Two Decades of Nursing Ethics

Ethical issues occurring within

nursing education

Nursing Ethics
20(2) 126141
The Author(s) 2013
Reprints and permission:
sagepub.co.uk/journalsPermissions.nav
10.1177/0969733012474290
nej.sagepub.com

Marsha D Fowler
Azusa Pacific University, USA

Anne J Davis
University of California, San Francisco, USA

Abstract
The large body of literature labeled ethics in nursing education is entirely devoted to curricular matters of
ethics education in nursing schools, that is, to what ought to be the ethics content that is taught and what
theory or issues ought to be included in all nursing curricula. Where the nursing literature actually focuses
on particular ethical issues, it addresses only single topics. Absent from the literature, however, is any
systematic analysis and explication of ethical issues or dilemmas that occur within the context of nursing
education. The objective of this article is to identify the spectrum of ethical issues in nursing education
to the end of prompting a systematic and thorough study of such issues, and to lay the groundwork for
research by identifying and provisionally typologizing the ethical issues that occur within the context of
academic nursing.
Keywords
Ethical issues, ethics, nursing education

Introduction
The modern nursing ethics literature in the United States is almost a century and a half long, reaching back
to a series of journal articles published in 1873. At that time, the first true nursing journal in the United
States, The Trained Nurse and Hospital Review, published a series of six articles on ethics in nursing.1
Although the literature hints at earlier books, Isabel Robbs book Nursing Ethics: For Hospital and Private
Use,2 published in 1900, is generally regarded as the first nursing ethics book in the United States. From
those days to the present, the nursing ethics literature has been broad, deep, and extensive, at times selfreflective and courageous. With the rise of bioethics in the 1960s, the already extensive nursing ethics literature burgeoned, growing to include 20 years of a dedicated journal, Nursing Ethics. Thus, given the
extent of the literature, we might ask whether there are any new frontiers for nursing ethics, any new ground
to be turned? Except for as yet unimagined advances in nursing and biosciences, it would seem unlikely. But
issues new to the nursing ethics literature do surface now and again. Witness, for example, Yilderim et al. s3
2007 article on mobbing of nursing faculty, an article that went where none had gone before. Freda and
Kearneys4 article also raises a new issue, that of ethical issues faced by nursing editors, and Freda, Broome
and others raise ethical issues encountered by nursing reviewers.5,6 The global nursing community and the

Corresponding author: Marsha D Fowler, 901 E. Alosta Ave, WCAM 219, P.O. Box 7000, Azusa, CA 91702-7000, USA.
Email: marsharaven@gmail.com

Fowler and Davis

127

issue of nurse migration is another emergent moral issue.7 Another domain in which new ground may be
turned is that of ethical issues in nursing education. The nursing literature does contain articles on specific
ethical issues that arise within the context of nursing education. However, there is nothing in the nursing
ethics literature in English that comprehensively or systematically addresses ethical issues arising within
the context of nursing education; here is a point at which new ground is ready to be plowed.8

Literature reviewethical issues and taboo areas

The literature labeled ethics in nursing education is entirely devoted to curricular matters of ethics education in nursing schools, that is, to what ought to be the ethics content that is taught and what theory or
issues ought to be included in all nursing curricula. Indeed, there are several hundred articles that research
or discuss ethics curriculum or issues of values clarification and socialization of students and their moral
formation or development. In the United States, all of these discussions can be traced back to foundations
in the late 1800s. Where the nursing literature actually focuses on particular ethical issues, it addresses only
single topicsconcerns such as ascribing authorship to faculty publications, cheating by students, or prejudicial assignment of grades (marks). Absent from the literature, however, is any systematic analysis and
explication of ethical issues or dilemmas that occur within the context of nursing education. Because of the
silence on this topic in the nursing literature, this study, thus, turns out to be far more a prolegomenon to
research on ethics within nursing education than had been anticipated at its inception.
Using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed databases, the
English language nursing literature was reviewed. Search terms used began with ethics and nursing education. Additional terms included ethical, moral, issues, dilemmas, conflict, nurse, college, schools, and so on.
Approximately 2600 articles were identified by the search as related to ethical issues in nursing education.
Without exception, these articles were concerned with either (a) ethics content thought to be important in
nursing curricula or (b) single issues in ethics. The review of the literature was intended to uncover the
nature and extent of ethical issues that occurred within the context of nursing education as reported in
the literature, as well as to examine the relative degree of attention given to these issues in the literature.
The literature review was not intended to evaluate the adequacy of the treatment of these issues or to evaluate the merit of specific articles. Although the nature of the articles differed dramatically (from first person
accounts, editorials, qualitative studies, quantitative studies, dissertations, to issue analyses, and more), all
articles identified by the search were reviewed. A subsequent review was conducted 4 years later specifically to look again at the relative degree of attention or weight and persistence, and to identify the rise of any
issues or new concerns.
In 2008, less than 10% of the nursing journal articles that were identified actually addressed ethical
issues in nursing education per se, rather than matters of curricular concern. Concern clustered among several topics. There were a disproportionate 21% of articles that touched upon the ethics of authorship: who is
named as an author, who is first or second author, the inclusion of faculty on student publications, and so on.
Another 18.4% of articles addressed integrity, whistle-blowing, and academic dishonesty in several forms.
While some of these articles addressed scientific misconduct, especially in relation to research, the majority
of articles in this category focused upon student academic dishonesty such as cheating, high-tech cheating,
purchase of term papers, falsification of patient clinical records, and plagiarism. Issues of prejudice (bigotry
and racism in varying forms), discrimination, injustice, and human rights violations in the nursing academy
were the primary foci of an additional 12.1% of articles. Another 9.5% of the articles dealt with what might
be called faculty moral formation, values and values conflicts. These articles frequently mentioned the
moral issues that troubled junior faculty vis-a`-vis senior faculty. Curricular or educational issues such as
unethical student behavior, indoctrination, socialization into nursing values, and the like were found
in 7.9% of the articles. This domain would subsequently grow and differentiate a bit more in the literature
127

Fowler and Davis

127

issue of nurse migration is another emergent moral issue.7 Another domain in which new ground may be
turned is that of ethical issues in nursing education. The nursing literature does contain articles on specific
ethical issues that arise within the context of nursing education. However, there is nothing in the nursing
ethics literature in English that comprehensively or systematically addresses ethical issues arising within
the context of nursing education; here is a point at which new ground is ready to be plowed.8

