nursing case study health education

Health Case Studies

(29 reviews)

Glynda Rees, British Columbia Institute of Technology

Rob Kruger, British Columbia Institute of Technology

Janet Morrison, British Columbia Institute of Technology

Publisher: BCcampus

Language: English

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Reviewed by Jessica Sellars, Medical assistant office instructor, Blue Mountain Community College on 10/11/23

Comprehensiveness rating: 5 see less

This is a book of compiled and very well organized patient case studies. The author has broken it up by disease patient was experiencing and even the healthcare roles that took place in this patients care. There is a well thought out direction and plan. There is an appendix to refer to as well if you are needing to find something specific quickly. I have been looking for something like this to help my students have a base to do their project on. This is the most comprehensive version I have found on the subject.

Content Accuracy rating: 5

This is a book compiled of medical case studies. It is very accurate and can be used to learn from great care and mistakes.

Relevance/Longevity rating: 5

This material is very relevant in this context. It also has plenty of individual case studies to utilize in many ways in all sorts of medical courses. This is a very useful textbook and it will continue to be useful for a very long time as you can still learn from each study even if medicine changes through out the years.

Clarity rating: 5

The author put a lot of thought into the ease of accessibility and reading level of the target audience. There is even a "how to use this resource" section which could be extremely useful to students.

Consistency rating: 5

The text follows a very consistent format throughout the book.

Modularity rating: 5

Each case study is individual broken up and in a group of similar case studies. This makes it extremely easy to utilize.

Organization/Structure/Flow rating: 5

The book is very organized and the appendix is through. It flows seamlessly through each case study.

Interface rating: 5

I had no issues navigating this book, It was clearly labeled and very easy to move around in.

Grammatical Errors rating: 5

I did not catch any grammar errors as I was going through the book

Cultural Relevance rating: 5

This is a challenging question for any medical textbook. It is very culturally relevant to those in medical or medical office degrees.

I have been looking for something like this for years. I am so happy to have finally found it.

Reviewed by Cindy Sun, Assistant Professor, Marshall University on 1/7/23

Interestingly, this is not a case of ‘you get what you pay for’. Instead, not only are the case studies organized in a fashion for ease of use through a detailed table of contents, the authors have included more support for both faculty and students. For faculty, the introduction section titled ‘How to use this resource’ and individual notes to educators before each case study contain application tips. An appendix overview lists key elements as issues / concepts, scenario context, and healthcare roles for each case study. For students, learning objectives are presented at the beginning of each case study to provide a framework of expectations.

The content is presented accurately and realistic.

The case studies read similar to ‘A Day In the Life of…’ with detailed intraprofessional communications similar to what would be overheard in patient care areas. The authors present not only the view of the patient care nurse, but also weave interprofessional vantage points through each case study by including patient interaction with individual professionals such as radiology, physician, etc.

In addition to objective assessment findings, the authors integrate standard orders for each diagnosis including medications, treatments, and tests allowing the student to incorporate pathophysiology components to their assessments.

Each case study is arranged in the same framework for consistency and ease of use.

This compilation of eight healthcare case studies focusing on new onset and exacerbation of prevalent diagnoses, such as heart failure, deep vein thrombosis, cancer, and chronic obstructive pulmonary disease advancing to pneumonia.

Each case study has a photo of the ‘patient’. Simple as this may seem, it gives an immediate mental image for the student to focus.

Interface rating: 4

As noted by previous reviewers, most of the links do not connect active web pages. This may be due to the multiple options for accessing this resource (pdf download, pdf electronic, web view, etc.).

Grammatical Errors rating: 4

A minor weakness that faculty will probably need to address prior to use is regarding specific term usages differences between Commonwealth countries and United States, such as lung sound descriptors as ‘quiet’ in place of ‘diminished’ and ‘puffers’ in place of ‘inhalers’.

The authors have provided a multicultural, multigenerational approach in selection of patient characteristics representing a snapshot of today’s patient population. Additionally, one case study focusing on heart failure is about a middle-aged adult, contrasting to the average aged patient the students would normally see during clinical rotations. This option provides opportunities for students to expand their knowledge on risk factors extending beyond age.

This resource is applicable to nursing students learning to care for patients with the specific disease processes presented in each case study or for the leadership students focusing on intraprofessional communication. Educators can assign as a supplement to clinical experiences or as an in-class application of knowledge.

Reviewed by Stephanie Sideras, Assistant Professor, University of Portland on 8/15/22

The eight case studies included in this text addressed high frequency health alterations that all nurses need to be able to manage competently. While diabetes was not highlighted directly, it was included as a potential comorbidity. The five overarching learning objectives pulled from the Institute of Medicine core competencies will clearly resonate with any faculty familiar with Quality and Safety Education for Nurses curriculum.

The presentation of symptoms, treatments and management of the health alterations was accurate. Dialogue between the the interprofessional team was realistic. At times the formatting of lab results was confusing as they reflected reference ranges specific to the Canadian healthcare system but these occurrences were minimal and could be easily adapted.

The focus for learning from these case studies was communication - patient centered communication and interprofessional team communication. Specific details, such as drug dosing, was minimized, which increases longevity and allows for easy individualization of the case data.

While some vocabulary was specific to the Canadian healthcare system, overall the narrative was extremely engaging and easy to follow. Subjective case data from patient or provider were formatted in italics and identified as 'thoughts'. Objective and behavioral case data were smoothly integrated into the narrative.

The consistency of formatting across the eight cases was remarkable. Specific learning objectives are identified for each case and these remain consistent across the range of cases, varying only in the focus for the goals for each different health alterations. Each case begins with presentation of essential patient background and the progress across the trajectory of illness as the patient moves from location to location encountering different healthcare professionals. Many of the characters (the triage nurse in the Emergency Department, the phlebotomist) are consistent across the case situations. These consistencies facilitate both application of a variety of teaching methods and student engagement with the situated learning approach.

Case data is presented by location and begins with the patient's first encounter with the healthcare system. This allows for an examination of how specific trajectories of illness are manifested and how care management needs to be prioritized at different stages. This approach supports discussions of care transitions and the complexity of the associated interprofessional communication.

The text is well organized. The case that has two levels of complexity is clearly identified

The internal links between the table of contents and case specific locations work consistently. In the EPUB and the Digital PDF the external hyperlinks are inconsistently valid.

The grammatical errors were minimal and did not detract from readability

Cultural diversity is present across the cases in factors including race, ethnicity, socioeconomic status, family dynamics and sexual orientation.

The level of detail included in these cases supports a teaching approach to address all three spectrums of learning - knowledge, skills and attitudes - necessary for the development of competent practice. I also appreciate the inclusion of specific assessment instruments that would facilitate a discussion of evidence based practice. I will enjoy using these case to promote clinical reasoning discussions of data that is noticed and interpreted with the resulting prioritizes that are set followed by reflections that result from learner choices.

Reviewed by Chris Roman, Associate Professor, Butler University on 5/19/22

It would be extremely difficult for a book of clinical cases to comprehensively cover all of medicine, and this text does not try. Rather, it provides cases related to common medical problems and introduces them in a way that allows for various... read more

Comprehensiveness rating: 4 see less

The narrative form of the cases is less subject to issues of accuracy than a more content-based book would be. That said, the cases are realistic and reasonable, avoiding being too mundane or too extreme.

These cases are narrative and do not include many specific mentions of drugs, dosages, or other aspects of clinical care that may grow/evolve as guidelines change. For this reason, the cases should be “evergreen” and can be modified to suit different types of learners.

Clarity rating: 4

The text is written in very accessible language and avoids heavy use of technical language. Depending on the level of learner, this might even be too simplistic and omit some details that would be needed for physicians, pharmacists, and others to make nuanced care decisions.

The format is very consistent with clear labeling at transition points.

The authors point out in the introductory materials that this text is designed to be used in a modular fashion. Further, they have built in opportunities to customize each cases, such as giving dates of birth at “19xx” to allow for adjustments based on instructional objectives, etc.

The organization is very easy to follow.

I did not identify any issues in navigating the text.

The text contains no grammatical errors, though the language is a little stiff/unrealistic in some cases.

Cases involve patients and members of the care team that are of varying ages, genders, and racial/ethnic backgrounds

Reviewed by Trina Larery, Assistant Professor, Pittsburg State University on 4/5/22

The book covers common scenarios, providing allied health students insight into common health issues. The information in the book is thorough and easily modified if needed to include other scenarios not listed. The material was easy to understand... read more

Content Accuracy rating: 4

The treatments were explained and rationales were given, which can be very helpful to facilitate effective learning for a nursing student or novice nurse. The case studies were accurate in explanation. The DVT case study incorrectly identifies the location of the clot in the popliteal artery instead of in the vein.

The content is relevant to a variety of different types of health care providers and due to the general nature of the cases, will remain relevant over time. Updates should be made annually to the hyperlinks and to assure current standard of practice is still being met.

Clear, simple and easy to read.

Consistent with healthcare terminology and framework throughout all eight case studies.

The text is modular. Cases can be used individually within a unit on the given disease process or relevant sections of a case could be used to illustrate a specific point providing great flexibility. The appendix is helpful in locating content specific to a certain diagnosis or a certain type of health care provider.

The book is well organized, presenting in a logical clear fashion. The appendix allows the student to move about the case study without difficulty.

The interface is easy and simple to navigate. Some links to external sources might need to be updated regularly since those links are subject to change based on current guidelines. A few hyperlinks had "page not found".

Few grammatical errors were noted in text.

The case studies include people of different ethnicities, socioeconomic status, ages, and genders to make this a very useful book.

I enjoyed reading the text. It was interesting and relevant to today's nursing student. There are roughly 25 broken online links or "pages not found", care needs to be taken to update at least annually and assure links are valid and utilizing the most up to date information.

Reviewed by Benjamin Silverberg, Associate Professor/Clinician, West Virginia University on 3/24/22

Comprehensiveness rating: 3 see less

The appendix reviews the "key roles" and medical venues found in all 8 cases, but is fairly spartan on medical content. The table of contents at the beginning only lists the cases and locations of care. It can be a little tricky to figure out what is going on where, especially since each case is largely conversation-based. Since this presents 8 cases (really 7 with one being expanded upon), there are many medical topics (and venues) that are not included. It's impossible to include every kind of situation, but I'd love to see inclusion of sexual health, renal pathology, substance abuse, etc.

Though there are differences in how care can be delivered based on personal style, changing guidelines, available supplies, etc, the medical accuracy seems to be high. I did not detect bias or industry influence.

Relevance/Longevity rating: 4

Medications are generally listed as generics, with at least current dosing recommendations. The text gives a picture of what care looks like currently, but will be a little challenging to update based on new guidelines (ie, it can be hard to find the exact page in which a medication is dosed/prescribed). Even if the text were to be a little out of date, an instructor can use that to point out what has changed (and why).

Clear text, usually with definitions of medical slang or higher-tier vocabulary. Minimal jargon and there are instances where the "characters" are sorting out the meaning as well, making it accessible for new learners, too.

Overall, the style is consistent between cases - largely broken up into scenes and driven by conversation rather than descriptions of what is happening.

There are 8 (well, again, 7) cases which can be reviewed in any order. Case #2 builds upon #1, which is intentional and a good idea, though personally I would have preferred one case to have different possible outcomes or even a recurrence of illness. Each scene within a case is reasonably short.

Organization/Structure/Flow rating: 4

These cases are modular and don't really build on concepts throughout. As previously stated, case #2 builds upon #1, but beyond that, there is no progression. (To be sure, the authors suggest using case #1 for newer learners and #2 for more advanced ones.) The text would benefit from thematic grouping, a longer introduction and debriefing for each case (there are learning objectives but no real context in medical education nor questions to reflect on what was just read), and progressively-increasing difficulty in medical complexity, ethics, etc.

I used the PDF version and had no interface issues. There are minimal photographs and charts. Some words are marked in blue but those did not seem to be hyperlinked anywhere.

No noticeable errors in grammar, spelling, or formatting were noted.

I appreciate that some diversity of age and ethnicity were offered, but this could be improved. There were Canadian Indian and First Nations patients, for example, as well as other characters with implied diversity, but there didn't seem to be any mention of gender diverse or non-heterosexual people, or disabilities. The cases tried to paint family scenes (the first patient's dog was fairly prominently mentioned) to humanize them. Including more cases would allow for more opportunities to include sex/gender minorities, (hidden) disabilities, etc.

The text (originally from 2017) could use an update. It could be used in conjunction with other Open Texts, as a compliment to other coursework, or purely by itself. The focus is meant to be on improving communication, but there are only 3 short pages at the beginning of the text considering those issues (which are really just learning objectives). In addition to adding more cases and further diversity, I personally would love to see more discussion before and after the case to guide readers (and/or instructors). I also wonder if some of the ambiguity could be improved by suggesting possible health outcomes - this kind of counterfactual comparison isn't possible in real life and could be really interesting in a text. Addition of comprehension/discussion questions would also be worthwhile.

Reviewed by Danielle Peterson, Assistant Professor, University of Saint Francis on 12/31/21

This text provides readers with 8 case studies which include both chronic and acute healthcare issues. Although not comprehensive in regard to types of healthcare conditions, it provides a thorough look at the communication between healthcare workers in acute hospital settings. The cases are primarily set in the inpatient hospital setting, so the bulk of the clinical information is basic emergency care and inpatient protocol: vitals, breathing, medication management, etc. The text provides a table of contents at opening of the text and a handy appendix at the conclusion of the text that outlines each case’s issue(s), scenario, and healthcare roles. No index or glossary present.

Although easy to update, it should be noted that the cases are taking place in a Canadian healthcare system. Terms may be unfamiliar to some students including “province,” “operating theatre,” “physio/physiotherapy,” and “porter.” Units of measurement used include Celsius and meters. Also, the issue of managed care, health insurance coverage, and length of stay is missing for American students. These are primary issues that dictate much of the healthcare system in the US and a primary job function of social workers, nurse case managers, and medical professionals in general. However, instructors that wish to add this to the case studies could do so easily.

The focus of this text is on healthcare communication which makes it less likely to become obsolete. Much of the clinical information is stable healthcare practice that has been standard of care for quite some time. Nevertheless, given the nature of text, updates would be easy to make. Hyperlinks should be updated to the most relevant and trustworthy sources and checked frequently for effectiveness.

The spacing that was used to note change of speaker made for ease of reading. Although unembellished and plain, I expect students to find this format easy to digest and interesting, especially since the script is appropriately balanced with ‘human’ qualities like the current TV shows and songs, the use of humor, and nonverbal cues.

A welcome characteristic of this text is its consistency. Each case is presented in a similar fashion and the roles of the healthcare team are ‘played’ by the same character in each of the scenarios. This allows students to see how healthcare providers prioritize cases and juggle the needs of multiple patients at once. Across scenarios, there was inconsistency in when clinical terms were hyperlinked.

The text is easily divisible into smaller reading sections. However, since the nature of the text is script-narrative format, if significant reorganization occurs, one will need to make sure that the communication of the script still makes sense.

The text is straightforward and presented in a consistent fashion: learning objectives, case history, a script of what happened before the patient enters the healthcare setting, and a script of what happens once the patient arrives at the healthcare setting. The authors use the term, “ideal interactions,” and I would agree that these cases are in large part, ‘best case scenarios.’ Due to this, the case studies are well organized, clear, logical, and predictable. However, depending on the level of student, instructors may want to introduce complications that are typical in the hospital setting.

The interface is pleasing and straightforward. With exception to the case summary and learning objectives, the cases are in narrative, script format. Each case study supplies a photo of the ‘patient’ and one of the case studies includes a link to a 3-minute video that introduces the reader to the patient/case. One of the highlights of this text is the use of hyperlinks to various clinical practices (ABG, vital signs, transfer of patient). Unfortunately, a majority of the links are broken. However, since this is an open text, instructors can update the links to their preference.

Although not free from grammatical errors, those that were noticed were minimal and did not detract from reading.

Cultural Relevance rating: 4

Cultural diversity is visible throughout the patients used in the case studies and includes factors such as age, race, socioeconomic status, family dynamics, and sexual orientation. A moderate level of diversity is noted in the healthcare team with some stereotypes: social workers being female, doctors primarily male.

As a social work instructor, I was grateful to find a text that incorporates this important healthcare role. I would have liked to have seen more content related to advance directives, mediating decision making between the patient and care team, emotional and practical support related to initial diagnosis and discharge planning, and provision of support to colleagues, all typical roles of a medical social worker. I also found it interesting that even though social work was included in multiple scenarios, the role was only introduced on the learning objectives page for the oncology case.

Reviewed by Crystal Wynn, Associate Professor, Virginia State University on 7/21/21

The text covers a variety of chronic diseases within the cases; however, not all of the common disease states were included within the text. More chronic diseases need to be included such as diabetes, cancer, and renal failure. Not all allied health care team members are represented within the case study. Key terms appear throughout the case study textbook and readers are able to click on a hyperlink which directs them to the definition and an explanation of the key term.

Content is accurate, error-free and unbiased.

The content is up-to-date, but not in a way that will quickly make the text obsolete within a short period of time. The text is written and/or arranged in such a way that necessary updates will be relatively easy and straightforward to implement.

The text is written in lucid, accessible prose, and provides adequate context for any jargon/technical terminology used

The text is internally consistent in terms of terminology and framework.

The text is easily and readily divisible into smaller reading sections that can be assigned at different points within the course. Each case can be divided into a chronic disease state unit, which will allow the reader to focus on one section at a time.

Organization/Structure/Flow rating: 3

The topics in the text are presented in a logical manner. Each case provides an excessive amount of language that provides a description of the case. The cases in this text reads more like a novel versus a clinical textbook. The learning objectives listed within each case should be in the form of questions or activities that could be provided as resources for instructors and teachers.

Interface rating: 3

There are several hyperlinks embedded within the textbook that are not functional.

The text contains no grammatical errors.

Cultural Relevance rating: 3

The text is not culturally insensitive or offensive in any way. More examples of cultural inclusiveness is needed throughout the textbook. The cases should be indicative of individuals from a variety of races and ethnicities.

Reviewed by Rebecca Hillary, Biology Instructor, Portland Community College on 6/15/21

This textbook consists of a collection of clinical case studies that can be applicable to a wide range of learning environments from supplementing an undergraduate Anatomy and Physiology Course, to including as part of a Medical or other health care program. I read the textbook in E-reader format and this includes hyperlinks that bring the students to subsequent clinical study if the book is being used in a clinical classroom. This book is significantly more comprehensive in its approach from other case studies I have read because it provides a bird’s eye view of the many clinicians, technicians, and hospital staff working with one patient. The book also provides real time measurements for patients that change as they travel throughout the hospital until time of discharge.

Each case gave an accurate sense of the chaos that would be present in an emergency situation and show how the conditions affect the practitioners as well as the patients. The reader gets an accurate big picture--a feel for each practitioner’s point of view as well as the point of view of the patient and the patient’s family as the clock ticks down and the patients are subjected to a number of procedures. The clinical information contained in this textbook is all in hyperlinks containing references to clinical skills open text sources or medical websites. I did find one broken link on an external medical resource.

The diseases presented are relevant and will remain so. Some of the links are directly related to the Canadian Medical system so they may not be applicable to those living in other regions. Clinical links may change over time but the text itself will remain relevant.

Each case study clearly presents clinical data as is it recorded in real time.

Each case study provides the point of view of several practitioners and the patient over several days. While each of the case studies covers different pathology they all follow this same format, several points of view and data points, over a number of days.

The case studies are divided by days and this was easy to navigate as a reader. It would be easy to assign one case study per body system in an Anatomy and Physiology course, or to divide them up into small segments for small in class teaching moments.

The topics are presented in an organized way showing clinical data over time and each case presents a large number of view points. For example, in the first case study, the patient is experiencing difficulty breathing. We follow her through several days from her entrance to the emergency room. We meet her X Ray Technicians, Doctor, Nurses, Medical Assistant, Porter, Physiotherapist, Respiratory therapist, and the Lab Technicians running her tests during her stay. Each practitioner paints the overall clinical picture to the reader.

I found the text easy to navigate. There were not any figures included in the text, only clinical data organized in charts. The figures were all accessible via hyperlink. Some figures within the textbook illustrating patient scans could have been helpful but I did not have trouble navigating the links to visualize the scans.

I did not see any grammatical errors in the text.

The patients in the text are a variety of ages and have a variety of family arrangements but there is not much diversity among the patients. Our seven patients in the eight case studies are mostly white and all cis gendered.

Some of the case studies, for example the heart failure study, show clinical data before and after drug treatments so the students can get a feel for mechanism in physiological action. I also liked that the case studies included diet and lifestyle advice for the patients rather than solely emphasizing these pharmacological interventions. Overall, I enjoyed reading through these case studies and I plan to utilize them in my Anatomy and Physiology courses.

Reviewed by Richard Tarpey, Assistant Professor, Middle Tennessee State University on 5/11/21

As a case study book, there is no index or glossary. However, medical and technical terms provide a useful link to definitions and explanations that will prove useful to students unfamiliar with the terms. The information provided is appropriate for entry-level health care students. The book includes important health problems, but I would like to see coverage of at least one more chronic/lifestyle issue such as diabetes. The book covers adult issues only.

Content is accurate without bias

The content of the book is relevant and up-to-date. It addresses conditions that are prevalent in today's population among adults. There are no pediatric cases, but this does not significantly detract from the usefulness of the text. The format of the book lends to easy updating of data or information.

The book is written with clarity and is easy to read. The writing style is accessible and technical terminology is explained with links to more information.

Consistency is present. Lack of consistency is typically a problem with case study texts, but this book is consistent with presentation, format, and terminology throughout each of the eight cases.

The book has high modularity. Each of the case studies can be used independently from the others providing flexibility. Additionally, each case study can be partitioned for specific learning objectives based on the learning objectives of the course or module.

The book is well organized, presenting students conceptually with differing patient flow patterns through a hospital. The patient information provided at the beginning of each case is a wonderful mechanism for providing personal context for the students as they consider the issues. Many case studies focus on the problem and the organization without students getting a patient's perspective. The patient perspective is well represented in these cases.

The navigation through the cases is good. There are some terminology and procedure hyperlinks within the cases that do not work when accessed. This is troubling if you intend to use the text for entry-level health care students since many of these links are critical for a full understanding of the case.

There are some non-US variants of spelling and a few grammatical errors, but these do not detract from the content of the messages of each case.

The book is inclusive of differing backgrounds and perspectives. No insensitive or offensive references were found.

I like this text for its application flexibility. The book is useful for non-clinical healthcare management students to introduce various healthcare-related concepts and terminology. The content is also helpful for the identification of healthcare administration managerial issues for students to consider. The book has many applications.

Reviewed by Paula Baldwin, Associate Professor/Communication Studies, Western Oregon University on 5/10/21

The different case studies fall on a range, from crisis care to chronic illness care. read more

The different case studies fall on a range, from crisis care to chronic illness care.

The contents seems to be written as they occurred to represent the most complete picture of each medical event's occurence.

These case studies are from the Canadian medical system, but that does not interfere with it's applicability.

It is written for a medical audience, so the terminology is mostly formal and technical.

Some cases are shorter than others and some go in more depth, but it is not problematic.

The eight separate case studies is the perfect size for a class in the quarter system. You could combine this with other texts, videos or learning modalities, or use it alone.

As this is a case studies book, there is not a need for a logical progression in presentation of topics.

No problems in terms of interface.

I have not seen any grammatical errors.

I did not see anything that was culturally insensitive.

I used this in a Health Communication class and it has been extraordinarily successful. My studies are analyzing the messaging for the good, the bad, and the questionable. The case studies are widely varied and it gives the class insights into hospital experiences, both front and back stage, that they would not normally be able to examine. I believe that because it is based real-life medical incidents, my students are finding the material highly engaging.

Reviewed by Marlena Isaac, Instructor, Aiken Technical College on 4/23/21

This text is great to walk through patient care with entry level healthcare students. The students are able to take in the information, digest it, then provide suggestions to how they would facilitate patient healing. Then when they are faced with... read more

The case studies provided accurate information that relates to the named disease.

It is relevant to health care studies and the development of critical thinking.

Cases are straightforward with great clinical information.

Clinical information is provided concisely.

Appropriate for clinical case study.

Presented to facilitate information gathering.

Takes a while to navigate in the browser.

Cultural Relevance rating: 1

Text lacks adequate representation of minorities.

