courses of the professional ethics for all students of
different medical sciences. Therefore, observing the principles of professional ethics in students will result in providing desirable services and
patients’ satisfaction.
Keywords: Professional ethics, student, nursing, midwifery, training workshop, principles
Corresponding author:
QR code
Ali Mansouri,
Faculty of Nursing and Midwifery,
Zabol University of Medical Sciences,
PO Box 61734-184, Ferdosi Shargi Street,
Zabol, Iran.
E-mail:[email protected]
Please cite this article in press as Ali Mansouri et al., Evaluation of Knowledge and Performance of Students of
Nursing and Midwifery Faculty in Clinical Environment Before and After Holding Training Workshop of
Professional Ethics in Zabol City, 2017,, Indo Am. J. P. Sci, 2017; 4(12).

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 IAJPS 2017, 4 (12), 4454-4458 Ali Mansouri et al ISSN 2349-7750

INTRODUCTION: Many studies have supported this theory that creative

Problem statement training during student life plays an important role in
Higher education provides good conditions for acquiring skills to deal with ethical problems, having
ethical problems and ethics in all areas and activities an active role in decision making, and gaining
of higher education are used as one of the main issues professional identity (9). Therefore, this study was
(1). conducted given the importance of this issue and no
study has been conducted regarding Nursing &
Professional ethics deals with ethical issues and Midwifery Faculty students’ knowledge of principles
questions as well as the ethical principles and values of professional ethics in Zabol.
of a system and considers the voluntary actions of
professionals within their own professional activities MATERIALS AND METHODS:
(2). The governance of professional ethics has many This study was a quasi-experimental study in the
benefits to the organization from the internal form of group trail with pre-workshop and post-
dimension of aspects of improving relationships, workshop method on all students of Nursing &
promoting the atmosphere of understanding, and Midwifery Faculty of Zabol University of Medical
reducing conflicts, increasing the commitment and Sciences and with the cooperation of the professors
accountability of employees, and reducing the costs of the Faculty of Nursing & Midwifery since
caused by control, and from the social responsibility 2017/6,22 to 2017/10/22. After coordinating with the
perspective, it affects the profitability and improving education department and professors of the faculty
the competitive advantage and organizational success and announcing the holding the workshop for each
through increasing the legitimacy of the organization academic level, subjects received the training and
and its actions (3). Promotion of professional ethics film for 21 days from 8am to 12am in 20-subject
at the university depends on the human perception of groups and each group in two days for four hours in
the organizational culture of the university (4). the Faculty of Nursing & Midwifery.

The effective promotion of ethics at university, as The inclusion criteria of research were 3th and high
with any other organization, depends on three major semester students studying at the bachelor level of
steps. First, knowledge of professional ethics focuses nursing and midwifery and entering to internship
on the specialized fields of the organization. Second, course. Exclusion criteria of research included
the internal orientation and self-motivation of the transfer of students to other medical universities of
organization, its managers and its human resources Iran. The first and second semester nursing &
are to achieve ethical values in the organization. The midwifery students were excluded from the research
third step is the organization's skill in implementing population due to their non-attending in the clinical
ethical principles. In the third step, the process, environment. The data collection tool was a
methods, and techniques for promoting ethics in an researcher-developed questionnaire, which the
organizational culture (such as behavioral considered cases were extracted by review of the
communication skills, and the skills to identify and relevant articles. The data collection tool was a two-
resolve ethical issues, especially the ability to deal part questionnaire: the first part included the personal
with moral conflicts) are discussed (5). With regard information with 6 questions (age, gender, field of
to ethical code of nurses and in an Interpretative study, academic level, GPA, and interest in the field
Statement in 2015, the American Nursing of study) and the second part included 48 questions
Association hopes that the nature of professional with yes or no answers, assessing the knowledge
ethics to be institutionalized in nursing training (6), level of the students. With regard to determining the
since ethics training for nursing students guides them validity and reliability of professional ethics
toward providing better care when faced with ethical questionnaire, the content validity of the
challenges. Although many studies have shown questionnaire was confirmed by five faculty
significant role of educators in promoting this issue, members of the Faculty of Nursing & Midwifery and
less attention nowadays is paid to this role (7). the reliability of the questionnaire was confirmed
Wehwein believed that ethics training is effective in 78% using Cronbach's alpha.
promoting student knowledge of ethical issues and
using them in the workplace. In addition, the ability RESULTS:
to make ethical decisions in students who have The results showed that out of the 300 participants in
completed the ethics course is greater than those who the professional ethics workshop, the majority of
have not completed this course (8). people (66%) were female. The majority (75%) of
them aged between 19 and 23 years, and 100% of the
research subjects stated that they had not participated

