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To identify and address ethical challenges in doctoral supervision within nursing and health sciences and propose strategies to overcome them.
Following PRISMA guidelines, this mixed-method systematic review synthesises findings from quantitative, qualitative and mixed-methods studies published in English between 2014 and 2025. Studies were included if they examined ethical challenges in doctoral supervision and strategies to address them within nursing and health sciences. Exclusion criteria encompassed reviews, books, editorials, opinion papers, conference papers, studies unrelated to nursing or health sciences or published before 2014.
A systematic search was conducted in CINAHL, Education Source, ERIC, PubMed, Scopus and Web of Science Core Collection, yielding 1100 citations.
The methodological quality of included studies was assessed using the STROBE checklist for quantitative studies and the COREQ framework for qualitative studies. The findings were then synthesised and thematically organised.
Eleven studies met the inclusion criteria: four quantitative, four qualitative and three mixed methods. Ethical challenges in doctoral supervision emerged at three levels: individual (e.g., misaligned expectations, inadequate feedback, student adjustment difficulties), institutional (e.g., high student–supervisor ratios, limited support structures), and cultural (e.g., differing norms around autonomy and academic authority). Supervisors also reported role conflicts. Strategies to address these challenges included improved communication, supervision agreements, institutional support and targeted training.
Ethical challenges in supervision are shaped by individual, institutional and cultural factors. Addressing them requires multi-level strategies, including clear expectations, feedback mechanisms, structured training and culturally sensitive supervision practices. Applying ethical principles fosters a transparent and supportive academic environment that enhances doctoral outcomes.
Universities should adopt multi-level strategies, including supervisor training, mentorship structures and culturally informed policies, to strengthen the ethical integrity and effectiveness of doctoral supervision.
What problem did the study address?: This study synthesises ethical challenges in doctoral supervision within nursing and health sciences, focusing on communication barriers, institutional constraints and the transition from clinical practice to academia. What were the main Findings?: Misaligned expectations between supervisors and students, inadequate feedback and structural limitations, negatively impact the quality of supervision. Doctoral students struggle to adapt to academic expectations, while supervisors face challenges in balancing multiple roles. Effective communication, institutional support and targeted training programmes are essential for improving supervisory experience. Where and on whom will the research have an impact?: The research will inform universities and institutions offering doctoral education in nursing and health sciences. It will benefit doctoral students, supervisors and academic administrators by providing insights and strategies to enhance supervision quality and promote ethical practices.
This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
No patient or public involvement.
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