Reviewed by Kim Garcia, Lecturer III, University of Texas Rio Grande Valley on 11/16/20

The book has 8 case studies, so obviously does not cover the whole of medicine, but the cases provided are descriptive and well developed. Cases are presented at different levels of difficulty, making the cases appropriate for students at different levels of clinical knowledge. The human element of both patient and health care provider is well captured. The cases are presented with a focus on interprofessional interaction and collaboration, more so than teaching medical content.

Content is accurate and un-biased. No errors noted. Most diagnostic and treatment information is general so it will remain relevant over time. The content of these cases is more appropriate for teaching interprofessional collaboration and less so for teaching the medical care for each diagnosis.

The content is relevant to a variety of different types of health care providers (nurses, radiologic technicians, medical laboratory personnel, etc) and due to the general nature of the cases, will remain relevant over time.

Easy to read. Clear headings are provided for sections of each case study and these section headings clearly tell when time has passed or setting has changed. Enough description is provided to help set the scene for each part of the case. Much of the text is written in the form of dialogue involving patient, family and health care providers, making it easy to adapt for role play. Medical jargon is limited and links for medical terms are provided to other resources that expound on medical terms used.

The text is consistent in structure of each case. Learning objectives are provided. Cases generally start with the patient at home and move with the patient through admission, testing and treatment, using a variety of healthcare services and encountering a variety of personnel.

The text is modular. Cases could be used individually within a unit on the given disease process or relevant sections of a case could be used to illustrate a specific point. The appendix is helpful in locating content specific to a certain diagnosis or a certain type of health care provider.

Each case follows a patient in a logical, chronologic fashion. A clear table of contents and appendix are provided which allows the user to quickly locate desired content. It would be helpful if the items in the table of contents and appendix were linked to the corresponding section of the text.

The hyperlinks to content outside this book work, however using the back arrow on your browser returns you to the front page of the book instead of to the point at which you left the text. I would prefer it if the hyperlinks opened in a new window or tab so closing that window or tab would leave you back where you left the text.

No grammatical errors were noted.

The text is culturally inclusive and appropriate. Characters, both patients and care givers are of a variety of races, ethnicities, ages and backgrounds.

I enjoyed reading the cases and reviewing this text. I can think of several ways in which I will use this content.

Reviewed by Raihan Khan, Instructor/Assistant Professor, James Madison University on 11/3/20

The book contains several important health issues, however still missing some chronic health issues that the students should learn before they join the workforce, such as diabetes-related health issues suffered by the patients. read more

The health information contained in the textbook is mostly accurate.

I think the book is written focusing on the current culture and health issues faced by the patients. To keep the book relevant in the future, the contexts especially the culture/lifestyle/health care modalities, etc. would need to be updated regularly.

The language is pretty simple, clear, and easy to read.

There is no complaint about consistency. One of the main issues of writing a book, consistency was well managed by the authors.

The book is easy to explore based on how easy the setup is. Students can browse to the specific section that they want to read without much hassle of finding the correct information.

The organization is simple but effective. The authors organized the book based on what can happen in a patient's life and what possible scenarios students should learn about the disease. From that perspective, the book does a good job.

The interface is easy and simple to navigate. Some links to external sources might need to be updated regularly since those links are subject to change that is beyond the author's control. It's frustrating for the reader when the external link shows no information.

The book is free of any major language and grammatical errors.

The book might do a little better in cultural competency. e.g. Last name Singh is mainly for Sikh people. In the text Harj and Priya Singh are Muslim. the authors can consult colleagues who are more familiar with those cultures and revise some cultural aspects of the cases mentioned in the book.

The book is a nice addition to the open textbook world. Hope to see more health issues covered by the book.

Reviewed by Ryan Sheryl, Assistant Professor, California State University, Dominguez Hills on 7/16/20

This text contains 8 medical case studies that reflect best practices at the time of publication. The text identifies 5 overarching learning objectives: interprofessional collaboration, client centered care, evidence-based practice, quality improvement, and informatics. While the case studies do not cover all medical conditions or bodily systems, the book is thorough in conveying details of various patients and medical team members in a hospital environment. Rather than an index or glossary at the end of the text, it contains links to outside websites for more information on medical tests and terms referenced in the cases.

The content provided is reflective of best practices in patient care, interdisciplinary collaboration, and communication at the time of publication. It is specifically accurate for the context of hospitals in Canada. The links provided throughout the text have the potential to supplement with up-to-date descriptions and definitions, however, many of them are broken (see notes in Interface section).

The content of the case studies reflects the increasingly complex landscape of healthcare, including a variety of conditions, ages, and personal situations of the clients and care providers. The text will require frequent updating due to the rapidly changing landscape of society and best practices in client care. For example, a future version may include inclusive practices with transgender clients, or address ways medical racism implicitly impacts client care (see notes in Cultural Relevance section).

The text is written clearly and presents thorough, realistic details about working and being treated in an acute hospital context.

The text is very straightforward. It is consistent in its structure and flow. It uses consistent terminology and follows a structured framework throughout.

Being a series of 8 separate case studies, this text is easily and readily divisible into smaller sections. The text was designed to be taken apart and used piece by piece in order to serve various learning contexts. The parts of each case study can also be used independently of each other to facilitate problem solving.

The topics in the case studies are presented clearly. The structure of each of the case studies proceeds in a similar fashion. All of the cases are set within the same hospital so the hospital personnel and service providers reappear across the cases, giving a textured portrayal of the experiences of the various service providers. The cases can be used individually, or one service provider can be studied across the various studies.

The text is very straightforward, without complex charts or images that could become distorted. Many of the embedded links are broken and require updating. The links that do work are a very useful way to define and expand upon medical terms used in the case studies.

Grammatical errors are minimal and do not distract from the flow of the text. In one instance the last name Singh is spelled Sing, and one patient named Fred in the text is referred to as Frank in the appendix.

The cases all show examples of health care personnel providing compassionate, client-centered care, and there is no overt discrimination portrayed. Two of the clients are in same-sex marriages and these are shown positively. It is notable, however, that the two cases presenting people of color contain more negative characteristics than the other six cases portraying Caucasian people. The people of color are the only two examples of clients who smoke regularly. In addition, the Indian client drinks and is overweight, while the First Nations client is the only one in the text to have a terminal diagnosis. The Indian client is identified as being Punjabi and attending a mosque, although there are only 2% Muslims in the Punjab province of India. Also, the last name Singh generally indicates a person who is a Hindu or Sikh, not Muslim.

Reviewed by Monica LeJeune, RN Instructor, LSUE on 4/24/20

Has comprehensive unfolding case studies that guide the reader to recognize and manage the scenario presented. Assists in critical thinking process. read more

Has comprehensive unfolding case studies that guide the reader to recognize and manage the scenario presented. Assists in critical thinking process.

Accurately presents health scenarios with real life assessment techniques and patient outcomes.

Relevant to nursing practice.

Clearly written and easily understood.

Consistent with healthcare terminology and framework

Has a good reading flow.

Topics presented in logical fashion

Easy to read.

No grammatical errors noted.

Text is not culturally insensitive or offensive.

Good book to have to teach nursing students.

Reviewed by april jarrell, associate professor, J. Sargeant Reynolds Community College on 1/7/20

The text is a great case study tool that is appropriate for nursing school instructors to use in aiding students to learn the nursing process. read more

The text is a great case study tool that is appropriate for nursing school instructors to use in aiding students to learn the nursing process.

The content is accurate and evidence based. There is no bias noted

The content in the text is relevant, up to date for nursing students. It will be easy to update content as needed because the framework allows for addition to the content.

The text is clear and easy to understand.

Framework and terminology is consistent throughout the text; the case study is a continual and takes the student on a journey with the patient. Great for learning!

The case studies can be easily divided into smaller sections to allow for discussions, and weekly studies.

The text and content progress in a logical, clear fashion allowing for progression of learning.

No interface issues noted with this text.

No grammatical errors noted in the text.

No racial or culture insensitivity were noted in the text.

I would recommend this text be used in nursing schools. The use of case studies are helpful for students to learn and practice the nursing process.

Reviewed by Lisa Underwood, Practical Nursing Instructor, NTCC on 12/3/19

The text provides eight comprehensive case studies that showcase the different viewpoints of the many roles involved in patient care. It encompasses the most common seen diagnoses seen across healthcare today. Each case study comes with its own set of learning objectives that can be tweaked to fit several allied health courses. Although the case studies are designed around the Canadian Healthcare System, they are quite easily adaptable to fit most any modern, developed healthcare system.

Content Accuracy rating: 3

Overall, the text is quite accurate. There is one significant error that needs to be addressed. It is located in the DVT case study. In the study, a popliteal artery clot is mislabeled as a DVT. DVTs are located in veins, not in arteries. That said, the case study on the whole is quite good. This case study could be used as a learning tool in the classroom for discussion purposes or as a way to test student understanding of DVTs, on example might be, "Can they spot the error?"

At this time, all of the case studies within the text are current. Healthcare is an ever evolving field that rests on the best evidence based practice. Keeping that in mind, educators can easily adapt the studies as the newest evidence emerges and changes practice in healthcare.

All of the case studies are well written and easy to understand. The text includes several hyperlinks and it also highlights certain medical terminology to prompt readers as a way to enhance their learning experience.

Across the text, the language, style, and format of the case studies are completely consistent.

The text is divided into eight separate case studies. Each case study may be used independently of the others. All case studies are further broken down as the focus patient passes through each aspect of their healthcare system. The text's modularity makes it possible to use a case study as individual work, group projects, class discussions, homework or in a simulation lab.

The case studies and the diagnoses that they cover are presented in such a way that educators and allied health students can easily follow and comprehend.

The book in itself is free of any image distortion and it prints nicely. The text is offered in a variety of digital formats. As noted in the above reviews, some of the hyperlinks have navigational issues. When the reader attempts to access them, a "page not found" message is received.

There were minimal grammatical errors. Some of which may be traced back to the differences in our spelling.

The text is culturally relevant in that it includes patients from many different backgrounds and ethnicities. This allows educators and students to explore cultural relevance and sensitivity needs across all areas in healthcare. I do not believe that the text was in any way insensitive or offensive to the reader.

By using the case studies, it may be possible to have an open dialogue about the differences noted in healthcare systems. Students will have the ability to compare and contrast the Canadian healthcare system with their own. I also firmly believe that by using these case studies, students can improve their critical thinking skills. These case studies help them to "put it all together".

Reviewed by Melanie McGrath, Associate Professor, TRAILS on 11/29/19

The text covered some of the most common conditions seen by healthcare providers in a hospital setting, which forms a solid general base for the discussions based on each case. read more

The text covered some of the most common conditions seen by healthcare providers in a hospital setting, which forms a solid general base for the discussions based on each case.

I saw no areas of inaccuracy

As in all healthcare texts, treatments and/or tests will change frequently. However, everything is currently up-to-date thus it should be a good reference for several years.

Each case is written so that any level of healthcare student would understand. Hyperlinks in the text is also very helpful.

All of the cases are written in a similar fashion.

Although not structured as a typical text, each case is easily assigned as a stand-alone.

Each case is organized clearly in an appropriate manner.

I did not see any issues.

I did not see any grammatical errors

The text seemed appropriately inclusive. There are no pediatric cases and no cases of intellectually-impaired patients, but those types of cases introduce more advanced problem-solving which perhaps exceed the scope of the text. May be a good addition to the text.

I found this text to be an excellent resource for healthcare students in a variety of fields. It would be best utilized in inter professional courses to help guide discussion.

Reviewed by Lynne Umbarger, Clinical Assistant Professor, Occupational Therapy, Emory and Henry College on 11/26/19

While the book does not cover every scenario, the ones in the book are quite common and troublesome for inexperienced allied health students. The information in the book is thorough enough, and I have found the cases easy to modify for educational purposes. The material was easily understood by the students but challenging enough for classroom discussion. There are no mentions in the book about occupational therapy, but it is easy enough to add a couple words and make inclusion simple.

Very nice lab values are provided in the case study, making it more realistic for students.

These case studies focus on commonly encountered diagnoses for allied health and nursing students. They are comprehensive, realistic, and easily understood. The only difference is that the hospital in one case allows the patient's dog to visit in the room (highly unusual in US hospitals).

The material is easily understood by allied health students. The cases have links to additional learning materials for concepts that may be less familiar or should be explored further in a particular health field.

The language used in the book is consistent between cases. The framework is the same with each case which makes it easier to locate areas that would be of interest to a particular allied health profession.

The case studies are comprehensive but well-organized. They are short enough to be useful for class discussion or a full-blown assignment. The students seem to understand the material and have not expressed that any concepts or details were missing.

Each case is set up like the other cases. There are learning objectives at the beginning of each case to facilitate using the case, and it is easy enough to pull out material to develop useful activities and assignments.

There is a quick chart in the Appendix to allow the reader to determine the professions involved in each case as well as the pertinent settings and diagnoses for each case study. The contents are easy to access even while reading the book.

As a person who attends carefully to grammar, I found no errors in all of the material I read in this book.

There are a greater number of people of different ethnicities, socioeconomic status, ages, and genders to make this a very useful book. With each case, I could easily picture the person in the case. This book appears to be Canadian and more inclusive than most American books.

I was able to use this book the first time I accessed it to develop a classroom activity for first-year occupational therapy students and a more comprehensive activity for second-year students. I really appreciate the links to a multitude of terminology and medical lab values/issues for each case. I will keep using this book.

Reviewed by Cindy Krentz, Assistant Professor, Metropolitan State University of Denver on 6/15/19

The book covers eight case studies of common inpatient or emergency department scenarios. I appreciated that they had written out the learning objectives. I liked that the patient was described before the case was started, giving some understanding of the patient's background. I think it could benefit from having a glossary. I liked how the authors included the vital signs in an easily readable bar. I would have liked to see the labs also highlighted like this. I also felt that it would have been good written in a 'what would you do next?' type of case study.

The book is very accurate in language, what tests would be prudent to run and in the day in the life of the hospital in all cases. One inaccuracy is that the authors called a popliteal artery clot a DVT. The rest of the DVT case study was great, though, but the one mistake should be changed.

The book is up to date for now, but as tests become obsolete and new equipment is routinely used, the book ( like any other health textbook) will need to be updated. It would be easy to change, however. All that would have to happen is that the authors go in and change out the test to whatever newer, evidence-based test is being utilized.

The text is written clearly and easy to understand from a student's perspective. There is not too much technical jargon, and it is pretty universal when used- for example DVT for Deep Vein Thrombosis.

The book is consistent in language and how it is broken down into case studies. The same format is used for highlighting vital signs throughout the different case studies. It's great that the reader does not have to read the book in a linear fashion. Each case study can be read without needing to read the others.

The text is broken down into eight case studies, and within the case studies is broken down into days. It is consistent and shows how the patient can pass through the different hospital departments (from the ER to the unit, to surgery, to home) in a realistic manner. The instructor could use one or more of the case studies as (s)he sees fit.

The topics are eight different case studies- and are presented very clearly and organized well. Each one is broken down into how the patient goes through the system. The text is easy to follow and logical.

The interface has some problems with the highlighted blue links. Some of them did not work and I got a 'page not found' message. That can be frustrating for the reader. I'm wondering if a glossary could be utilized (instead of the links) to explain what some of these links are supposed to explain.

I found two or three typos, I don't think they were grammatical errors. In one case I think the Canadian spelling and the United States spelling of the word are just different.

This is a very culturally competent book. In today's world, however, one more type of background that would merit delving into is the trans-gender, GLBTQI person. I was glad that there were no stereotypes.

I enjoyed reading the text. It was interesting and relevant to today's nursing student. Since we are becoming more interprofessional, I liked that we saw what the phlebotomist and other ancillary personnel (mostly different technicians) did. I think that it could become even more interdisciplinary so colleges and universities could have more interprofessional education- courses or simulations- with the addition of the nurse using social work, nutrition, or other professional health care majors.

Reviewed by Catherine J. Grott, Interim Director, Health Administration Program, TRAILS on 5/5/19

The book is comprehensive but is specifically written for healthcare workers practicing in Canada. The title of the book should reflect this. read more

The book is comprehensive but is specifically written for healthcare workers practicing in Canada. The title of the book should reflect this.

The book is accurate, however it has numerous broken online links.

Relevance/Longevity rating: 3

The content is very relevant, but some links are out-dated. For example, WHO Guidelines for Safe Surgery 2009 (p. 186) should be updated.

The book is written in clear and concise language. The side stories about the healthcare workers make the text interesting.

The book is consistent in terms of terminology and framework. Some terms that are emphasized in one case study are not emphasized (with online links) in the other case studies. All of the case studies should have the same words linked to online definitions.

Modularity rating: 3

The book can easily be parsed out if necessary. However, the way the case studies have been written, it's evident that different authors contributed singularly to each case study.

The organization and flow are good.

Interface rating: 1

There are numerous broken online links and "pages not found."

The grammar and punctuation are correct. There are two errors detected: p. 120 a space between the word "heart" and the comma; also a period is needed after Dr (p. 113).

I'm not quite sure that the social worker (p. 119) should comment that the patient and partner are "very normal people."

There are roughly 25 broken online links or "pages not found." The BC & Canadian Guidelines (p. 198) could also include a link to US guidelines to make the text more universal . The basilar crackles (p. 166) is very good. Text could be used compare US and Canadian healthcare. Text could be enhanced to teach "soft skills" and interdepartmental communication skills in healthcare.

Reviewed by Lindsey Henry, Practical Nursing Instructor, Fletcher on 5/1/19

I really appreciated how in the introduction, five learning objectives were identified for students. These objectives are paramount in nursing care and they are each spelled out for the learner. Each Case study also has its own learning... read more

As a seasoned nurse, I believe that the content regarding pathophysiology and treatments used in the case studies were accurate. I really appreciated how many of the treatments were also explained and rationales were given, which can be very helpful to facilitate effective learning for a nursing student or novice nurse.

The case studies are up to date and correlate with the current time period. They are easily understood.

I really loved how several important medical terms, including specific treatments were highlighted to alert the reader. Many interventions performed were also explained further, which is great to enhance learning for the nursing student or novice nurse. Also, with each scenario, a background and history of the patient is depicted, as well as the perspectives of the patient, patients family member, and the primary nurse. This really helps to give the reader a full picture of the day in the life of a nurse or a patient, and also better facilitates the learning process of the reader.

These case studies are consistent. They begin with report, the patient background or updates on subsequent days, and follow the patients all the way through discharge. Once again, I really appreciate how this book describes most if not all aspects of patient care on a day to day basis.

Each case study is separated into days. While they can be divided to be assigned at different points within the course, they also build on each other. They show trends in vital signs, what happens when a patient deteriorates, what happens when they get better and go home. Showing the entire process from ER admit to discharge is really helpful to enhance the students learning experience.

The topics are all presented very similarly and very clearly. The way that the scenarios are explained could even be understood by a non-nursing student as well. The case studies are very clear and very thorough.

The book is very easy to navigate, prints well on paper, and is not distorted or confusing.

I did not see any grammatical errors.

Each case study involves a different type of patient. These differences include race, gender, sexual orientation and medical backgrounds. I do not feel the text was offensive to the reader.

I teach practical nursing students and after reading this book, I am looking forward to implementing it in my classroom. Great read for nursing students!

Reviewed by Leah Jolly, Instructor, Clinical Coordinator, Oregon Institute of Technology on 4/10/19

Good variety of cases and pathologies covered. read more

Good variety of cases and pathologies covered.

Content Accuracy rating: 2

Some examples and scenarios are not completely accurate. For example in the DVT case, the sonographer found thrombus in the "popliteal artery", which according to the book indicated presence of DVT. However in DVT, thrombus is located in the vein, not the artery. The patient would also have much different symptoms if located in the artery. Perhaps some of these inaccuracies are just typos, but in real-life situations this simple mistake can make a world of difference in the patient's course of treatment and outcomes.

Good examples of interprofessional collaboration. If only it worked this way on an every day basis!

Clear and easy to read for those with knowledge of medical terminology.

Good consistency overall.

Broken up well.

Topics are clear and logical.

Would be nice to simply click through to the next page, rather than going through the table of contents each time.

Minor typos/grammatical errors.

No offensive or insensitive materials observed.

Reviewed by Alex Sargsyan, Doctor of Nursing Practice/Assistant Professor , East Tennessee State University on 10/8/18

Because of the case study character of the book it does not have index or glossary. However it has summary for each health case study outlining key elements discussed in each case study. read more

Because of the case study character of the book it does not have index or glossary. However it has summary for each health case study outlining key elements discussed in each case study.

Overall the book is accurately depicting the clinical environment. There are numerous references to external sites. While most of them are correct, some of them are not working. For example Homan’s test link is not working "404 error"

Book is relevant in its current version and can be used in undergraduate and graduate classes. That said, the longevity of the book may be limited because of the character of the clinical education. Clinical guidelines change constantly and it may require a major update of the content.

Cases are written very clearly and have realistic description of an inpatient setting.

The book is easy to read and consistent in the language in all eight cases.

The cases are very well written. Each case is subdivided into logical segments. The segments reflect different setting where the patient is being seen. There is a flow and transition between the settings.

Book has eight distinct cases. This is a great format for a book that presents distinct clinical issues. This will allow the students to have immersive experiences and gain better understanding of the healthcare environment.

Book is offered in many different formats. Besides the issues with the links mentioned above, overall navigation of the book content is very smooth.

Book is very well written and has no grammatical errors.

Book is culturally relevant. Patients in the case studies come different cultures and represent diverse ethnicities.

Reviewed by Justin Berry, Physical Therapist Assistant Program Director, Northland Community and Technical College, East Grand Forks, MN on 8/2/18

This text provides eight patient case studies from a variety of diagnoses, which can be utilized by healthcare students from multiple disciplines. The cases are comprehensive and can be helpful for students to determine professional roles, interprofessional roles, when to initiate communication with other healthcare practitioners due to a change in patient status, and treatment ideas. Some additional patient information, such as lab values, would have been beneficial to include.

Case study information is accurate and unbiased.

Content is up to date. The case studies are written in a way so that they will not be obsolete soon, even with changes in healthcare.

The case studies are well written, and can be utilized for a variety of classroom assignments, discussions, and projects. Some additional lab value information for each patient would have been a nice addition.

The case studies are consistently organized to make it easy for the reader to determine the framework.

The text is broken up into eight different case studies for various patient diagnoses. This design makes it highly modular, and would be easy to assign at different points of a course.

The flow of the topics are presented consistently in a logical manner. Each case study follows a patient chronologically, making it easy to determine changes in patient status and treatment options.

The text is free of interface issues, with no distortion of images or charts.

The text is not culturally insensitive or offensive in any way. Patients are represented from a variety of races, ethnicities, and backgrounds

This book would be a good addition for many different health programs.

Reviewed by Ann Bell-Pfeifer, Instructor/Program Director, Minnesota State Community and Technical College on 5/21/18

The book gives a comprehensive overview of many types of cases for patient conditions. Emergency Room patients may arrive with COPD, heart failure, sepsis, pneumonia, or as motor vehicle accident victims. It is directed towards nurses, medical laboratory technologists, medical radiology technologists, and respiratory therapists and their roles in caring for patients. Most of the overview is accurate. One suggestion is to provide an embedded radiologist interpretation of the exams which are performed which lead to the patients diagnosis.

Overall the book is accurate. Would like to see updates related to the addition of direct radiography technology which is commonly used in the hospital setting.

Many aspects of medicine will remain constant. The case studies seem fairly accurate and may be relevant for up to 3 years. Since technology changes so quickly in medicine, the CT and x-ray components may need minor updates within a few years.

The book clarity is excellent.

The case stories are consistent with each scenario. It is easy to follow the structure and learn from the content.

The book is quite modular. It is easy to break it up into cases and utilize them individually and sequentially.

The cases are listed by disease process and follow a logical flow through each condition. They are easy to follow as they have the same format from the beginning to the end of each case.

The interface seems seamless. Hyperlinks are inserted which provide descriptions and references to medical procedures and in depth definitions.

The book is free of most grammatical errors. There is a place where a few words do not fit the sentence structure and could be a typo.

The book included all types of relationships and ethnic backgrounds. One type which could be added is a transgender patient.

I think the book was quite useful for a variety of health care professionals. The authors did an excellent job of integrating patient cases which could be applied to the health care setting. The stories seemed real and relevant. This book could be used to teach health care professionals about integrated care within the emergency department.

