Moral competence is the capacity to make decisions and judgments which are moral based on internal principles and to act according to them (1). It is also the ability of using moral principles in action and workplace to cope with problems and use in conflict resolution based on inner moral principles rather than external social expectations (2, 3). It is needed competence for nurses to provide moral care provision (4). Professional identity is defined as “the attitudes, values, knowledge, beliefs and skills shared with others within a professional group” (5). The formation of it is critical to the effective and safe practice of all health professions including nurses. The development of professional identity is a continuous process. The formation of it is critical to the effective and safe practice of all health professions including nurses. The development of professional identity is a continuous process. The process is influenced by factors such as professional socialization and experiences in practice (6). A significant amount of the development of professional identity occurs during college years (7, 8).
It needs ethical nursing practice which is increasingly challenging by technological and technical growth in health systems (9). Therefore, new strategies are needed to support the nurses’ moral care provision (10). 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 (11).It needs ethical nursing practice which is increasingly challenging by technological and technical growth in health systems (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).
Acquisition of moral competences happens in a process called moral development. Moral development is defined as the change in moral behavior over time (12). Development of moral competence in nurses begins from college years. However, recent studies have shown that the degree of moral competence development in all students is not equal and satisfactory (13, 14). Moral behavior is the capacity to distinguish between right and wrong and to act accordingly (15). Nurses needs to reach to high levels of moral competence because most of the procedures and decisions in their daily practice have moral dimensions.
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 (16). 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 (17, 18), low level of competencies among nursing graduates (19) including moral competence (12, 20, 21). 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 (22), 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 (23). 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 (24). 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 (14). 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 (25, 26). 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 (27, 28).
In the literature review we did not find any study that assessed the correlation between the two constructs of moral development and professional identity in nurses or nursing students. Ranjbar, Joolaee (14) discussed that maybe there is a correlation between professional identity formation and development of morality in nursing students. The concluded that in order to higher moral practice in nursing students, nursing instructors should promote the professional identity them. Bliss, Baltzly (29) argued that the nurse’s professional identity associates their practice with the care relationship between them and patients, which morality is one of its most important dimensions (30). Some scholars argued that professional values, including moral values, are essential in the formation of professional identity in nursing students (31, 32). Also, Dehghani, Mosalanejad (33) found that individual character and responsibility are two important factors affecting professional ethics in nursing practice.
While one of the most important aims of all education systems is development of morality of their graduates (34), some of them failed to reach to this aim (35). Failure to develop the morality in nursing students can have bad consequences. There are many factors that influence the moral development of nursing students. Professional identity is a potential one of them that mentioned in the literature. If there is a correlation between these two constructs, managers and educators can enhance the moral competence of students by techniques and strategies that improve professional identity development of students and through that they will enhance the moral competence of nurses.
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 purpose of this study is to investigate the relationship between moral competencies and the formation of professional identity among nursing students.