Literature reviewethical issues and taboo areas

The literature labeled ethics in nursing education is entirely devoted to curricular matters of ethics education in nursing schools, that is, to what ought to be the ethics content that is taught and what theory or
issues ought to be included in all nursing curricula. Indeed, there are several hundred articles that research
or discuss ethics curriculum or issues of values clarification and socialization of students and their moral
formation or development. In the United States, all of these discussions can be traced back to foundations
in the late 1800s. Where the nursing literature actually focuses on particular ethical issues, it addresses only
single topicsconcerns such as ascribing authorship to faculty publications, cheating by students, or prejudicial assignment of grades (marks). Absent from the literature, however, is any systematic analysis and
explication of ethical issues or dilemmas that occur within the context of nursing education. Because of the
silence on this topic in the nursing literature, this study, thus, turns out to be far more a prolegomenon to
research on ethics within nursing education than had been anticipated at its inception.
Using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed databases, the
English language nursing literature was reviewed. Search terms used began with ethics and nursing education. Additional terms included ethical, moral, issues, dilemmas, conflict, nurse, college, schools, and so on.
Approximately 2600 articles were identified by the search as related to ethical issues in nursing education.
Without exception, these articles were concerned with either (a) ethics content thought to be important in
nursing curricula or (b) single issues in ethics. The review of the literature was intended to uncover the
nature and extent of ethical issues that occurred within the context of nursing education as reported in
the literature, as well as to examine the relative degree of attention given to these issues in the literature.
The literature review was not intended to evaluate the adequacy of the treatment of these issues or to evaluate the merit of specific articles. Although the nature of the articles differed dramatically (from first person
accounts, editorials, qualitative studies, quantitative studies, dissertations, to issue analyses, and more), all
articles identified by the search were reviewed. A subsequent review was conducted 4 years later specifically to look again at the relative degree of attention or weight and persistence, and to identify the rise of any
issues or new concerns.
In 2008, less than 10% of the nursing journal articles that were identified actually addressed ethical
issues in nursing education per se, rather than matters of curricular concern. Concern clustered among several topics. There were a disproportionate 21% of articles that touched upon the ethics of authorship: who is
named as an author, who is first or second author, the inclusion of faculty on student publications, and so on.
Another 18.4% of articles addressed integrity, whistle-blowing, and academic dishonesty in several forms.
While some of these articles addressed scientific misconduct, especially in relation to research, the majority
of articles in this category focused upon student academic dishonesty such as cheating, high-tech cheating,
purchase of term papers, falsification of patient clinical records, and plagiarism. Issues of prejudice (bigotry
and racism in varying forms), discrimination, injustice, and human rights violations in the nursing academy
were the primary foci of an additional 12.1% of articles. Another 9.5% of the articles dealt with what might
be called faculty moral formation, values and values conflicts. These articles frequently mentioned the
moral issues that troubled junior faculty vis-a`-vis senior faculty. Curricular or educational issues such as
unethical student behavior, indoctrination, socialization into nursing values, and the like were found
in 7.9% of the articles. This domain would subsequently grow and differentiate a bit more in the literature
127

128

Nursing Ethics 20(2)

particularly with respect to student incivility. Another 5.8% of the articles dealt with bullying, mobbing,
respect/disrespect, and uncivil or abusive communicationanother area of subsequent growth in the literature. Only 4.7% of the articles addressed the academic freedom of faculty. Another 4.7% of the articles
focused on the changing educational environment including global collaboration, distance education, software piracy, cultural barriers to progress, technological innovation, and the nursing shortage; this too is an
area of growth in the most recent literature. Only 1%2.1% of the remaining articles dealt with the remaining categories. These categories included the profession and society, including cross-cultural education, political involvement of nursing, and the knowledge economy. Issues in evaluation, including
topics of incompetent students, performance criteria for faculty, grading students, merit pay for faculty, and
post-tenure evaluationa small category indeed, and covering both student and faculty evaluation
received minor attention. Additional categories included faculty conflicts-of-interest and facultystudent
interaction. A scant 1% of the remaining articles addressed issues of faculty misconduct generally, sexual
misconduct specifically (i.e. student sexual involvement with patients), and developing a code of ethics for
nursing educators.
Many of the ethical issues that arise in nursing education are not addressed in the nursing literature,
though those same issues may be addressed in reference to nursing practice. For example, there are many
hundreds of articles devoted to the topic of the impaired nurse, that is, the nurse who is practicing clinically under the influence of drugs or alcohol. These articles also touch upon diversion programs for the
impaired nurse, so that the nurse might be rehabilitated to return to practice rather than being prosecuted
within the criminal justice system. The impaired nurse educator is never mentioned nor is the impaired student addressed.
In addition, some ethical issues that are amply addressed in the general higher education literature are not
touched upon in the nursing education literature. For example, considerable attention is given to the topic of
faculty sexual misconduct in the higher education literature (i.e. facultystudent sexual involvement). This
topic is not addressed in the nursing literature though there are a small number of articles that enjoin faculty
to be aware of the potential for student sexual involvement with patients.
It is of interest that the same relative weight of attention vis-a`-vis specific issues has persisted across the
two literature reviews. There has been a persistence of concern, still disproportionate, for issues of designating authorship, particularly for research-based journal articles. Student cheating also remains in the foreground. It is of some concern that a major continuing focus of the literature on ethics in nursing education
remains heavily weighted toward authorship concerns, and student cheating; not only are there ethical
issues that deserve greater attention than they have received, but there are also significant issues that are
not addressed at all.
The follow-up review of the approximately 1800 articles keyed as ethics and nursing education showed,
as noted above, that there has been some growth and some shift in the nursing literature in English. Those
articles still remain focused on what to teach in the nursing ethics curriculum. However, with regard to ethical issues actually occurring within the context of nursing education, the areas where the nursing literature
has grown have been in relation to (a) student incivility, including disengaged, disinterested, disrespectful,
disruptive, defiant, and disturbed behaviors;9 (b) concerns with regard to cheating, plagiarism, fabrication
of data, and facilitating cheating have received greater attention particularly in the form of technocheating or cyber cheating; (c) the implications of global migration or immigration of students and
poaching faculty from other nations; (d) racism, bigotry, prejudice, intolerance, and injustice in academics;
and (e) mobbing, bullying, and violence in the academic setting. Clearly, globalization has had an impact on
the nursing academic arena particularly in the domain of intercultural sensitivity and hospitality.
There are domains of ethical concern that continue to be taboo in the nursing ethics literature. One example is that of the impaired nurse educator, whether by virtue of substance abuse, mental illness, or perhaps
more frequently because of decline with aging. We can be reluctant to retire older faculty, particularly
128