Reviewed by Shelley Wolfe, Assistant Professor, Winona State University on 5/21/18

This text is comprised of comprehensive, detailed case studies that provide the reader with multiple character views throughout a patient’s encounter with the health care system. The Table of Contents accurately reflected the content. It should be noted that the authors include a statement that conveys that this text is not like traditional textbooks and is not meant to be read in a linear fashion. This allows the educator more flexibility to use the text as a supplement to enhance learning opportunities.

The content of the text appears accurate and unbiased. The “five overarching learning objectives” provide a clear aim of the text and the educator is able to glean how these objectives are captured into each of the case studies. While written for the Canadian healthcare system, this text is easily adaptable to the American healthcare system.

Overall, the content is up-to-date and the case studies provide a variety of uses that promote longevity of the text. However, not all of the blue font links (if using the digital PDF version) were still in working order. I encountered links that led to error pages or outdated “page not found” websites. While the links can be helpful, continued maintenance of these links could prove time-consuming.

I found the text easy to read and understand. I enjoyed that the viewpoints of all the different roles (patient, nurse, lab personnel, etc.) were articulated well and allowed the reader to connect and gain appreciation of the entire healthcare team. Medical jargon was noted to be appropriate for the intended audience of this text.

The terminology and organization of this text is consistent.

The text is divided into 8 case studies that follow a similar organizational structure. The case studies can further be divided to focus on individual learning objectives. For example, the case studies could be looked at as a whole for discussing communication or could be broken down into segments to focus on disease risk factors.

The case studies in this text follow a similar organizational structure and are consistent in their presentation. The flow of individual case studies is excellent and sets the reader on a clear path. As noted previously, this text is not meant to be read in a linear fashion.

This text is available in many different forms. I chose to review the text in the digital PDF version in order to use the embedded links. I did not encounter significant interface issues and did not find any images or features that would distract or confuse a reader.

No significant grammatical errors were noted.

The case studies in this text included patients and healthcare workers from a variety of backgrounds. Educators and students will benefit from expanding the case studies to include discussions and other learning opportunities to help develop culturally-sensitive healthcare providers.

I found the case studies to be very detailed, yet written in a way in which they could be used in various manners. The authors note a variety of ways in which the case studies could be employed with students; however, I feel the authors could also include that the case studies could be used as a basis for simulated clinical experiences. The case studies in this text would be an excellent tool for developing interprofessional communication and collaboration skills in a variety healthcare students.

Reviewed by Darline Foltz, Assistant Professor, University of Cincinnati - Clermont College on 3/27/18

This book covers all areas listed in the Table of Contents. In addition to the detailed patient case studies, there is a helpful section of "How to Use this Resource". I would like to note that this resource "aligns with the open textbooks... read more

The book appears to be accurate. Although one of the learning outcomes is as follows: "Demonstrate an understanding of the Canadian healthcare delivery system.", I did not find anything that is ONLY specific to the Canadian healthcare delivery system other than some of the terminology, i.e. "porter" instead of "transporter" and a few french words. I found this to make the book more interesting for students rather than deter from it. These are patient case studies that are relevant in any country.

The content is up-to-date. Changes in medical science may occur, i.e. a different test, to treat a diagnosis that is included in one or more of the case studies, however, it would be easy and straightforward to implement these changes.

This book is written in lucid, accessible prose. The technical/medical terminology that is used is appropriate for medical and allied health professionals. Something that would improve this text would to provide a glossary of terms for the terms in blue font.

This book is consistent with current medical terminology

This text is easily divided into each of the 6 case studies. The case studies can be used singly according to the body system being addressed or studied.

Because this text is a collection of case studies, flow doesn't pertain, however the organization and structure of the case studies are excellent as they are clear and easy to read.

There are no distractions in this text that would distract or confuse the reader.

I did not identify any grammatical errors.

This text is not culturally insensitive or offensive in any way and uses patients and healthcare workers that are of a variety of races, ethnicities and backgrounds.

I believe that this text would not only be useful to students enrolled in healthcare professions involved in direct patient care but would also be useful to students in supporting healthcare disciplines such as health information technology and management, medical billing and coding, etc.

Introduction

Case Study #1: Chronic Obstructive Pulmonary Disease (COPD)

Learning Objectives
Patient: Erin Johns
Emergency Room

Case Study #2: Pneumonia

Day 0: Emergency Room
Day 1: Emergency Room
Day 1: Medical Ward
Day 2: Medical Ward
Day 3: Medical Ward
Day 4: Medical Ward

Case Study #3: Unstable Angina (UA)

Patient: Harj Singh

Case Study #4: Heart Failure (HF)

Patient: Meryl Smith
In the Supermarket
Day 0: Medical Ward

Case Study #5: Motor Vehicle Collision (MVC)

Patient: Aaron Knoll
Crash Scene
Operating Room
Post Anaesthesia Care Unit (PACU)
Surgical Ward

Case Study #6: Sepsis

Patient: George Thomas
Sleepy Hollow Care Facility

Case Study #7: Colon Cancer

Patient: Fred Johnson
Two Months Ago
Pre-Surgery Admission

Case Study #8: Deep Vein Thrombosis (DVT)

Patient: Jamie Douglas

Appendix: Overview About the Authors

Ancillary Material

About the book.

Health Case Studies is composed of eight separate health case studies. Each case study includes the patient narrative or story that models the best practice (at the time of publishing) in healthcare settings. Associated with each case is a set of specific learning objectives to support learning and facilitate educational strategies and evaluation.

The case studies can be used online in a learning management system, in a classroom discussion, in a printed course pack or as part of a textbook created by the instructor. This flexibility is intentional and allows the educator to choose how best to convey the concepts presented in each case to the learner.

Because these case studies were primarily developed for an electronic healthcare system, they are based predominantly in an acute healthcare setting. Educators can augment each case study to include primary healthcare settings, outpatient clinics, assisted living environments, and other contexts as relevant.

About the Contributors

Glynda Rees teaches at the British Columbia Institute of Technology (BCIT) in Vancouver, British Columbia. She completed her MSN at the University of British Columbia with a focus on education and health informatics, and her BSN at the University of Cape Town in South Africa. Glynda has many years of national and international clinical experience in critical care units in South Africa, the UK, and the USA. Her teaching background has focused on clinical education, problem-based learning, clinical techniques, and pharmacology.

Glynda‘s interests include the integration of health informatics in undergraduate education, open accessible education, and the impact of educational technologies on nursing students’ clinical judgment and decision making at the point of care to improve patient safety and quality of care.

Faculty member in the critical care nursing program at the British Columbia Institute of Technology (BCIT) since 2003, Rob has been a critical care nurse for over 25 years with 17 years practicing in a quaternary care intensive care unit. Rob is an experienced educator and supports student learning in the classroom, online, and in clinical areas. Rob’s Master of Education from Simon Fraser University is in educational technology and learning design. He is passionate about using technology to support learning for both faculty and students.

Part of Rob’s faculty position is dedicated to providing high fidelity simulation support for BCIT’s nursing specialties program along with championing innovative teaching and best practices for educational technology. He has championed the use of digital publishing and was the tech lead for Critical Care Nursing’s iPad Project which resulted in over 40 multi-touch interactive textbooks being created using Apple and other technologies.

Rob has successfully completed a number of specialist certifications in computer and network technologies. In 2015, he was awarded Apple Distinguished Educator for his innovation and passionate use of technology to support learning. In the past five years, he has presented and published abstracts on virtual simulation, high fidelity simulation, creating engaging classroom environments, and what the future holds for healthcare and education.

Janet Morrison is the Program Head of Occupational Health Nursing at the British Columbia Institute of Technology (BCIT) in Burnaby, British Columbia. She completed a PhD at Simon Fraser University, Faculty of Communication, Art and Technology, with a focus on health information technology. Her dissertation examined the effects of telehealth implementation in an occupational health nursing service. She has an MA in Adult Education from St. Francis Xavier University and an MA in Library and Information Studies from the University of British Columbia.

Janet’s research interests concern the intended and unintended impacts of health information technologies on healthcare students, faculty, and the healthcare workforce.

She is currently working with BCIT colleagues to study how an educational clinical information system can foster healthcare students’ perceptions of interprofessional roles.

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Teaching with Case Studies to Develop Clinical Reasoning

By Ann Horigan

Owen, M.I. (2017). A case study scavenger hunt for senior nursing students. Journal of Nursing Education, 56(3), 191. doi: 10.3928/01484834-20170222-13. Describes the use of a case study and simulation used with a group of senior nursing students in a synthesis seminar. The purpose of the exercise in this course was to provide students with a standardized method of analyzing and synthesizing content from previous courses to help prepare them for the RN licensure exam. Good example of using a case study with low fidelity simulation and demonstrates that students benefit from this type of exercise. However, this was done in a sim lab setting in small groups of students and does not delve into issues of using case studies in a didactic setting to establish and further clinical reasoning.
Peery, A. (2015). Use of the unfolding case study in teaching nurse educator master of science in nursing students. Journal of Nursing Education, 54(3), 180. doi: 10.3928/01484834-20150217-11 . Course for nurse educator MSN students done in an online format which uses an unfolding case study to work through challenging issues that a nurse educator is likely to encounter. Unfolding cases promote inquiry among students and should be believable and relevant to the class. Four steps to developing an unfolding case study are discussed. Students found the exercise useful and made them aware of situations they otherwise may not have been aware of in education. It is a dynamic and engaging method for teaching and preparing for real-life scenarios. This article is helpful as it notes the steps in devising an unfolding case study and the benefits of using this type of exercise. It would be more helpful if this had been set up as a formal inquiry with specific measures of application and synthesis pre and post. As it is, it describes an experience and innovative method which is helpful.
Kaylor, S. and Strickland, H. (2015). Unfolding case studies as a formative teaching methodology for novice nursing students. Journal of Nursing Education, 54(2), 106-110. doi:10.3928/01484834-20150120-06. Describes a way in which unfolding case studies can be used to teach undergraduate nursing, novice students evidence based practice information rather than the case study acting as a summative evaluation of knowledge. Unfolding case studies develop over time and are unpredictable to the learner. If well done, promotes experiential education and imagination. Students picture themselves as part of the scenario. Enables students to practice making decisions and evaluating the effects of those decisions in a non-threatening environment. When this is done in small groups, students are developing decision making, communication, clinical judgment and problem solving. Helps students connect dots between theory and practice. Authors recommend that this is not the only method of active learning used throughout the semester and should be used several times but not exhaustively. Excellent article that presents a unique active learning method with benefits, barriers, lessons learned. Would be interesting to see what students thought of it as a learning method.
Dudas, K. (2012). Podcast and unfolding case study to promote active learning. Journal of Nursing Education, 51(8), 476. DOI:10.3928/01484834-20120719-02. Describes the use of a pre-class podcast used to give information for an unfolding case study on a patient with a neuromuscular disorder completed in class. Information from the podcast was reviewed at the beginning of class and then students were given the unfolding case study. Class reconvened and answers to the case study reviewed. Students reported feeling actively involved in learning and that clinical decision making skills improved. Students wanted these more frequently in the course. Authors state that while unfolding case studies are time consuming to prepare, the benefits from active learning outweigh the time needed.
Utterback, V., Davenport, D. Gallegos, B. & Boyd, E. (2012). The critical difference assignment: An innovative instructional method. Journal of Nursing Education, 51(1), 42-45. DOI:10.3928/01484834-20111116-03. Describes an assignment called the Critical Difference assignment where two case studies are given to students who must use reasoning to differentiate between the 2 cases. The cases have similar patient presentations but have differing and unknown underlying pathophysiologies. Students must compare and contrast symptoms, lab results, diagnostic studies to come to an understanding of the critical difference between the 2 cases and then develop a plan of care for each case based on the similarities and differences in the cases. These studies are called companion case studies and are purposely constructed so that students must discriminate between 2 similarly presenting patient problems. The outcomes from this type of learning are that the learner can learn by themselves, learn with others, share information, and make decisions. This mirrors the ability to work with others in the clinical setting. Excellent example of how to move students thinking to the next level. Again, would be interesting to see what students thought of experience as well as any objective measures of how this has helped initiate clinical judgment or improve abilities in clinical judgment.
Priddy, K. & Crow, M. (2011). Clinical imagination: Dynamic cast studies using an attribute listing matrix. Journal of Nursing Education, 50(10), 591-594. DOI:10.3928/01484834-20110630-03. Describes how to develop and use a matrix for choosing elements of a case study so that they are randomly generated and students have differing elements with different outcomes. It allows for more opportunities to role model and richer discussion. The number of choices on the matrix can be based on the context and the problem at hand. This can be done based on developmental level of students and where they are in the nursing curriculum. It describes the steps of how to implement this in class in detail which is very helpful. The variety of options possible gives opportunity for great discussion and generation of nursing knowledge. Great example of what can be done in smaller groups as formative or summative evaluation. Would be difficult to do in a large lecture course. Again, no objective measures of how this has pushed students to think and engage.
Bennett, C., Kennedy, S. & Donato, A. (2011). Preparing NP’s for primary care: Unraveling complexity with unfolding cases. Journal of Nursing Education, 50(6), 328-331. doi:10.3928/01484834-20110228-05. Describes the use of Backward Design (identifying desired results, identifying evidence of learning and developing teaching methods) to design a course for nurse practitioners in a behavioral health therapeutics course. Faculty developed cases that included an initial patient encounter and follow up encounter which were video taped with actors and complications of treatment or new problems were added at follow up visits. In the final step of Backward Design, creating teaching methods, the authors used Zull’s model of learning as brain change, which encourage innovative strategies to teach in context. There is an emphasis on reflection and iterative knowledge development. The authors found that students’ iterative thought processes advanced as they were able to practice as independent clinicians in a safe and collaborative environment. Course evaluations were done based on university requirements and therefore did not evaluate this method specifically, but they state that written feedback was overwhelmingly positive. Would be nice to see objective measures of advancement of clinical thinking, maybe samples of how grades improved over the semester or how pass rates on certification exams improved.
Beyer, D. (2011). Reverse case study: To think like a nurse. Journal of Nursing Education, 50(1), 48-50. doi:10.3928/01484834-20101029-06. Describes combining two active learning strategies, case studies and concept mapping into a reverse case study to promote critical thinking and problem solving. The article outlines a process for creating a reverse case study to be used in small groups. They are given a blank concept map with elements of the nursing process and patient history on it, but with no specific information other than a list of medications. Students work backward from that point to devise a list of anticipated medical problems the patient probably experiences and the care for these problems. The complexity of the cases can be manipulated by the number and type of medications. Groups then present their cases and priorities. This is a unique twist on the traditional case study. It could be done at every level of nursing education and development. A lab or discussion course would probably be best, not a class of 100+ students.
Tanner, C. (2009). The case for cases: A pedagogy for developing habits of thought. Journal of Nursing Education, 48(6), 299-300. An editorial that argues that the use of case based learning as a method that supports experiential thinking, clinical judgment and encourages students to “think like a nurse”. No information on actual work done in classroom.
Sandstom, S. (2006). Use of case studies to teach diabetes and other chronic illnesses to nursing students. Journal of Nursing Education, 45(6), 229-232. Case studies increase learning by “placing” them in a situation where they must use or apply knowledge learned in the classroom. They are in a real world situation with decisions to make. The use of the example case study is done in the laboratory setting about diabetes as students are learning to draw up insulin and monitor blood glucose. Discusses 2 other assignments related to diabetes content that students are assigned. The article lacks depth about how the case studies are developed and why. No objective findings of student evaluation or learning other than the author’s recitation of what has been said in lab.
Schlenker, E. & Kerber, C. (2006). The CARE case study method for teaching community health nursing. Journal of Nursing Education, 45(4), 144. Stands for Case study, Application, Research, Evaluation. Goal of this method is to facilitate understanding of theoretical content, foster interaction between faculty and students and knowledge sharing, give opportunities to apply knowledge in the classroom. Case studies are developed based on current topics in community health nursing and introduced during class time. Students work in small groups to answer clinical questions. The authors state that this has been well received by students who are motivated and excited to come to class and have done the prep work. There is no description of how the case studies are generated other than by choosing current topics in community health nursing, there is also no further discussion of how this method is used but a generic description. More detail would be helpful.
Loving, G. & Siow, P. (2005). Use of an online case study template in nursing education. Journal of Nursing Education, 44(8), 387-388. The authors created a template to be used in online nursing courses that was based on interactivity and feedback for faculty to use in the design of case studies. It is a set of online forms that allows faculty to enter information. Students also work through this case study and click on multiple choice answers where feedback is given. This isn’t particularly helpful information. It doesn’t inform how the body of the case should be created, the elements, whether they should unfold and how or how the students interface with the case study in detail.
Tarcinale, M. (1987). The case study as a vicarious learning technique. Journal of Nursing Education, 26(8), 340-341. Discusses vicarious learning or learning through imagination, which I think now 30 years later would be experiential, or situational learning. The learner will use information from previous experiences to help solve current situational problems. Components of a case study are discussed (very helpful and one of only a few articles that do this). The placement of the case study in class depends on what it would be used for. Helpful information, but I think that the case study method has evolved quite a bit over time to include the reverse and unfolding case studies. However this is a good summary of how a basic case study can be used to bring abstract concepts to more concrete understanding.
Page, J., Kowlowitz, V. & Alden, K. (2010). Development of a scripted unfolding case study focusing on delirium in older adults. The Journal of Continuing Education in Nursing, 41(5), 225-230. DOI:10.3928/00220124-20100423-05. The article begins by talking about how simulation is an important piece of practice based learning and that continuing education for nurses should incorporate more of it. The article then goes on to describe how to develop an unfolding case study. (might be splitting hairs, but case studies and simulation are not the same, many times simulation will use a case study, but sometimes it doesn’t. And not all uses of case studies are simulation. They don’t do a good job of connecting the two in the article) The steps for developing a case study for use are outlined as well as how to review it before implementing it. The authors present data on evaluation of the case by nurses who were involved in the continuing education. This is good information, detailed in the description of how the case can be developed, presented and evaluated.
Jones, D. & Sheridan, M., (1999). A case study approach: Developing critical thinking skills in novice pediatric nurses. The Journal of Continuing Education in Nursing, 30(2), 75-78. Key component of nursing is problem solving, but not all nurses are good at it. The use of case studies promotes problem solving and critical thinking. They can be done with real or hypothetical situations. Provides an opportunity to enact in decision making when a real clinical situation isn’t available. In novice pediatric nurses, case studies reinforce what was learned in school but also introduce them to unique situations in family focused nursing. The article goes on to describe that case studies should include certain elements and gives and example. The article does not present data on how case studies have improved novice nurses comfort level or competence in working with families and children or if novice nurses found them useful during an orientation period.
Smallheer, B. (2016). Reverse case study: A new perspective on an existing teaching strategy. Nurse Educator, 41(1), 7-8. DOI: 10.1097/NNE.0000000000000186. Traditional case studies can be limited to utilizing the lower portion of Blooms taxonomy, remembering, understanding, applying. The reverse case study can engage students in higher parts of taxonomy: analyzing evaluating and creating. Students actually develop the scenario which means they must analyze and evaluate material in creating the materials and data for the case study. The article gives an example of a graded reverse case study done in a nursing pharmacology class. During the session, faculty observed collaboration, team work, prioritization and critical thinking. This type of case study refocuses students from being task oriented to being thinkers and planners. Would be an excellent process for lab or seminar group, clinical post conference group. May be difficult to do in a large class without splitting into groups. Again, wonder if there are any objective measures regarding student outcomes.
Porter-Wenzlaff, L. (2013). Unfolding multicourse case study: Developing students administrative competencies. Nurse Educator, 38(6), 241-245. DOI: 10.1097/01.NNE.0000435263.15495.9f. The articles describes an unfolding case study that is done over 2 semesters in 2 courses. This is done in 2 graduate level nurse executive courses that are leveled. Students work in teams as the nurse executive of a fictional facility and must work through administrative complexities such as physician relations, resource allocation etc. Students are to do individual pieces of projects and come together and use the work in the larger objective. The projects progress across semesters and ideally students teams are the same as semesters change. The author recognized that students felt over whelmed and unprepared for this learning (and probably would have no matter the format) but found ways to help them work through by validating their concerns, having help available and that learning is an ongoing process. This paper does a great job of reporting anecdotal feedback from students, although it acknowledges there were no formal pre and post measures of implementation of this case study format.
Harrison, E., (2012). How to develop well written case studies: The essential elements. Nurse Educator, 37(2), 67-70. DOI: 10.1097/NNE.0b013e3182461ba2. Briefly discusses the history of the use of case studies as educational tool in nursing. Suggests that case studies, much like narratives, should have a setting, characters, plot and elements of style that come together to create a mystery, a puzzle to be solved by the information given and knowing what additional information is needed. Students identify important data from that data that may be superfluous or not essential to the case. This is a unique way to describe a case study and how to create elements that nurses may forget, or not emphasize in their creation of case studies. Would be helpful to know if this paradigm has been used by others and if they found it effective.
Henning, J.E., Nielsen, L.E. & Hauschildt, J.A. (2006). Implementing case study methodology in critical care nursing: a discourse analysis. Nurse Educator, 31(4):153-8. Describes a change in content delivery technique based on student feedback that lectures were boring and they wanted to experience more patient scenarios. Case study approach was adopted to increase interaction between teacher and students. Used method by Stepien et al. to analyze the case. A model for discussion was then used with the case method which uses 3 types of discussion, 1. Frame the discussion where interest is generated and background information is given. 2. Conceptual discussion – teacher guides students in grasping concept 3. Application discussions where students discuss newly acquired knowledge is discussed as applied to scenarios. Using this method required that the teacher learn a new way to talk with or to students; had to learn how to elicit information from students and respond to them. Student participation increased significantly with each addition of the next level of discussion where the teacher adjusted their questioning/cuing of students to elicit more response. They found that students spoke 2x as much as professor and both students and teacher seemed to become more comfortable with their new role as discussions went on. Very helpful in describing a way in which a classroom discussion can take place, one that elicits student participation and lets students guide the learning and morphs into a review discussion where the teacher makes sure that students understand the material accurately and use their discussion to apply newly acquired material.
Ciesielka, D. (2003). Clues for clinicians: a case study approach to educating the renaissance nurse. Nurse Educator, 28(1), 3-4. Describes a way to integrate the humanities into a rigorous graduate curriculum already packed with science in order to prepare nurses to be able to work with patients of all cultures and social status. Developed Clues for Clinicians and used in the first clinical reasoning/clinical judgment course in nurse practitioner program. Instead of deriving cases from standard everyday clinical practice, cases were developed based on historical accounts. Faculty guided students in problem solving and students found themselves discussing the medical issue while also investigating a part of medical history.. Feedback was unanimously positive. I’m not convinced that this infuses humanities to the extent that the authors think it does, but it does keep interest and encourages student participation and reasoning as well as gives students something memorable to hang the information on.
Dowd, S.B. & Davidhizar, R. (1999). Using case studies to teach clinical problem-solving. Nurse Educator, 24(5), 42-6. Discusses advantages of using case studies to as well as preparation for faculty. Lists ways to prepare the case studies and how case studies can be solved. Case studies connect theory to practice. They require preparation on the part of faculty and flexibility in allowing students to solve the case.
Summary of findings: Most studies lack any data regarding student performance in clinical reasoning or judgment pre/post implementation of this method. While there is evidence that students find this method useful and engaging, no study presents findings that demonstrate that the case study method does what it’s purported to do. Studies discuss the preparation that must go into the case study development, that there are different ways of using the case study method (traditional, unfolding, reverse) and that students find them beneficial as well as how thinking is transformed to reach higher levels of Blooms Taxonomy. Almost all studies discuss case studies used in small groups or large classes broken into groups. None discuss how to lead a large class through a case and if/how this can engage students as well as improve their clinical reasoning. Only one articles discusses the use of an ongoing case that continues to the next semester, and this is for graduate students who are at a very different level of processing information than undergraduate students.

Nursing Case Study Examples and Solutions

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August 17, 2023
Nursing Essay Examples

NursingStudy.org is your ultimate resource for nursing case study examples and solutions. Whether you’re a nursing student, a seasoned nurse looking to enhance your skills, or a healthcare professional seeking in-depth case studies, our comprehensive collection has got you covered. Explore our extensive category of nursing case study examples and solutions to gain valuable insights, improve your critical thinking abilities, and enhance your overall clinical knowledge.

Comprehensive Nursing Case Studies

Discover a wide range of comprehensive nursing case study examples and solutions that cover various medical specialties and scenarios. These meticulously crafted case studies offer real-life patient scenarios, providing you with a deeper understanding of nursing practices and clinical decision-making processes. Each case study presents a unique set of challenges and opportunities for learning, making them an invaluable resource for nursing education and professional development.

