Date of Award


Degree Name

Doctor of Philosophy (College of Nursing)

Schools and Centres

Nursing and Midwifery

First Supervisor

Associate Professor Bethne Hart

Second Supervisor

Dr Helen McCabe

Third Supervisor

Reverend Anthony Crook


The development of moral competence is central to the profession of nursing and its practice. Nurses engage in moral decision making that impacts the health of people, families, and communities. It is important, then, to ensure that nursing graduates possess the necessary moral development for engaging in professional practice. To this end, research was conducted, the principle premise of which was to explore the use of the introduction of the Giving Voice to Values curriculum (Gentile, 2010) and its contribution to the development of moral competence in nursing. The Giving Voice to Values curriculum is a values-based methodology enabling students to find their voice, speak up, and act on their values effectively. The curriculum develops the students’ confidence in identifying moral issues during their professional education. This research explored the use of the Giving Voice to Values curriculum as a component of an undergraduate nursing program in Australia.

The exploration of the Giving Voice to Values curriculum was undertaken within a wider investigation of moral theory, moral competence, and the profession of nursing. The research undertaken in this study analysed the perceptions and practices underpinning contemporary methodologies of moral competence in nursing, and the professional regulations that uphold and secure this. Using a mixed methods research design, this study draws on a collection of data from two sources: (a) a survey of first year nursing students’ understanding of moral competence at the completion of the GVV Curriculum; and (b) semi-structured interviews of nursing experts and stakeholders’ understandings of both moral development and the morally competent nurse.

Findings from this study demonstrated that the students’ understanding of both the actions and influences of moral competence remained low on completion of the Giving Voice to Values curriculum. Specifically, the study revealed developments in students’ ability to reason or to ‘think ethically’ or to recognise ethical anomalies, as well as an increase in actions taken to ‘give voice’ to their values; however, these findings were not supported by a noticeable development in students’ capacity to identify their ethical position. Nonetheless, the study revealed a development in students’ moral awareness, thereby providing a basis for the development of moral competence.

Nursing experts and stakeholders perceived moral competence in nursing as a circular developmental process that required solid foundations in moral theory and communication skills, as acquired and assessed throughout undergraduate nursing education. These participants proposed that a morally competent nurse must be able to uphold professional values, moral principles, and professional practices. They emphasised that the development of moral competence within nursing must be founded on the codes and regulations that govern and guide the profession. The participants also identified observed gaps between the theory and practice of moral competence, leading to weaknesses within professional practice and health care.

The Giving Voice to Values curriculum is not a moral theory in itself. The introduction of this curriculum within undergraduate nursing education must be based upon the teaching of both moral theory and professional ethics, as foundational for ongoing development of moral competence.

Included in

Nursing Commons