Exploring Digital Care: Developing Ethical Competencies

Abstract

Purpose: The advancement of digitization in nursing care is expected to significantly increase in the near future. Nursing staff need appropriate training opportunities that integrate ethical skills alongside digital skills to effectively participate in this transformation (Becka et al., 2020). Most training courses in this area have a rather low ethics component. The “Consultant for Digital Healthcare” training is intended to close this gap (Kraft et al., 2024). Research question: How does the "Consultants for Digital Healthcare" continuing education program impact the ethical skills development of participants? Method: A mixed-methods design is used to assess the learning impact of the ethics module in terms of ethical skills. Quantitatively, self-assessment of ethical competence is measured using the "Ethical Decision-Making Confidence Scale for Nursing Leaders" (EDMC) (Birkholz et al., 2022). Qualitatively, twelve semi-structured interviews explore connections in ethical competence development with a particular focus on the use of digital technologies. An exploratory approach is therefore being pursued in the new area of ethical competence development for digitally supported care. Results and Discussion: The intervention shows a significant increase in ethical competence, particularly in articulating moral distress, applying ethical decision-making models, and guiding mediation in complex clinical scenarios. The area of explaining one's own ethical decisions using the appropriate ethical terminology and language is increasing less rapidly. Interviews confirm participants' increased awareness of ethical dimensions in digitally supported nursing practice and willingness to consider ethics in technology use and in the implementation of new technologies. Thus the further training impacts ethical skills in a comprehensive sense, on a cognitive, affective and practical level. These include a variety of general areas of ethical competence, such as knowledge of ethical principles or awareness of the ethical dimension of professional behavior and specific technology-related competence areas, such as willingness to take ethical aspects into account when using technology. The training intervention effectively enhances ethical competence among participants. The results presented here result from the subjective self-assessment of the participants. Thus, future research should explore the correlation between subjective self-assessments and objective measures of ethical competence and the possibility of developing further instruments for evaluation. In addition, further research is needed on the relationship between ethical and digital skills and what it takes to learn and apply competent and professional ethical behavior in the area of digitalization of care.