The purpose of the assignment:
To demonstrate critical understanding of the implementation and appraisal of a decision-making process using legal and ethical frameworks with application to current and future practice as a nurse.
Summative Assessment
The summative assessment will be a 2000-word problem-based essay.
Students will be presented with a selection of ethical scenarios after completion of the formative quiz. Students will need to select one of the ethical scenarios to write for the summative assessment.
There is no template for the summative assessment, however, the essay should consist of the following sections (with suggested word count):
- Introduction: Provide an introduction to the scenario and make links to the importance of law and ethics in nursing practice. Outline the ethical dilemma and conflicting ethical principles or professional and legal aspects (300 words)
- Main Body – evaluation and analysis of the situation: you should then discuss this scenario from an ethical standpoint taking into account relevant legal and/or professional issues as appropriate that must include relevant references from the academic literature to support your writing. Please use an ethical framework, such as the four bioethical principles, to structure your discussion. You may also wish to consider philosophical theories of deontology, utilitarianism and values-based care as appropriate (1200 words)
- Conclusion: Summarise the key legal and ethical points from the essay (200 words)
- Action Plan: Reflect on how this learning will inform your future practice (300 words)
- References: following APA 7th guidelines
Students will be marked on their ability to fulfil the module learning outcomes (see rubrics on following page). Key to fulfilling the learning outcomes will be criticality which will have been discussed with students in lectures and tutorials. Being ‘critical’ means being able to synthesise sometimes conflicting evidence in a systematic and balanced manner. The aim of this synthesis is to recommend a particular course of action as a logical consequence of your analysis. It is likely there will be no right or wrong solutions to some or even most of the scenarios we will discuss, just a better or worse argument for or against particular actions.
However, there is a lot of evidence to support decision making and it would be very rare to be faced with an entirely unique situation, so the student needs to be able to demonstrate that they know where the ‘jumping off’ point is. In most cases this will involve following local policy and legal and/or professional guidelines, so the student will need to be able to cite these in the assessment.
Please note: in accordance with the SNB code, any cases discussing patients must be anonymised, and have no identifiable information (including name, age and clinical area the patient attended).
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Scenario 1 – Ms Wong
Ms Wong is a 40-year-old lady who was admitted to a psychiatric unit due to a new onset of psychosis. She was brought in by her brother to a psychiatric emergency department due to shouting and screaming at home, paranoia against neighbours, and not sleeping for about 4 days. Upon admission to the unit, she was not engaging, irrelevant in speech, not forthcoming when questions asked, actively responding to the auditory and visual hallucinations, gesticulating in the air, talking to herself, and mumbling to herself. She strictly refuses to take her medications which are metformin 850mg for her type 2 diabetes, risperidone 2mg, and haloperidol 1.5mg as anti-psychotic drugs. Her condition was deteriorating as she had been refusing to take her medication. Some nurses from the unit decided to serve her covert medication, however, this approach was met with differing views from the nursing team.
Guidance on the assessment
Choose ONE of the scenarios listed in this workbook to write for your summative assessment. Some points you may want to consider with regards to the scenarios might be:
- Why is the scenario an ethical dilemma?
- What are the ethical principles in conflict here?
- Are there any nursing values at stake here?
- Are there any cultural or societal norms to be considered?
- What frameworks could be used to decide on the course of action?
- How would ethical theories view this scenario? Would any ethical theories be useful in deciding what to do next?
- How could the bioethics principles be applied to the scenario in deciding the next course of action?
- Are there legal aspects that need to be considered in this scenario?
- What are the professional implications of this scenario?
- What do you think are the key pointsyou will take away from this discussion for future practice?
Marking rubrics
| Introduction | <34% | Fail (35-39%) | Pass (40-49%) | 50-64% | 65-74% Merit | 75%+ |
| Key Areas:
Examining the importance of law and ethics in nursing practice.
Highlighting the ethical dilemma and conflicting ethical principles or professional and legal aspects |
Poor or inaccurate information related to law and ethics in nursing.
Does not highlight the ethical dilemma. |
Missing some key information related to law and ethics in nursing.
Minimal highlight of the ethical dilemma with some attempt at outlining conflicting principles or professional/legal aspects. |
An adequate amount of information related to law and ethics in nursing.
Adequate highlight of the ethical dilemma with some attempt at outlining conflicting principles or professional/legal aspects. |
Good attempt to discuss law and ethics in nursing.
Good highlight of the ethical dilemma with good attempts at outlining conflicting principles or professional/legal aspects.
|
Very good discussion about the importance to law and ethics in nursing.
Very good highlight of the ethical dilemma with very good outlining of conflicting principles or professional/legal aspects.
|
Comprehensive understanding and excellent discussion importance of law and ethics in nursing.