Fowler and Davis

129

beloved older faculty, in the same ways that we are often reluctant to constrain the freedom of a declining
parent. A second example of a taboo is that of sexual relationships/misconduct between faculty, junior
faculty, and students. More specifically, there is nothing in the nursing ethics literature that addresses multigenerational lesbian sexual misconduct within schools of nursing. This issue is not addressed in the nursing
literature nor is it addressed in the higher education literature. A third example is the failure of the literature
to address the academically successful student who has no fit with the profession. Such issues arise when
economic recession and job loss cause persons in unrelated fields, so-called second-career students, to enter
nursing to secure employment. Some of these students fail ever to identify with nursing values and in some
cases, actively dislike the profession yet succeed in the classroom. The presence of a nursing shortage compounds such cases. These three issues may themselves be taboo, but perhaps they hint at a broader concernthat the entire domain of ethics in nursing education is, itself, taboo. Pursuing this line of inquiry
is certainly a painful self-reflection, disclosure, and exposure; it is, however, a necessary part of moral
self-regulation.
The concern herein is not to evaluate the literature in terms of the issues it raises or does not raise, or even
to evaluate the quality of the extant literature or specific studies. Rather, the concern here is to survey the
landscape of ethical issues that occur in nursing education to two ends. First, we hope to prompt a systematic
and thorough study of such issues that will expand the moral reflection and discourse upon such issues. Second, it is hoped that comprehensive study of these issues could ultimately eventuate in formalized moral
standards for nursing education and for the development and adoption of broad policies and procedures for
dealing with specific issues. The first step in this endeavor is to lay the groundwork for research by identifying the nature, extent, and prevalence of issues and to typologize provisionally the ethical issues that occur
within the context of nursing education.
The weakness of the nursing ethics literature in this domain requires that we provisionally amplify the
literature with our own knowledge and experience. In doing so, we go beyond the literature to include issues
with which we are familiar, either directly or indirectly. Here, we draw upon a combined 80 plus years as
nursing educators. Many of these issues have been brought to us for consultation, others we have observed,
and yet others have been brought to our attention by faculty colleagues both within and outside the United
States. All of the issues named below do fall within our experience, even if infrequently. We have chosen
specifically to exclude issues of which we have only hearsay documentation as well as those that we deem
one-off occurrences tied to a specific person or context. This list does not include system-based ethical
issues (such as unjust salaries/wages for faculty, the glass-ceiling for nursing faculty advancement in
universities, prejudicial barriers to nursing education, nontraditional clinical settings/web-based nursing
education, cyber-space research, etc.). These issues remain to be explored separately and are not
addressed here.

A proposed typology
Our current typology includes six categories:







Faculty
Students
Facultystudent roles and interaction
Academic and scientific integrity
Nursing educational administration
Profession, society, and global relations.

In each category, the issues are listed in subcategories. An attempt has been made to be as inclusive as
possible, recognizing that this is a preliminary typology.
129

130

The categories and issues

I. Faculty
A. Faculty formation, values, and moral conflict
1. Academic socialization and mentorship
2. Values/moral conflict
3. Integrity, moral sensitivity, and awareness
B. Qualifications and evaluation
1. Teaching and subject matter competence and currency
2. Experience and credentials
3. The cognitively declining or impaired faculty person
4. Peer review
5. Faculty evaluation by students
6. Fair warning, due process
7. Educational malpractice
C. Relationships
1. Respect and civility
2. Intrafaculty abuse and exploitation
3. Intercultural understanding, awareness, and sensitivity
4. Mobbing, bullying, and abuse
5. Facultyfaculty sexual misconduct
D. Faculty freedom and its limits
1. Academic freedom
2. Outside employment
3. Financial fraud/misappropriation in budgets or in grant administration
4. Conflicts of interest
5. Competing loyalties: profession, school, student, patient, and self
6. Creedal/religious institutions
7. Curricular bias
E. Authorship and publication
1. Ownership of intellectual work
2. Dissertations and theses
3. Faculty research/student assistants
4. Multiple authorship
F. Faculty evaluation of students
1. Evenhandedness
2. Grade inflation
3. Student advising
4. Privacy and confidentiality
5. Fair warning and due process
6. Tuition-driven or shortage-driven student retention
7. Gifts and bribes
II. Students
A. Respect for persons
1. Respect and civility
2. Student incivility and classroom disruption
3. Bullying, mobbing, and cyber-bullying among students
130

Nursing Ethics 20(2)

Fowler and Davis

131

4. Student violence
5. Racism, bigotry, and intolerance among students
6. Privacy and confidentiality: background checks on studentsdata pooling, data surveillance,
and drug testing
7. Exchange student experiences: international experiences
B. Clinical education in the practice setting
1. Moral objection to participation
2. Clinical risk
3. Bullying of students in clinical facilities
4. Racism, bigotry, and intolerance in clinical facilities
5. Use of students for service
C. Student evaluation
1. Fair warning and due process
2. Grievances
3. Good grades and nursing misfit
4. Cheating, plagiarism, facilitation of dishonesty, and academic dishonesty
5. Unsafe students
6. Student academic freedom
III. Facultystudent roles and interaction
A. Role boundaries
1. Friendship versus mentorship
2. Student advising
3. Therapy or education
B. Faculty power and authority
1. Students as status individuals (vulnerable)
2. Undue influence and coercion
3. Student labor: using students for faculty ends
4. Faculty research on nursing students
5. Sexual misconduct
C. Respect for persons
1. Respect and civility
2. Racism, bigotry, and intolerance
IV. Academic and Scientific Integrity
A. Dishonesty
1. Faculty plagiarism
2. Falsification or fabrication of research findings
3. Research fraud
4. Grant misconduct
5. Academic records: falsification of/tampering with
6. Reports: fraud and misrepresentation
B. Integrity
1. Openness, self-policing, and peer review
2. Whistle-blowing
V. Nursing Educational Administration
A. Governance
1. Shared faculty governance
2. Evenhandedness and cronyism
131

132

Nursing Ethics 20(2)

