The Process of Professional Ethics Development in Midwifery Students: A Grounded Theory Study.

Background: Midwives are faced with important ethical issues in their professional lives; therefore, becoming a midwife is not only the acquisition of knowledge and skills but also includes acquiring moral values that cause fundamental changes in their attitudes toward their professional responsibilities. The aim of this study was to explore the process of professional ethics development in midwifery students. Materials and Methods: This grounded theory study was conducted from 2020 to 2022 at Mashhad University of Medical Sciences, Mashhad, Iran. The participants included 17 midwifery students and 14 key informants. They were selected through purposeful and theoretical sampling. Data were collected using semi-structured in-depth interviews, field notes, and theoretical notes until theoretical saturation was achieved. Data collection and data analysis were performed simultaneously. Data were analyzed based on the grounded theory presented by Corbin and Strauss (2014) using MAXQDA Analytics Pro 2020. Results: The core category was "interactive-cognitive learning in a two-way reasoning path" which addressed the participants' main issue of moral numbness. Moral distress, interactive-cognitive learning, moral reasoning, and moral hopelessness were the midwifery students' strategies that led to a spectrum of moral internalization to moral burnout. The improper context of moral development was the context theme of this study. Conclusions: The theory of "interactive-cognitive learning in the two-way path of reasoning" creates a deep understanding of the process of formation of professional ethics in midwifery students and it can be used in the effective training of students with the aim of promoting professional ethics in midwifery.