Nursing Students' Perspectives and Experiences of Digital Ethics During Clinical Education: An International Qualitative Study.

AIM: To explore perceptions and experiences of nursing students in three European countries in relation to (a) digital ethics and (b) its violations in clinical education. BACKGROUND: The increasing use of digital technologies in clinical education presents nursing students with complex digital ethics challenges related to confidentiality, professionalism, and responsible data use. DESIGN: A descriptive qualitative study design with thematic and content analysis in 2025. The Consolidated Criteria for Reporting Qualitative Research guidelines were followed to report the findings. METHODS: The target population was nursing students attending their education in three public universities (Italy, Poland, and Türkiye). Students who were proficient in their native language, had successfully completed at least one ethics course as part of their nursing education, had at least one clinical experience, and were participating in clinical training during data collection were purposefully identified. All approached students (n = 46) participated in the study: 20 in Italy, 11 in Poland, and 15 in Türkiye. FINDINGS: The findings indicate that students have substantial awareness of digital ethics. However, they encounter ethical uncertainties and inconsistencies in practices related to patient consent and procedures for accessing, storing, and sharing patient data. Students reported digital ethics violations at both individual and peer levels, attributing these breaches to educational pressures, insufficient digital ethics training, reliance on personal devices, and the influence of clinical role models. The results underscore the importance of education, institutional regulations, and ethical role modelling in reinforcing digital ethics. CONCLUSIONS: This study identifies a notable discrepancy between nursing students' awareness of digital ethics and their experiences in clinical practice. Bridging this gap will require coordinated efforts at multiple levels, including enhancing individual awareness, educational processes, institutional regulations, and clinical role modelling. IMPLICATIONS FOR NURSING AND NURSING POLICY: Strengthening the implementation of digital ethics requires expanding structured digital ethics training in nursing education, enhancing institutional digital infrastructure, reducing reliance on personal devices, and supporting ethical role modelling in clinical settings.