3. Oligarchic despotism
4. Intrafaculty ethos and relationships
B. Faculty recruitment
1. Process and participation
2. Stealing faculty
3. Employing registered students as faculty
4. Employing ones own graduates as faculty
C. Administrator relationships
1. Respect and civility
2. Bullying, coercion, and mobbing
D. Administrative role
1. Interference with teaching or grading
2. Violations of procedure, process, policy, and bylaws
3. Violations of academic standards
4. Misrepresentation, fraud, and illegal acts
E. Use of resources
1. Misappropriation or misuse of funds and resources
2. Conflicts of interest
VI. Profession, Society, and Global Relations (related to nursing education)
A. Educational standards and accreditation
B. Professional standards and ethics
C. Educating for reality and educating for the ideal
D. Socialization versus indoctrination
E. Prejudice, discrimination, and injustice in academic nursing
1. Community outreach and programs
2. Admissions policies
3. Scholarships and financial aid
F. Cultural conformity versus social activism
G. The changing educational environment
H. Transnational nursing education, educational imperialism, and neocolonialism
I. Stealing faculty internationally
The sixth category differs in that it represents social ethical concerns that arise within nursing education
within particular schools but function at a macrolevel. Failure of schools to oversee adherence to national
standards for education and practice, reinforcing empire in distance or global education, schools engaging in robbing the poor to staff the schools in rich countries with faculty (as when wealthy nations
refuse to develop national workforce sustainability), and prioritizing business values over nursing values are
local issues with profound effect upon the global nursing community.
Of approximately 100 person-based ethical issues in nursing education, 70% are not moral dilemmas at
all, that is, there is no conflict of norms or values. They represent, instead, moral failure. In these instances,
there is no question as to what is right or good; rather, these issues reflect a failure to adhere to what is commonly understood and affirmed as right or good. These ethical issues thus represent a failure of moral character, that is, a failure of virtue. Early US nursing ethics (from the 1870s through the 1950s) emphasized
virtue over duty, particularly in the moral formation of nurses.10 The shift from a virtue ethics toward a
duty-based ethics within American culture, nursing, and education is well documented.11,12 In addition, the
educational environment in the United States is changing as institutions increasingly seek funding from corporate foundation sources resulting in the importation of business priorities and values into nursing and
132

Fowler and Davis

133

university education.13,14 These values can be inimical to nursing values. These two factors combine to
mitigate against nursings traditional concern for virtue and nursing values and can set the stage for a continuation of or rise in the neglect or failure of virtue in nursing educational settings.

Conclusion and implications

Our reflection upon the ethical issues that arise within nursing education and our concern for the patchiness
of the nursing literature on these issues gives rise to specific implications. First, what is advanced herein is a
prolegomenon to a typology and list of ethical issues in nursing education; a more refined typology and list
needs to be formulated collaboratively, nationally and internationally. The typology that we propose needs
expansion to include the range of system-based issues. In addition, because key words and classification
within the databases are inconsistent, a consistent nomenclature needs to be developed. Second, there is
an acute need for research and scholarship on ethical issues occurring in nursing education, including both
person- and system-based issues, particularly (but not only) in order to adequately prepare those newly
entering the academy as faculty. There is an equally acute need for a systematic and comprehensive analysis
of ethical issues in nursing education and a dissemination of such analysis to the broader nursing audience.
Third, specific ethical issues, including those that are taboo, need to receive attention in research and
scholarship. Fourth, the conflict between the meaning and value structures of the nursing profession, and
the ambient social values and political exigencies needs closer scrutiny and assessment. Fifth, the failure
of virtue (evidenced by the ethical dilemmas in nursing education that can be identified) is of grave concern
and requires more concerted moral attention. Following on that, and sixth, the influence of the moral milieu
of nursing education vis-a`-vis the flourishing of virtues and excellences among students and faculty is in
urgent need of examination. Finally, a significant number of these issues are the common experience of
many nursing schools both within and outside the United States. This sort of study needs to be extended
collaboratively beyond the Anglophone nations and specifically beyond the United States. We can begin
to address some of these issues more effectively if faculty were to communicate and collaborate internationally to develop research-informed moral policies and standards for the academy that can be shared between
and among schools of nursing internationally. Shared issues can be amenable to shared solutions.
Funding
This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors.
Conflict of Interest
The authors declare that there is no conflict of interest.
References
1. HCC. (Otherwise unidentified superintendent of a Brooklyn school of nursing): the ethics of nursing. Trained
Nurse 1889; 2(5): 179183. (The remaining articles of the series are found in 3(1): 15, 3(2): 4043, 3(3):
8185, 3(4): 121124, 3(5): 161164, 3(6): 199201).
2. Robb IAH. Nursing ethics: for hospital and private use. New York: E.C. Koeckert, 1900.
3. Yildirim D, Yildirim A and Timuchin A. Mobbing behaviors encountered by nurse teaching staff. Nurs Ethics
2007; 14(4): 447463.
4. Freda MC and Kearney MH. Ethical issues faced by nursing editors. West J Nurs Res 2005; 27(4): 487499.
5. Broome M, Dougherty MC, Freda MC, et al. Ethical concerns of nursing reviewers: an international survey. Nurs
Ethics 2010; 17(6): 741748.
6. Wiwanitkit V. Ethical concerns of reviewers: more issues. Nurs Ethics 2011; 18(6): 862.
133

134

Nursing Ethics 20(2)

7. Milton CL. The ethics of nurse migration: an evolution of community change. Nurs Sci Q 2007; 20(4): 319322.
8. Fowler M and Davis A. Ethical issues in nursing education. In: International nursing research conference,
Jerusalem, Israel, June 30July 3 2008.
9. Gonzales V and Lopez E. The age of incivility. AAHE Bull 2001; 53: 36.
10. Fowler M. Ethics in nursing, 1893-1984: the ideal of service, the reality of history. Los Angeles, CA: University of
Southern California, 1984.
11. Fowler M. Nursings ethical tradition: the 1890s to the rise of bioethics. In: Davis A, Fowler M, Aroskar M (eds)
Ethical dilemmas and nursing practice. 5th ed. Upper Saddle River, NJ: Prentice Hall, 2009, pp. 3042.
12. Fowler M and Tschudin V. Ethics in nursing: an historical perspective. In: Davis A, De Raeve L, Tschudin V (eds)
Essentials of teaching and learning in nursing ethics: perspectives and methods. London: Elsevier, 2006, pp.
1326.
13. Sturgeon D. Higher education reform: conflict of interest or enhanced experience? Br J Nurs 2012; 21(1): 4448.
14. Rolfe G. Fast food for thought: how to survive and thrive in the corporate university. Nurse Educ Today 2012;
32(7): 732736.

