To assess the effect of a teaching strategy on student development, the value analysis model was used to guide undergraduate nursing instruction concerning moral and ethical dilemmas common in contemporary practice. This study hypothesized that such guidance would bring about measurable changes in cognitive and/or moral development over the course of an academic semester. Three research questions were posed: (1) Do students who complete a value analysis of a major ethical problem involving their intended profession demonstrate more advanced moral judgment on other, perhaps unrelated, problems included in standard measurement scales of moral development? (2) Do students who are taught a cognitively-based method of analyzing values issues but with no additional emphasis on enhancement of cognitive skills have measurable changes in cognitive development? (3) In this research setting, is there a correlation between measurements of cognitive and moral development?.

Study and control populations were derived from two groups of junior nursing students sequentially enrolled in a course in psychiatric/mental health nursing at Southeast Missouri State University. Both groups were assessed on a broad range of demographic variables to ensure comparability. Measures of developmental outcome included Rest's Defining Issues Test (DIT), Crisham's Nursing Dilemma Test (NDT), and the Allen Instrument.

The control group was enrolled Spring 1985 and comprised 24 students. The experimental group was enrolled Fall 1985 and comprised 28 students in three discussion sections. The experimental and control groups were comparable on a range of demographic variables as were the three experimental sections. Pre- and post-testing using the stage score on the DIT showed significant differences (p < .05) between experimental and control subjects. There were statistically significant differences among experimental sections on DIT P score gains and NDT gains. Several factors may explain these intersectional differences. There was a strong association (p < .05) between DIT P score gain and self-report of peer discussion of ethical issues. There was a lack of consistent correlation among the various instruments used to measure moral and cognitive development.

This study demonstrated that brief but highly structured exposure to ethical dilemmas of nursing practice can bring about measurable gains on standardized tests of moral development.