Nursing Case Study Analysis [10 Examples & How-To Guides] What is a case study analysis? A case study analysis is a detailed examination of a specific real-world situation or event. It is typically used in business or nursing school to help students learn how to analyze complex problems and make decisions based on limited information.
State three nursing diagnoses using taxonomy of North American Nursing Diagnosis Association (NANDA) that are appropriate, formatted correctly, prioritized, and are based on the case study. NUR 403 Week 2 Individual Assignment Case Study comprises: Resources: The case study found on p. 131 in Nursing Theory and the Case Study Grid on the Materials page of the student website Complete the Case Study Grid. List five factors of patient history that demonstrates nursing needs.
Neuro Case Study
Endocrine Case Study
Anxiety & Depression Case Study
Ethical dilemma
A Puerto Rican Woman With Comorbid Addiction
Tina Jones Comprehensive SOAP Note
Insomnia 31 year old Male
Chest Pain Assessment

Pediatric Nursing Case Studies

In this section, delve into the world of pediatric nursing through our engaging and informative case studies. Gain valuable insights into caring for infants, children, and adolescents, as you explore the complexities of pediatric healthcare. Our pediatric nursing case studies highlight common pediatric conditions, ethical dilemmas, and evidence-based interventions, enabling you to enhance your pediatric nursing skills and deliver optimal care to young patients.

Case on Pediatrics : Part 1& 2 Solutions
Pediatric Infant Reflux : History and Physical – Assignment 1 Solution
Otitis Media Pediatrics Toddler – NSG 5441 Reflection Assignment/Discussion – Solution
Pediatric Patient With Strep – NSG 5441 Reflection Assignment/Discussion
Pediatric Urinary Tract infections (UTI) -NSG 5441 Reflection Assignment/Discussion – Solution
Week 3 discussion-Practical Application in critical care/pediatrics
Cough Assessmen t

Mental Health Nursing Case Study Examples

Mental health nursing plays a crucial role in promoting emotional well-being and providing care for individuals with mental health conditions. Immerse yourself in our mental health nursing case studies, which encompass a wide range of psychiatric disorders, therapeutic approaches, and psychosocial interventions. These case studies offer a holistic view of mental health nursing, equipping you with the knowledge and skills to support individuals on their journey to recovery.

Psychiatric Nursing: Roles and Importance in Providing Mental Health Care
Mental Health Access and Gun Violence Prevention
Fundamentals of neurotransmission as it relates to prescribing psychotropic medications for clients with acute and chronic mental health conditions – Unit 8 Discussion – Reflection
Unit 7 Discussion- Complementary and Alternative Medicine in Mental Health Care – Solution
Ethical and Legal Foundations of PMHNP Care Across the Lifespan Assignment – Analyze salient ethical and legal issues in psychiatric-mental health practice | Solution
Pathways Mental Health Case Study – Review evaluation and management documentation for a patient and perform a crosswalk of codes – Solution
Analyze salient ethical and legal issues in psychiatric-mental health practice
SOAP notes for Mental Health Examples
compare and contrast two mental health theories
Environmental Factors and Health Promotion Presentation: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants

Geriatric Nursing Case Studies

As the population ages, the demand for geriatric nursing expertise continues to rise. Our geriatric nursing case studies focus on the unique challenges faced by older adults, such as chronic illnesses, cognitive impairments, and end-of-life care. By exploring these case studies, you’ll develop a deeper understanding of geriatric nursing principles, evidence-based gerontological interventions, and strategies for promoting optimal health and well-being in older adults.

M5 Assignment: Elderly Driver
HE003: Delivery of Services – Emmanuel is 55-year-old man Case – With Solution The Extent of Evidence-Based Data for Proposed Interventions – Sample Assignment 1 Solution
Planning Model for Population Health Management Veterans Diagnosed with Non cancerous chronic pain – Part 1 & 2 Solutions
PHI 413 Case Study Fetal Abnormality Essay
Insomnia Response and Insomnia
Analysis of a Pertinent Healthcare Issue: Short Staffing
Paraphrenia as a Side of the Schizophrenia – Week 4 Solution
Module 6 Pharm Assignment: Special Populations
Public Health Nursing Roles and Responsibilities in Disaster Response – Assignment 2 Solution
Theory Guided Practice – Assignment 2 Solution
How can healthcare facilities establish a culture of safety – Solution
Discuss the types of consideration a nurse must be mindful of while performing a health assessment on a geriatric patient as compared to a middle-aged adult – Solution
Promoting And Protecting Vulnerable Populations – Describe what is meant by vulnerable populations and explain strategies you, as the public health nurse, could use to best facilitate the achievement of healthful outcomes in this population?

Community Health Nursing Case Studies

Community health nursing plays a vital role in promoting health, preventing diseases, and advocating for underserved populations. Dive into our collection of community health nursing case studies, which explore diverse community settings, public health issues, and population-specific challenges. Through these case studies, you’ll gain insights into the role of community health nurses, interdisciplinary collaboration, health promotion strategies, and disease prevention initiatives.

Community and Target Aggregate: Residents of the community health center, particularly those aged 65 and above Topic: Secondary Prevention/Screenings for a Vulnerable Population
Tools For Community Health Nursing Practice2
5 Theories in Community Health Nursing: A Complete Guide
Role of community health nursing and community partnerships as they apply to the participating family’s community – Assignment 1 Solution
Community/Public Health Nursing DQ2
CSU-Community healthcare Presentation – Assignment 1 Solution
Community Healthcare Presentation – Domestic Violence And Level Of Prevention – Solution

Critical Care Nursing Case Study Examples

Critical care nursing demands swift decision-making, advanced technical skills, and the ability to provide intensive care to acutely ill patients. Our critical care nursing case studies encompass a range of high-acuity scenarios, including trauma, cardiac emergencies, and respiratory distress. These case studies simulate the fast-paced critical care environment, enabling you to sharpen your critical thinking skills, enhance your clinical judgment, and deliver exceptional care to critically ill patients.

Nursing Case Study Parkinsons Disease
Nursing Case Study: Patient with Drug and Alcohol Induced Paranoid Schizophrenia
Neonatal Hypothermia and Neonatal Sepsis: Nursing Case Study
Chronic Obstructive Pulmonary Disease Nursing Case Study

Maternal and Child Health Nursing Case Study Examples

The field of maternal and child health nursing requires specialized knowledge and skills to support the health and well-being of women and children throughout their lifespan. Explore our collection of maternal and child health nursing case studies, which encompass prenatal care, labor and delivery, postpartum care, and pediatric nursing. These case studies provide a comprehensive view of maternal and child health, allowing you to develop expertise in this essential area of nursing practice.

You can also check out Patient Safety in High-Tech Settings PICOT Questions Examples

Surgical Nursing Case Studies

Surgical nursing involves caring for patients before, during, and after surgical procedures. Our surgical nursing case studies cover a wide range of surgical specialties, including orthopedics, cardiovascular, and gastrointestinal surgeries. Delve into these case studies to gain insights into preoperative assessment, perioperative management, and postoperative care. By examining real-life surgical scenarios, you’ll develop a comprehensive understanding of surgical nursing principles and refine your skills in providing exceptional care to surgical patients.

Discuss DI in relation to a postoperative neurosurgical patient – Week 2, 3, 4 Solution
DISCUSSION WK 3
Career Planning & Professional Identity Paper
N ursing Case Analysis
Ethical Dilemma on Robotic Surgery and ACS Codes of Ethics – Post 2
NURS – 6521C Advanced Pharmacology
Essay on Alterations in Neurological and Endocrine Functions
Clinical Preparation Tool – Child and Adolescent Symptom Inventory – Unit
Initial Psychiatric Interview/SOAP Note – Assignment 1 Solution
Current Trends in Nursing Practice: Electronic Prescriptions for Opioids – Week 4 Solution
Nurse-Sensitive Indicators -Week 3 Solution
Theory–Practice Gap in Jean Watson Theory of Human Caring – Assignment 1 Solution
Bowel Obstruction Case Video Presentation – Week 4 Solution
Appendicitis SOAP Note – Sample SOAP Solution 1
Week 4: GERD SOAP Note Assignment Solution

Obstetric Nursing Case Study

Obstetric nursing focuses on providing care to women during pregnancy, childbirth, and the postpartum period. Our obstetric nursing case studies explore various aspects of prenatal care, labor and delivery, and postpartum recovery. Gain valuable knowledge about common obstetric complications, evidence-based interventions, and strategies for promoting maternal and fetal well-being. These case studies will enhance your obstetric nursing skills and prepare you to deliver compassionate and competent care to expectant mothers.

Capstone Proposal: Postpartum Hemorrhage Education To Nursing Students
Progress Evaluation Telecommunication: Teleconference on Post-Partum Hemorrhage
Case Study 5.2 the Moral and Ethical Questions of Aborting an Anencephalic Baby
Holistic intervention plan design to improve the quality of outcomes – Problem Statement (PICOT)
ADV HEALTH ASSESSMENT: TJ a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge – Solution
Facilitative Communication and Helping Skills in Nursing & Decision Making Assignment Solution
Benchmark – Evidence-Based Practice Proposal Paper Example
Three nursing diagnoses for this client based on the health history and screening (one actual nursing diagnosis, one wellness nursing diagnosis, and one “risk for” nursing diagnosis)
Identify two or more issues with the existing system
Differences between inpatient and outpatient coding

Nursing Ethics Case Study

Ethical dilemmas are an inherent part of nursing practice. Our nursing ethics case studies shed light on complex ethical issues that nurses encounter in their daily work. Explore thought-provoking scenarios involving patient autonomy, confidentiality, end-of-life decisions, and resource allocation. By examining these case studies, you’ll develop a deeper understanding of ethical principles, ethical decision-making frameworks, and strategies for navigating ethical challenges in nursing practice.

Ethics in Complementary Therapies
Ethics Case Study Analysis
Ethics in Practice
Ethical Dilemma on Robotic Surgery and ACS Codes of Ethics – Post 1
Case Study on Biomedical Ethics in the Christian Narrative
Academic Success and Professional Development Plan Part 2: Strategies to Promote Academic Integrity and Professional Ethics
Week 9 Assignment 9.1: Mercy Killing Ethics – Using one theory that you have studied that you agree with and one theory that you disagree with, describe how Officer Jones would act in each case – Solution
Deliverable 4 – Code of Ethics Intake Packet
Ethics in the Workplace
code of ethics for nurses
Applying the ANA Code of Ethics

Health Promotion Case Study

Community health promotion plays a crucial role in improving the health and well-being of populations. Our community health promotion case studies highlight successful initiatives aimed at preventing diseases, promoting healthy lifestyles, and addressing social determinants of health. Explore strategies for community engagement, health education, and collaborative interventions that make a positive impact on the well-being of individuals and communities.

Health Promotion in Minority Populations
Environmental Factors and Health Promotion Presentation: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants
Health Education And Current Challenges For Family-Centered Health Promotion
Cultural Competence And Nutrition In Health Promotion
Why is the concept of family health important? Consider the various strategies for health promotion.
levels of health promotion
Integrate evidence from research and theory into discussions of practice competencies, health promotion and disease prevention strategies, quality improvement, and safety standards.
Discuss various theories of health promotion, including Pender’s Health Promotion Model, the Health Belief Model, the Transtheoretical Theory, and the Theory of Reasoned Action.
What strategies, besides the use of learning styles, can a nurse educator consider when developing tailored individual care plans, or for educational programs in health promotion?
Describe health promotion for Pregnant women
Identify a health problem or need for health promotion for a particular stage in the life span of a population from a specific culture in your area. Choose one of the Leading Health Indicators (LHI) priorities from Healthy People 2020: https://www.healthypeople.gov/2020/Leading-Health-Indicators
A description of a borrowed theory (expectancy-value theory and social cognitive theory) that could be applied to improve health promotion patient education in primary care clinic. Is this borrowed theory appropriate?
How has health promotion changed over time
Primary Prevention/Health Promotion
Health Risk Assessment and Health Promotion Contract

Nursing Leadership Case Studies

Nursing leadership is essential for driving positive change and ensuring high-quality patient care. Our nursing leadership case studies examine effective leadership strategies, change management initiatives, and interprofessional collaboration in healthcare settings. Gain insights into the qualities of successful nurse leaders, explore innovative approaches to leadership, and learn how to inspire and motivate your team to achieve excellence in nursing practice.

Part 3: Nursing Leadership – Childbearing after menopause – Assignment Solution
Capstone Project Ideas for Nursing Leadership
The purpose of this assignment is to examine the impact of contemporary challenges in care delivery facing nursing leadership. Select and research a major issue in the delivery of care facing nurse leaders today and write a 1,250-1,500 word paper addressing the following:
One nursing theory will be presented as a framework to resolve a problem occurring within one of the professional areas of leadership, education, informatics, healthcare policy or advance clinical practice. The same nursing theory selected in Assignment One may be used to resolve the identified problem.
Module 6: Change and Leadership in Nursing Education – Professional Development
Module 6: Change and Leadership in Nursing Education – Critical Thinking
Module 6: Change and Leadership in Nursing Education – Discussion
Analyze one of the following concepts: “Advanced Practice Nursing,” “Leadership in Nursing Practice” or “Holistic Nursing Practice”
Nursing Administration Function: A Comprehensive Guide for Nursing Students
Theory and Leadership
NUR-514: Organizational Leadership and Informatics
Leadership: Workplace Environment Assessment
Professional Development in Nursing – Topic 3 Assignment Solution
Leadership Change Framework – Week 8 Assignment Solution

At NursingStudy.org, we strive to provide you with a comprehensive collection of nursing case study examples and solutions that align with the best practices recommended by YOAST and RankMath. By exploring these diverse case studies, you’ll enhance your clinical knowledge, critical thinking abilities, and overall understanding of nursing practice. Take advantage of this valuable resource and elevate your nursing skills to new heights.

Remember, success in nursing begins with knowledge and continues with lifelong learning. Explore our nursing case study examples and solutions today and embark on a journey of professional growth and excellence.

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An Exploration of Nursing Students’ Experiences Using Case Report Design: A Case Study

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First Online: 05 October 2023
Cite this conference paper

Yayu Nidaul Fithriyyah 6 ,
Arif Annurrahman 7 ,
Khudazi Aulawi 6 ,
Atikah Kurnia Alda 7 &
Astrid Pratidina Susilo 8

Part of the book series: Springer Proceedings in Humanities and Social Sciences ((SPHSS))

Included in the following conference series:

International Conference of Indonesian Medical and Health Professions Education

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Case report design in nursing practice and education encourages active learning, scientific writing, and critical thinking. This study explores the experiences of nursing students using a case report design. This study used a case study design. Data collection for the nursing student professional program from January to September 2022 included demographics, case report data, educational media, and semi-structured interviews. The thematic analysis followed Braun and Clarke’s framework. The results showed no difference in the characteristics of the four nursing students, who are all women. Differences were found in the patient characteristics and the type of educational media. Two themes emerge: (1) Students learn from patient case reports; and (2) Students learning for scientific writing of case reports. Each theme consists of three sub-themes. Results showed that the case studies can improve students’ clinical reasoning in providing quality care. In conclusion, according to the evidence, this study can assist professional nursing education in understanding and improving the integration of clinical practice skills and students' writing skills. In the future, clear guidelines, training, and guidance from lecturers and clinical supervisors are needed.

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End-stage renal disease

Hemodialysis

Ahmed S, Prakash R (2020) A study to assess the efficacy of case study method on knowledge and skill of U.G. nursing students regarding chest physiotherapy in selected institution of Dehradun, Uttarakhand. Int J Sci Res 9(8):287–291. https://www.ijsr.net/get_abstract.php?paper_id=SR20727164241

Li H, He L, Zhang C, Eisinger R, Pan Y, Wang T et al (2019) LibGuides: quantitative study designs: case studies/case report/case series. CNS Neurosci Ther

Google Scholar

Alpi KM, Evans JJ (2019) Distinguishing case study as a research method from case reports as a publication type. J Med Libr Assoc 107:1–5. https://doi.org/10.5195/JMLA.2019.615

Florek AG, Dellavalle RP (2016) Case reports in medical education: a platform for training medical students, residents, and fellows in scientific writing and critical thinking. J Med Case Rep. https://doi.org/10.1186/S13256-016-0851-5

Popil I (2011) Promotion of critical thinking by using case studies as teaching method. Nurse Educ 204–207. https://doi.org/10.1016/J.NEDT.2010.06.002

Nursing Universitas Gadjah Mada: The Nursing Science Program—FK-KMK UGM

Baker GR (2011) The contribution of case study research to knowledge of how to improve quality of care. BMJ Qual Saf. https://doi.org/10.1136/BMJQS.2010.046490

Seshan V, Matua GA, Raghavan D, Arulappan J, Al Hashmi I, Roach EJ, Sunderraj SE, Prince EJ (2021) Case study analysis as an effective teaching strategy: perceptions of undergraduate nursing students from a Middle Eastern country. https://doi.org/10.1177/23779608211059265

Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, Allaire A, Aronson J, Carpenter J, Gagnier J, Hanaway P, Hayes C, Jones D, Kaszkin-Bettag M, Kidd M, Kiene H, Kienle G, Kligler B, Knutson L, Koch C, Milgate K, Mittelman M, Oltean H, Plotnikoff G, Rison RA, Sethi A, Shamseer L, Smith R, Tugwell P (2014) The CARE guidelines: consensus-based clinical case report guideline development. J Clin Epidemiol 67:46–51. https://doi.org/10.1016/J.JCLINEPI.2013.08.003

Jha P, Thakur A, Klumb J, Bhandari S (2018) Perceptions of fourth-year medical students on writing and presenting case reports. Cureus 10. https://doi.org/10.7759/CUREUS.2341

Mabasa LT, Themane MJ (2021) Experiences of educational researchers in the use of the case study design during the COVID-19 pandemic: lessons from a South African rural setting. Int J Qual Stud 20. https://doi.org/10.1177/16094069211022567

Stork MG (2017) Implementing a digital learning initiative: a case study in K-12 classrooms. J Form Des Learn. https://doi.org/10.1007/s41686-017-0013-1

Article Google Scholar

Thompson VL, McDowell YL (2019) A case study comparing student experiences and success in an undergraduate mathematics course offered through online, blended, and face-to-face instruction. Int. J. Educ. Math. Sci. Technol. 2019; 7:116–136. Available from: https://doi.org/10.18404/ijemst.552411

Holloway I, Galvin K (2017) Qualitative research in nursing and healthcare—Immy Holloway, Kathleen Galvin—Google Books. John Wiley & Son, West Sussex, UK

Braun V, Clarke V (2021) Thematic analysis: a practical guide. Sage, London

Boonkong D, Junsevg K, Sangsaikaew A, Utaisang A (2022) The effects of case study-based learning on nursing care plan ability in nursing process of nursing students. Malays J Med Health Sci. eISSN 2636-9346

Burgess A, Matar E, Roberts C, Haq I, Wynter L, Singer J, Kalman E, Bleasel J (2021) Scaffolding medical student knowledge and skills: team-based learning (TBL) and case-based learning (CBL). BMC Med Educ 21:1–14. https://doi.org/10.1186/S12909-021-02638-3/TABLES/4

Heale R, Twycross A (2018) What is a case study? Evid Based Nurs 21:7–8. https://doi.org/10.1136/EB-2017-102845

Rison RA (2013) A guide to writing case reports. J Med Case Rep 7:1–9. https://doi.org/10.1186/1752-1947-7-239/PEER-REVIEW

Chutinan S, Kim J, Chien T, Meyer HY, Ohyama H (2021) Can an interactive case-based activity help bridge the theory-practice gap in operative dentistry? Eur J Dent Educ 25:199–206. https://doi.org/10.1111/EJE.12591

Wihlborg J, Edgren G, Johansson A, Sivberg B, Gummesson C (2019) Using the case method to explore characteristics of the clinical reasoning process among ambulance nurse students and professionals. Nurse Educ Pract 35:48–54. https://doi.org/10.1016/J.NEPR.2019.01.001

Rashid Y, Rashid A, Warraich MA, Sabir SS, Waseem A (2019) Case study method: a step-by-step guide for business researchers. Int J Qual Meth 18. https://doi.org/10.1177/1609406919862424/ASSET/IMAGES/LARGE/10.1177_1609406919862424-FIG1.JPEG

Sayre JW, Toklu HZ, Ye F, Mazza J, Yale S (2017) Case reports, case series: from clinical practice to evidence-based medicine in graduate medical education. Cureus 9. https://doi.org/10.7759/CUREUS.1546

Brogan P, Hasson F, McIlfatrick S (2019) Lessons learnt: examining the use of case study methodology for nursing research in the context of palliative care. J Res Nurs JRN 24:446. https://doi.org/10.1177/1744987119867737

Alsaywid B, Abdulhaq N (2019) Guideline on writing a case report. Urol Ann 11:126. https://doi.org/10.4103/UA.UA_177_18

Li J, Wilson J, Lau WB (2019) A case report of case report pursuit by medical student. MedEdPublish 8:73. https://doi.org/10.15694/MEP.2019.000073.1

Gopikrishna V (2010) A report on case reports. J Conserv Dent 13:265. https://doi.org/10.4103/0972-0707.73375

Pierson DJ (2004) Case reports in respiratory care. Respir Care 49:1186–1194

PubMed Google Scholar

Baškarada S (2014) Qualitative case study guidelines. Qual Rep 19:1–18. https://doi.org/10.46743/2160-3715/2014.1008

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Acknowledgements

We appreciate everyone involved, both the educational institution of the Bachelor of Nursing Study Program and the Academic Hospital of Universitas Gadjah Mada, which are not all individually identifiable, who have contributed to this case study.

There is no financial support from any organization. The authors declare that they have no conflict of interest.

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Department of Medical-Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia

Yayu Nidaul Fithriyyah & Khudazi Aulawi

School of Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia

Arif Annurrahman & Atikah Kurnia Alda

Department of Medical Education and Bioethics, University of Surabaya, Surabaya, 60293, Indonesia

Astrid Pratidina Susilo

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Contributions

Yayu Nidaul Fithriyyah —responsible for the conceptualization, methodology of collecting data, and writing the initial manuscript draft.

Arif Annurrahman —responsible for collecting data, conducting transcription and analysis, and writing manuscript drafts.

Khudazi Aulawi— responsible for reviewing the data collection and analysis and revising the manuscript draft.

Atikah Kurnia Alda— responsible for collecting data, conducting transcription and analysis, and writing manuscript drafts.

Astrid Pratidina Susilo —responsible for methods and analysis and writing manuscript drafts.

All authors have read and approved the published version of the manuscript.

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Correspondence to Yayu Nidaul Fithriyyah .

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Department of Medical Education and Bioethics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

Mora Claramita

Department of Medical Education, Universitas Indonesia, Jakarta, Indonesia

Diantha Soemantri

Rachmadya Nur Hidayah

Ardi Findyartini

Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Dujeepa D. Samarasekera

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All the participants voluntarily participated in this study and provided written informed consent. Permission was obtained from the head of the medical-surgical nursing department.

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Fithriyyah, Y.N., Annurrahman, A., Aulawi, K., Alda, A.K., Susilo, A.P. (2023). An Exploration of Nursing Students’ Experiences Using Case Report Design: A Case Study. In: Claramita, M., Soemantri, D., Hidayah, R.N., Findyartini, A., Samarasekera, D.D. (eds) Character Building and Competence Development in Medical and Health Professions Education. INA-MHPEC 2022. Springer Proceedings in Humanities and Social Sciences. Springer, Singapore. https://doi.org/10.1007/978-981-99-4573-3_2

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Al Kasir, A., Coles, E. & Siegrist, R. , 2019. Anchoring Health beyond Clinical Care: UMass Memorial Health Care’s Anchor Mission Project , Harvard Business Publishing: Harvard T.H. Chan School of Public Health case collection. Available from Harvard Business Publishing Abstract As the Chief Administrative Officer of UMass Memorial Health Care (UMMHC) and president of UMass Memorial (UMM) Community Hospitals, Douglas Brown had just received unanimous and enthusiastic approval to pursue his "Anchor Mission" project at UMMHC in Worcester, Massachusetts. He was extremely excited by the board's support, but also quite apprehensive about how to make the Anchor Mission a reality. Doug had spearheaded the Anchor Mission from its earliest exploratory efforts. The goal of the health system's Anchor Mission-an idea developed by the Democracy Collaborative, an economic think tank-was to address the social determinants of health in its community beyond the traditional approach of providing excellent clinical care. He had argued that UMMHC had an obligation as the largest employer and economic force in Central Massachusetts to consider the broader development of the community and to address non-clinical factors, like homelessness and social inequality that made people unhealthy. To achieve this goal, UMMHC's Anchor Mission would undertake three types of interventions: local hiring, local sourcing/purchasing, and place-based community investment projects. While the board's enthusiasm was palpable and inspiring, Doug knew that sustaining it would require concrete accomplishments and a positive return on any investments the health system made in the project. The approval was just the first step. Innovation and new ways of thinking would be necessary. The bureaucracy behind a multi-billion-dollar healthcare organization would need to change. Even the doctors and nurses would need to change! He knew that the project had enormous potential but would become even more daunting from here.