Further reading
Faculty
Authorship and publication
Albarran JW. How to get published: seven easy steps. Nurs Crit Care 2005; 10(2): 7277.
Banoub-Baddour S. Student-faculty joint-authorship: mentorship in publication. Can J Nurs Res 1991; 23(1): 513.
Blancett SS. The ethics of writing and publishing. J Nurs Adm 1991; 21(5): 3136.
Broome ME. From the editor. Self-plagiarism: oxymoron, fair use, or scientific misconduct? Nurs Outlook 2004; 52(6):
273274.
Butler L. Canadian nurses views on assignment of publication credit for scholarly and scientific work. Can J Nurs Res
1998; 30(1): 171183.
Erlen JA. Multiple authorship: issues and recommendations. J Prof Nurs 1997; 13(4): 262270.
Freshwater D. Editors and publishing: integrity, trust and faith. J Psychiatr Ment Health Nurs 2006; 13(1): 12.
Ginn D. Moving toward policy development on assigning publication credit for oncology nurses contributions to scholarly and scientific work. Can Oncol Nurs J 1998; 8(2): 108113.
Hanson SMH. Collaborative research and authorship credit: beginning guidelines. Nurs Res 1988; 37(1): 4952.
Kennedy MS, Roush K and Barnsteiner J. Ethics of authorship. Am J Nurs 2012; 112(9): 7.
Mcneal GJ. African American nurse faculty satisfaction and scholarly productivity at predominantly white and historically black colleges and universities. ABNF J 2003; 14(1): 412.
Nehring W. Multiple authorship and professional advancement. Dimens Crit Care Nurs 1986; 5(1): 5862.
Nehring WM. Multiple authorship in nursing. Nurse Educ 1986; 11(1): 1518.
Oddi LF. Student-faculty joint authorship: ethical and legal concerns. J Prof Nurs 2000; 16(4): 219227.
Parse RR. Making more out of less . . . Publishing the same manuscript in more than one journal. Nurs Sci Q
1989; 2(4): 155.
White AH. From authorship to contributorship: promoting integrity in research publication. Nurse Educ 1998; 23(6):
2632.
Whitley GG. Graduate student-faculty collaboration in research and publication. West J Nurs Res 1998; 20(5): 572583.
Winslow EH. Guest editorial. Failure to publish research: a form of scientific misconduct? Heart Lung 1996; 25(3):
169171.
134

Fowler and Davis

135

Faculty formation, values, moral conflict, and moral pluralism

Caldwell ES, Lu H and Harding T. Encompassing multiple moral paradigms: a challenge for nursing educators. Nurs
Ethics 2010; 17(2): 189199.
Erlen JA. Conflict of interest: its relationship to integrity in the academic setting. J Prof Nurs 1994; 10(2): 9196.
Lewenson SB. Practice what you teach: a case study of ethical conduct in the academic setting. J Prof Nurs 2005; 21(2):
8996.
Lyndaker CZ. Resolution of ethical value conflicts by nurse educators: a pilot study. Nursing Connections 1992; 5(2):
4348.
Milton CL. Ethical issues. Symbols and ethics: integrity and the discipline of nursing. Nurs Sci Q 2005; 18(3): 211214.
Savage JS. Nursing students perceptions of ethical behavior in undergraduate nursing faculty. Nurse Educ Pract 2006;
6(1): 4754.
Silva MC. Unethical student and faculty behaviors. In: Moody L (ed.) Research on ethics in nursing education: an integrative review and critique. National League for Nursing Council for the Society for Research in Nursing Education,
New York, NY, 1991, pp. 5563.
Szirony TA. Perceptions of nursing faculty regarding ethical issues in nursing research. J Nurs Educ 2004; 43(6):
270279.

Faculty misconduct and sexual misconduct

Dinc L. Ethics education and academic misconduct. Nurs Ethics 2008; 15(1): 35.
Morin KH. Faculty Q&A. J Nurs Educ 2007; 46(5): 201202.
Sheets VR. Raising awareness regarding the phenomenon of professional sexual misconduct. Part two: implications of
professional sexual misconduct for nursing faculty. Deans Notes 1996; 18(2): 13.
Sheets VR. Raising awareness of professional boundaries and sexual misconduct. Nursing faculty are encouraged to
take a proactive role. Issues 1996; 17(2): 1113.

Conflicts of interest
Anselmi KK, Dreher HM, Glasgow MES, et al. Faculty colleagues in your classroom as doctoral students. Nurse Educ
2010; 35(5): 213219.
Duronio CD. Dealing with conflicts of interest. Clin J Oncol Nurs 2004; 8(2): 115116.
Erlen JA. Conflict of interest: its relationship to integrity in the academic setting. J Prof Nurs 1994; 10(2): 9196.
Ethics update. Professional independence and conflicts of interest. Perspect Infirm 2006; 3(5): 10.

Academic freedom
Bellack JP. Academic freedom, academic duty. J Nurs Educ 2003; 42(12): 527528.
Fahrenwald NL. Academic freedom and academic duty to teach social justice: a perspective and pedagogy for public
health nursing faculty. Public Health Nurs 2007; 24(2): 190197.
Kneipp SM. Academic freedom: protecting liberal science in nursing in the 21st century. Adv Nurs Sci 2007; 30(1): 313.
Sheehe JB. Academic freedom: history, constraints, and recommendations for nursing education. Nurse Educ 1994;
19(6): 1519.
Snelling PC. Academic freedom, analysis, and the Code of Professional Conduct. Nurse Educ Today 2004; 24(8): 615621.
Sweeney SS. Academic freedom: a relevant concept for collegiate nursing education. Nurs Forum 1980; 19(1): 418.

Evaluation
Duke M. Clinical evaluationdifficulties experienced by sessional clinical teachers of nursing: a qualitative study.
J Adv Nurs 1996; 23(2): 408414.
135

136

Nursing Ethics 20(2)

Jenkins HM. Developing performance criteria for merit pay: one schools process. J Prof Nurs 1988; 4(2): 126130.
Mcdaniel C. Anonymous grading: an ethical teaching strategy. Nurse Educ 1994; 19(5): 1112.
Morgan JE. Confidential student information in nursing education. Nurse Educ 2001; 26(6): 289292.
Suess LR. Attitudes of nurse-faculty toward post-tenure performance evaluations. PhD Thesis, Boston College, Boston,
MA, 1989, 224 pp.

