Moral care provision is an essential part of nursing work (1). It needs ethical nursing practice which is increasingly challenging by technological and technical growth in health sciences (2). Therefore, new strategies are needed to support the nurses’ moral care provision (3). One of the recommended strategies is strengthening professional competencies. The assumption of this strategy is that people who are more professionally competent can do their duties more professionally. Moral competency, the capability to make moral decisions and judgments and to act in accordance with them, is one of the main competencies in nursing (4).
Development of moral competence in nursing begins from college years. However, recent studies have shown that the degree of moral competence development in all students is not equal and satisfactory (5, 6). Acquisition of moral competences happens in a process called moral development. Moral development is defined as the change in moral behavior over time (7). Moral behavior is the capacity to distinguish between right and wrong and to act accordingly (8). While the nursing shortage became a global problem, many nursing students, who should replace with retired nurses, do not have the required moral competence to deal with workplace issues at graduation (9). It is the responsibility of nursing education institutes to develop professional competencies, especially moral competence in their students.
Nursing education faces several challenges such as the high rate of retirement of registered nurses and nursing educators (10, 11), low level of competencies among nursing graduates (12) including moral competence (7, 13, 14). Considering the commission and the Global Health Workforce Alliance report which indicates that professional education has not kept up the speed of health care challenges (15), these challenges will be worsened in the future decade. It is also because the demands for nurses will increase globally with the aging societies and new ethical dilemmas will raise by technological innovations (16). Due to these challenges, the training of nurses who can provide moral care is increasingly challenging.
Moral competence is an abstract concept, and it consists of cognitive, affective and behavioral components (17). While nursing programs have ethical courses, evaluation of their outcomes may not be easy. At the beginning of their career, measuring nurses’ moral competences is not easy, as well. How can nurses' professional competencies be more effectively developed? and how can their professional competences be predicted at the start of their career? The results of a recent study showed that there is probably a relationship between moral development and the formation of professional identity in nursing students (6). The findings indicate that the development of morality may be connected to the formation of professional identity. Professional identity is defined as a self-perception about the profession based on attitudes, beliefs, feelings, values, motivations, and experiences (18, 19). The formation of professional identity, is an essential factor in increasing self-confidence, feeling of belonging to the profession and establishing interpersonal communication among nurses (20, 21).
Since the measurement of professional identity is more accessible than moral development, it can be used in prediction of the moral development of nurses. Also, if there is a relationship between these two variables, then nursing programs can benefit from helping the formation of professional identity in the development of moral competencies. Based on this hypothesis, the aim of this study was to assess the relationship between the formation of professional identity and development of morality in nursing students.