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Johnson, P. & Gordon, R. , 2014. Dr. Sam Thenya: A Women's Health Pioneer , Harvard University: Global Health Education and Learning Incubator. Access online Abstract This case tracks Dr. Sam Thenya’s challenges in establishing and sustaining two Kenyan health organizations for women’s health. Thenya founded the Gender Violence Recovery Centre (GVRC) and the Nairobi Women’s Hospital (NWH) Medical Training College. In particular, the case focuses on the choices made as he expanded these two closely connected enterprises even though the GVRC was a non-profit enterprise while the NWH was a for-profit enterprise. Students consider how he led change to improve women’s health at both the population and system levels. They reflect on his leadership and lessons learned as he sought to change the face of women’s health care in Kenya and shift societal attitudes about gender-based violence (GBV). Students analyze how Dr. Thenya scaled up his innovative model, and the subsequent decisions he made to sustain his enterprise. They consider the ways in which he adapted his vision in order to provide GBV services free of charge and expand the reach of these services. This case also provides a Kenyan context in which to discuss health care delivery, and explores general attitudes and issues surrounding GBV.

Quelch, J.A. & Rodriguez, M. , 2014. Vaxess Technologies, Inc , Harvard Business Publishing. Available from Harvard Business Publishing Abstract In February 2014, Michael Schrader, chief executive of Vaxess Technologies, Inc., was assessing the startup health care company's 2014 marketing plan. On December 31st, 2013, Vaxess had obtained an exclusive license to a series of patents for a silk protein technology that, when added to vaccines, reduced or removed the need for refrigeration between manufacturing and delivery to the end patient. Schrader and his colleagues had to decide on which vaccines to focus and whether and how to target the drug companies that manufactured the vaccines or the quasi-government organizations (such as UNICEF and PAHO) and nongovernment organizations (such as GAVI) that purchased large quantities of vaccines for the developing world.

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Nurses' roles in health promotion practice: an integrative review

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Virpi Kemppainen, Kerttu Tossavainen, Hannele Turunen, Nurses' roles in health promotion practice: an integrative review, Health Promotion International , Volume 28, Issue 4, December 2013, Pages 490–501, https://doi.org/10.1093/heapro/das034

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Nurses play an important role in promoting public health. Traditionally, the focus of health promotion by nurses has been on disease prevention and changing the behaviour of individuals with respect to their health. However, their role as promoters of health is more complex, since they have multi-disciplinary knowledge and experience of health promotion in their nursing practice. This paper presents an integrative review aimed at examining the findings of existing research studies (1998–2011) of health promotion practice by nurses. Systematic computer searches were conducted of the Cochrane databases, Cinahl, PubMed, Web of Science, PsycINFO and Scopus databases, covering the period January 1998 to December 2011. Data were analysed and the results are presented using the concept map method of Novak and Gowin. The review found information on the theoretical basis of health promotion practice by nurses, the range of their expertise, health promotion competencies and the organizational culture associated with health promotion practice. Nurses consider health promotion important but a number of obstacles associated with organizational culture prevent effective delivery.

The role of nurses has included clinical nursing practices, consultation, follow-up treatment, patient education and illness prevention. This has improved the availability of health-care services, reduced symptoms of chronic diseases, increased cost-effectiveness and enhanced customers' experiences of health-care services ( Strömberg et al ., 2003 ; Griffiths et al ., 2007 ). In addition, health promotion by nurses can lead to many positive health outcomes including adherence, quality of life, patients' knowledge of their illness and self-management ( Bosch-Capblanc et al ., 2009 ; Keleher et al ., 2009 ). However, because of the broad field of health promotion, more research is needed to examine the role of health promotion in nursing ( Whitehead, 2011 ).

The concept of health promotion was developed to emphasize the community-based practice of health promotion, community participation and health promotion practice based on social and health policies ( Baisch, 2009 ). However, empirical studies indicate that nurses have adopted an individualistic approach and a behaviour-changing perspective, and it seems that the development of the health promotion concept has not influenced practical health promotion practices by nurses ( Casey, 2007a ; Irvine, 2007 ). On the other hand, there has been much discussion about how to include health promotion in nursing programmes and how to redirect nurse education from being disease-orientated towards a health promotion ideology ( Rush, 1997 ; Whitehead, 2003 ; Mcilfatrick, 2004 ).

The aim of this integrative review was to collate the findings of past research studies (1998–2011) of nurses' health promotion activities. The research questions addressed were: (i) What type of health promotion provides the theoretical basis for nurses' health promotion practice? (ii) What type of health promotion expertise do nurses have? (iii) What type of professional knowledge and skills do nurses undertaking health promotion exhibit? (iv) What factors contribute to nurses' ability to carry out health promotion?

An integrative review was chosen because it allowed the inclusion of studies with diverse methodologies (for example, qualitative and quantitative research) in the same review ( Cooper, 1989 ; Whittemore, 2005 ; Whittemore and Knafl, 2005 ). Integrative reviews have the potential to generate a comprehensive understanding, based on separate research findings, of problems related to health care ( Kirkevold, 1997 ; Whittemore and Knafl, 2005 ). The integrative review was split into the following phases: problem identification, literature search, data evaluation, data analysis and presentation of the results ( Whittemore and Knafl, 2005 ).

Search method

Several different databases were searched to identify relevant published material. Systematic searches of the Cochrane databases, Cinahl, PubMed, Web of Science, PsycINFO and Scopus databases were undertaken using the search string ‘nurs* AND professional competence* OR clinical competence* OR professional skill* OR professional knowledg* OR clinical skill* OR clinical knowledg* AND health promotion OR preventive health care OR preventive healthcare’. The searches were limited to studies published during the period 1998–2011 because, prior to 1998, nurses' health promotion practice was mainly linked to health education.

Search result

The original search identified 1141 references: 119 in the Cochrane databases; 227 in Cinah, 345 in PubMed, 128 in the Web of Science, 100 in PsycINFO and 222 in Scopus. After duplicate papers were excluded one researcher (V.K.) read the titles and abstracts of the remaining 412 research papers. No specific evaluation criteria are employed when conducting an integrative review using diverse empirical sources; one approach is to evaluate methodological quality and informational value ( Whittemore and Knafl, 2005 ). All three researchers (V.K., K.T. and H.T.) defined the inclusion criteria together. Studies were included in the integrative review if they met the following criteria: the language had to be English, Swedish or Finnish, as translators for other languages were not available and the papers had to be published in peer-reviewed journals and describe nurses' health promotion roles, knowledge or skills and/or factors that contributed to nurses' ability to implement health promotion in nursing delivered through hospital or primary health-care services. The main exclusion criteria were: the published works were editorials, opinions, discussions or textbooks, or they described health promotion programmes, competencies other than health promotion or nursing curricula, or if the group studied included patients. The included studies were tabulated in chronological order under the following headings: citation, aim of the paper, methodology, size of the sample, measured variables, method of analysis, major results, concepts used as the basis of the study and limitations. Studies included in this review are available in Supplementary data, Table S1 .

Data analysis

Conducting an integrative review that analyses various types of research paper is a major challenge ( Whittemore and Knafl, 2005 ). In this review, the concept map method was adopted for both data analysis and presentation of the results. The use of concept mapping promotes conceptual understanding and provides a strategy for analysing and organizing information and identifying, graphically displaying and linking concepts. The concept map method was applied according to the recommendations of Novak and Gowin [( Novak and Gowin, 1984 ), p. 15–40] and Novak ( Novak, 1993 , 2002 , 2005 ). According to Novak ( Novak, 1993 , 2002 , 2005 ) the process of concept mapping involves six phases: (i) Identify a key question that focuses on a problem, issue or knowledge central to the purpose of the concept map. (ii) Identify concepts through the key question. (iii) Start to construct the concept map by placing the key concepts at the top of the hierarchy. After that, select defining concepts and arrange hierarchially below of the key concepts. (iv) Combine the concepts by cross-links or links between concepts in different segments or domains of the concept map. (v) Give the cross-links a name of a word or two. (vi) To concepts can be added specific examples of events or objectives that clarify the meaning of the concept.

All three researchers (V.K., K.T. and H.T.) were involved in the concept mapping process. The process proceeded as follows: first, one researcher (V.K.) read studies that met the inclusion criteria and the concepts were identified through the four research questions upon which the review is based. Second, one researcher (V.K.) began to construct four concept maps hierarchically. This was achieved by putting the key concepts on the top of the left side of a page then listing definitions of the concepts down the middle of each page. Other researchers (K.T. and H.T.) verified the first and the second phases of the concept mapping process. Third, one researcher (V.K.) continued the construction of each concept map by combining main concepts and definition concepts using links that were then named. Other researchers (K.T. and H.T.) critically evaluated the concept maps thus produced. Fourth, one researcher (V.K.) selected examples of the main concepts and these were listed on the right side of each page for clarification.

In the end 40 research papers, were included in our integrative review. The research papers were methodologically very diverse: 16 of them included qualitative approaches; 14 were different types of reviews; 8 were quantitative; 1 used concept analysis and 1 was a mixed-method study. Twelve empirical studies were conducted in hospitals and fourteen in primary health-care settings. Eleven studies were published in the period 1998–2004, twenty-two between 2005 and 2009 six between 2010 and 2011.

What type of health promotion provides the theoretical basis for nurses' health promotion practice?

The theoretical basis underlying nurses' health promotion activities was identified in 25 of the research papers ( Benson and Latter, 1998 ; McDonald, 1998 ; Robinson and Hill, 1998 ; Sheilds and Lindsey, 1998 ; Burge and Fair, 2003 ; Hopia et al ., 2004 ; Whitehead, 2004 , 2006a , b , c , 2009 , 2011 ; Berg et al ., 2005 ; Runciman et al ., 2006 ; Casey, 2007a , b ; Folke et al ., 2007 ; Irvine, 2007 ; Piper, 2008 ; Witt and Puntel de Almeida, 2008 ; Chambres and Thompson, 2009 ; Fagerström, 2009 ; Richard et al ., 2010 ; Samarasinghe et al ., 2010 ; Povlsen and Borup, 2011 ). According to these papers the theoretical basis of health promotion reflects the type of practical actions undertaken by nurses to promote the health of patients, families and communities. The research suggests that nurses work from either a holistic and patient-oriented theoretical basis or take a chronic diseases and medical-oriented approach. These theoretical foundations were considered to represent the main concepts of health promotion orientation and public health orientation in this review (Figure 1 ).

Concepts and examples of the theoretical basis of nurses' health promotion activities.

Health promotion orientation

The most common factor influencing the concept of health promotion orientation was individual perspective ( Robinson and Hill, 1998 ; Hopia et al ., 2004 ; Runciman et al ., 2006 ; Casey, 2007a ; Chambres and Thompson, 2009 ; Samarasinghe et al ., 2010 ; Povlsen and Borup, 2011 ). When nurses' health promotion activities were guided by individual perspective nurses' exhibited a holistic approach in their health promotion practice, they concentrated on activities such as helping individuals or families to make health decisions or supporting people in their engagement with health promotion activities ( Hopia et al ., 2004 ; Irvine, 2007 ; Chambres and Thompson, 2009 ; Samarasinghe et al ., 2010 ; Povlsen and Borup, 2011 ). Nurses' strategies for health promotion included giving information to patients and providing health education ( Casey, 2007a ). However, patient participation was mainly limited to personal aspects of care, such as letting patients decide on a menu, when to get out of bed and what clothes they wanted to wear ( Casey, 2007a ).

The second common defining concept of health promotion orientation was empowerment, which was related to collaboration with individuals, groups and communities ( McDonald, 1998 ; Berg et al., 2005 ; Whitehead, 2006a ; Irvine, 2007 ; Piper, 2008 ; Richard et al ., 2010 ; Samarasinghe et al ., 2010 ). Such orientation was described in these studies in terms of nurse–patient communication and patient, group and community participation. Although these studies found empowerment to be one of the most important theoretical bases for health promotion activities by nurses, empowerment was not embedded in nurses' health promotion activities ( Irvine, 2007 ).

The third common defining concept of health promotion orientation was social and health policy ( Benson and Latter, 1998 ; Whitehead, 2004 , 2006a , b , 2009 , 2011 ). These studies suggested that nurses' health promotion activities should be based on the recommendations in, for example, the World Health Organization's (WHO) charters and declarations and directives and guidance from professional and governmental organizations. However, the studies examined found that nurses were not familiar with social and health policy documents and that they did not apply them to their nursing practice ( Benson and Latter, 1998 ; Whitehead, 2011 ).

The last defining concept of health promotion orientation was community orientation ( Sheilds and Lindsey, 1998 ; Whitehead, 2004 ; Witt and Puntel de Almeida, 2008 ). These papers revealed that nurses had knowledge of community-orientated health promotion: they were expected to use health surveillance strategies, work collaboratively with other professionals and groups and respect and interact with different cultures. In addition a health promotion orientation appeared to result in nurses working more closely with members of communities, for example, being involved in voluntary work and implementation of protective and preventive health measures.

Public health orientation

Public health-orientated chronic disease prevention and treatment has traditionally been the theoretical basis of nurses' health promotion activities ( Burge and Fair, 2003 ; Berg et al ., 2005 ; Whitehead, 2006c ; Folke et al ., 2007 ; Casey, 2007b ; Irvine, 2007 ; Chambres and Thompson, 2009 ; Fagerström, 2009 ; Richard et al. , 2010 ). The first defining concept of public health orientation was disease prevention ( Berg et al ., 2005 ; Whitehead, 2006c , Folke et al ., 2007 ; Irvine, 2007 ; Fagerström, 2009 ; Richard et al. , 2010 ). According to these studies, this occurred in health promotion when the focus was on diagnosis, physical health and the relief of the physical symptoms of disease. The second defining concept of public health orientation was the authoritative approach ( Burge and Fair, 2003 ; Casey, 2007b ; Irvine, 2007 ; Chambres and Thompson, 2009 ). This approach emphasizes the need for nurses to give information to patients. In addition, the authoritative approach suggests that health promotion activities should aim to change patients' behaviour ( Irvine, 2007 ; Chambres and Thompson, 2009 ).

What type of health promotion expertise do nurses have?

The expertise of nurses with respect to health promotion was described in 16 research papers ( Robinson and Hill, 1998 ; Whitehead, 2001 , 2006b , 2007 , 2009 , 2011 ; Hopia et al ., 2004 ; Cross, 2005 ; Jerden et al ., 2006 ; Runciman et al ., 2006 ; Kelley and Abraham, 2007 ; Witt and Puntel de Almeida, 2008 ; Fagerström, 2009 ; Parker et al ., 2009 ; Goodman et al ., 2011 ; Whitehead, 2011 ). According to these papers nurses implemented a range of types of health promotion activity and applied different health promotion expertise across a wide range of nursing contexts. Depending on the context nurses are able to make use of a variety of types of expertise in health promotion. Nurses can be classified into: general health promoters, patient-focused health promoters and project management health promoters (Figure 2 ).

Concepts and examples of the types of nurses' expertise as health promoters.

General health promoters

Health promotion by nurses is associated with common universal principles of nursing. The most common health promotion intervention used by nurses is health education ( Robinson and Hill, 1998 ; Whitehead, 2001 , 2007 , 2011 ; Runciman et al ., 2006 ; Witt and Puntel de Almeida, 2008 ; Parker et al ., 2009 ). General health promoters are expected to have knowledge of health promotion, effective health promotion actions, national health and social care policies and to have the ability to apply these to their nursing practice ( Witt and Puntel de Almeida, 2008 ; Whitehead, 2009 ).

Patient-focused health promoters

There is growing recognition that different patient groups, such as the elderly or families with chronic diseases, have different health promotion needs. In promoting the health of these different groups, nurses can be regarded as patient-focused health promoters ( Hopia et al ., 2004 ; Cross, 2005 ; Jerden et al ., 2006 ; Kelley and Abraham, 2007 ; Goodman et al ., 2011 ). These studies revealed that when health promotion for patient groups who need high levels of care and treatment is required, nurses must have the ability to include health promotion activities in their daily nursing practice.

Managers of health promotion projects

Nurses should be able to plan, implement and evaluate health promotion interventions and projects ( Runciman et al ., 2006 ; Whitehead, 2006b ; Witt and Puntel de Almeida, 2008 ; Fagerström, 2009 ). Projects can facilitate the development of health promotion in nursing practice ( Runciman et al ., 2006 ). Thus, managers of health promotion projects should have advanced clinical skills and take the responsibility in supervising and leading research and development actions in nursing as well as having the ability to co-ordinate educational and developmental interventions in health-care units and communities ( Witt and Puntel de Almeida, 2008 ; Fagerström, 2009 ).

What type of professional knowledge and skills do nurses undertaking health promotion exhibit?

Nurses' knowledge of health promotion and their relevant practical skills were described in 18 research papers ( McDonald, 1998 ; Nacion et al. , 2000 ; Burge and Fair, 2003 ; Whitehead, 2003 ; Hopia et al ., 2004 ; Reeve et al ., 2004 ; Spear, 2004 ; Cross, 2005 ; Irvine, 2005 , 2007 ; Rush et al ., 2005 ; Jerden et al ., 2006 ; Casey, 2007b ; Kelley and Abraham, 2007 ; Piper, 2008 ; Witt and Puntel de Almeida, 2008 ; Wilhelmsson and Lindberg, 2009 ; Goodman et al ., 2011 ). These studies suggested that nurses' health promotion activities consisted of a variety of competencies. We classified these into multidisciplinary knowledge, skill-related competence, competence with respect to attitudes and personal characteristics (Figure 3 ).

Concepts and examples of nurses' health promotion competencies.

Multidisciplinary knowledge

Nurses' health promotion activities were often based on a broad and multidisciplinary knowledge ( Nacion et al ., 2000 ; Burge and Fair, 2003 ; Spear, 2004 ; Irvine, 2005 ; Casey, 2007b ; Witt and Puntel de Almeida, 2008 ; Whitehead, 2009 ). This included a knowledge of: health in different age groups; epidemiology and disease processes and health promotion theories. In addition, nurses need to have the ability to apply this knowledge to their health promotion activities ( Burge and Fair, 2003 ; Spear, 2004 ; Irvine, 2005 ; Runciman et al ., 2006 ; Piper, 2008 ; Witt and Puntel de Almeida, 2008 ). Nurses were also expected to be aware of economic, social and cultural issues, social and health policies and their influence on lifestyle and health behaviour ( Burge and Fair, 2003 ; Irvine, 2005 ).

Skill-related competence

Nurses must possess a variety of health promotion skills; of these, communication skills were considered to be the most important ( McDonald, 1998 ; Nacion et al. , 2000 ; Burge and Fair, 2003 ; Hopia et al ., 2004 ; Irvine, 2005 ; Jerden et al ., 2006 ; Casey, 2007b ). Nurses play a particularly important role when they encourage patients and their families to participate in decision-making related to treatment or to discuss and express their feelings about situations associated with serious illness ( Hopia et al ., 2004 ). Skill-related competence also includes the ability to support behavioural changes in patients and the skill to respond to patients' attitudes and beliefs ( Burge and Fair, 2003 ). In addition, skill-related competence involves teamwork, time management, information gathering and interpretation and the ability to search for information from different data sources ( Irvine, 2005 ; Jerden et al ., 2006 ).

Competence with respect to attitudes

Competence with respect to attitudes emerged as a positive feature of health promotion ( Whitehead, 2003 ; Reeve et al ., 2004 ; Spear, 2004 ; Cross, 2005 ; Irvine, 2005 , 2007 ; Kelley and Abraham, 2007 ; Piper, 2008 ; Wilhelmsson and Lindberg, 2009 ). Effective health promotion practice requires nurses to adopt a proactive stance and act as an advocate. An affirmative and egalitarian attitude towards patients and their families, as well as the desire to promote their health and well-being, are important attitudes with respect to health promotion activities ( Irvine, 2005 , 2007 ; Wilhelmsson and Lindberg, 2009 ). In addition, nurses who have personal experience, for example, of having had a baby, have a more positive attitude towards promoting the health of patients in the same situation ( Spear, 2004 ).

Personal characteristics

Traditionally, nurses were perceived to be healthy role models, engaging in healthy activities, not smoking and maintaining an ideal weight Burge and Fair, (2003) ; Reeve et al. , 2004 ; Rush et al ., 2005 ). In addition, personal confidence and flexibility are personal characteristics that nurses working in health promotion are expected to possess ( Burge and Fair, 2003 ; Rush et al ., 2005 ).

What factors contribute to nurses' ability to carry out health promotion?

Thirteen research papers identified features which contributed to nurses' health promotion activities ( Robinson and Hill, 1998 ; Reeve et al ., 2004 ; Jerden et al. , 2006 ; Runciman et al ., 2006 ; Whitehead, 2006b , 2009 , 2011 ; Casey, 2007a , b ; Kelley and Abraham, 2007 ; Wilhelmsson and Lindberg, 2009 ; Beaudet et al ., 2011 ; Goodman et al ., 2011 ). All of the features related to cultural aspects of the organization in which nurses work. We considered that these could be classified as either supportive or discouraging (Figure 4 ).

Concepts and examples of organizational culture associated with health promotion activities.

First, organizational culture consisted of three supportive aspects: hospital managers, culture of health and education. The hospital managers were responsible for whether health promotion was a strategically planned and whether it was considered to be of great importance ( Whitehead, 2006b , 2009 ). In addition, the hospital managers were key individuals in ensuring that health promotion activities did not conflict with other work priorities ( Jerden et al ., 2006 ; Casey, 2007a ; Beaudet et al ., 2011 ). Hospital managers also have an important role in cultivating a culture of health in the work community, for instance by prohibiting smoking during working time ( Casey, 2007a ). Education enhanced nurses' health promotion skills and health promotion projects were catalysts for health promotion in nursing practice ( Goodman et al ., 2011 ). Organizational culture included three discouraging factors. The major one was a lack of resources, including a lack of time, equipment (e.g. computers) and health education material ( Robinson and Hill, 1998 ; Reeve et al ., 2004 ; Runciman et al ., 2006 ; Casey, 2007b ; Kelley and Abraham, 2007 ; Wilhelmsson and Lindberg, 2009 ; Beaudet et al ., 2011 ). In addition, nurses may lack skills to implement health promotion in their working place ( Goodman et al ., 2011 ). Recent studies have also revealed that health promotion activities are still unclear to nurses ( Beaudet et al ., 2011 ; Whitehead, 2011 ).

Several authors have identified a need to clarify the concept of health promotion in nursing ( Goodman et al ., 2011 ; Whitehead, 2011 ). We found the concept map method useful to enhance conceptual understanding of this complex nursing phenomenon. This integrative review was intended to identify the findings of nursing-specific studies of health promotion activities published in the period 1998–2011. We identified 40 relevant English research papers. Most of these studies were published between 2005 and 2009. Combining qualitative and quantitative studies is complex and can introduce bias and error ( Whittemore and Knafl, 2005 ). The data examined herein originated from methodologically diverse research. Therefore, we should be cautious of generalizing our findings. Most of the studies were qualitative, but a broad range of health promotion activities undertaken by nurses was described. The concept map method was used to analyse the data; the results of this review are reported both as text and concept maps. Concept maps are rarely used as a data analysis tool and therefore we employed researcher triangulation (V.K., K.T. and H.T.) during the research process; this enhanced our understanding and increased scientific rigour ( Jones and Bugge, 2006 ).

