A multi-component professional ethics education program incorporating AI-assisted learning for nursing students: changes in moral reasoning in a quasi-experimental study

Abstract

Moral reasoning is an essential professional competency in nursing and supports ethical decision-making. This study examined changes in moral reasoning following a multi-component professional ethics education program incorporating AI-assisted case exploration, compared with the routine curriculum. This quasi-experimental study included 80 nursing students (40 per group); one comparison participant was lost to follow-up ( n = 39). Moral reasoning was assessed using Crisham’s Nursing Dilemma Test (NDT) at baseline, post-test, and three-month follow-up. Mean scores in the experimental group were 43.13 ± 5.29, 48.83 ± 5.97, and 48.68 ± 5.43, respectively; corresponding comparison-group scores were 43.90 ± 5.69, 44.59 ± 5.21, and 43.97 ± 5.37. Repeated-measures ANCOVA showed significant effects of time ( p = 0.001) and group × time interaction ( p = 0.001). After adjustment for academic term, the group effect was significant ( p = 0.025). Post-test and follow-up scores were higher than baseline (both p = 0.001), whereas post-test and follow-up scores did not differ ( p = 0.138). Participation in the multi-component program was associated with greater improvement in moral reasoning than the routine curriculum alone. Because the intervention comprised multiple components, the independent contribution of AI-assisted learning could not be determined.