Ethical violations in the clinical setting: The hidden curriculum learning experience of Pakistani nurses Ethics in Clinical Practice

BMC Medical Ethics

Volumn 16, Issue 1, 2015, Pages

  Jafree, Sara Rizvi ^a   Zakar, Rubeena ^a   Fischer, Florian ^b   Zakar, Muhammad Zakria ^a  

^a UNIVERSITY OF THE PUNJAB   (Pakistan)

^b BIELEFELD UNIVERSITY   (Germany)

Author keywords

Clinical setting; Ethical violations; Ethics; Hidden curriculum; Nurse

Indexed keywords

CURRICULUM; DEVELOPING COUNTRY; HEALTH PERSONNEL ATTITUDE; HOSPITAL; HUMAN; INFORMATION PROCESSING; INFORMED CONSENT; LEARNING; MEDICAL ETHICS; MORALITY; NURSE; NURSE ATTITUDE; PAKISTAN; PATIENT RIGHT; QUALITATIVE RESEARCH;

ATTITUDE OF HEALTH PERSONNEL; CODES OF ETHICS; CURRICULUM; DEVELOPING COUNTRIES; ETHICS, MEDICAL; ETHICS, NURSING; FOCUS GROUPS; HOSPITALS; HUMANS; INFORMED CONSENT; LEARNING; MORALS; NURSE'S ROLE; NURSES; PAKISTAN; PATIENT RIGHTS; QUALITATIVE RESEARCH;

EID: 84925304997     PISSN: None     EISSN: 14726939     Source Type: Journal    
DOI: 10.1186/s12910-015-0011-2     Document Type: Article

References (98)