We found that health promotion and public health orientation have guided nurses' health promotion activities (e.g. McDonald, 1998 ; Whitehead, 2009 ; Richard et al ., 2010 ; Povlsen and Borup, 2011 ). It was surprising that, even though there has been much public debate and research has emphasized that health policies should guide nurses' health promotion activities worldwide, health policies have little impact on nursing practice (e.g. Benson and Latter, 1998 ; Irvine, 2007 ; Whitehead, 2011 ). Nurses have a variety of types of expertise, some working as general health promoters, some as patient-focused health promoters and some as managers of health promotion projects (e.g. Whitehead, 2008 ; Witt and Puntel de Almeida, 2008 ; Fagerström, 2009 ; Goodman et al ., 2011 ). The management of health promotion projects is particularly important, although only three studies ( Whitehead, 2006b ; Witt and Puntel de Almeida, 2008 ; Fagerström, 2009 ) described the type of expertise possessed by such managers. We found that there has been great interest in nurses' health promotion competencies (e.g. Irvine, 2005 , 2007 ; Witt and Puntel de Almeida, 2008 ; Wilhelmsson and Lindberg, 2009 ). A number of studies found that nurses' health promotion activities were based on multidisciplinary knowledge (e.g. Burge and Fair, 2003 ; Irvine, 2005 ; Whitehead, 2009 ). Interestingly, knowing about the trends that will influence the population's health in the future, such as multiculturalism, new technologies and ecological changes, were not identified as nurses' health promotion competencies. Unexpectedly for us the competencies associated with attitudes were not emphasized as one of the most important competencies even though nurses should be advocates of good health. We also found that nurses' individual health-related beliefs and lifestyles are important personal characteristics in health promotion and that nurses are expected to be healthy role models (e.g. Burge and Fair, 2003 ; Reeve et al. , 2004 ; Rush et al. , 2005 ). Nurses are aware of the importance of health promotion, but organizational culture with respect to health promotion can either support or discourage them from implementing it (e.g. Reeve et al ., 2004 ; Casey, 2007a , b ; Goodman et al ., 2011 ; Whitehead, 2011 ). Managers in health-care organizations should appreciate the value of health promotion activities and ensure adequate resources for their implementation (e.g. Casey, 2007b ; Beaudet et al ., 2011 ).

According to much of the health promotion research, it appears that nurses have not yet demonstrated a clear and obvious political role in implementing health promotion activities. Instead, nurses can be considered general health promoters, with their health promotion activities based on sound knowledge and giving information to patients. Nursing is an appropriate profession in which to implement health promotion, but several barriers associated with organizational culture have a marked effect on delivery. Therefore, more research is needed to determine how to support nurses in implementing health promotion in their roles in a variety of health-care services.

V.K. was responsible for the computer-based data searches and the data analysis via the concept map method. K.T. and H.T. verified that the data searches were made properly. K.T. and H.T. verified that the concept mapping process proceeded properly and made critical appraisals in every phase of the research process. V.K. was responsible for the drafting of the manuscript. K.T. and H.T. made critical revisions to the paper for important intellectual contents, conceptualization, support in theorizing the findings and provided material support. K.T. and H.T. supervised the study.

This research received a specific grant from The Finnish Foundation for Nurse Education and The Finnish Nurses Association.

Virpi Kemppainen would like to acknowledge the support from the University of Eastern Finland, Department of Nursing Science.

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Roberta Heale 1 ,
Alison Twycross 2
1 School of Nursing , Laurentian University , Sudbury , Ontario , Canada
2 School of Health and Social Care , London South Bank University , London , UK
Correspondence to Dr Roberta Heale, School of Nursing, Laurentian University, Sudbury, ON P3E2C6, Canada; rheale{at}laurentian.ca

https://doi.org/10.1136/eb-2017-102845

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What is it?

Case study is a research methodology, typically seen in social and life sciences. There is no one definition of case study research. 1 However, very simply… ‘a case study can be defined as an intensive study about a person, a group of people or a unit, which is aimed to generalize over several units’. 1 A case study has also been described as an intensive, systematic investigation of a single individual, group, community or some other unit in which the researcher examines in-depth data relating to several variables. 2

Often there are several similar cases to consider such as educational or social service programmes that are delivered from a number of locations. Although similar, they are complex and have unique features. In these circumstances, the evaluation of several, similar cases will provide a better answer to a research question than if only one case is examined, hence the multiple-case study. Stake asserts that the cases are grouped and viewed as one entity, called the quintain . 6 ‘We study what is similar and different about the cases to understand the quintain better’. 6

The steps when using case study methodology are the same as for other types of research. 6 The first step is defining the single case or identifying a group of similar cases that can then be incorporated into a multiple-case study. A search to determine what is known about the case(s) is typically conducted. This may include a review of the literature, grey literature, media, reports and more, which serves to establish a basic understanding of the cases and informs the development of research questions. Data in case studies are often, but not exclusively, qualitative in nature. In multiple-case studies, analysis within cases and across cases is conducted. Themes arise from the analyses and assertions about the cases as a whole, or the quintain, emerge. 6

Benefits and limitations of case studies

If a researcher wants to study a specific phenomenon arising from a particular entity, then a single-case study is warranted and will allow for a in-depth understanding of the single phenomenon and, as discussed above, would involve collecting several different types of data. This is illustrated in example 1 below.

Using a multiple-case research study allows for a more in-depth understanding of the cases as a unit, through comparison of similarities and differences of the individual cases embedded within the quintain. Evidence arising from multiple-case studies is often stronger and more reliable than from single-case research. Multiple-case studies allow for more comprehensive exploration of research questions and theory development. 6

Despite the advantages of case studies, there are limitations. The sheer volume of data is difficult to organise and data analysis and integration strategies need to be carefully thought through. There is also sometimes a temptation to veer away from the research focus. 2 Reporting of findings from multiple-case research studies is also challenging at times, 1 particularly in relation to the word limits for some journal papers.

Examples of case studies

Example 1: nurses’ paediatric pain management practices.

One of the authors of this paper (AT) has used a case study approach to explore nurses’ paediatric pain management practices. This involved collecting several datasets:

Observational data to gain a picture about actual pain management practices.

Questionnaire data about nurses’ knowledge about paediatric pain management practices and how well they felt they managed pain in children.

Questionnaire data about how critical nurses perceived pain management tasks to be.

These datasets were analysed separately and then compared 7–9 and demonstrated that nurses’ level of theoretical did not impact on the quality of their pain management practices. 7 Nor did individual nurse’s perceptions of how critical a task was effect the likelihood of them carrying out this task in practice. 8 There was also a difference in self-reported and observed practices 9 ; actual (observed) practices did not confirm to best practice guidelines, whereas self-reported practices tended to.

Example 2: quality of care for complex patients at Nurse Practitioner-Led Clinics (NPLCs)

The other author of this paper (RH) has conducted a multiple-case study to determine the quality of care for patients with complex clinical presentations in NPLCs in Ontario, Canada. 10 Five NPLCs served as individual cases that, together, represented the quatrain. Three types of data were collected including:

Review of documentation related to the NPLC model (media, annual reports, research articles, grey literature and regulatory legislation).

Interviews with nurse practitioners (NPs) practising at the five NPLCs to determine their perceptions of the impact of the NPLC model on the quality of care provided to patients with multimorbidity.

Chart audits conducted at the five NPLCs to determine the extent to which evidence-based guidelines were followed for patients with diabetes and at least one other chronic condition.

The three sources of data collected from the five NPLCs were analysed and themes arose related to the quality of care for complex patients at NPLCs. The multiple-case study confirmed that nurse practitioners are the primary care providers at the NPLCs, and this positively impacts the quality of care for patients with multimorbidity. Healthcare policy, such as lack of an increase in salary for NPs for 10 years, has resulted in issues in recruitment and retention of NPs at NPLCs. This, along with insufficient resources in the communities where NPLCs are located and high patient vulnerability at NPLCs, have a negative impact on the quality of care. 10

These examples illustrate how collecting data about a single case or multiple cases helps us to better understand the phenomenon in question. Case study methodology serves to provide a framework for evaluation and analysis of complex issues. It shines a light on the holistic nature of nursing practice and offers a perspective that informs improved patient care.

Gustafsson J
Calanzaro M
Sandelowski M

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

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National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on the Future of Nursing 2020–2030; Flaubert JL, Le Menestrel S, Williams DR, et al., editors. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington (DC): National Academies Press (US); 2021 May 11.

Cover of The Future of Nursing 2020-2030

The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity.

Hardcopy Version at National Academies Press

7 Educating Nurses for the Future

You cannot transmit wisdom and insight to another person. The seed is already there. A good teacher touches the seed, allowing it to wake up, to sprout, and to grow. —Thich Nhat Hanh, global spiritual leader and peace activist

By 2030, the nursing profession will look vastly different and will be caring for a changing America. Nursing school curricula need to be strengthened so that nurses are prepared to help promote health equity, reduce health disparities, and improve the health and well-being of everyone. Nursing schools will need to ensure that nurses are prepared to understand and identify the social determinants of health, have expanded learning experiences in the community so they can work with different people with varied life experiences and cultural values, have the competencies to care for an aging and more diverse population, can engage in new professional roles, are nimble enough to adapt continually to new technologies, and can lead and collaborate with other professions and sectors. And nursing students—and faculty—not only need to reflect the diversity of the population, but also need to help break down barriers of structural racism prevalent in today’s nursing education.

Throughout the coming decade, it will be essential for nursing education to evolve rapidly in order to prepare nurses who can meet the challenges articulated in this report with respect to addressing social determinants of health (SDOH), improving population health, and promoting health equity. Nurses will need to be educated to care for a population that is both aging, with declining mental and physical health, and becoming increasingly diverse; to engage in new professional roles; to adapt to new technologies; to function in a changing policy environment; and to lead and collaborate with professionals from other sectors and professions. As part of their education, aspiring nurses will need new competencies and different types of learning experiences to be prepared for these new and expanded roles. Also essential will be recruiting and supporting diverse students and faculty to create a workforce that more closely resembles the population it serves. Given the growing focus on SDOH, population health, and health equity within the public health and health care systems, the need to make these changes to nursing education is clear. Nurses’ close connection with patients and communities, their role as advocates for well-being, and their placement across multiple types of settings make them well positioned to address SDOH and health equity. For future nurses to capitalize on this potential, however, SDOH and equity must be integrated throughout their educational experience to build the competencies and skills they will need.

The committee’s charge included examining whether nursing education provides the competencies and skills nurses will need—the capacity to acquire new competencies, to work outside of acute care settings, and to lead efforts to build a culture of health and health equity—as they enter the workforce and throughout their careers. A thorough review of the current status and future needs of nursing education in the United States was beyond the scope of this study, but in this chapter, the committee identifies priorities for the content and nature of the education nurses will need to meet the challenge of addressing SDOH, advancing health equity, and improving population health. Nursing education is a lifelong pursuit; nurses gain knowledge and skills in the classroom, at work, through continuing professional development, and through other formal and informal mechanisms ( IOM, 2016b ). While the scope of this study precluded a thorough discussion of learning outside of nursing education programs, readers can find further discussion of lifelong learning in A Framework for Educating Health Professionals to Address the Social Determinants of Health ( IOM, 2016b ), Redesigning Continuing Education in the Health Professions ( IOM, 2010 ), and Exploring a Business Case for High-Value Continuing Professional Development: Proceedings of a Workshop ( NASEM, 2018a ).

To change nursing education meaningfully so as to produce nurses who are prepared to meet the above challenges in the decade ahead will require changes in four areas: what is taught, how it is taught, who the students are, and who teaches them. This chapter opens with a description of the nursing education system and the need for integrating equity into education, and then examines each of these four areas in turn:

domains and competencies for equity,
expanded learning opportunities,
recruitment of and support for diverse prospective nurses, and
strengthening and diversification of the nursing faculty.

In addition to changes in these specific areas, there is a need for a fundamental shift in the idea of what constitutes a “quality” nursing education. Currently, National Council Licensure Examination (NCLEX) pass rates are used as the primary indicator of quality, along with graduation and employment rates ( NCSBN, 2020a ; O’Lynn, 2017 ). This narrow focus on pass rates has been criticized for diverting time and attention away from other goals, such as developing student competencies, investing in faculty, and implementing innovative curricula ( Giddens, 2009 ; O’Lynn, 2017 ; Taylor et al., 2014 ). In addition, the NCLEX is heavily focused on acute care rather than on such areas of nursing as primary care, disease prevention, SDOH, and health equity ( NCSBN, 2019 ). In response to such concerns about the NCLEX, the National Council of State Boards of Nursing (NCSBN) conducted a study to identify additional quality indicators for nursing education programs; indicators were identified in the areas of administration, program director, faculty, students, curriculum and clinical experiences, and teaching and learning resources ( Spector et al., 2020 ). To realize the committee’s vision for nursing education, it will be necessary for nursing schools, accreditors, employers, and students to look beyond NCLEX pass rates and include these types of indicators in the assessment of a quality nursing education.

OVERVIEW OF NURSING EDUCATION

Nurses are educated at universities, colleges, hospitals, and community colleges and can follow a number of educational pathways. Table 7-1 identifies the various degrees that nurses can hold, and describes the programs that lead to each degree and the usual amount of time required to complete them. In 2019, there were more than 200,000 graduates from baccalaureate, master’s, and doctoral nursing programs in the United States and its territories, including 144,659 who received a baccalaureate degree ( AACN, 2020a ) (see Table 7-2 ).

Pathways in Nursing Education.

Number of Graduates from Nursing Programs in the United States and Territories, 2019.

Nursing programs are nationally accredited by the Accreditation Commission for Education in Nursing (ACEN); the Commission on Collegiate Nursing Education (CCNE); the Commission for Nursing Education and Accreditation (CNEA); and other bodies focused on specialty areas of nursing, such as midwifery. Graduating registered nurses (RNs) seek licensure as nurses through state boards, and take examinations administered by the NCSBN as graduates with their first professional degree and then as specialists with certification exams offered through specialty organizations. These bodies set minimum standards for nursing programs and establish criteria for certification and licensing, faculty qualifications, course offerings, and other features of nursing programs ( Gaines, n.d. ).

The Need for Nursing Education on Social Determinants of Health and Health Equity

A report of the Institute of Medicine (IOM) from nearly two decades ago asserts that all health professionals, including nurses, need to “understand determinants of health, the link between medical care and healthy populations, and professional responsibilities” ( IOM, 2003 , p. 209). The literature is replete with calls for all nurses to understand concepts associated with health equity, such as disparities, culturally competent care, equity, and social justice. For example, Morton and colleagues (2019) identify essential content to prepare nurses for community-based practice, including SDOH, health disparities/health equity, cultural competency, epidemiology, community leadership, and the development of enhanced skills in community-based settings. O’Connor and colleagues (2019) call for an inclusive educational environment that prepares nurses to care for diverse patient populations, including the study of racism’s impacts on health from the genetic to the societal level, systems of marginalization and oppression, critical self-reflection, and preparation for lifelong learning in these areas. And Thornton and Persaud (2018) state that the content of nursing education should include instruction in cultural sensitivity and culturally competent care, trauma-informed care and motivational interviewing, screening for social needs, and referring for services. These calls align with the Health Resources and Services Administration’s (HRSA’s) most recent strategic plan, which prioritizes the development of a health care workforce that is able to address current and emerging needs for improving equity and access ( HRSA, 2019 ). Additionally, recommendations of the National Advisory Council on Nurse Education and Practice (NACNEP) (2016) include that population health concepts be incorporated into nursing curriculum and that undergraduate programs create partnerships with HRSA, the U.S. Department of Veterans Affairs (VA), and the Indian Health Service (IHS), agencies that serve rural and frontier areas, to increase students’ exposure to different competencies, experiences, and environments.

In concert with these perspectives and recommendations, nursing organizations have developed guidelines for how nursing education should prepare nurses to work on health equity issues and address SDOH. In 2019, the National League for Nursing (NLN) issued a Vision for Integration of the Social Determinants of Health into Nursing Education Curricula , which describes the importance of SDOH to the mission of nursing and makes recommendations for how SDOH should be integrated into nursing education (see Box 7-1 ).

National League for Nursing’s (NLN’s) Vision for Integration of the Social Determinants of Health into Nursing Education Curricula.

As described in Chapter 9 , the American Association of Colleges of Nursing’s (AACN’s) Essentials 1 provides an outline for the necessary curriculum content and expected competencies for graduates of baccalaureate, master’s, and doctor of nursing practice (DNP) programs. Essentials identifies “Clinical Prevention and Population Health” as one of the nine essential areas of baccalaureate nursing education. Among other areas of focus, Essentials calls for baccalaureate programs to prepare nurses to

collaborate with other health care professionals and patients to provide spiritually and culturally appropriate health promotion and disease and injury prevention interventions;
assess the health, health care, and emergency preparedness needs of a defined population;
collaborate with others to develop an intervention plan that takes into account determinants of health, available resources, and the range of activities that contribute to health and the prevention of illness, injury, disability, and premature death;
participate in clinical prevention and population-focused interventions with attention to effectiveness, efficiency, cost-effectiveness, and equity; and
advocate for social justice, including a commitment to the health of vulnerable populations and the elimination of health disparities.

Curriculum content and expected competencies laid out in Essentials for master’s- and DNP-level nursing education also address SDOH, disparities, equity, and social justice ( AACN, 2006 , 2011 ). While Essentials only guides baccalaureate, master’s, and DNP programs, the document’s emphasis on health equity and SDOH demonstrates the importance of these topics to the nursing profession as a whole.

As of 2020, AACN has been shifting toward a competency-based curriculum. As part of this effort, AACN published a draft update to Essentials that identifies 10 domains for nursing education: knowledge for nursing practice; person-centered care; population health; scholarship for nursing discipline; quality and safety; interprofessional partnerships; systems-based practice; informatics and health care technologies; professionalism; and personal, professional, and leadership development. Within these 10 domains are specific competencies that AACN believes are essential for nursing practice ( AACN, 2020b ), including

engage in effective partnerships,
advance equitable population health policy,
demonstrate advocacy strategies,
use information and communication technologies and informatics processes to deliver safe nursing care to diverse populations in a variety of settings, and
use knowledge of nursing and other professions to address the health care needs of patients and populations.

Nurses themselves have also indicated the need for more education and training on these topics. The 2018 National Sample Survey of Registered Nurses (NSSRN) asked the question, “As of December 31, 2017, what training topics would have helped you do your job better?” Figure 7-1 shows the percentage of six different training topics that RNs said would help them do their job better. Overall, RNs working in schools, public health, community health, and emergency and urgent care were more likely than RNs working in all other employment settings listed in Figure 7-1 to indicate that they could have done their job better if they had received training in SDOH, population health, working in underserved communities, caring for individuals with complex health and social needs, and especially mental health. These results could reflect RNs encountering increasingly complex individuals and populations, rising numbers of visits and caseloads, the fact that the RNs working in these settings frequently provide care for people facing multiple social risk factors that harm their health and well-being, or inadequacy of the training in these areas that RNs had received. RNs—particularly those working in informatics, health care management and administration, and education—also indicated that training in value-based care would have been helpful. Additionally, RNs who had graduated after 2010 were more likely than those who had graduated before then to indicate that they could have done their job better with training across all of these topics.

Training topics that would have helped registered nurses do their jobs better, by type of work performed and graduation from their nursing program, 2018. SOURCE: Calculations based on the 2018 National Sample Survey of Registered Nurses (HRSA, 2020). (more...)

Nurse practitioners (NPs) have also indicated the need for more training in SDOH. In response to the 2018 NSSRN question described above, NPs working in public health and community health, emergency and urgent care, education, and long-term care reported that they could have done their job better if they had received training in SDOH, mental health, working in underserved communities, and providing care for medically complex/special needs. Across all types of practice settings, one-third felt that training in mental health issues would have helped them do their job better, while very few NPs indicated that training in value-based care would have been helpful. Additionally, NPs who had graduated since 2010 were more likely than those who had graduated before then to indicate that they would have benefited from training in these topics. Figure 7-2 shows the percentage of six different training topics that NPs mentioned would have helped them do their job better.

Training topics that would have helped nurse practitioners do their jobs better, by type of work performed and graduation from their nursing education program, 2018. SOURCE: Calculations based on the 2018 National Sample Survey of Registered Nurses (HRSA, (more...)

The Need for Integration of Social Determinants of Health and Health Equity into Nursing Education

Despite guidelines from both the American Association of Colleges of Nursing (AACN) and the National League for Nursing (NLN) and numerous calls for including equity, population health, and SDOH in nursing education, SDOH and related concepts are not currently well integrated into undergraduate and graduate nursing education. Nor has the degree to which nurses are prepared and educated in these areas been studied systematically ( NACNEP, 2019 ; Tilden et al., 2018 ). The committee was unable to locate a central repository of information about the coursework and other educational experiences available to nursing students across types of programs and institutions, or any other source of systematic analysis of nursing curricula. This lack of information about nursing preparation programs limits the conclusions that can be drawn about them. Thus, the discussion in this chapter is based on the assumption that some nursing programs are likely already pursuing many of the goals identified herein, but that this critically important content is not yet standard practice throughout nursing education.

One way to explore whether and how health equity and related concepts are currently integrated into nursing education is to look at accreditation standards. While the standards do not detail every specific topic to be covered in nursing curricula, they do set expectations, convey priorities, and identify important areas of study. For example, the accreditation standards of the CCNE state that advanced practice registered nurse (APRN) programs must include study of advanced physiology, advanced health assessment, and advanced pharmacology ( CCNE, 2018 ). Accreditation standards could be used to prioritize the inclusion of health equity and SDOH in nursing curriculum; however, this is not currently the case. The CCNE standards state that accredited programs must incorporate the AACN Essentials into their curricula, and while these standards do not specifically mention equity, SDOH, or other relevant concepts ( CCNE, 2018 ), that is expected to change to correspond with the updates to the Essentials described previously (see Box 7-1 ). CNEA’s accreditation standards likewise include no mention of population health, SDOH, or health equity ( NLN, 2016 ), although a more recent document from NLN makes a strong case for the integration of SDOH into nursing education curricula ( NLN, 2019 ). ACEN’s associate’s and baccalaureate standards call for inclusion of “cultural, ethnic, and socially diverse concepts” in the curriculum; the master’s and doctoral standards require that curriculum be “designed so that graduates of the program are able to practice in a culturally and ethnically diverse global society,” but do not address health equity, population health, or SDOH.

Another approach for examining the inclusion of these concepts in nursing education is to look at exemplar programs. As part of the Future of Nursing: Campaign for Action, the Robert Wood Johnson Foundation commissioned a study of best practices in nursing education to support population health ( Campaign for Action, 2019b ). That report notes that although many nursing programs reported including population health content in their curriculum, few incorporated the topic substantially. However, the report also identifies exemplars of programs with promising population health models. These exemplars include Oregon Health & Science University, which incorporates population health throughout the curriculum as a key competency; Rush University, which incorporates cultural competence throughout the curriculum; and Thomas Jefferson University, which offers courses in health promotion, population health, health disparities, and SDOH. NACNEP has also examined exemplars of nursing programs that incorporate health equity and SDOH into their curricula ( NACNEP, 2019 ). The programs highlighted include the University of Pennsylvania School of Nursing, which has a course called Case Study—Addressing the Social Determinants of Health: Community Engagement Immersion ( Schroeder et al., 2019 ). This course offers experiential learning opportunities that focus on SDOH in vulnerable and underserved populations and helps students design health promotion programs for these communities. The school also offers faculty education in SDOH.

As far as the committee was able to determine, most programs include content on SDOH in community or public health nursing courses. However, this material does not appear to be integrated thoroughly into the curriculum in the majority of programs, nor could the committee identify well-established designs for curricula that address this content outside of community health rotations ( Campaign for Action, 2019b ; Storfjell et al., 2017 ; Thornton and Persaud, 2018 ). In the committee’s view, a single course in community and/or public health nursing is insufficient preparation for creating a foundational understanding of health equity and for preparing nurses to work in the wide variety of settings and roles envisioned in this report. Ideally, education in these concepts would be integrated throughout the curriculum to give nurses a comprehensive understanding of the social determinants that contribute to health inequities ( NACNEP, 2019 ; NLN, 2019 ; Siegel et al., 2018 ). Moreover, academic content alone is insufficient to provide students with the knowledge, skills, and abilities they need to advance health equity; rather, expanded opportunities for experiential and community learning are critical for building the necessary competencies ( Buhler-Wilkerson, 1993 ; Fee and Bu, 2010 ; NACNEP, 2016 ; Sharma et al., 2018 ). All those involved in nursing education—administrators, faculty, accreditors, and students—need to understand that health equity is a core component of nursing, no less important than alleviating pain or caring for individuals with acute illness. Graduating students need to understand and apply knowledge of the impact of such issues as classism, racism, sexism, ageism, and discrimination and to be empowered to advocate on these issues for people who they care for and communities.

