Faculty members in the Doctor of Nursing Practice (DNP) program at the University of Portland noticed a concerning pattern: Graduate students were not able to identify ethical dilemmas. “This was despite the inclusion of an ethics thread in our curriculum,” notes Amber Vermeesch, PhD, MSN, FNP-C, RN, CNE, the study’s lead author and associate professor at University of Portland’s School of Nursing.

The faculty members were former fellows in the university’s Dundon-Berchtold Applied Ethics Faculty Fellowship program. “We had experience in identifying and applying an ethical framework in practice,” says Vermeesch.

Concerned about their students’ apparent inability to identify ethical issues, they decided to explore further.1

“We proposed the inclusion of focused ethics education into all of our clinical courses for the DNP program,” says Patricia H. Cox, DNP, MPH, FNP-BC, director of the DNP program and an assistant professor at University of Portland School of Nursing.

The collaboration of PhD and DNP faculty members changed the way ethics is taught. Ethical dilemma case studies are now integrated into course outcomes for clinical courses.

“Understanding ethical frameworks and the process required for critical decision-making allows for the highest provision of patient care,” the researchers concluded.


1. Vermeesch A, Cox PH, Baca S, et al. Strategies for strengthening ethics education in a DNP program. Nurs Educ Perspect 2018; 39(5):309-311.


• Patricia H. Cox, DNP, MPH, FNP-BC, School of Nursing, University of Portland (OR). Phone: (503) 943-7987. Email: coxp@up.edu.

• Amber Vermeesch, PhD, MSN, FNP-C, RN, CNE, School of Nursing, University of Portland (OR). Phone: (503) 943-7357. Email: vermeesc@up.edu.