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 IAJPS 2017, 4 (12), 4454-4458 Ali Mansouri et al ISSN 2349-7750

in professional ethics training workshops. The results after the workshop 97% of them stated that they had
also showed that students' knowledge of their rights information on the confidentiality rules in the
was 58% before workshop, while it was 98% after workplace and the patient.
workshop. In addition, their knowledge of the patient
rights charter was 40% before the workshop and In terms of training the patient during the
100% after the workshop. In addition, 98% of them hospitalization and discharge time before the
stated that the name and characteristics of the student workshop was 30%, while it was 92% after the
are known to patients. In addition, 60% of them workshop, and 75% of the students stated that they
stated that they did not have information on the way did not explain the goal of the work therapy or care
of training and guiding the patients, and after the before the workshop, and after the workshop, this
workshop, 97% of them stated that patient training is reached to 96%. Eighty percentages of them stated
one of the requirements for increasing the patient that respect for patient was an important point in
knowledge. Before the workshop, the students' establishing a good relationship and mutual trust.
knowledge of stating the professional errors report The results showed that there is no significant
was 30%, while it was 100% after the workshop. relationship between the variables of academic
Seventy and five percentage of the students stated semester and ethnicity and mean score of knowledge
that they had complete sense of responsibility and of professional ethics. Observing ethical codes
care of the patient in the department and 85% of the among the students was significantly observed after
students have knowledge on confidentiality of the the workshop.
patient information and the work environment, and

Table 1: Mean and standard deviation of the scores of knowledge before and after training and retest
(One month after training workshop)

stage Knowledge level p-value

Mean± SD
Pre-test 21 ± 3.11 0.02
Immediately after training workshop 4.27± 41

One month after training workshop 4.84 ±45.5

As seen, mean scores before training, after training, and one month after training were 45.5 and has difference with
ANOVA test (p = 0.02).

Table 2: Level of satisfaction of the participants in the workshop based on the survey

Satisfaction n %
Very good 285 95
Good 15 5
Average - -
Bad - -
Total 300 100

The table above shows that 95% of the participants were very satisfied with training workshop of the professional
ethics.

One month after the completion of the training workshop, the results showed that 75% of the students had desirable
performance and 25% of them had a moderate performance in observing the professional ethics.

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DISCUSSION: increasing the ethical judgment of nursing students

In the current research, 85% of the students stated was examined (16) and its results showed that the
that they had knowledge of the confidentiality of mean score of nursing professional ethics was higher
patient information and the work environment. In the in those who had completed special course in ethics
study conducted by Jahanpour et al., results of the compared to those, who did not complete any course.
study showed that students' knowledge on the Felton believes that by completing targeted ethics
confidentiality of patient information by a health training, students' ability in ethical positions increases
professional, if patient requested, was very high. This (17). In the present study, the knowledge of the
study was consistent with the present study (10). In students before the workshop was 51.8%. In the
the present study, 60% of the students stated that they study conducted by Masoumi, the mean score of
had knowledge on the way of educating the patient, students in observing professional ethics codes in the
which it increased to 97%. In a study carried out by area paying attention to their rights was 89.4. In the
Veskoi Eshkevari et al., results showed that present findings, there is no significant relationship
appropriate information is not provided about the between the variables of the academic semester and
disease and caring methods in 52.7% of cases, and the mean score of the knowledge of professional
the patients’ privacy (45%) and the independence of ethics.
patients (64%) are not observed in the cares (11). The In the study conducted by Masoumi, results showed
results of this study are in line with results of before that there is a significant relationship between the
the workshop. This suggests that nursing professors variables of academic semester and ethnicity and
have more emphasis on training topics of nursing in mean score of observing the ethical codes, which is
order to empower students. Lack of receiving the not consistent with the present study (20). In the
trainings and adequate information is complaints, present study, 75% of students stated that they had
which are repeatedly discussed by clients in legal complete sense of responsibility and care of the
communities (12). In the present study, 80% of patient in the ward. In the study conducted by
students stated that respect for the client is an Masoumi, the mean score of observing the ethical
important point in establishing the communication codes related to the scope of professional obligations
and mutual trust. In addition, in their ethical codes, (86.7%) ranked second. This might be explained by
Nursing & Midwifery Council of the United importance of the provision of midwifery services by
Kingdom has stated its behavior, performance, and training authorities in the internship environment,
ethics standards for nursing and midwifery groups. which is consistent with our study.
Accordingly, the first point that nurse or midwife In our study, ethical codes (88%) were observed
should focus on caring the people and respecting to significantly among the students after the
dignity of the people, providing required support in workshop. In the study conducted by Masoumi, there
providing care for them, is cooperating with their was no meaningful relationship between completing
colleagues (teamwork), the patient's family, and other the ethics course and level of observing ethical codes
community members for health and welfare of the (200).
people, providing the best care standards, being kind
and honest and acting honestly and in according to CONCLUSION:
laws of Iran (13). Respecting people, obtaining the Findings of the study indicate the need to increase the
consent, assisting and cooperating with them, professional ethics training courses for all students of
confidentiality in preserving their information, different medical sciences.
obtaining the knowledge and skills required, Improving professional ethics training in nursing and
reliability, identifying, and reducing the potential midwifery faculties can play a major role in
risks are the general principles that a nurse or increasing the level of knowledge of professional
midwife should consider them in dealing with patient ethics and observing the patients' rights. Moreover,
or other clients (14). The ethical codes of the the institutionalization of ethical training in medical
midwifery profession emphasize that the midwife's science faculties requires transformation and it may
behavior in relation to the client and providing be necessary to review the ethics curriculum, which
service to him should be along with kindness in is under the responsibility of the university directors.
behavior and words and consider social, cultural, and Professional ethics in a strategic attitude is at the
social beliefs (15). The results of the present study individual level is the responsibility of the individual
indicated significant increase with regard to towards himself, his colleagues, and the organization,
professional ethics of the students after the workshop. which plays a vital role in guiding the individual in
order to achieve the determined position and goal of
In the study conducted by Hadi Jafari, the importance the organization. Therefore, observing the principles
of training ethics and its positive impact on