As currently constituted, then, nursing education programs fall short of conveying this information sufficiently in the curriculum or through experiential learning opportunities. Yet, the existing evidence on what nursing education programs offer is scant. Research is therefore needed to assess whether and how many nursing programs are offering sufficient coursework and learning opportunities related to SDOH and health equity and to examine the extent to which graduating nurses have the competencies necessary to address these issues in practice.

The Need for BSN-Prepared Nurses

The 2011 The Future of Nursing report includes the recommendation that the percentage of nurses who hold a baccalaureate degree or higher be increased to 80 percent by 2020. The report gives several reasons for this goal, including that baccalaureate-prepared nurses are exposed to competencies including health policy, leadership, and systems thinking; they have skills in research, teamwork, and collaboration; and they are better equipped to meet the increasingly complex demands of care both inside and outside the hospital ( IOM, 2011 , p. 170). In 2011, 50 percent of employed nurses held a baccalaureate degree or higher; as of 2019, that proportion had increased to 59 percent ( Campaign for Action, 2020 ). Both the number of baccalaureate programs and program enrollment have increased substantially since 2011 2 ( AACN, 2019a ), and the number of RNs who went on to receive BSNs in RN-to-BSN programs increased 236 percent between 2009 and 2019 ( Campaign for Action, n.d. ). However, the goal of 80 percent of nurses holding a BSN was still not achieved by 2020, for a number of reasons. Although the proportion of new graduates with a BSN is higher than the proportion of existing nurses with a BSN, the percentage of new graduates joining the nursing workforce each year is small. Given this ratio, it would have been “extraordinarily difficult” to achieve the goal of 80 percent by 2020 ( IOM, 2016a ; McMenamin, 2015 ). Nurses already in the workforce face barriers to pursuing a BSN, including time, money, work–life balance, and a perception that additional postlicense education is not worth the effort ( Duffy et al., 2014 ; Spetz, 2018 ). Moreover, schools and programs have limited capacity for first-time nursing students and ADN, LPN nurses, or RNs without BSN degrees ( Spetz, 2018 ).

Nonetheless, the goal of achieving a nursing workforce in which 80 percent of nurses hold a baccalaureate degree or higher remains relevant, and continuing efforts to increase the number of nurses with a BSN are needed. Across the globe, the proportion of BSN-educated nurses is correlated with better health outcomes ( Aiken et al., 2017 ; Baker et al., 2020 ), and there are clear differences as well as similarities between associate’s degree in nursing (ADN) programs and BSN programs. In particular, BSN programs are more likely to cover topics relevant to liberal education, organizational and systems leadership, evidence-based practice, health care policy, finance and regulatory environments, interprofessional collaboration, and population health ( Kumm et al., 2014 ). Accelerated, nontraditional, and other pathways to the BSN degree are discussed later in this chapter.

The Need for PhD-Prepared Nurses

There are two types of doctoral degrees in nursing: the PhD and the DNP. The former is designed to prepare nurse scientists to conduct research, whereas the latter is a clinically focused doctoral degree designed to prepare graduates with advanced competencies in leadership and management, quality improvement, evidence-based practice, and a variety of specialties. PhD-prepared nurses are essential to the development of the research base required to support evidence-based practice and add to the body of nursing knowledge, and DNP-educated nurses play a key role in translating evidence into practice and in educating nursing students in practice fundamentals ( Tyczkowski and Reilly, 2017 ) (see Chapter 3 for further discussion of the role of DNPs).

The number of nurses with doctoral degrees has grown rapidly since the 2011 The Future of Nursing report was published ( IOM, 2011 ). As a proportion of doctorally educated nurses, however, the number of PhD graduates has remained nearly flat. In 2010, there were 1,282 graduates from DNP programs and 532 graduates receiving a PhD in nursing. By 2019, the number of DNP graduates had grown more than 500 percent to 7,944, while the number of PhD graduates had grown about 50 percent to 804 ( AACN, 2011 , 2020a ).

The slow growth in PhD-prepared nurses is a major concern for the profession and for the nation, because it is these nurses who serve as faculty at many universities and who systematically study issues related to health and health care, including the impact of SDOH on health outcomes, health disparities, and health equity. PhD-prepared nurses conduct research on a wide variety of issues relating to SDOH, including the effect of class on children’s health; linguistic, cultural, and educational barriers to care; models of care for older adults aging in place; and gun violence (Richmond and Foman, 2018; RWJF, 2020 ; Szanton et al., 2014 ). Nurse-led research provided evidence-based solutions in the early days of the COVID-19 pandemic for such challenges as the shift to telehealth care, expanding demand for health care workers, and increased moral distress ( Lake, 2020 ). However, Castro-Sánchez and colleagues (2021) note a dearth of nurse-led research specifically related to COVID-19; they posit that this gap can be attributed to workforce shortages, a lack of investment in clinical academic leadership, and the redeployment of nurses into clinical roles. More PhD-prepared nurses are needed to conduct research aimed at improving clinical and community health, as well as to serve as faculty to educate the next generation of nurses ( Broome and Fairman, 2018 ; Fairman et al., 2020 ; Greene et al., 2017 ).

Nursing practice is dependent on a robust pipeline of research to advance evidence-based care, inform policy, and address the health needs of people and communities ( Bednash et al., 2014 ). The creation of the BSN-to-PhD direct entry option has helped produce more research-oriented nurse faculty ( Greene et al., 2017 ), but time, adequate faculty mentorship, mental health issues, and financial hardships, including the cost of tuition, are barriers for nurses pursuing these advanced degrees ( Broome and Fairman, 2018 ; Fairman et al., 2020 ; Squires et al., 2013 ). One approach for increasing the number of PhD-prepared nurses is the Future of Nursing Scholars program, which successfully graduated approximately 200 PhD students through an innovative accelerated 3-year program ( RWJF, 2021 ). Similar programs have been funded by such foundations as the Hillman Foundation and Jonas Philanthropies to help stimulate the pipeline, build capacity (especially in health policy) among graduates, and model innovative curricular approaches ( Broome and Fairman, 2018 ; Fairman et al., 2020 ).

DOMAINS AND COMPETENCIES FOR EQUITY

As noted earlier, a number of existing recommendations specify what nurses need to know to address SDOH and health inequity in a meaningful way. In addition, the Future of Nursing: Campaign for Action surveyed and interviewed faculty and leaders in nursing and public health, asking about core content and competencies for all nurses ( Campaign for Action, 2019b ). Respondents specifically recommended that nursing education cover seven areas:

policy and its impact on health outcomes;
epidemiology and biostatistics;
a basic understanding of SDOH and illness across populations and how to assess and intervene to improve health and well-being;
health equity as an overall goal of health care;
interprofessional team building as a key mechanism for improving population health;
the economics of health care, including an understanding of basic payment models and their impact on services delivered and outcomes achieved; and
systems thinking, including the ability to understand complex demands, develop solutions, and manage change at the micro and macro system levels.

Drawing on all of these recommendations, guidelines, and perspectives, as well as looking at the anticipated roles and responsibilities outlined in other chapters of this report, the committee identified the core concepts pertaining to SDOH, health equity, and population health that need to be covered in nursing school and the core knowledge and skills that nurses need to have upon graduation. For consistency with the language used by the AACN, these are referred to, respectively, as “domains” (see Box 7-2 ) and “competencies” (see Box 7-3 ). The domains in Box 7-2 are fundamental content that the committee believes can no longer be covered in public health courses alone, but need to be incorporated and applied by nursing students throughout nursing curricula. All nurses, regardless of setting or type of nursing, need to understand and be prepared to address the underlying barriers to better health in their practice.

Domains for Nursing Education.

Competencies for Nursing Education, Depending on Preparation Level.

The committee believes that incorporation of these domains and competencies can guide expeditious and meaningful changes in nursing education. The committee acknowledges that making room for these concepts will inevitably require eliminating some existing material in nursing education. The committee does not believe that it is the appropriate entity to identify what specific curriculum changes should be made; a nationwide evaluation will be needed to ensure that nursing curricula are preparing the future workforce with the skills and competencies they will need. The committee also acknowledges that nursing programs differ in length, and that an ADN program cannot cover SDOH equity to the same extent as a BSN program. The specific knowledge and skills a nurse will need will vary depending on her or his level of nursing education. For example, a nurse with a BSN may need to understand and be able to use the technologies that are relevant to his or her area of work (e.g., telehealth applications, electronic health records [EHRs], home monitors), while an APRN may need a deeper understanding of how to analyze health records in order to provide care and monitor health status for populations outside clinical settings.

Nonetheless, nursing education at all levels—from licensed practical nurse (LPN) to ADN to BSN and beyond—needs to incorporate and integrate the domains and competencies in Boxes 7-2 and 7-3 to the extent possible so as to develop knowledge and skills that will be relevant and useful to nurses and essential to achieving equity in health and health care. Given the relationship among SDOH, social needs, and health outcomes and the increasing focus of health care systems on addressing these community and individual needs, the domains and competencies identified here are essential to ensure that all nurses understand and can apply concepts related to these issues; work effectively with people, families, and communities across the spectrum of SDOH; promote physical, mental, and social health; and assume leadership and entrepreneurial roles to create solutions, such as by fostering partnerships in the health and social sectors, scaling successful interventions, and engaging in policy development. While none of the domains listed in Box 7-2 are new to nursing, the health inequities that have become increasingly visible—especially as a result of the COVID-19 pandemic—demand that these domains now be substantively integrated into the fabric of nursing education and practice.

Many sources highlight both the challenges faced by front-line graduates when confronted with these issues, and the reality that many nursing schools lack faculty members with the knowledge and competencies to educate nurses effectively on these issues ( Befus et al., 2019 ; Effland et al., 2020 ; Hermer et al., 2020 ; Levine et al., 2020 ; Porter et al., 2020 ; Rosa et al., 2019 ; Valderama-Wallace and Apesoa-Varano, 2019 ). To remedy the latter gap, educators need to have a clear understanding of these issues and their links to both educational and patient outcomes (see the section below on strengthening and diversifying the nursing faculty). It is important to note as well that some of these topics, including the connections among implicit biases, structural racism, and health equity, may be difficult for educators and students to discuss (see Box 7-4 ).

Discussing Difficult Topics.

Given the limited scope of this report, the committee has chosen to highlight three of the competencies from Box 7-3 in this section. 3 The first is delivering person-centered care to diverse populations. As the United States becomes increasingly diverse, nurses will need to be aware of their own implicit biases and be able to interact with diverse patients, families, and communities with empathy and humility. The second is learning to collaborate across professions, disciplines, and sectors. As discussed previously in this report, addressing SDOH is necessarily a multisectoral endeavor given that these determinants go beyond health to include such issues as housing, education, justice, and the environment. The third is continually adapting to new technologies. Advances in technology are reshaping both health care and education, and making it possible for both to be delivered in nontraditional settings and nontraditional ways. In the present context, technology can expand access to underserved populations of patients and students—for example, telehealth and online platforms can be used to connect with those living in rural areas—but it can also exacerbate existing disparities and inequities. Nurses need to understand both the promises and perils of technology, and be able to adapt their practice and learning accordingly.

Delivering Person-Centered Care and Education to Diverse Populations

As discussed in Chapter 2 , people’s family and cultural background, community, and other experiences may have profound impacts on their health. Given the increasing diversity of the U.S. population, it is critical that nurses understand the impact of these factors on health, can communicate and connect with people of different backgrounds, and can be self-reflective about how their own beliefs and biases may affect the care they provide. To this end, the committee believes it is essential that nursing education include the concepts of cultural humility and implicit bias as a thread throughout the curriculum.

An integral part of learning about these concepts is an opportunity to reflect on what one is learning and to draw connections with past learning and experiences. Researchers have established that instruction that guides students in reflection helps reinforce skills and competencies (see, e.g., NASEM, 2018c ). This idea has been explored in the context of education in health professions and has been identified as a valuable way to foster understanding of health equity and SDOH ( IOM, 2016b ; Mann et al., 2007). While the strategies, goals, and structure of such reflection may vary, the process in general helps learners in health care settings examine their own values, assumptions, and beliefs ( El-Sayed and El-Sayed, 2014 ; Scheel et al., 2017 ). In the course of structured reflection, for example, students might consider how such issues as racism, implicit bias, trauma, and policy affect the care people receive and create conditions for poor health, or how their own experiences and identities influence the care they provide.

Cultural Humility

In recent years, the focus in discussions of patient care has shifted from cultural competency to cultural humility ( Barton et al., 2020 ; Brennan et al., 2012 ; Kamau-Small et al., 2015 ; Periyakoil, 2019 ; Purnell et al., 2018 ; Walker et al., 2016 ). The concept of cultural competency has been interpreted by some as limited for a number of reasons. First, it implies that “culture” is a technical skill in which clinicians can develop expertise, and it can become a series of static dos and don’ts ( Kleinman and Benson, 2006 ). Second, the concept of cultural competency tends to promote a colorblind mentality that ignores the role of power, privilege, and racism in health care (Waite and Nardi, 2017). Third, cultural competency is not actively antiracist but instead leaves institutionalized structures of White privilege and racism intact ( Schroeder and DiAngelo, 2010 ).

In contrast, cultural humility is defined by flexibility, a lifelong approach to learning about diversity, and a recognition of the role of individual bias and systemic power in health care interactions ( Agner, 2020 ). Cultural humility is considered a self-evaluating process that recognizes the self within the context of culture ( Campinha-Bacote, 2018 ). The concept of cultural humility can be woven into most aspects of nursing and interprofessional education. For example, case studies in which students learn about the experience of a particular disease or strategies for disease prevention can be designed to model culturally humble approaches in the provision of nursing care and the avoidance of stereotypical thinking ( Foronda et al., 2016 ; Mosher et al., 2017 ). One effective approach to cultivating cultural humility is to accompany experiential learning opportunities or case studies with reflection that expands learning beyond skills and knowledge. This includes questioning current practices and proposing changes to improve the efficiency and quality of care, equality, and social justice ( Barton et al., 2020 ; Foronda et al., 2013 ). Programs designed to develop nurses’ cultural sensitivity and humility, as well as cultural immersion programs, have been developed, and research suggests that such programs can effectively develop skills that strengthen nurses’ confidence in treating diverse populations, improve patient and provider relationships, and increase nurses’ compassion ( Allen, 2010 ; Gallagher and Polanin, 2015 ; Sanner et al., 2010 ).

Implicit Bias

Implicit bias is an unconscious or automatic mental association made between members of a group and an attribute or evaluation ( FitzGerald and Hurst, 2017 ). For example, a clinician may unconsciously view White patients as more medically compliant than Black patients ( Sabin et al., 2008 ). These types of biases not only can have consequences for individual health outcomes ( Aaberg, 2012 ; Linden and Redpath, 2011 ) but also may play a role in maintaining or exacerbating health disparities ( Blair et al., 2011 ). There are many resources available for implicit bias awareness and training; for example, Harvard University offers a number of Implicit Association Tests (IATs), the Institute for Healthcare Improvement offers free online resources to address implicit bias, and the AACN offers implicit bias workshops for nurses ( AACN, n.d. ; Foronda et al., 2018 ).

Evidence on the use of implicit bias training is limited. One review of the use of an IAT in health professions education found that the test had contrasting uses, with some curricula using it as a measure of implicit bias and others using it to initiate discussions and reflection. The review found a dearth of research on the use of IATs; the authors note that the nature of implicit bias is highly complex and cannot necessarily be reduced to the “time-limited” use of an IAT ( Sukhera et al., 2019 ). A systematic review of interventions designed to reduce implicit bias found that many such interventions are ineffective, and some may even increase implicit biases. The authors note that while there is no clear path for reducing biases, the lack of evidence does not weaken the case for “implementing widespread structural and institutional changes that are likely to reduce implicit biases” (FitzGerald et al., 2019). One promising model is an intervention that helps participants break the “prejudice habit” ( Devine et al., 2012 ). This multifaceted intervention, which includes situational awareness of bias, education about the consequences of bias, strategies for reducing bias, and self-reflection, has been shown to reduce implicit racial bias for at least 2 months ( Devine et al., 2012 ). Clearly, more research is needed in this area.

Learning to Collaborate Across Professions, Disciplines, and Sectors

As discussed in Chapter 9 , eliminating health disparities will require the active engagement and advocacy of a broad range of stakeholders working in partnership to address the drivers of structural inequities in health and health care ( NASEM, 2017 ). In these efforts, nurses may lead or work with people from a variety of professions, disciplines, and sectors, including, for example, physicians, social workers, educators, policy makers, lawyers, faith leaders, government employees, community advocates, and community members. Working across sectors, especially as they relate to SDOH (food insecurity, transportation barriers, housing, etc.), is a critical competence. Collaboration among these types of stakeholders has multiple benefits, including broader expertise and perspective, the capacity to address wide-ranging social needs, the ability to reach underserved populations, and sustainability and alignment of efforts (see Chapter 9 for further discussion). A traditional nursing education, which focuses on what is taught rather than on building competencies, is unlikely to give students the understanding of broader social, political, and environmental contexts that is necessary for working in these types of strategic partnerships ( IOM, 2016b ). If nursing students are to be prepared to practice interprofessionally after graduation, they must be given opportunities to collaborate with others before graduation ( IOM, 2013 ) and to build the competencies they will need for collaborative practice. The Interprofessional Education Collaborative (IPEC) identified four core competencies for interprofessional collaborative practice ( IPEC, 2016 ). While these competencies were developed specifically to prepare students for interprofessional practice within health care, they are also applicable to broader collaborations among other professions, disciplines, and sectors both within and outside of health care:

Work with individuals of other professions to maintain a climate of mutual respect and shared values.
Use the knowledge of one’s own role and those of other professionals to appropriately assess and address the health care needs of patients and to promote and advance the health of populations.
Communicate with patients, families, communities, and professionals in health and other fields in a responsive and responsible manner that supports a team approach to the promotion and maintenance of health and the prevention and treatment of disease.
Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles in planning, delivering, and evaluating patient/population-centered care and population health programs and policies that are safe, timely, efficient, effective, and equitable.

There are opportunities for nursing students to gain interprofessional and multisector collaborative competencies through both experiential learning in the community (discussed in detail below) and classroom work. Increasingly, nursing schools are working with other institutions to offer students classes in which they learn with or from students and professionals in other disciplines. For example, the University of Michigan Center for Interprofessional Education offers courses in such topics as health care delivery in low- and middle-income countries, social justice, trauma-informed practice, interprofessional communication, and teamwork. Courses are open to students from the schools of social work, pharmacy, medicine, nursing, dentistry, physical therapy, public health, and business. 4

Despite the benefits of interprofessional education, however, there are barriers that affect the implementation of such programs in health professions education, including different schedules, lack of meeting space, incongruent curricula plans, faculty not trained to teach interprofessionally, faculty overload, and the challenge of providing adequate opportunities for all levels of students ( NLN, 2015a ). The use of simulation has been proposed as a vehicle for overcoming such barriers to impart interprofessional collaborative competencies ( NLN, 2013 ); a systematic review of the evidence found that this approach can be effective ( Marion-Martins and Pinho, 2020 ). Nurses can also gain interprofessional experience by pursuing dual degrees. For example, the University of Pennsylvania offers dual degrees that combine nursing with health care management, bioethics, public health, law, or business administration.

Continually Adapting to New Technologies

Nurses can use a wide variety of existing and emerging technologies and tools to address SDOH and provide high-quality care to all patients (see Box 7-5 ). Broadly speaking, these technologies and tools fall into three categories: patient-facing, clinician-facing, and data analytics. Patient- and clinician-facing tools collect data and help providers and patients connect and make decisions about care. Data analytics uses data, collected from patients or other sources, to analyze trends, identify disparities, and guide policy decisions. Beginning as students, all nurses need to be familiar with these technologies, be able to engage with patients or other professionals around their appropriate use, and understand how their use has the potential to exacerbate inequalities.

Highlights from the Seattle Townhall on Technology and Health Equity and Implications for Nursing Education.

Patient-facing technologies include apps and software, such as mobile and wearable health devices, as well as telehealth and virtual visit technologies ( FDA, 2020 ). These tools allow nurses and other health care providers to expand their reach to those who might otherwise not have access because of geography, transportation, social support, or other challenges. For example, telehealth and mobile apps allow providers to see people in their homes, mitigating such barriers to care as transportation while also helping providers understand people in the context of their everyday lives. Essential skills for nurses using these new tools will include the ability to project a caring relationship through technology (Massachusetts Department of Higher Nursing Education Initiative, 2016 ) and to use technology to personalize care based on patient preferences, technology access, and individual needs ( NLN, 2015b ). The role of telehealth and the importance of training nurses in this technology have been recognized for several years ( NONPF, 2018 ; Rutledge et al., 2017 ), but the urgent need for telehealth services during the COVID-19 pandemic has made it “imperative” to include telehealth training in nursing curricula ( Love and Carrington, 2020 ). Moreover, it is anticipated that the shift to telehealth for some types of care will become a permanent feature of the health care system in the future ( Bestsennyy et al., 2020 ).

Clinician-facing technologies include EHRs, clinical decision support tools, mobile apps, and screening and referral tools ( Bresnick, 2017 ; CDC, 2018 ; Heath, 2019 ). A number of available digital technologies can facilitate the collection and integration of data on social needs and SDOH and help clinicians hold compassionate and empathetic conversations about those needs ( AHA, 2019 ; Giovenco and Spillane, 2019 ). In 2019, for example, Kaiser Permanente launched its Thrive Local network (Kaiser Permanente, 2019 ), which can be used to screen for social needs and connect people with community resources that can meet these needs. The system is integrated with the EHR, and it is capable of tracking referrals and outcomes to measure whether needs are being met; these data can then be used to continuously improve the network.

Nurses will need to understand how and when to use these types of tools, and can leverage their unique understanding of patient and community needs to improve and expand them. As described in Chapter 10 , such technologies as EHRs and clinical alarms can burden nurses and contribute to workplace stress. However, nurses have largely been left out of conversations about how to design and use these systems. For example, although nurses are one of the primary users of EHR systems, little research has been conducted to understand their experiences with and perceptions of these systems, which may be different from those of other health care professionals ( Cho et al., 2016 ; Higgins et al., 2017 ). Out of 346 usability studies on health care technologies conducted between 2003 and 2009, only 2 examined use by nurses ( Yen and Bakken, 2012 ). Educating nurses to understand and assess the benefits and drawbacks of health care technologies and have the capacity to help shape and revamp them can ultimately improve patient care and the well-being of health professionals.

Tools for data analytics are increasingly important for improving patient care and the health of populations ( Ibrahim et al., 2020 ; NEJM Catalyst, 2018 ). Analysis of large amounts of data from such sources as EHRs, wearable monitors, and surveys can help in detecting and tracking disease trends, identifying disparities, and finding patterns of correlation ( Breen et al., 2019 ; NASEM, 2016a ; Shiffrin, 2016 ). The North Carolina Institute for Public Health, for example, collaborated with a local health system in analyzing data to inform a community health improvement plan ( Wallace et al., 2019 ). Data on 12 SDOH indicators were sourced from the American Community Survey and mapped by census tract. The mapping provided a visualization of the disparities in the community and allowed the health system to focus its efforts strategically to improve community health. The North Carolina Department of Health and Human Services later replicated this strategy across the entire state ( NCDHHS, 2020 ).

There are opportunities for nurses to specialize in this type of work. For example, nursing informatics is a specialized area of practice in which nurses with expertise in such disciplines as information science, management, and analytical sciences use their skills to assess patient care and organizational procedures and identify ways to improve the quality and efficiency of care. In the context of SDOH, nursing informaticists will be needed to leverage artificial intelligence and advanced visualization methods to summarize and contextualize SDOH data in a way that provides actionable insights while also eliminating bias and not overwhelming nurses with extraneous information. Big data are increasingly prevalent in health care, and nurses need the skills and competencies to capitalize on its potential ( Topaz and Pruinelli, 2017 ). Even nurses who do not specialize in informatics will need to understand how the analysis of massive datasets can impact health ( Forman et al., 2020 ; NLN, 2015b ). Investments in expanding program offerings, certifications, and student enrollment will be needed to meet the demand for nurses with such skills.