Ethics and a code of ethics for nurse educators

Benoliel JQ. Ethics in nursing practice and education. Nurs Outlook 1983; 31(4): 210215.
Rosenkoetter MM. A code of ethics for nurse educators. Nurs Outlook 1983; 31(5): 288.

Students
Academic dishonesty, integrity, and whistle-blowing
Bailey PA. Academic misconduct: responses from deans and nurse educators. J Nurs Educ 2001; 40(3): 124131.
Balik C, Sharon D, Kelishek S, et al. Attitudes towards academic cheating during nursing studies. Med Law 2010; 29(4):
547563.
Bradshaw MJ. Perspectives on academic dishonesty. Nurse Educ 1990; 15(5): 1015.
Bradshaw MJ. Academic dishonesty: addressing the problems of cheating, plagiarism, and professional misconduct. In:
Stevens KR (ed.) Evidence-based teaching: current research in nursing education. Jones and Bartlett Publishers,
Boston, MA, 1999, pp. 105134.
Davis M. The case for a student honor code and beyond. J Prof Nurs 1996; 12(1): 2430.
Denham SA. Stemming the tide of disreputable science: implications for nursing. Nurs Forum 1993; 28(2):
1118.
Drew BL. What if the whistleblower is a student? The advisory role of the instructor. In: White GB (ed.) Ethical dilemmas in contemporary nursing practice. American Nurses Association, Silver Springs, MD, 1992, pp. 117127.
Fosbinder D. Cheating and plagiarism. Nurse Educ 1991; 16(6): 5.
Gaberson KB. Academic dishonesty among nursing students. Nurs Forum 1997; 32(3): 1420.
Ganske KM. Moral distress in academia. Online J Issues Nurs 2010; 15(3): 1.
Harper MG. High tech cheating. Nurse Educ Pract 2006; 6(6): 364371.
Hart L and Morgan L. Academic integrity in an online registered nurse to baccalaureate in nursing program. J Contin
Educ Nurs 2010; 41(11): 498505.
Hawley DJ. Scientific misconduct as a dilemma for nursing. Image J Nurs Sch 1992; 24(1): 5155.
Jeffreys MR. Student academic dishonesty. Annu Rev Nurs Educ 2004; 2: 255281.
Kennedy D. Sherlock Holmes and the case of the plagiarised paper. Nurse Educ Today 2011; 31(5): 525530.
Ketefian S. Promoting scientific integrity in nursing research, part II: strategies. J Prof Nurs 1995; 11(5): 263269.
Kiehl EM. Faculty forum. Using an ethical decision-making model to determine consequences for student plagiarism.
J Nurs Educ 2006; 45(6): 199203.
Langone M. Educational innovation. Promoting integrity among nursing students. J Nurs Educ 2007; 46(1): 4547.
Macrina FL. The case study approach to teaching scientific integrity in nursing and the biomedical sciences. J Prof Nurs
1995; 11(1): 4044.
Osinski K. Faculty forum. Due process rights of nursing students in cases of misconduct. J Nurs Educ 2003; 42(2):
5558.
Roberts EF. Nursing facultys handling of academic dishonesty. Nursing Connections 1999; 12(2): 1322.
Rankin M. Perceptions of scientific misconduct in nursing. Nurs Res 1997; 46(5): 270276.
Roberts EF. Ethical issues. Academic misconduct in schools of nursing. Nursing Connections 1997; 10(3): 2836.
136

Fowler and Davis

137

Schmidt SD. Cheating: an ethical concern for nursing educators. Kans Nurse 2006; 81(1): 12.
Sheer BL. The relationships among socialization, empathy, autonomy and unethical student behaviors in baccalaureate
nursing students. DNS Thesis, Widener University School of Nursing, Chester, PA, 1989, 138 pp.
Solomon MR. Teaching strategies. Academic dishonesty and professional practice: a convocation. Nurse Educ 2000;
25(6): 270271.
Tanner CA. Moral decline or pragmatic decision making? Cheating and plagiarism in perspective. J Nurs Educ 2004;
43(7): 291292.
Tippitt MP, Ard N, Kline JR, et al. Creating environments that foster academic integrity. Nurs Educ Perspect 2009;
30(4): 239244.
Woith W, Jenkins SD and Kerber C. Perceptions of academic integrity among nursing students. Nurs Forum 2012;
47(4): 253259.

Clinical practice: moral/physical risk

Agelii E. Ethical dimensions of supervision: the supervisors experiences. Nurs Ethics 2000; 7(4): 350359.
Granot T. Nurs students right to refuse to treat patients and the relationship between year of study and attitude towards
patient care. Med Law 2002; 21(3): 549566.
Lenis J. Danger at work . . . Students accounts of dangerous or outdated practice pose ethical dilemmas for examiners.
Nurs Stand 1994; 8(35): 39.
Morgan DA. Student nurse perceptions of risk in relation to international placements: a phenomenological research
study. Nurse Educ Today 2012; 32(8): 956960.

Facultystudent relationships
Professional boundaries in nurse education
Alland C. Staying close: creating distance? The ethics of constant observation. Ment Health Pract 2003; 7(3): 1516.
Cleary M, Horsfall J, Jackson D, et al. Ethical conduct in nurse education: creating safe staff-student boundaries. Nurse
Educ Today 2012; 32(3): 320324.
Henshaw CM. Boundary issues between faculty and students in associate degree nursing programs. EdD Thesis, Seattle
University, Washington, DC, 2004, 145 pp.

Facultystudent interaction
De Tornyay R. Ethical teaching behaviors. J Nurs Educ 1988; 27(3): 101.
Ferguson LM, Myrick F and Yonge O. Ethically involving students in faculty research. Nurse Educ Today 2006; 26(8):
705711.
Ivan M and Fowler M. Flies in the ointment: psychosocial nursing educationwhen the student becomes a client and
the educator becomes a therapist. Nurs Outlook 1985; 33(1): 910, 47.
Schaffer MA. An ethical analysis of student-faculty interactions. Nurse Educ 1993; 18(3): 2528.
Theis EC. Nursing students perspectives of unethical teaching behaviors. J Nurs Educ 1988; 27(3): 102106.
Wilson CB. Caring connections: self-disclosure of students stories to teachers in nursing. Int J Hum Caring 2000; 4(2):
1925.

