Guest Blog: The Ethics Café: An Educational Innovation for Student Engagement in Ethical Content by Dr. Lynn Stover Nichols

I am very excited to present my first guest blog written by a dear colleague. Today's guest blog author is Dr. Lynn Stover Nichols. We met quite a few years ago through, our involvement with, the American Association of Colleges of Nursing (AACN) Faculty Leadership Network (FLN). We bonded early on through our love of ethics and nursing education. 

BIO for Dr. Lynn Stover Nichols PhD, RN, PED-BC, SANE, ANEF

Dr. Lynn Stover Nichols PhD, RN, PED-BC, SANE, ANEF, is an Associate Professor of Nursing at Boise State University in Boise, Idaho. Her nursing education experience spans several decades and includes both undergraduate and graduate programs. She implemented the Ethics Café program for two years at the University of Alabama at Birmingham as an Honors College Faculty Fellow, where she taught a Freshman Honors Seminar, Ethical Issues in Women’s Health.

The Case for Ethics in Nursing Education

The nature of the work of the registered nurse provides limitless opportunities for the application of ethical principles. Ethical behavior has been deemed significant enough to be a vital part of the American Nurses Association’s Scope and Standards of Practice (2021) and Code of Ethics (2025), providing direction to all who practice nursing regarding ethical obligations, personal and professional decision-making, and the application of ethical principles in nursing practice. Because ethical skills cannot be directly seen or observed, this skill set is often considered to be “soft skills” and can be overlooked in nursing curricula in favor of the “hard skills” (i.e. psychomotor) that gain the attention in nursing skills lab settings. Additionally, the American Association of Colleges of Nursing’s Essentials (2021) considers ethics as a “featured concept” and “core component of knowledge, facts and skills across multiple situations and contexts within nursing practice” (p. 12).  The resulting challenge to nurse educators is how to effectively integrate this content into nursing curricula. The purpose of this blog post is to describe a successful program, The Ethics Café, that served to engage interprofessional undergraduate students in ethical content.

The Ethics Café

Overview

The Ethics Café consists of a once a month dinner seminar open to all honors students (interprofessional, including nursing students) at one university. The first 30 minutes of the seminar is for dinner and networking, with the rest of the time (1.5 hours) devoted to exploring an ethical topic, applying principles and small/large group facilitated discussions. The program topics for each semester (see list below) were developed using a student focus team to determine what topics would be of most interest to the students. A stipend from the school was used to pay for a light dinner and supplies.

Format

The agenda for each of the Ethics Café seminars began with attendee introductions and an overview of the Ethics Café, followed by ground rules for discussion. The Ground Rules, similar to the Basic Assumption often used with nursing simulation experiences, addressed the fact that everyone present wanted to learn and interact with others in a respectful manner, and provided an assurance that this event was a safe place to engage in activities and grow together. (Of special note, there was never a reported infraction of these rules.) Before moving into the specific topic, a brief overview was provided of selected ethical principles, including: autonomy, nonmaleficence, beneficence, justice, fidelity, veracity and standard of best interest. These principles were used for reference points during the remainder of the event and helped to contextualize the ethical content.

The facilitator provided a brief 10-15 minute overview of the topic, sharing facts, data and additional information to contextualize the ethical issue. The remainder of the time was devoted towards engaging activities that allowed students to explore the ethical issue with their peers.

Small and large group discussion were often used, but there were also other activities that served to engage students, such as social media bingo (students talked with other attendees to check boxes on a bingo card that addressed common experiences on social media), Kahoot! as a platform to conduct surveys and make thought word clouds, the “Trolley Problem” and the “Heinz Dilemma” (see video links in references, or Google to see many examples), watching the Kennedy-Nixon debate (see video link) and evaluating the performance of each using an evaluation form,  an escape room, learning stress management techniques, and earning Stop The Bleed certificates. The COVID-19 pandemic occurred at the end of one academic year and continued into the next academic year. This caused the Ethics Café programming to pivot to an online format, which was easily done. 