Excellent highlight of the ethical dilemma with comprehensive outlining of conflicting principles or professional/legal aspects.
|
| Main body | <34% | Fail (35-39%) | Pass (40-49%) | 50-64% | 65-74% Merit | 75%+ |
| Key Areas:
Discussion, analyses and evaluation of the evidence base that informs the discussion related to the scenario from an ethical standpoint taking into account relevant legal and/or professional issues as appropriate and supported by academic literature. |
No mention of several key bio-ethical principles, ethical theories and/or legal issues aligned to scenario.
Lack of evaluation, analysis and/or reference to support discussion
|
Partially covered main body. Some key areas not addressed related to the 4 bio-ethical principles, ethical theories and/or legal issues aligned to scenario.
Little evidence of evaluation, analysis and/or reference to support discussion.
|
Fair description for some content of the main body; some key areas not addressed related to the 4 bio-ethical principles, ethical theories and/or legal issues aligned to scenario.
Fair evidence of evaluation, analysis and/or reference to support discussion.
|
Broad and integrated knowledge and understanding of key areas in the main body relevant to all key areas.
Satisfactory evidence of evaluation, analysis and/or reference to support discussion. |
Very good discussion of all key areas of the main body in depth.
Demonstrates substantial knowledge and understanding about the 4 bio-ethical principles, ethical theories and/or legal issues aligned to scenario discussed
Good evidence of evaluation, analysis and/or reference to support discussion.
|
Excellent discussion of all key areas of the main body in depth.
Demonstrates excellent knowledge and understanding about the 4 bio-ethical principles, ethical theories and/or legal issues aligned to scenario discussed
Excellent evidence of evaluation, analysis and/or reference to support discussion.
|
| Conclusion | <34% | Fail (35-39%) | Pass (40-49%) | 50-64% | 65-74% Merit | 75%+ |
| Key areas:
A summary of key points raised in the main body
|
No mention of several areas of content. | Partially covered content in conclusion
Many key areas not addressed. |
Descriptive conclusion.
|
A satisfactory conclusion
|
Discussed all areas covered in the main body.
|
Evaluates all key areas relevant to the main body. |
| Action Plan | <34% | Fail (35-39%) | Pass (40-49%) | 50-64% | 65-74% Merit | 75%+ |
| Key areas:
States how they would manage situation if it arose again. This should be linked to the scenario and outlines actionable steps in taking forward new learning. |
Action Plan absent or irrelevant.
Implications for future nursing practice absent or irrelevant.
|
Partially covered content in action plan. Many key areas not addressed.
Implications for future nursing practice not fully addressed |
Adequate attempt to develop an action plan.
Adequate attempt to state possible implications for future nursing practice |
Relevant action plan that informs practice and satisfactory implications
for future nursing practice. |
Well considered action plan that informs practice.
Well considered implications for future nursing practice. |
Demonstrates extensive integrated knowledge and understanding of the main areas and boundaries to implementation of the action plan and recommendations relevant to practice. |
| Referencing & Presentation | <34% | Fail (35-39%) | Pass (40-49%) | 50-64% | 65-74% Merit | 75%+ |
| Key Areas;
Assignment presented in accordance with University Guidelines.
Reference to appropriate literature to support assignment.
Logical sequencing of assignment.
Accurate Grammar and Spelling. Accurate referencing (APA7th referencing system).
Adheres to word limit (see penalties grid).
|
Some use of core evidence, which is poorly integrated into the text.
Consistently inaccurate use of APA7th citation method).
Shows some attempt to present information but not in a logical manner. Poor structure of sentences and paragraphs.
Little attempt to follow guidelines for presentation of academic work.
|
Limited to a variety of textbooks and no evidence of wider reading.
References poorly integrated into the text. Some inaccuracies in the use of APA7th citation method.
Shows some attempt to present information in a logical manner. Structure of sentences and paragraphs not consistent. Some attempt to follow guidelines for presentation of academic work. |
Limited to a variety of textbooks with little evidence of wider reading. Adheres to presentation guidance.
Generally, the information is logically presented. Adequately structured sentences and paragraphs.
Attempts to follow guidelines for the presentation of academic work. |
Use of core and a more extensive range of other evidence that is accurately integrated into the text.
Few inaccuracies in the use of APA7th citation method.
Logical presentation of information. Clearly structured sentences and paragraphs. Follows guidelines for presentation of academic work. |
Comprehensive use of core and other evidence that is accurately integrated into the text.
No inaccuracies in the use of APA7th citation method. Logical presentation of information. Well-structured sentences and paragraphs. Follows guidelines for the presentation of academic work. |
Comprehensive use of core and other evidence that is accurately integrated into the text.
No inaccuracies in the use of APA7th citation method.
Logical presentation of information. Well-structured sentences and paragraphs. Follows guidelines for presentation of academic work. |
Over word count |
0-10% | 11-20% | 21-40% | 41-60% | 61-80% | 81-100% | >100% |
| Penalty | No penalty | -10% | -20% | -30% | -40% | -50% | Not marked |
The maximum word count for the summative assessment is 2000 words.
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