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of professional ethics in students will result in Medical ethics Journal [Serial online] 2011 [cited
providing services satisfied by patients. 2012]; 5(15): [20 screens]. Available from: URL:
www.sid.ir
ACKNOWLEDGMENT: 10-Jahanpour F, Khalili A, Ravanipour M, Nourouzi
This article is result of a research project approved by L, Khalili M, Dehghan F. Investigating Awareness
the research council of Zabol University of Medical Amount of Nursing Students of Medical Sciences
Sciences. We thereby appreciate Research and University of Bushehr about Ethic in Nursing
Technology Deputy of University, the faculty Profession -2013. Armaghane danesh. 2014; 19 (3)
members of the Faculty of Nursing & Midwifery and :223-232
honorable students who cooperated in performing 11-Eshkevari KV, Karimi M, Asnaashari H, Kohan
this study. N. The assessment of observing patients’ right in
Tehran University of Medical Sciences’ hospitals.
REFERENCES: Iran J Med Ethics Hist Med 2009;2(4):47-54. [In
1-Mcneal G. (2009). Organizational Culture, Persian].
Professional Ethics and Guantanamo. Unit State; 42: 12-Bastable SB. Nurse as educator: Principles of
125-147 teaching and learning for nursing practice. USA:
2-Biedenweg K, Monroe M C, Oxarart A. (2013). Jones & Bartlett Learning; 2013. p. 168.
The importance of teaching ethics of sustainability. 13- Anonymous. The Nursing and Midwifery
International Journal of Sustainability in Higher Council. The Code: Standards of Conduct,
Education; 14(1): 6-14. Performance and Ethics for Nurses and Midwives.
3-Faramarze Gharamaki A.(2006). Ethics in business http://www.nmc-uk.org/Nursesand-
organizations. Qom: Majnoon Publishing. (In midwives/The-code/The-code-in-full/ (accessed in
Persian). 2011)
4- Faghihi A, Rezaee Manesh B. (2006). Business 14- Anonymous. The Nursing and Midwifery
Ethics. Journal of Management Studies; 47: 53-60. Council. The NMC Code of Professional Conduct:
(In Persian). Standards for Conduct. http://www.positiveoptions.
5-Braxton J. (2011). Proper EM, Bayer AE. com/news/downloads/NMC_
Professors behaving badly: faculty misconduct in _Code_of_Professional_Conduct_- _2004.pdf
graduate education. Baltimore: Johns Hopkins (accessed in 2011)28-Group of authors. Codes of
University Press. ethics in midwifery in iran. Tehran: Deputy
6-Butts JB, Rich KL. Nursing Ethics: Across the treatment; 2014.
Curriculum and Into Practice. 4th Ed. United States: 15- Group of athors .codes of ethics in midwifery in
Jones & Bartlett Learning; 2015 iran .Tehran: Deputy btreatment; 2014
7-. Borhani F, Alhani F, Mohammadi E, Abbaszadeh 16-Jafari manesh H, Ranjbaran M, Vakilian K, Tajik
A. Professional Ethical Competence in nursing: the R, Almasi-Hashiani A. Nursing’s code of ethics: a
role of nursing instructors. J Med Ethics Hist Med survey of respecting the code among nursing
2010; 3: 3 students. ijme. 2014; 6 (6) :45-55
8-Wehrwein T. Moral reasoning and ethical decision 17-Felton G, Parsons M. The impact of nursing
making in beginning baccalaureate nursing students. education on ethical/moral decision making. J Nurs
Wayne: Wayne State University; 1990. Educ 1987; 26(1):7.
9-Sadeghi R, Ashk Torab T. Observed ethical
problems by nursing student: qualitative approach.

www.iajps.com Page 4458