A feature that was embedded in the Ethics Café was the opportunity to earn an Ethics Café Scholar Award. Students were awarded Gold, Silver or Bronze Scholar Certificates based upon their attendance over the academic year, with certificates awarded in April of each year. There were about 50 Scholar awards given out each year.

Student Feedback

Student feedback for the Ethics Café events was overwhelmingly positive, even when the format had to abruptly shift to 100% online. The last Spring 2020 Ethics Café seminars focused on developing resilience skills for students to help them to cope with the unprecedented changes in their environment. This online seminar focused on stress management skills, and included a brief overview of how stress can impact the body, some popular memes that promoted stress management, and a “Stress Reduction Show and Tell”, where students were invited to share an object, photo or quick story about something that made them smile that day. The seminar ended with a facilitated guided imagery exercise, (see script in Resources below or listen to recording below) where they were invited to close their eyes, put their heads down and listen to the story of “A Walk On The Beach”, which allowed them to explore the beach using all of their senses. A recording of this session was available to the attendees. All attendees were appreciative of the timing of this session, and we received feedback about how they used strategies from the seminar during finals week.

Additional student feedback indicated that they liked the “laid back nature” of the events and commented how that made them “feel comfortable” speaking up in the discussions. They appreciated the opportunity to talk about the effects of the pandemic and that there was some acknowledgement of the “burnout” caused by the pandemic. Other student feedback was related to the “unbiased nature of the discussions” that allowed them to consider other viewpoints.

Future Directions

How you would like to engage students in ethical content in your program? The big decision is to determine whether to offer this as part of the nursing curriculum or as an extracurricular activity, as your answer will take you in divergent directions to develop the program. Next, think about the resources of space and time and what is available for an activity like the Ethics Café. You may find that this Ethics Café format doesn’t work for your group, so take it in the direction that works, using bits and pieces from this exemplar, to create your own ethical innovation. Talk with students to determine their interests with regard to topic, format and any incentives that you may wish to embed into your programming. Ask faculty experts to share their expertise and serve as discussion facilitators. Many of these conversations are not easy to have and benefit from an expert to lead them and create the safe space to engage students in the content.

I wish each of you the best as you determine the best place in your nursing curriculum for placement of the ethics concepts. If I can be of any assistance to you or if you have any questions, please reach out to me via my email. I’m always happy to help a colleague to design a unique teaching activity and would love to assist you to develop a successful ethics program that meets your needs.

Best regards,

Lynn Nichols

Lynnmarienichols@boisestate.edu

 

Ethics Café topics:

All Needed To know About Ethics I Learned In Honors College

Ethical Issues in Culture and Diversity

Social Media and Ethical Responsibility

What To Do When Your Ethics/Values Clash With Your Friend’s

Leadership Ethics

Ethics Escape Room

Stress Management Relaxation Techniques

Stop The Bleed Course

The Ethics of The Vote

The Ethical Lens of Politics

Healthcare Ethics and COVID

Ethics of Teamwork

Vaccine Ethics

Human Trafficking

 

References

American Association of Colleges of Nursing (2021). The Essentials: Core competencies for professional nursing education.

American Nurses Association. Code of Ethics for Nurses (2025).

American Nurses Association. Scope and Standards of Practice (2021) (4th ed).

 

Resources

ANA ethics resources https://codeofethics.ana.org/related-resources

A Walk Along The Beach guided imagery script chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://facultyombuds.ncsu.edu/files/2020/04/Guided-Imagery-A-Walk-on-the-Beach.pdf

Beach Guided Imagery example https://www.youtube.com/watch?v=6Kig63LCXTI

Heinz dilemma https://youtu.be/5czp9S4u26M

Nixon-Kennedy debate https://www.youtube.com/watch?v=GMWQnoDA0o8

The Trolley Problem  https://www.youtube.com/watch?v=bOpf6KcWYyw

Many ethical case studies are available online via Google search; additionally, Google can be used to locate various versions of the Trolley Problem, the Heinz Dilemma and examples of guided imagery scripts and recordings.