1. Caldicott CV, Faber-Langendoen K. Deception, discrimination, and fear of reprisal: lessons in ethics from third-year medical students. Acad Med. 2005;80(9):866-73.
2. Branch WT. Supporting the moral development of medical students. J Gen Intern Med. 2000;15(7):503-8.
3. Sokol DK. William Osler and the jubjub of ethics; or how to teach medical ethics in the 21st century. J R Soc Med. 2007;100(12):544-6.
4. Allan HT, Smith P, O'Driscoll M. Experiences of supernumerary status and the hidden curriculum in nursing: a new twist in the theory-practice gap? J Clin Nurs. 2011;20(5-6):847-55.
5. Lempp H, Seale C. The hidden curriculum in undergraduate medical education: qualitative study of medical students' perceptions of teaching. BMJ. 2004;329(7469):770.
6. Goldie J. Review of ethics curricula in undergraduate medical education. Med Educ. 2000;34(2):108-19.
7. Goldie J, Schwartz L, McConnachie A, Morrison J. The impact of three years' ethics teaching, in an integrated medical curriculum, on students' proposed behaviour on meeting ethical dilemmas. Med Educ. 2002;36(5):489-97.
8. Paice E, Heard S, Moss F. How important are role models in making good doctors? BMJ. 2002;325(7366):707.
9. Goldie J, Schwartz L, Morrison J. A process evaluation of medical ethics education in the first year of a new medical curriculum. Med Educ. 2000;34(6):468-73.
10. Nilstun T, Cuttini M, Saracci R. Teaching medical ethics to experienced staff: participants, teachers and method. J Med Ethics. 2001;27(6):409-12.
11. Butts JB, Rich KL. Nursing ethics: Across the curriculum and into practice. 3rd ed. Burlington: Jones & Bartlett Publishers; 2013.
12. Needleman J, Hassmiller S. The role of nurses in improving hospital quality and efficiency: real-world results. Health Aff. 2009;28(4):625-33.
13. Mueller PS. Incorporating professionalism into medical education: the Mayo Clinic experience. Keio J Med. 2009;58(3):133-43.
14. Gibeau AM. Female genital mutilation: when a cultural practice generates clinical and ethical dilemmas. J Obstet Gynecol Neonatal Nurs. 1998;27(1):85-91.
15. Moazam F, Jafarey AM. Pakistan and biomedical ethics: Report from a Muslim country. Camb Q Healthc Ethics. 2005;14(3):249-55.
16. Ahmed B, Shad I, Mumtaz R, Tanveer Z. Organizational ethics and job satisfaction: Evidence from Pakistan. Afr J Bus Manage. 2012;6(8):2966-73.
17. Ahmad K. Pakistan: a cirrhotic state? Lancet. 2004;364(9448):1843-4.
18. Rahman A, Malik A, Sikander S, Roberts C, Creed F. Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial. Lancet. 2008;372(9642):902-9.
19. Avan B, Raza S, Khokhar S, Awan F, Sohail N, Rashid S, et al. Residents' perceptions of work environment during their postgraduate medical training in Pakistan. J Postgrad Med. 2006;52(1):11.
20. Hyder AA, Nadeem S. Health Ethics in Pakistan: A literature review of its present state. J Health Popul Nutr. 2001;19(1):6-11.
21. Shamin S. To Continue or Discontinue Treatment: What Should Families Consider when Deciding for an Incompetent Patient? Asian Bioethics Review. 2013;5(2):159-61.
22. Moazam F. Families, patients, and physicians in medical decisionmaking: a Pakistani perspective. Hastings Cent Rep. 2000;30(6):28-37.
23. Khan AJ, Luby SP, Fikree F, Karim A, Obaid S, Dellawala S, et al. Unsafe injections and the transmission of hepatitis B and C in a periurban community in Pakistan. Bull World Health Organ. 2000;78(8):956-63.
24. Khan RI. End of Life Care in Pakistan; Some Ethical Issues. J Coll Physicians Surg Pak. 2012;22(12):745-6.
25. Jafarey A, Farooqui A. Informed consent in the Pakistani milieu: the physician's perspective. J Med Ethics. 2005;31(2):93-6.
26. Ahmer S, Yousafzai AW, Bhutto N, Alam S, Sarangzai AK, Iqbal A. Bullying of medical students in Pakistan: a cross-sectional questionnaire survey. PLoS One. 2008;3(12):e3889.
27. Shaikh A, Humayun N. Medical Ethics in Undergraduate Medical Education in Pakistan: Towards a Curricular Change. In: Clark PA, editor. Contemporary Issues in Bioethics. Rijeka: InTech; 2012. p. 115-30.
28. Lee MB, Saeed I. Oppression and horizontal violence: The case of nurses in Pakistan. Nurs Forum. 2001;36(1):15-24.
29. Somani RK. Workplace violence towards nurses: A reality from the Pakistani context. J Nurs Educ Pract. 2012;2(3):148.
30. Jafarey AM, Iqbal SP, Hassan M. Ethical review in Pakistan: The credibility gap. J Pak Med Assoc. 2012;62(12):1354-7.
31. Shamim MS, Shamim MS. Medical Ethics: A slow but sustained revolution in Pakistan's healthcare. J Pak Med Assoc. 2010;60:706-7.
32. Dias JM, Ajani K, Mithani Y. Conceptualization and operationalization of a baccalaureate nursing curriculum in Pakistan: Challenges; hurdles and lessons learnt. Procedia Soc Behav Sci. 2010;2(2):2335-7.
