Navigating ethical challenges in global health clinical settings: A collaborative approach between nursing students, faculty, and preceptors

Ethical challenges encountered in global health settings during clinical placements shape nursing students' moral development and professional integrity. This study aimed to explore how 4th-year baccalaureate nursing students and recent nursing graduates navigate ethical challenges in resource-limited global health settings, from the perspectives of students, faculty members, and preceptors. This qualitative study utilized Sally Thorne's interpretive description methodology to generate knowledge that could inform teaching practices within a Canadian School of Nursing. Purposive sampling and one-on-one semi-structured interviews were carried out with 17 participants including 4th-year nursing students and recent nursing graduates who completed clinical placements in resource-limited international settings, faculty members who taught them, and clinical preceptors who supervised their clinical rotations. Data analysis followed a constant comparative and iterative approach. The proposed Relational Interplay model illustrates participants' experiences, and emphasizes the interdependent roles of students, preceptors, and faculty in navigating ethical challenges. Four key themes emerged: grappling with cognitive dissonance, engaging in an internal process, undergoing personal transformation, and deepening relational practice. Findings from this study may inform the development of global health nursing practicum curricula and provide valuable insights for faculty, preceptors, and students involved in global health nursing experiences. • Using interpretive description, this study shows the importance of the triad's collaboration in navigating ethical challenges. • In facing ethical challenges, students undergo transformation and a deepening relational practice guided by preceptor and faculty. • The Relational Interplay model may support triad members in global health nursing education in local and international contexts.