118 Chapter 5 colleagues, for example: ‘Should I inform our boss about a colleague who decided to remove a prisoner from solitary confinement on her/his own against the rules, or should I confront my colleague personally? Health care professionals working in prisons showed dilemmas around their code of confidentiality versus prison security, for example: a prisoner has bruises and talks about a potential new fight, do I discuss this with the prison guards? A systematic overview of all themes and dilemmas from the MCD sessions are mentioned in a recently published article (Schaap et al., 2022). Procedure of the impact measurement The participants of the MCD sessions received one questionnaire before the series of MCD (pre-measurement) and one after (post-measurement). The teams in the control group received the questionnaires at the same times. The questionnaire was developed to measure various elements of MCS, which over time can possibly show the impact of an intervention, such as MCD, on MCS. The questionnaire took approximately 20 minutes to complete and started with nine questions about the socio-demographics of the participants (sex, age, and education) and about specific features of their employment (assignment, location at the DCIA, etc.). In the second part of the questionnaire, the participants were presented with a list of 70 items based on an explorative analysis of the relatively unknown concept of MCS. This conceptual analysis of MCS and the developmental process of the questionnaire will be published in a separate article. We developed new items for this list, some tailored to the work practice of DCIA. We also used some items from existing questionnaires from academic literature, such as the Moral Competence Questionnaire (MCQ) (Oprins et al., 2011) or items about ‘team reflexivity’ (Schippers et al., 2005). In the end, the items of the newly developed MCS questionnaire cover topics such as moral awareness, moral reasoning, responsibility, collaboration with colleagues and superiors, attitude toward prisoners, and moral leadership. The latter (4 of the 70 items) are only for superiors. The response options were ‘totally disagree’, ‘disagree’, ‘neutral’, ‘agree’ and ‘totally agree’; or when asked about frequency ‘never’, ‘a few times per year’, ‘monthly’, ‘weekly’ and ‘daily’. In the postmeasurement, 15 questions were added about the number of MCD sessions attended and how participants evaluated the MCD sessions. Data analysis The main analysis was performed on all respondents who completed either the premeasurement and/or the post-measurement. Descriptive statistics were used for demographic characteristics and scores on all items. In an exploratory factor analysis