33. London L, Tangwa G, Matchaba-Hove R, Mkhize N, Nwabueze R, Nyika A, et al. Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context. BMC Med Ethics. 2014;15(1):48.
34. Hicks LK, Lin Y, Robertson DW, Robinson DL, Woodrow SI. Understanding the clinical dilemmas that shape medical students' ethical development: questionnaire survey and focus group study. BMJ. 2001;322(7288):709-10.
35. Williams JR. Medical ethics manual. World Medical Association: Ferney-Voltaire; 2005.
36. Vaughan D. Theorizing Disaster Analogy, historical ethnography, and the Challenger accident. Ethnography. 2004;5(3):315-47.
37. Lawton R, Carruthers S, Gardner P, Wright J, McEachan RR. Identifying the latent failures underpinning medication administration errors: An exploratory study. Health Serv Res. 2012;47(4):1437-59.
38. Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative. Philadelphia: Lippincott Williams & Wilkins; 2011.
39. Singer PA, Pellegrino ED, Siegler M. Clinical ethics revisited. BMC Med Ethics. 2001;2(1):1.
40. D'eon M, Lear N, Turner M, Jones C. Perils of the hidden curriculum revisited. Med Teach. 2007;29(4):295-6.
41. Ohnishi K, Hayama Y, Asai A, Kosugi S. The process of whistleblowing in a Japanese psychiatric hospital. Nurs Ethics. 2008;15(5):631-42.
42. Hashemi F, Nasrabadi AN, Asghari F. Factors associated with reporting nursing errors in Iran: a qualitative study. BMC Nurs. 2012;11(1):20.
43. Higher Education Commission Islamabad, Pakistan Nursing Council Islamabad. Curriculum of Nursing Education BScN. Islamabad: Higher Education Commission Islamabad, Pakistan Nursing Council; 2006.
44. ICoN. The ICN code of ethics for nurses. Geneva: International Council of Nurses; 2006.
45. UNESCO. Ethics Education Programme. Paris: UNESCO; 2003.
46. Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res. 2007;42(4):1758-72.
47. Burns N, Grove SK. Understanding nursing research: Building an evidence-based practice. Oxford: Elsevier; 2010.
48. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-15.
49. Murakami M, Kawabata H, Maezawa M. The perception of the hidden curriculum on medical education: an exploratory study. Asia Pac Fam Med. 2009;8(1):9.
50. Lamiani G, Leone D, Meyer EC, Moja EA. How Italian students learn to become physicians: a qualitative study of the hidden curriculum. Med Teach. 2011;33(12):989-96.
51. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12.
52. Polit DF, Beck CT. The content validity index: are you sure you know what's being reported? Critique and recommendations Res Nurs Health. 2006;29(5):489-97.
53. Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-88.
54. Barbour RS. Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? BMJ. 2001;322(7294):1115.
55. Zafar SN, Syed R, Waqar S, Irani FA, Saleem S. Prescription of medicines by medical students of Karachi, Pakistan: A cross-sectional study. BMC Public Health. 2008;8(1):162.
56. Humayun A, Fatima N, Naqqash S, Hussain S, Rasheed A, Imtiaz H, et al. Patients' perception and actual practice of informed consent, privacy and confidentiality in general medical outpatient departments of two tertiary care hospitals of Lahore. BMC Med Ethics. 2008;9(1):14.
57. Upvall M, Hashwani S. Negotiating the informed consent process in developing countries: a comparison of Swaziland and Pakistan. Int Nurs Rev. 2001;48(3):188-92.
58. Khowaja K. Healthcare systems and care delivery in Pakistan. J Nur Adm. 2009;39(6):263-5.
59. Nayyer-ul-Islam MY-I, Farooq MS. Workplace violence experienced by doctors working in government hospitals of Karachi. J Coll Physicians Surg Pak. 2014;24(9):698-9.
60. Babar M, Ul Haq SM. Self-esteem in a palliative care population. Am J Hosp Palliative Care. 2000;17(5):327-32.
61. Castellón AMD. Occupational violence in nursing: explanations and coping strategies. Rev Lat Am Enfermagem. 2011;19(1):156-63.
62. Tourangeau AE, Doran DM, Hall LM, O'Brien Pallas L, Pringle D, Tu JV, et al. Impact of hospital nursing care on 30-day mortality for acute medical patients. J Adv Nurs. 2007;57(1):32-44.
63. Shields L. Editorial: The nursing shortage and developing countries: an ethical dilemma. J Clin Nurs. 2005;14(7):787-8.
64. Esmaeilpour M, Salsali M, Ahmadi F. Workplace violence against Iranian nurses working in emergency departments. Int Nurs Rev. 2011;58(1):130-7.
65. Halligan P. Caring for patients of Islamic denomination: critical care nurses' experiences in Saudi Arabia. J Clin Nurs. 2006;15(12):1565-73.
66. Johnson C. Bad blood: doctor-nurse behavior problems impact patient care. Physician Exec. 2009;35(6):6-11.