Academic and scientific integrity

Scientific integrity, misconduct, whistle-blowing, and fraud
Becker PT. Scientific integrity and the journal review process. Res Nurs Health 1998; 21(4): 283284.
137

138

Nursing Ethics 20(2)

Broome ME. Scientific misconduct: experiences of research coordinators. In: 16th international nursing research
congress, Waikoloa, Hawaii, 1416 July 2005, p. 6. Indianapolis, IN: Sigma Theta Tau International.
Broome ME. Research corner. Scientific integritythe cornerstone of knowledge. J Neurosci Nurs 2003; 35(1): 5659.
Buchsel PC. Researching and referencing. Clin J Oncol Nurs 2001; 5(3 Suppl): 711.
Carroll-Johnson RM. So far away and yet so close to home . . . Falsified data. Oncol Nurs Forum 2000; 27(5): 747.
Castledine G. Professional misconduct case studies. Case 78: falsifying data. Research nurse who falsified the results of
research. Br J Nurs 2002; 11(17): 1119.
Chop RM. Scientific fraud: definitions, policies, and implications for nursing research. J Prof Nurs 1991; 7(3): 166171.
Cunningham M. Fraud is a serious offence in nursing . . . Research nurse who falsified the results of research (11(17):
1119). Br J Nurs 2002; 11(18): 1178.
Davis T. Research rounds. Responsible conduct in research: recent policy developments in the area of research integrity. Can J Cardiovasc Nurs 1996; 7(2): 2124.
Gift AG. Utilizing research assistants and maintaining research integrity. Res Nurs Health 1991; 14(3): 229233.
Hansen BC. Academic and scientific misconduct: issues for nursing educators. J Prof Nurs 1995; 11(1): 3139.
James N. Commentary on: scientific integrity: a review of the Institute of Medicines (IOM) reports. Nurs Outlook
2003; 51(5): 239241.
Jeffers BR. Research environments that promote integrity (corrected) (published erratum appears in Nurs Res 2005;
54(2): 132). Nurs Res 2005; 54(1): 6370.
Ketefian S. The challenge for nursing research: scientific integrity. Int J Nurs Pract 2001; 7(4): 227278.
Ketefian S. Promoting scientific integrity in nursing research, part II: strategies. J Prof Nurs 1995; 11(5): 263269.
Lenz ER. Promoting scientific integrity in nursing research. Part I: current approaches in doctoral programs. J Prof Nurs
1995; 11(4): 213219.
Morrison RS. Scientific integrity in nursing research. J Neurosci Nurs 1993; 25(5): 321325.
Morrison RS. Disreputable science: definition and detection. J Adv Nurs 1990; 15(8): 911913.
Parse RR. Integrity in the advancement of nursing knowledge. Nurs Sci Q 1999; 12(3): 187.
Pryor ER. Scientific misconduct from the perspective of research coordinators: a national survey. J Med Ethics 2007;
33(6): 365369.
Rankin M. Perceptions of scientific misconduct in nursing. Nurs Res 1997; 46(5): 270276.
Rudy EB. Auditing research studies. Nurs Res 2000; 49(2): 117120.
Timmons S. Research fraud. Br J Perioper Nurs 2002; 12(8): 288291, 293.
Trossman S. Issues update. A chill in the air: the ANA fights to preserve the integrity of scientific research. Am J Nurs
2004; 104(11): 74, 7778.
Wocial LD. The role of mentors in promoting integrity and preventing scientific misconduct in nursing research. J Prof
Nurs 1995; 11(5): 276280.

Prejudice, unjust discrimination, injustice, human rights violations, bigotry, and racism
Amaro DJ. Perceived barriers for ethnically diverse students in nursing programs. J Nurs Educ 2006; 45(7):
247254.
Canales MK. Othering: toward an understanding of difference. Adv Nurs Sci 2000; 22(4): 1631.
Cortis J. Anti-racist innovation and nurse education. Nurse Educ Today 2005; 25(3): 204213.
Davis SP. Continuing education. Experiences of ethnic minority faculty employed in predominantly white schools of
nursing. J Cult Divers 1998; 5(2): 6879.
Doutrich D. Professional values of Hispanic nurses: the experience of nursing education. Hispanic Health Care Int
2005; 3(3): 161170.
Gorton B. Same old prejudices against nurse lecturers . . . The devils in the detail of poor care. Nurs Times 2001;
97(9): 21.
138

Fowler and Davis

139

Hassouneh D. Anti-racist pedagogy: challenges faced by faculty of color in predominantly white schools of nursing.
J Nurs Educ 2006; 45(7): 255262.
Kossman SP. Student and faculty perceptions of nursing education culture and its impact on minority students. PhD
Thesis, Illinois State University, Normal, IL, 2003, 226 pp.
Macrina FL. The case study approach to teaching scientific integrity in nursing and the biomedical sciences. J Prof Nurs
1995; 11(1): 4044.
Markey K. Education and development. Racism in nursing education: a reflective journey. Br J Nurs 2007; 16(7):
390393.
Nairn S. Multicultural or anti-racist teaching in nurse education: a critical appraisal. Nurse Educ Today 2004; 24(3):
188195.
Robinson AM. Black nurses tell you: why so few blacks in nursing. RN 1972; 35: 3541.
Scammell JME and Olumide G. Racism and the mentor-student relationship: nurse education through a white lens.
Nurse Educ Today 2012; 32(5): 545550.
Schroeder C and DiAngelo R. Addressing whiteness in nursing education: the sociopolitical climate project at the
University of Washington School of Nursing. Adv Nurs Sci 2010; 33(3): 244255.
Taxis JC. The underrepresentation of Hispanics/Latinos in nursing education: a deafening silence. Res Theory Nurs
Pract 2002; 16(4): 249262.

