Evidence map›Paper›PMID 41128068›Full record

SynthesisJournal of advanced nursing2026

Ethical Challenges and Strategies in Nursing Doctoral Supervision: A Systematic Mixed-Method Review.

Tove Godskesen, Maria Grandahl, Amalie Nilsen Hagen, Stefan Eriksson

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of advanced nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Tove GodskesenFaculty of Nursing and Health Sciences, Nord University, Bodø, Norway.ORCID https://orcid.org/0000-0001-6011-6740
Maria GrandahlDepartment of Women's and Children's Health, Uppsala University, Uppsala, Sweden.ORCID https://orcid.org/0000-0002-4553-6656
Amalie Nilsen HagenFaculty of Nursing and Health Sciences, Nord University, Bodø, Norway.ORCID https://orcid.org/0000-0002-7462-4778
Stefan ErikssonCentre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.ORCID https://orcid.org/0000-0001-7486-4678

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo identify and address ethical challenges in doctoral supervision within nursing and health sciences and propose strategies to overcome them.

designFollowing PRISMA guidelines, this mixed-method systematic review synthesises findings from quantitative, qualitative and mixed-methods studies published in English between 2014 and 2025. Studies were included if they examined ethical challenges in doctoral supervision and strategies to address them within nursing and health sciences. Exclusion criteria encompassed reviews, books, editorials, opinion papers, conference papers, studies unrelated to nursing or health sciences or published before 2014. DATA SOURCES: A systematic search was conducted in CINAHL, Education Source, ERIC, PubMed, Scopus and Web of Science Core Collection, yielding 1100 citations. REVIEW

methodsThe methodological quality of included studies was assessed using the STROBE checklist for quantitative studies and the COREQ framework for qualitative studies. The findings were then synthesised and thematically organised.

resultsEleven studies met the inclusion criteria: four quantitative, four qualitative and three mixed methods. Ethical challenges in doctoral supervision emerged at three levels: individual (e.g., misaligned expectations, inadequate feedback, student adjustment difficulties), institutional (e.g., high student-supervisor ratios, limited support structures), and cultural (e.g., differing norms around autonomy and academic authority). Supervisors also reported role conflicts. Strategies to address these challenges included improved communication, supervision agreements, institutional support and targeted training.

conclusionsEthical challenges in supervision are shaped by individual, institutional and cultural factors. Addressing them requires multi-level strategies, including clear expectations, feedback mechanisms, structured training and culturally sensitive supervision practices. Applying ethical principles fosters a transparent and supportive academic environment that enhances doctoral outcomes. IMPLICATIONS FOR THE INSTITUTIONS: Universities should adopt multi-level strategies, including supervisor training, mentorship structures and culturally informed policies, to strengthen the ethical integrity and effectiveness of doctoral supervision. IMPACT: What problem did the study address?: This study synthesises ethical challenges in doctoral supervision within nursing and health sciences, focusing on communication barriers, institutional constraints and the transition from clinical practice to academia. What were the main Findings?: Misaligned expectations between supervisors and students, inadequate feedback and structural limitations, negatively impact the quality of supervision. Doctoral students struggle to adapt to academic expectations, while supervisors face challenges in balancing multiple roles. Effective communication, institutional support and targeted training programmes are essential for improving supervisory experience. Where and on whom will the research have an impact?: The research will inform universities and institutions offering doctoral education in nursing and health sciences. It will benefit doctoral students, supervisors and academic administrators by providing insights and strategies to enhance supervision quality and promote ethical practices. REPORTING

methodThis systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement.

Indexed as

Education, Nursing, GraduateEthics, NursingFaculty, NursingFemaleHumansMaledoctoral educationethical challengeshealth sciencesnursing sciencesstrategiessystematic review

Identifiers

PMID41128068
PMCPMC13069218

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.