Joanne Connor

Date of Award


Document Type


Degree Name

Doctor of Philosophy (Ph.D.) Nursing




Statement of the Problem The nurse executive must navigate a health care environment with competing priorities and conflicting pressures. The rapid changes and economic demands in healthcare present challenges and ethical dilemmas for the nurse executive. The nurse executive is to be professionally and morally responsible to meet the expectation of the role in accordance with ethical standards of the nursing profession. Professional moral courage is the attribute necessary to influence decisions and actions when advocating for the nurse and the patient, while benefiting the organization. Subsequently, the ability to accurately assess this characteristic is an imperative. The Professional Moral Courage (PMC) scale is a tool designed to measure the construct of moral courage as a managerial competency. The purpose of this study was to validate the PMC scale for use in the nurse executive population. Method This was a non-experimental methodological study. The sample consisted of 478 nurse executives. The participants all: (a) held a title of Chief Nursing Officer (CNO) or Chief Nurse Executive (CNE); (b) were employed in a healthcare organization; and (c) were members of the American Organization of Nurse Executives (AONE). The psychometric validation of the PMC scale included evaluating reliability, convergent validity, hypothesis testing, and factor analysis. The three instruments used in this study were: (1) the Professional Moral Courage (PMC) scale, to assess and quantify the ii construct of moral courage in the nurse executive population; (2) the Values in Action-Inventory of Strengths (VIA-IS) scale, specifically the bravery items, to determine if the character strength of bravery is convergent with professional moral courage; and (3) the Marlowe-Crowne Social Desirability scale, to evaluate the potential influence of social desirability on PMC scale responses. Results The psychometric analyses supported the validity and reliability of the PMC scale in the nurse executive population. Correlational analysis for convergent validity concluded convergence between the PMC and VIA-IS bravery items. The hypothesis that the more years of experience working as a nurse executive, the higher the level of moral courage, was supported. Confirmatory factor analysis findings suggest the internal structure of the PMC scale and measurement of the underlying construct, professional moral courage, is acceptable. The model is an acceptable fit for the data and the PMC scores were not influenced by socially desirable responses. Conclusion The Professional Moral Courage scale was psychometrically validated within the nurse executive population and this study strengthened the construct of professional moral courage as a recognized competency.

Related Pillar(s)


Included in

Nursing Commons