Clinical Courage in Nursing: A Concept Analysis Using Walker and Avant's Approach

ABSTRACT Aim This study aimed to clarify the concept of clinical courage in nursing by identifying its defining attributes, antecedents, consequences, and empirical referents, addressing conceptual ambiguity hindering its integration into education and practice. Design Concept analysis. Data Sources A comprehensive literature search was performed across PubMed, Scopus, Web of Science, and Google Scholar databases from inception to December 2025 without time restrictions. The search included peer‐reviewed, full‐text, English‐language articles. From an initial pool, 15 articles were selected for final in‐depth review, achieving conceptual saturation of the identified defining attributes, antecedents, and consequences. Review Methods Walker and Avant's eight‐step framework guided this concept analysis. Peer‐reviewed, full‐text English articles were included. After screening, 15 articles met inclusion criteria and underwent qualitative content analysis guided by Walker and Avant's framework until conceptual saturation was achieved. Results Clinical courage emerged as a multidimensional, context‐dependent construct distinct from general or moral courage. Three core defining attributes were identified: (1) clinical and ethical awareness—acute sensitivity to ethical dimensions and risks; (2) moral agency prioritization of the patient—conscious actions placing patient well‐being above personal or organizational repercussions; and (3) professional accountability and independence—willingness to make independent decisions and accept full responsibility despite hierarchical pressures. Antecedents included ethical uncertainty, perceived risk, and professional competence. Consequences encompassed enhanced patient safety, improved ethical climate, and professional fulfilment. Conclusion Clinical courage is defined as conscious, deliberate, and accountable professional action taken by a nurse in ambiguous or risky situations to prioritize patient safety and uphold ethical principles, despite potential personal or professional costs. This clarified definition offers a foundational framework for distinguishing clinical courage from related constructs and paves the way for developing educational strategies, measurement tools, and supportive policies to foster this virtue in nursing practice. Reporting Method Walker and Avant's framework (informed by PRISMA principles).