LEAD 6113 Module 2 Ethical Decision-Making Model Application Example

Eight Logged Hours at a Clinic That Was Closed: Applying Moral Intensity and Rest's Four Components to a Graduating Nursing Student's Clinical Record

Student Name

American College of Education

LEAD6113: Ethical Leadership and Social Justice

Module 2 Assignment

Instructor Name

October 19, 2026

Introduction

In Module 1 I compared four ethical frameworks on a student's appeal for a third attempt. This module asks for a structured decision model applied to a dilemma, and the one I chose arrived on my desk three weeks before graduation. A faculty member reported that a senior in our composite Georgia BSN program had logged eight community health clinical hours at a county clinic on a Saturday when, according to the clinic manager, the clinic was closed. The student is near the top of her class and has a job offer in the hospital's intensive care unit. This paper applies an issue-contingent model of ethical decision-making to the case, step by step, and explains the decision I reached.

The Model

Jones (1991) built on Rest's four components of moral behavior, recognizing a moral issue, making a moral judgment, establishing an intention to act morally and acting on that intention, and argued that the characteristics of the issue itself shape every step. He called those characteristics moral intensity and named six: the magnitude of consequences, social consensus about whether the act is wrong, the probability that harm will occur, temporal immediacy, proximity to those affected and concentration of effect. Issues high in moral intensity are more likely to be recognized as moral issues and to produce ethical intentions and behavior. The model suits this case because the temptation in such cases is to treat it as an administrative paperwork error and so never recognize the moral issue at all.

Step 1: Recognizing the Moral Issue

The first temptation was to see a scheduling mix-up. The student may have entered the wrong date; the clinic may have opened for a special event. Before deciding anything, I asked for facts: the clinic manager confirmed the building was closed that Saturday with no event, the student's preceptor confirmed she had not worked with the student that day and the clinical log showed the entry was made the following Tuesday. The moral issue is therefore real: either the log is false, or there is an explanation we have not heard. Recognizing it as a moral issue, not a clerical one, is the step Jones (1991) placed first, and the moral intensity of the case made recognition hard to avoid once the facts were in.

Step 2: Assessing Moral Intensity

Applying the six dimensions clarifies what is at stake. The magnitude of consequences is high: falsifying clinical documentation in nursing school resembles falsifying patient records in practice, and the student will soon document care for critically ill patients. Social consensus is strong; few nurses would call falsified hours acceptable. The probability of harm from eight missing hours is low, but the probability that the behavior continues is unknown. Temporal immediacy is high because she graduates in three weeks. Proximity is close: I know her, her faculty admire her and her classmates will hear what happens. Concentration of effect falls heavily on one person whose career depends on the decision. High magnitude, strong consensus and immediacy push toward action; closeness and concentration push toward leniency, which is precisely why the decision feels hard.

What the Evidence Says About Clinical Dishonesty

The research gives the case context. In a study of 336 nursing students, Krueger (2014) reported that a majority admitted to some form of cheating, whether in class or on clinical placements, and that classroom and clinical cheating were positively related, with peer behavior and personal beliefs associated with how often students cheated. McCrink (2010), surveying 193 associate degree students in two programs, found misconduct in both classroom and clinical settings and examined the rationalizations students used to justify it. These findings argue against two easy responses: treating the case as unthinkable for a strong student, and treating it as a one-time slip unrelated to future practice.

Step 3: Moral Judgment

Judgment requires the student's account. I met with her, with the program's academic integrity officer present, and asked her to explain the entry. She said she had missed the Saturday because of a family obligation, intended to make the hours up and logged them in advance so she would not lose her place on the clinical roster; she then never made them up. She acknowledged that the entry was false. The judgment that follows is that she falsified a clinical record, without evidence of a pattern, and admitted it when asked. The university's academic integrity policy treats falsification of clinical records as a serious violation with sanctions ranging from course failure to dismissal.

Step 4: Intention and Action

Establishing a moral intention means deciding what the right response is, not only what the policy permits. The options were dismissal, failure of the community health course with the chance to repeat it, or a lesser sanction with completion of the missing hours. Dismissal would protect the program's standards but seemed disproportionate to a single admitted falsification of eight hours with no harm to patients. A lesser sanction would treat the falsification too lightly given its resemblance to falsifying patient records. I recommended failure of the course, which delays graduation by one term and the job start by four months, with the opportunity to repeat it, a written reflection on documentation integrity reviewed by the ethics faculty and a requirement that her future clinical logs be verified by preceptor signature. The program did not contact the hospital that offered her the job; explaining the delayed start to her future employer is her responsibility, and she has said she will tell them the truth.

Weighing the Decision

The decision is defensible on several grounds. It responds to the high magnitude and social consensus of the issue without letting closeness to a strong student soften it, which the moral intensity analysis warned against. It treats the student fairly by matching the sanction to an admitted single act. And it addresses the risk the research suggests, that dishonesty in school is linked to dishonesty in clinical settings, through verification rather than punishment alone. Its cost to the student is real, and I do not pretend otherwise.

What the Case Revealed About the Program

The case also exposed a weakness in how the program runs clinical logs. Students enter hours in an online system that accepts entries without any confirmation from the site, and preceptors sign a summary only at the end of the term, when eight hours among 90 are easy to miss. The roster rule that led this student to log hours in advance, losing her place if she fell behind, created a pressure the program itself designed. None of that excuses the falsification, but an ethical leader asks what conditions made the wrong choice easier. I have asked the clinical coordinator to require weekly preceptor confirmation of logged hours and to replace the roster rule with a simple make-up process.

Conclusion

A structured model helped me see that the hardest part of this case was not judgment but recognition: the pull to call it a paperwork error was strong because the student was admired. Applying moral intensity made the stakes visible and guarded against both leniency born of closeness and severity born of alarm. The decision will be explained to faculty, in general terms and without the student's name, as an example of how the program treats documentation, which is part of what ethical leadership requires.

References

Jones, T. M. (1991). Ethical decision making by individuals in organizations: An issue-contingent model. Academy of Management Review, 16(2), 366-395. https://doi.org/10.2307/258867

Krueger, L. (2014). Academic dishonesty among nursing students. Journal of Nursing Education, 53(2), 77-87. https://doi.org/10.3928/01484834-20140122-06

McCrink, A. (2010). Academic misconduct in nursing students: Behaviors, attitudes, rationalizations, and cultural identity. Journal of Nursing Education, 49(11), 653-659. https://doi.org/10.3928/01484834-20100831-03