Curricular issues
Cartwright T. Moral philosophy and nursing curricula: indoctrination of the new breed. J Nurs Educ 1992; 31(5):
225258.
Eddy DM. Importance of professional nursing values: a national study of baccalaureate programs. J Nurs Educ 1994;
33(6): 257262.
Johnson SA. Generational diversity: teaching and learning approaches. Nurse Educ 2005; 30(5): 212216.
Killeen ML. Nursing fundamentals texts: wheres the ethics? J Nurs Educ 1986; 25(8): 334340.
Labunski AJ. Decision making in nursing education: whose ethics? Chart 2003; 100(4): 10.
Lyndaker CZ. Ethical issues. Identifying ethical values conflict in nursing education. Nursing Connections 1996; 9(1):
2833.
Marshall SJ. In my opinion. Academics that fail the grade: the CREST factors . . . Cost, respect, ethics, support, and
timeliness. Nurse Educ 2002; 27(2): 5355.
Mcgregor AJ. The professional socialization of nursing students: failure as a social construction. EdD Thesis, University
of Toronto, Toronto, ON, Canada, 1996, 423 pp.
Myrick F. Pedagogical integrity in the knowledge economy. Nurs Philos 2004; 5(1): 2329.
Schmitz K. Ethical problems encountered in the teaching of nursing: student and faculty perceptions. J Nurs Educ 1995;
34(1): 4244.
Sheer BL. The relationships among socialization, empathy, autonomy and unethical student behaviors in baccalaureate
nursing students. DNS Thesis, Widener University School of Nursing, Chester, PA, 1989, 138 pp.

Nursing educational administration

Educational administration and administrators
Curran V. Academic administrators attitudes towards interprofessional education in Canadian schools of health
professional education. J Interprof Care 2005; 19(Supplement 1): 7686.
Duke LK. Relationships between nurse education administrators leadership behaviors and empowerment of nursing
faculty and students. EdD Thesis, Brigham Young University, UT, 1988, 120 pp.
139

140

Nursing Ethics 20(2)

Gray MT. Nursing leaders experiences with the ethical dimensions of nursing education. Nurs Ethics 2008; 15(3):
332345.
Hawken PL. Robbing Peter to pay Paulor, stealing faculty hurts us all. J Prof Nurs 1993; 9(3): 127.
Yeaworth RC. Ethics and research priorities in academic administration. J Prof Nurs 1997; 13(2): 6975.

Respect, communication, incivility, bullying, and mobbing

Brown G. Student disruption in a global college classroom: multicultural issues as predisposing factors. ABNF J 2012;
23(3): 6369.
Clark CM. Incivility in nursing education: a descriptive study of definitions and prevalence. J Nurs Educ 2007; 46(1):
714.
Clark CM, Werth L and Ahten S. Cyber-bullying and incivility in the online learning environment, part 1: addressing
faculty and student perceptions. Nurse Educ 2012; 37(4): 150106.
Clark CM, Werth L and Ahten S. Cyber-bullying and incivility in an online learning environment, part 2: promoting
student success in the virtual classroom. Nurse Educ 2012; 37(5): 192197.
Crane-Roberts NJ. The relationship among nurse faculty and nursing education administrators attitudes toward and
knowledge of academic freedom and role strain. DNS Thesis, Widener University School of Nursing, Chester, PA,
1998, 275 pp.
Edwards SL. Exploring bullying: implications for nurse educators. Nurse Educ Pract 2007; 7(1): 2635.
Ferns T and Meerabeau L. Verbal abuse experienced by nursing students. J Adv Nurs 2008; 61(4): 436444.
Fraser K. Helping students deal with harassment. Kai Tiaki Nurs NZ 2002; 8(2): 1415.
Gallo VJ. Incivility in nursing education: a review of the literature. Teach Learn Nurs 2012; 7(2): 6266.
Kolanko KM. Academic dishonesty, bullying, incivility, and violence: difficult challenges facing nurse educators. Nurs
Educ Perspect 2006; 27(1): 3443.
Luparell S. Why and how we should address student incivility in nursing programs. Annu Rev Nurs Educ 2005; 3:
2336.
Luparell S. The effects of student incivility on nursing faculty. J Nurs Educ 2007; 46(1): 1519.
Randle J. Bullying in the nursing profession. J Adv Nurs 2003; 43(4): 395401.
Wehrwein T. Developing an ethical basis for student-teacher interaction. J Prof Nurs 1996; 12(5): 297302.
Yildirim D. Mobbing behaviors encountered by nurse teaching staff. Nurs Ethics 2007; 14(4): 447463.

Profession, society, and global issues in relation to nursing education

Profession and society
Dodgson JE. Teaching cross-culturally: pedagogical and ethical dilemmas. In: 16th international nursing research
congress, Waikoloa, Hawaii, 1416 July 2005. p. 1. Indianapolis, IN: Sigma Theta Tau International.
Kennedy PH. Ethics and the nurses commitment to political involvement: an educators perspective on ethics and
nursing. Semin Perioper Nurs 1996; 5(2): 6871.
Martin P. Profession and society. Professional values held by baccalaureate and associate degree nursing students.
J Nurs Sch 2003; 35(3): 291296.
Myrick F. Pedagogical integrity in the knowledge economy. Nurs Philos 2004; 5(1): 2329.

Changing educational environment

Faller HS. Bridge to the future: nontraditional clinical settings, concepts and issues. J Nurs Educ 1995; 34(8): 344349.
140

Fowler and Davis

141

Gear E. Immoral education? Some of the moral and ethical problems related to implementing learner-centred
approaches to nurse education. Sr Nurs 1990; 10(1): 910.
Hewitt-Taylor J. Self-directed learning: views of teachers and students. J Adv Nurs 2001; 36(4): 496504.
Jacobson GA. Faculty forum. Maintaining professional boundaries: preparing nursing students for the challenge. J Nurs
Educ 2002; 41(6): 279281.
Lindell AR. Piracy: pirate or privateer . . . copying software programs or disks. J Prof Nurs 1987; 3(2): 78, 124.
McElmurry BJ. Minority international research training program: global collaboration in nursing research. J Prof Nurs
2003; 19(1): 2231.
Miers M. Nurse education in higher education: understanding cultural barriers to progress. Nurse Educ Today 2002;
22(3): 212219.
Moody RC. Educational innovations. Appreciative inquiry for leading in complex systems: supporting the transformation of academic nursing culture. J Nurs Educ 2007; 46(7): 319324.
Pearson GA. Business ethics: implications for continuing education/staff development practice. J Contin Educ Nurs
1987; 18(1): 2024.
Sherrod RA. Ethics of web-based learning. Annu Rev Nurs Educ 2003; 1: 309321.
Zungolo EH. Nursing and academic mergers of the health sciences: a critique. Nurs Outlook 2003; 51(2): 5258.

141