Frequently Asked Questions (FAQs) Rushton Moral Resilience Scale

The RMRS-16 has been shortened, the personal integrity sub-scale improved, and overall validity enhanced. 

We recommend that you use the revised RMRS-16™ for ongoing research.  If you are currently conducting research using the original scale, please follow the scoring instructions for the scale and cite the following article.

Heinze, K. E., Hanson, G., Holtz, H., Swoboda, S. M., & Rushton, C. H. (2021). Measuring Health Care Interprofessionals’ Moral Resilience: Validation of the Rushton Moral Resilience Scale. Journal of palliative medicine, 24(6), 865–872. https://doi.org/10.1089/jpm.2020.0328

The levels of moral resilience of interprofessional clinicians (nurses, physicians, social workers and chaplains)

The RMRS-16™ are available for use at no cost. There are no license fees. We do require that the Rushton Moral Resilience Scale ™ be properly cited/referenced in publications and/or presentations.

We do require that you receive permission to use the RMRS-16™, whether for research or clinical use. The scale is copyrighted and Trademarked by Johns Hopkins University.
Obtaining permission to use the scales is a simple, automated process. To receive permission to use the scale(s), please go to the Obtain the Scales section of this website.

There are three steps to obtain the scales:

o Submit the Permission Request Form online.
o Receive an email confirmation with a link to review the User Permission Agreement and download the RMRS-16™
o Review the User Permission Agreement.
o At the end of the page, click on a button to download The RMRS-16™

To receive permission to use the RMRS-16™, Complete and Submit the Permission Request Form. We will then email you the User Permission Agreement, which further describes terms of use. The User Permission Agreement specifies that the scale must be referenced in your research and subsequent publications and presentations and may not be modified. To improve scale utility and adoption, please notify us of any resulting publication and/or presentation for inclusion in our dynamic, public databases and provide us with scale-translations for public dissemination (if applicable). Once the User Permission Agreement has been completed and returned to us, we will promptly send the scale and Scoring Guide to you.

The original Rushton Moral Resilience Scale ™ and the RMRS-16 were created and validated in English.

If you decide to perform your own translation of the scale(s), please share a copy of the translated scale with us for public access.

We do require that the RMRS-16™ be properly cited/referenced in publications and/or presentations.

The RMRS-16 should be properly referenced as follows (APA format)

Rushton, C., Hanson, G., Boyce, D., Holtz, H., Nelson, K., Splilg, E., Robilliard, R. (in press). Reliability and Validity of the Revised Rushton Moral Resilience Scale. Journal of Advanced Nursing.

The original article may be referenced as follows (APA format, 7th edition):
Heinze KE, Hanson G, Holtz H, Swoboda S, & Rushton CH. (2020). Measuring Healthcare Inter-Professionals’ Moral Resilience: Validation of the Rushton Moral Resilience Scale. Journal of Palliative Medicine. https://www.liebertpub.com/doi/10.1089/jpm.2020.0328

Please reference other articles/publications/presentations accordingly.

We do require that the Rushton Moral Resilience Scale ™ be properly cited/referenced in publications and/or presentations.

The original article may be referenced as follows (APA format, 7th edition):

Heinze, K. E., Hanson, G., Holtz, H., Swoboda, S. M., & Rushton, C. H. (2021). Measuring Health Care Interprofessionals’ Moral Resilience: Validation of the Rushton Moral Resilience Scale. Journal of palliative medicine, 24(6), 865–872. https://doi.org/10.1089/jpm.2020.0328

The second version, the Rushton Moral Resilience Scale-16 ™ (RMRS-16) should be references as follows:

Rushton, C., Hanson, G., Boyce, D., Holtz, H., Nelson, K., Splilg, E., Robilliard, R. (in press). Reliability and Validity of the Revised Rushton Moral Resilience Scale. Journal of Advanced Nursing.

Yes, you may translate the RMRS-16™. We recommend that you translate and back-translate to improve accuracy of the translation. If you do decide to perform your own translation of a scale, we ask that you provide us with the final translation of the scale for public dissemination on our webpage.

We will credit your work and provide reference to any affiliated publications that accompany the translated scale.

You will be responsible for the validation and forward and backward translation of the instrument.  We will not verify the accuracy of the translation.

The scales may be self-administered.

The RMRS-16 includes items that form 4 subscales: 1) Response to Moral Adversity; 2) Personal Integrity; 3) Relational Integrity; and 4) Moral Efficacy. All items should be coded so that higher scores indicate more moral resiliency. This will require recoding negatively worded items indicated with a (R) in the items listed on the scale. Obtain each subscale score by computing the mean for scores on the items associated with that subscale. See specific instructions below. Alternatively, you can compute an overall score by taking the mean of all 16 items.

Subscale computations:
Response to Moral Adversity=(item3+item5+item7+item9)/4
Personal Integrity=(item2+item4+item6+item8)/4
Relational Integrity=(item11+item13+item14+item16)/4
Moral Efficacy=(item1+item10+item12+item15)/4

Total Score:
Total RMRS = (item1+item2+item3+item4+item5+ item6+item7+item8+item9+item10+ item11+item12+item13+item14+item15+item16)/16

We do not prescribe any cut-offs, for example for low/moderate/high moral resilience. The scale was created to be used to demonstrate relationships between varying levels of moral resilience and other constructs (e.g., burnout) as well as evaluating change over time. The scale was not designed to be diagnostic. As such grouping scores into categories would be based on arbitrary criteria and result in a loss of information.