The purpose of this study was to clarify educational problems by analyzing the contents of ethical dilemmas experienced by nursing students in gerontological nursing clinical practice. The subjects were 53 third-year nursing students of the nursing department who performed gerontological nursing clinical practice. Situations in which the students experienced dilemmas were classified based on the description contents in a 'Worksheet", and the deepening of their understanding regarding ethical problems was analyzed based on the "Code of Ethics for Nurses". As a result, the students experienced dilemmas "when nursing care was refused", and considered that their role as nurses involving 'being responsible as an individual for nursing care provided". The students became aware of ethical considerations accompanying nursing practice and learned the necessity of evidence for care. It is important for clinical practice instructors to create environments facilitating students' expression of their feelings regarding dilemmas and provide support for their consideration from multiple aspects.

【目的】学生が老年看護学実習で感じた倫理的ジレンマの学習内容を分析することで教育的課題を明らかにすることを目的とした。【研究方法】対象は,老年看護学実習を行った看護学科3年生53名。『ワークシート』の記述内容から,学生が倫理的ジレンマを感じた場面を分類,どのように倫理的課題について学習を深めたのか「看護者の倫理綱領」を基に分析した。
【結果】〈看護ケアを拒否された場面〉において倫理的ジレンマを感じており,看護者に期待される役割として<実施した看護について個人としての責任を持つ>ことを多く挙げていた。学生は,ワークシートを使用し,患者にケアを拒否された体験を再構成することで,すべての看護実践には倫理的配慮が伴うことに気づき,ケア時の根拠の必要性を改めて学んでいた。【結論】教員は,学生が感じているジレンマを表出しやすい環境をつくり,看護状況を多角的にアセスメントできるよう支援することが重要である。