67. Anderson OA, Wearne IMJ. Informed consent for elective surgery - what is best practice? J R Soc Med. 2007;100(2):97-100.
68. Shorideh FA, Ashktorab T, Yaghmaei F. Iranian intensive care unit nurses' moral distress: A content analysis. Nurs Ethics. 2012;19(4):464-78.
69. Akram M, Khan FJ. Health care services and government spending in Pakistan. Pakistan Institute of Development Economics: Islamabad; 2007.
70. Solvoll B-A, Heggen KM. Teaching and learning care - Exploring nursing students' clinical practice. Nurse Educ Today. 2010;30(1):73-7.
71. Lopez V. Clinical teachers as caring mothers from the perspectives of Jordanian nursing students. Int J Nurs Stud. 2003;40(1):51-60.
72. Shiraz B, Shamim MS, Ahmed A. Medical ethics in surgical wards: knowledge, attitude and practice of surgical team members in Karachi. Indian J Med Ethics. 2005;2(3):94.
73. Niaz U. Women's mental health in Pakistan. World Psychiatry. 2004;3(1):60.
74. Johnson S. International perspectives on workplace bullying among nurses: a review. Int Nurs Rev. 2009;56(1):34-40.
75. Shiwani MH, Gadit A. Medical Negligence: A growing problem in Pakistan. J Pak Med Assoc. 2011;61(6):610-1.
76. Sheikh SA. The importance of ethics in health care system. J Dow Univ Health Sci. 2007;1(1):46-8.
77. Budiani-Saberi DA, Delmonico F. Organ trafficking and transplant tourism: a commentary on the global realities. Am J Transplant. 2008;8(5):925-9.
78. Shields L. A review of the literature from developed and developing countries relating to the effects of hospitalization on children and parents. Int Nurs Rev. 2001;48(1):29-37.
79. Berwick DM, Kotagal M. Restricted visiting hours in ICUs: time to change. JAMA. 2004;292(6):736-7.
80. Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med. 1994;69(11):861-71.
81. Christakis DA, Feudtner C. Ethics in a short white coat: the ethical dilemmas that medical students confront. Acad Med. 1993;68(4):249-54.
82. Luthar HK, DiBattista RA, Gautschi T. Perception of what the ethical climate is and what it should be: The role of gender, academic status, and ethical education. J Bus Ethics. 1997;16(2):205-17.
83. Hariharan S, Jonnalagadda R, Walrond E, Moseley H. Knowledge, attitudes and practice of healthcare ethics and law among doctors and nurses in Barbados. BMC Med Ethics. 2006;7(1):7.
84. DuBois JM, Burkemper J. Ethics education in US medical schools: a study of syllabi. Acad Med. 2002;77(5):432-7.
85. Daar AS, Khitamy A. Bioethics for clinicians: 21 Islamic bioethics. CMAJ. 2001;164(1):60-3.
86. Bhui K, Warfa N, Edonya P, McKenzie K, Bhugra D. Cultural competence in mental health care: a review of model evaluations. BMC Health Serv Res. 2007;7(1):15.
87. Stirrat G, Johnston C, Gillon R, Boyd K. Medical ethics and law for doctors of tomorrow: the 1998 Consensus Statement updated. J Med Ethics. 2010;36(1):55-60.
88. Calman K, Downie R. Practical problems in the teaching of ethics to medical students. J Med Ethics. 1987;13(3):153-6.
89. Wade GH, Kasper N. Nursing students' perceptions of instructor caring: an instrument based on Watson's Theory of Transpersonal Caring. J Nurs Educ. 2006;45(5):162-8.
90. Mlinar S. First-and third-year student nurses' perceptions of caring behaviours. Nurs Ethics. 2010;17(4):491-500.
91. Wolf G. Portrayal of negative qualities in a doctor as a potential teaching tool in medical ethics and humanism: Journey to the End of Night by Louis-Ferdinand Celine. Postgrad Med J. 2006;82(964):154-6.
92. Hanson S. Teaching health care ethics: why we should teach nursing and medical students together. Nurs Ethics. 2005;12(2):167-76.
93. Liao JM, Thomas EJ, Bell SK. Speaking Up About The Dangers Of The Hidden Curriculum. Health Aff. 2014;33(1):168-71.
94. Pierson S, Hansen R, Greene S, Williams C, Akers R, Jonsson M, et al. Preventing medication errors in long-term care: results and evaluation of a large scale web-based error reporting system. Qual Saf Health Care. 2007;16(4):297-302.
95. Dalton JM. Development and testing of the theory of collaborative decision making in nursing practice for triads. J Adv Nurs. 2003;41(1):22-33.
96. Jütting JP, Morrisson C. Changing social institutions to improve the status of women in developing countries. Paris: OECD; 2005.
97. Sadat Hoseini AS, Alhani F, Khosro panah A, Behjatpour A. A Concept Analysis of Nursing Based on Islamic Sources: Seeking Remedy. Int J Nurs Knowl. 2013;24(3):142-9.
98. Donelan K, Buerhaus P, DesRoches C, Dittus R, Dutwin D. Public perceptions of nursing careers: the influence of the media and nursing shortages. Nurs Econ. 2007;26(3):143-50.