Journal of Advanced Nursing, 1997, 25, 1151–1161 Development and testing of the ethical reasoning tool (ERT): an instrument to measure the ethical reasoning of nurses Heather McAlpine RN BSN MSc Lecturer and PhD Candidate, School of Nursing, Edith Cowan University, Perth, Australia Linda Kristjanson RN BN MN PhD Associate Professor, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada and Davina Poroch RN BAppSc MSc Lecturer and PhD Candidate, School of Nursing, Edith Cowan University, Perth, Australia Accepted for publication 28 May 1996 MCALPINE H., KRISTJANSON L. & POROCH D. (1997) Journal of Advanced Nursing 25, 1151–1161 Development and testing of the ethical reasoning tool (ERT): an instrument to measure the ethical reasoning of nurses Ascertaining the thinking of professionals as they are confronted with ethical practice issues is a prerequisite to understanding ethical decision making. Before researchers or educators can examine the eectiveness of various approaches to ethics teaching and learning, there is a need for reliable and valid tools to assess practitioners’ cognition. A potential problem with the few measuring instruments currently available is the fact that they ask subjects to rank order existing lists of issues. This says little about an individuals’ own thinking about ethical issues and may prompt thinking or responses which would not otherwise have occurred. This paper reports the results of a study to test the psychometric properties of a new instrument, the Ethical Reasoning Tool (ERT) that measures ethical reasoning of nurses. The ERT demonstrates a promising way to reveal unprompted ethical thinking about a practice dilemma, thereby clarifying ‘real’ versus ‘assumed’ professional reasoning. The tool allows nurse educators to identify areas of student learning/reasoning deficiency that can be addressed by educational interventions. The ERT also allows nurse educators to evaluate the eectiveness of nursing ethics study units in a trustworthy way. ized the crucial need for practitioners who are able to INTRODUCTION provide ethically sensitive, morally justifiable care. An acknowledged goal of nursing education is to develop such Bioethics, the study of the moral/ethical health care prob- lems created by rapid technological advances, has emphas- practitioners (Bevis 1993, Cohen 1992, Kessenich 1992). There has been consistent recommendation by theorists, educators and researchers that education programmes Correspondence: Heather McAlpine, School of Nursing, Edith Cowan University, Perth, Western Australia 6018, Australia. fostering reflective thinking about ethical issues be part of 1151 © 1997 Blackwell Science Ltd