title: Caring for tomorrow's workforce: Moral resilience and healthcare ethics education.
abstract: BACKGROUND
  Preparing tomorrow's healthcare workforce for managing the growing complexity of care places high demands on students, educators, and faculties. In the light of worrying data about study-related stress and burnout, understanding how students manage stressors and develop resilience has been identified as a priority topic of research. In addition to study-related stressors, also moral stressors are known to characterize the students' first clinical experiences.
  
  
  OBJECTIVE
  However, current debates show that it remains unclear how healthcare ethics education should address them. In order to clarify this issue, this study first develops the notion of moral resilience as a response to moral stressors involving both situations of moral complexity and moral wrongness. Second, it explores the potential of healthcare ethics education in fostering moral resilience. For this purpose, it defines moral resilience operationally as a reduction of moral distress in a given axis of time measured by a validated tool.
  The educational transferability was assessed within an explorative, quantitative pre-post interventional study with a purposive sample of 166 nursing students. The educational intervention comprised a lecture introducing the typology of moral stressors. Before and after the lecture, students were presented vignettes depicting morally stressful situations.
  
  
  METHODS
  The competent research ethics committee confirmed that no ethical approval was needed. Informed consent was obtained from participants.
  
  
  RESULTS
  Three of four vignettes showed a modest but statistically significant reduction in measured levels of distress after the lecture (p < 0.05, α = 5%).
  
  
  CONCLUSIONS
  The study shows the potential of healthcare ethics education in providing students with transformative knowledge that fosters moral resilience.
  
  
  CONCLUSIONS
  In times of global scarcity of educational resources, healthcare ethics education has an important contribution to offer in the promotion of students' mental and physical health by strengthening the knowledge base of moral resilience. This legitimates its costs for societies, faculties, and professional bodies.
authors.affiliation: University of Zurich, Switzerland settimio.monteverde@uzh.ch.
authors.forename: Settimio
authors.initials: S
authors.lastname: Monteverde
mesh_terms: D004508:Education, Nursing, Baccalaureate; D004993:Ethics, Nursing / Q000193:education*; D005181:Faculty, Nursing; D006801:Humans; D007400:Interprofessional Relations; D009014:Morals; D015402:Nursing Education Research; D055500:Resilience, Psychological; D013315:Stress, Psychological / Q000517:prevention & control*; D013338:Students, Nursing / Q000523:psychology*
keywords: Ethics; healthcare ethics education; moral distress; moral resilience; nursing education; nursing ethics