Work

Self-perceived moral competence among healthcare students in Slovakia: a cross-sectional study

Year: 2026

Type: article

Abstract: BACKGROUND: The ability to provide ethical and effective care depends on healthcare professionals possessing certain moral competence level. Moral development captures the progressive enhancement of one’s moral competence, enabling informed and principled decision-making, while ethical development focuses on the acquisition and implementation of ethical knowledge and standards. The Moral Competence Test measure including ethical proficiency, moral reasoning, and the ability to navigate ethical decisions make sound moral judgments, and act in accordance with established ethical principles. The assessment and development of these attributes are imperative for optimizing healthcare outcomes and mitigating ethical conflicts. AIM: This study aimed to examine the relationship between moral competence levels and selected variables - namely gender, field of study, and year of study – among healthcare students in Slovakia. METHODS: A cross-sectional, descriptive, and comparative design was used to investigate moral competence involving healthcare students, Faculty of Medicine in Slovakia. The study adhered to the STROBE checklist, and data were collected using the Moral Competence Test. Descriptive and inductive statistics were conducted using the Mann-Whitney U test and the Kruskal-Wallis test to examine differences between variables. To assess the distribution of the C-score and guide statistical analysis, both the Shapiro-Wilk and Kolmogorov-Smirnov tests for normality were applied. A significance level of p < 0.05 was used for all analyses. IBM SPSS Statistics version 25.0 was used for data processing. RESULTS: The primary outcome of moral competence is the C-score, which was at a medium level (16.72 ± 12.54) for all students enrolled in this study. The analysis revealed no statistically significant differences in moral competence based on study program. Of particular interest, a gradual decline in average C-scores was observed with increasing years of study: first-year students scored 17.71 ± 14.76, second-year students 16.67 ± 11.94, and third-year students 16.42 ± 13.27. A statistically significant difference (p = 0.020*) was identified between medical and healthcare students and those international medical students studying in English, with the latter group exhibiting higher, albeit still moderate, C-scores. CONCLUSIONS: These findings highlight the need for further research to explore the factors underlying higher moral competence scores among international students and the declining scores observed in Slovak students throughout their studies. We recommend revisiting academic curricula for two key reasons: first, to explore why first-year students demonstrate higher moral competence than those in their final year; and second, to promote the overall development of moral competence in future Slovak healthcare professionals.

Source: BMC Medical Education

DOI: 10.1186/s12909-026-08627-8