As noted, however, despite its promise for improving patient care and community health, technology can also exacerbate existing disparities ( Ibrahim et al., 2020 ). For example, people who lack access to broadband Internet and/or devices are unable to take advantage of such technologies as remote monitoring and telehealth appointments ( Wise, 2012 ). Older adults, people with limited formal education, those living in rural and remote areas, and the poor are less likely to have access to the Internet. As health care becomes more reliant on technology, these groups are likely to fall behind ( Arcaya and Figueroa, 2017 ). In addition, such technologies as artificial intelligence and algorithmic decision-making tools may exacerbate inequities by reflecting existing biases ( Ibrahim et al., 2020 ). Nursing education needs to prepare nurses to understand these potential downsides of technology in order to prevent and mitigate them. This has become a particularly critical issue during the COVID-19 pandemic, with the rapid shift to telehealth potentially having consequences for those with low digital literacy, limited English proficiency, and a lack of access to the Internet ( Velasquez and Mehrotra, 2020 ).

Not all nurses will need to acquire all of the key technological competencies; curricula can be developed according to the likely needs of nurses working at different levels. For example, most nurses will need the knowledge and skills to use telehealth, digital health tools, and data-driven clinical decision-making skills in practice, whereas nurse informaticians and some doctoral-level nurses will need to be versed in device design, bias assessment in algorithms, and big data analysis.

EXPANDING LEARNING OPPORTUNITIES

As stated previously, the domains and competencies enumerated above cannot be conveyed to nursing students through traditional lectures alone. Building the competencies to address population health, SDOH, and health inequities will require substantive experiential learning, collaborative learning, an integrated curriculum, and continuing professional development throughout nurses’ careers ( IOM, 2016b ). The 2019 Campaign for Action survey of nursing educators and leaders found that a majority of respondents identified “innovative community clinical experiences” and “interprofessional education experiences” as the top methods for teaching population health ( Campaign for Action, 2019b ). A recurrent theme in interviews with respondents was the importance of active and experiential learning, with opportunities for partnering with nontraditional agencies ( Campaign for Action, 2019b ). These types of community-based educational opportunities, particularly when they involve partnerships with others, are critical for nursing education for multiple reasons.

First, experience in the community is essential to understanding SDOH and gaining the competencies necessary to advance health equity ( IOM, 2016b ). In fact, restricting education in SDOH to the classroom may even be harmful, given the finding of a 2016 study that medical students who learned about SDOH in the classroom rather than through experiential learning demonstrated an increase in negative attitudes toward medically underserved populations ( Schmidt et al., 2016 ).

Second, community-based education offers opportunities for students to engage with community partners from other sectors, such as government offices of housing and transportation or community organizations, preparing them for the essential work of participating in and leading partnerships to address SDOH. An example is a pilot interdisciplinary partnership between a school of nursing and a city fire department in the Pacific Northwest that allows students to practice such skills as motivational interviewing to identify the range of problems (e.g., transportation issues, difficulty accessing insurance or providers, lack of caregiving support) faced by people calling emergency services ( Yoder and Pesch, 2020 ).

Third, nursing is increasingly practiced in community settings, such as schools and workplaces, as well as through home health care ( WHO, 2015 ). Nursing students are prepared to practice in hospitals, but do not necessarily receive the same training and preparation for these other environments ( Bjørk et al., 2014 ). Education in the community allows nursing students to learn about the broad range of care environments and to work collaboratively with other professionals who work in these environments. For example, students may work in a team with community health workers, social workers, and those from other sectors (e.g., housing and transportation), work that both enriches the experience of student nurses and creates bridges between nursing and other fields ( Zandee et al., 2010) . Nurses who have these experiences during school may then be more prepared to lead and participate in multisector efforts to address SDOH—the importance of which is emphasized throughout this report—once they enter practice. Evidence suggests that graduating students are more likely to seek work in areas that are familiar to them from their education, clinical experience, and theoretical training ( Jamshidi et al., 2016 ); thus, these nontraditional educational experiences may increase the number of nurses interested in working in the community. Moreover, while training in acute care settings has often been regarded as more valuable than that provided in community settings, evidence indicates that the two offer comparable opportunities for learning clinical skills ( Morton et al., 2019 ). In fact, clinical care in community-based settings can present greater complexity relative to that in the hospital, and some technical skills (e.g., epidemiologic disease tracking, tuberculosis assessment and management, immunizations) are more available in community than in acute care settings ( Morton et al., 2019 ).

Some nursing programs have incorporated community-based experiential learning into their programs. At community colleges and universities, schools have implemented nurse-managed clinics that serve the local population and their own students while also giving students technical skills and experience in interacting with the community. Lewis and Clark Community College, for example, operates a mobile health unit that brings health and dental care to six counties in southern Illinois ( Lewis and Clark, n.d. ), while nursing students at Alleghany College of Maryland can gain experience in the Nurse Managed Wellness Clinic, which offers such services as immunizations, screenings, and physicals ( Alleghany College, 2020 ). At the baccalaureate and master’s level, a number of schools offer longitudinal, integrated experiences in settings as varied as federally qualified health centers (FQHCs), public health departments, homeless shelters, public housing sites, public libraries, and residential addiction programs ( AACN, 2020c ). Students and faculty at the University of Washington School of Nursing, for example, support community-oriented projects in partnership with three underserved communities in the Seattle area. Graduate students work for 1 year on grassroots projects (e.g., food banks, school health) and then reinforce this experience with 1 year of work at the policy level ( AACN, 2020c ). At the doctoral level, Washburn University transformed its DNP curriculum to incorporate SDOH and reinforce that instruction through experiential learning in the community (see Box 7-6 ). In addition to clinical education, nursing students can participate in nontraditional clinical community engagement and service learning opportunities, such as volunteering at a homeless shelter or working in a service internship for a community organization. These opportunities get students into the community, help them build relationships with people from health care and other sectors, and promote understanding of and engagement with SDOH ( Bandy, 2011 ).

Pine Ridge Family Health Center.

Simulation-Based Education

Simulation-based education is another useful tool for teaching nursing concepts and developing competencies and skills ( Kononowicz et al., 2019 ; Poore et al., 2014 ; Shin et al., 2015 ). It can range from very low-tech (e.g., using oranges to practice injections) to very high-tech (e.g., a virtual reality emergency room “game”), but all simulations share the ability to bridge the gap between education and practice by imparting skills in a low-risk environment ( SSIH, n.d. ).

Simulations give students an opportunity to make real-time decisions and interact with virtual patients without having to face many of the challenges of traditional clinical education ( Hayden et al., 2014 ). They can be used to enhance many types of skills, including communication ( NASEM, 2018b ), cultural sensitivity ( Lau et al., 2016 ), and screening for SDOH ( Thornton and Persaud, 2018 ). Several simulation-based tools are available for learning about the realities of poverty, such as the Community Action Poverty Simulation (see Box 7-7 ) and the Cost of Poverty Experience ( ThinkTank, n.d. ). Such tools can help nurses identify ways in which their practice could directly mitigate the effects of poverty on individuals, families, and communities. Evaluations of poverty simulations have found that they can positively impact attitudes toward poverty and empathy among nurses and nursing students ( Phillips et al., 2020 ; Turk and Colbert, 2018 ), although one study noted that the simulations should be accompanied by the inclusion of social justice concepts throughout the curriculum to achieve lasting change ( Menzel et al., 2014 ).

The Community Action Poverty Simulation.

Individual schools may or may not have the resources or faculty to support some types of simulation activities. For those that do not, simulation centers shared by schools of multiple professions and hospitals can provide access ( Marken et al., 2010 ). For example, the New York Simulation (NYSIM) Center was created through a public–private partnership to manage interprofessional, simulation-based education for students and hospital employees across multiple sites ( NYSIM, 2017 ). The opportunity to take part in simulation experiences with students from other health professions can also improve collaboration and teamwork and prepare nurses for practicing interprofessionally in the workplace (von Wendt and Niemi-Murola, 2018 ).

Limitations on in-person clinical training during the COVID-19 pandemic conditions have demonstrated the promise of simulation-based education as a way to supplement traditional nursing education, allowing students to complete their education and sustaining the nursing workforce pipeline ( Horn, 2020 ; Jiménez-Rodríguez et al., 2020 ; Yale, 2020 ). Before the pandemic, the NCSBN conducted a longitudinal, randomized controlled trial of the use of simulation and concluded that substituting simulation-based education for up to half of a nursing student’s clinical hours produces comparable educational outcomes and students who are ready to practice ( Hayden et al., 2014 ). The COVID-19 pandemic has necessitated and accelerated the use of simulation to replace direct care experience in nursing schools, and state boards of nursing have loosened previous restrictions on its use ( NCSBN, 2020b ). Evaluation of this expanded use of simulation and other virtual experiences during the pandemic is needed, both in preparation for future emergencies and for use in nursing education generally.

RECRUITING AND SUPPORTING DIVERSE PROSPECTIVE NURSES

The composition of the population of prospective nurses and the ways they are supported throughout their education are important factors in how prepared the future nursing workforce will be to address SDOH and health equity. As discussed in prior chapters, developing a more diverse nursing workforce will be key to achieving the goals of reducing health disparities, providing culturally relevant care for all populations, and fostering health equity (Center for Health Affairs, 2018 ; IOM, 2011 , 2016 ; Williams et al., 2014 ). A diverse workforce is one that reflects the variations in the nation’s population in such characteristics as socioeconomic status, religion, sexual orientation, gender, race, ethnicity, and geographic origin.

The nursing workforce has historically been overwhelmingly White and female, although it is steadily becoming more diverse (see Chapter 3 ). The 2016 IOM report assessing progress on the 2011 The Future of Nursing report notes that shifting the demographics of the overall workforce is inevitably a slow process since only a small percentage of the workforce leaves and enters each year ( IOM, 2016a ). The pipeline of students entering the field, on the other hand, can respond much more rapidly to efforts to increase diversity ( IOM, 2016a ). Since the 2011 report was published, significant gains have been realized in the diversity of nursing students. The number of graduates from historically underrepresented ethnic and racial groups more than doubled for BSN programs, more than tripled for entry-level master’s programs, and more than doubled for PhD programs ( AACN, 2020a ). The number of underrepresented students graduating from DNP programs grew by more than 1,000 percent, although this gain was due in large part to rapid growth in these programs generally. Yet, despite these gains, nursing students remain largely female and White: in 2019, 85–90 percent of students were female, and around 60 percent were White. The percentages of ADN, BSN, entry-level master’s, PhD, and DNP graduates in 2019 by race/ethnicity and gender are shown in Tables 7-3 and 7-4 , respectively. For example, the proportion of Hispanic or Latino nurses is highest among ADN graduates (12.8 percent) and lowest among PhD (5.5 percent) and DNP (6 percent) graduates, while the proportion of Asian nurses is highest among MSN graduates (11.2 percent) and lower among graduates with all other degrees. The proportion of PhD graduates who are male (9.9 percent) is significantly lower than the proportion of graduates with other degrees who are male.

Nursing Program Graduates by Degree Type and by Race/Ethnicity, 2019.

Nursing Program Graduates by Degree Type and Gender, 2019.

Diversifying and strengthening the nursing student body—and eventually, the nursing workforce—requires cultivating an inclusive environment, recruiting and admitting a diverse group of students, and providing students with support and addressing barriers to their success throughout their academic career and into practice. In addition, it is essential to make available information that will enable prospective students to make informed decisions about their education and give them multiple pathways for completing their education (e.g., distance learning, accelerated programs). Accrediting bodies can play a role in advancing diversity and inclusion in nursing schools by requiring certain policies, practices, or systems. For example, the accreditation standards for medical schools of the Liaison Committee on Medical Education (LCME) include the following expectation ( LCME, 2018 ):

A medical school has effective policies and practices in place, and engages in ongoing, systematic, and focused recruitment and retention activities, to achieve mission appropriate diversity outcomes among its students, faculty, senior administrative staff, and other relevant members of its academic community. These activities include the use of programs and/or partnerships aimed at achieving diversity among qualified applicants for medical school admission and the evaluation of program and partnership outcomes.

Currently, none of the major nursing accreditors (ACEN, CCNE, CNEA) includes similar language in its accreditation standards. As shown in Table 7-5 , of six possible areas for standards on diversity and inclusion, ACEN and CCEN have standards only for student training, while CNEA has standards for student training and faculty diversity. No nursing accreditors have standards for student diversity; in comparison, accrediting bodies for pharmacy, physician assistant, medical, and dental schools all have such standards.

Diversity and Inclusion in Accreditation Standards.

Cultivating an Inclusive Environment

Efforts to recruit and educate prospective nurses to serve a diverse population and advance health equity will be fruitless unless accompanied by efforts to acknowledge and dismantle racism within nursing education and nursing practice ( Burnett et al., 2020 ; Schroeder and DiAngelo, 2010 ; Villaruel and Broome, 2020 ; Waite and Nardi, 2019 ). The structural, individual, and ideological racism that exists in nursing is rarely called out, and this silence further entrenches the idea of Whiteness as the norm within nursing while marginalizing and silencing other groups and their perspectives ( Burnett et al., 2020 ; Iheduru-Anderson, 2020 ; Schroeder and DiAngelo, 2010 ). Non-White students report a wide variety of negative experiences in nursing school, including unsupportive faculty, discrimination and microaggressions 5 on the part of faculty and peers, bias in grading, loneliness and social isolation, feeling unwelcome and excluded, being viewed as a homogeneous population despite being from varying racial/ethnic groups, lack of support for career choices, and a lack of mentors ( Ackerman-Barger et al., 2020 ; Graham et al., 2016 ; Johansson et al., 2011 ; Loftin et al., 2012 ; Metzger et al., 2020 ). These experiences are associated with adverse outcomes that include disengagement from education, loss of “self,” negative perceptions of inclusivity and diversity at the institution, and institutions’ inability to recruit and retain a diversity of students ( Metzger et al., 2020 ). By contrast, when students characterize the learning environment as inclusive, they are more satisfied and confident in their learning and rate themselves higher on clinical self-efficacy and clinical belongingness ( Metzger and Taggart, 2020 ).

Notably, however, underrepresented and majority students describe inclusive environments differently. In a study of fourth-year baccalaureate nursing students, both groups described an inclusive classroom as one where they felt comfortable and respected and had a sense of belonging, but underrepresented minority students also noted the importance of feeling safe, feeling free from hostility, and being seen as themselves and not a representative of their group ( Metzger and Taggart, 2020 ). Both groups agreed that inclusivity requires a top-down approach, and that faculty are particularly influential in creating an inclusive environment, yet underrepresented students shared many experiences in which faculty either disrupted the sense of belonging or did not intervene when someone else did ( Metzger and Taggart, 2020 ).

While increased attention has recently been focused on increasing diversity in nursing education, the pervasiveness of racism requires more open acknowledgment and discussion and a systematic and intentional approach that may, as discussed earlier, be uncomfortable for some ( Ackerman-Barger et al., 2020 ; Villaruel and Broome, 2020 ). Cultivating an inclusive environment requires acknowledging and challenging racism in all aspects of the educational experience, including curricula, institutional policies and structures, pedagogical strategies, and the formal and informal distribution of resources and power ( Iheduru-Anderson, 2020 ; Koschmann et al., 2020 ; Metzger and Taggart, 2020 ; Schroeder and DiAngelo, 2010 ; Villaruel and Broome, 2020 ; Waite and Nardi, 2019 ). Nursing school curricula have historically focused on the contributions of White and female nurses ( Waite and Nardi, 2019 ). The weight given to this curricular content sends a message to students—both White students and students of color—about what faculty consider important ( Villaruel and Broome, 2020 ). Moving forward, curricula need to include a critical examination of the history of racism within nursing and an acknowledgment and celebration of the contribution of nurses of color ( Waite and Nardi, 2019 ). Such efforts need to be led by a broad group of individuals from all levels within an institution; racism in institutional practices can be so ingrained that it is difficult for those with power to recognize ( Villaruel and Broome, 2020 ). Faculty often understand the importance of an inclusive learning environment, but struggle with moving from intention to action (Beard, 2013, 2014 ; Metzger et al., 2020 ).

While institutional efforts to change organizational culture are thoroughly described in the literature, they remain too rare to address the problems described above effectively ( Breslin et al., 2018 ). In the early 2000s, the University of Washington School of Nursing implemented a project designed to change the “climate of whiteness” at the school ( Schroeder and DiAngelo, 2010 ). The project involved many facets, including year-long antiracist workshops; a comprehensive and institutionalized diversity statement; and action plans for addressing admission barriers, encouraging ongoing education for faculty, and disseminating antiracist information to the entire campus. The authors of an evaluation of the project note that while initial feedback was positive, changing the sociopolitical climate of a school is a long-term process that requires institutional commitment, innovative leadership, long- and short-term strategies, and patience ( Schroeder and DiAngelo, 2010 ). Unfortunately, many administrators and leaders may hesitate to initiate dialogues about these issues or may lack knowledge of how to address the challenges, and in many institutions, faculty and administrators from underserved groups have been expected to carry this burden, which can allow their colleagues to remain passive ( Lim et al., 2015 ). The committee stresses that addressing racism and discrimination within the nursing profession requires more than mere programs or statements; it requires developing action-oriented strategies, holding difficult conversations about privilege, dismantling long-standing structures and traditions, conducting curricular reviews to detect biases and correct as necessary, and exploring how interpersonal and structural racism shapes the student experience both consciously and unconsciously ( Burnett et al., 2020 ; Iheduru-Anderson, 2020 ; Waite and Nardi, 2019 ).

Recruitment and Admissions

Many social and structural barriers impede the entry of underrepresented students into the nursing profession ( NACNEP, 2019 ). Several approaches can be taken to improve access for prospective underrepresented students and, by extension, increase the diversity of the nursing workforce. Recruitment of underrepresented students can start years before nursing school through such approaches as improved K–12 science education ( AAPCHO, 2009 ) and outreach to junior high and high school students, such as through summer pipeline programs ( Katz et al., 2016 ) or health career clubs ( Murray et al., 2016 ). K–12 education is particularly important for sparking students’ interest in the health professions, as well as for giving them the foundational knowledge necessary for success ( NASEM, 2016b ). One innovative approach to preparing young people for a career in nursing is the Rhode Island Nurses Institute Middle College Charter High School (RINIMC). RINIMC offers a free, 4-year, nursing-focused, high school education open to any student in Rhode Island; students graduate with experience in health care as well as up to 20 college credits. Nearly half of the program’s students are Latinx, and more than one-third are Black ( RINIMC, n.d. ). Establishing a pathway to nursing education for diverse students well before undergraduate school is important, particularly for first-generation students ( Katz et al., 2016 ; McCue, 2017 ). Some states offer dual enrollment programs. An example is Ohio’s College Credit Plus program, in which students in grades 7 to 12 have the opportunity to earn college and high school credits simultaneously, thus preparing them for postsecondary success. 6

Once students have applied to nursing school, a system of holistic admissions can improve the diversity of the incoming class ( Glazer et al., 2016 , 2020 ). A holistic admissions system involves evaluating an applicant based not only on academic achievement but also on experiences, attributes, potential contributions, and the fit between the applicant and the institutional mission ( DeWitty, 2018 ; NACNEP, 2019 ). Schools that have implemented such a system have seen an increase in the diversity of their student body ( Glazer et al., 2016 , 2018 ). Academic measures (e.g., graduation and exam pass rates) have remained unchanged or improved, and schools have reported increases in such measures as student engagement, cooperation and teamwork, and openness to different perspectives ( Artinian et al., 2017 ; Glazer et al., 2016 , 2020 ). In a recent paper published by AACN (2020d) , the following promising practices in holistic admissions were identified: (1) review institutional mission, vision, and values statements to ensure that they value diversity and inclusion; (2) create an “experience, attributes, and metrics (E-A-M) model” (p. 16) that connects back to the institution’s mission statement; (3) identify recruitment practices that align with the E-A-M model; (4) design rubrics to be used by admissions committees that are reflective of the E-A-M model; (5) engage faculty and staff in the holistic admissions review process; (6) use technology resources such as a centralized application system to maintain efficiencies; (7) develop tailored support services for underrepresented students; and (8) engage in a review and assessment of the entire process.

Addressing Barriers to Success

Part of cultivating an inclusive educational environment is acknowledging and addressing barriers that may prevent students from achieving their potential. As noted previously, some students—particularly those from underrepresented groups—may need support in a number of areas, including economic, social and emotional, and academic and career progression. Attention to the barriers faced by students is essential at each step along the pathway from high school preparation; to recruitment, admission, retention, and academic success in nursing school; to graduation and placement in a job; to retention and advancement within a nursing career ( IOM, 2016b ).

Providing Economic Supports

Cost is a key factor in decisions about nursing education for most students, and is particularly salient for those from underrepresented groups, who come disproportionately from families with comparatively low incomes and levels of wealth ( Diefenbeck et al., 2016 ; Graham et al., 2016 ; Sullivan, 2004 ). Sabio and Petges (2020) interviewed associate’s degree nursing students in a Midwestern state and found that the total cost of a baccalaureate degree and student debt was the greatest barrier to pursuing a degree, followed by family and personal, such as head-of-household, responsibilities. This challenge is pervasive in higher education, and there are indications that the problem is growing (Advisory Committee on Student Financial Assistance, 2013 ). Students need to have the financial resources not only for tuition but also for an array of education-related expenses, including housing, food, work attire, books, and supplies.

Providing clear information about the costs of nursing education and available financial supports early in the recruitment and admission process is key to identifying those who need help and encouraging them to enroll ( Pritchard et al., 2016 ). Recruitment and admission practices need to take into account student finances and how future salaries affect choices, particularly for certain groups of students. Most health care systems provide some level of tuition reimbursement for baccalaureate and higher education, and this support may lead students toward certain settings (e.g., acute care) and away from others (e.g., public health, primary care) ( Larsen, 2012 ). Other financial support options are available, including the Public Service Loan Forgiveness program, which offers full forgiveness after 10 years for employees of nonprofit or government organizations ( U.S. Department of Education, n.d.b ), and programs through HRSA that award loan repayment to RNs and advanced practice nurses who work in health professions shortage areas for at least 2 years ( HRSA, 2021 ).

State policy reform can help remove some of the structural barriers to education. For example, New York State has implemented a program that allows New York households earning less than $125,000 annually to qualify for free instate tuition at state public universities ( New York State, n.d. ). New nurses who complete an associate’s degree in New York are required to complete a bachelor’s degree within 10 years of graduation; free in-state tuition could make a considerable difference for these nurses in pursuing their next degree. While it is too early to assess the effects on the composition of the nursing workforce, this approach bears further evaluation. Certainly it is critical for state policies to facilitate the financing of nursing education using models other than additional student loans. There are demonstrated disparities in the burden of student debt between Black and White students (Brookings Institution, 2016 ), and the risk of assuming large amounts of debt for students from disadvantaged backgrounds may be one they cannot afford to take. Therefore, innovative financing models are necessary to ensure that all nurses can pursue educational opportunities.

It is also important to note that as they progress in their education, students of many backgrounds may experience food insecurity, struggles with housing, or issues with transportation that affect their ability to perform ( AAC&U, 2019 ; Laterman, 2019 ; Strauss, 2020 ). Institutions need to ensure that students’ basic needs are met during their studies through sustained, multiyear funding and resources to support students facing financial emergencies.

Social and Academic Supports

Once students have been admitted, some nursing schools offer programs, such as summer programs that bridge high school and college, designed to prepare them academically and socially for the rigors of nursing education. Some of these programs are designed specifically for underrepresented and/or first-generation college students ( Pritchard et al., 2016 ), who may lack adequate family, emotional, and moral support; mentorship opportunities; professional socialization; and academic support ( Banister et al., 2014 ; Loftin et al., 2012 ). A study at the University of Cincinnati College of Nursing found that the impact of its summer bridge program lasted throughout the first year of school, and that grade point averages and retention were similar between underrepresented and majority students ( Pritchard et al., 2016 ). The Recruitment & Retention of American Indians into Nursing (RAIN) program at the University of North Dakota conducts a “No Excuses Orientation” workshop to give incoming American Indian students an opportunity to create connections and become acquainted with people and resources at the university ( UND, 2020 ). Tribal leaders are included in the orientation, along with discussions of cultural and family values and issues.

Another approach for supporting students is through mentoring programs. As discussed in Chapter 9 , these programs create supportive environments by providing peer and faculty role modeling, academic guidance, and support ( Wilson et al., 2010 ). Evidence indicates that mentoring programs for students from underrepresented groups are more effective when they include nurses and faculty from those groups, who have firsthand understanding of the unique challenges these students and nurses regularly confront ( Banister et al., 2014 ). This observation underscores the need for diverse faculty, mentors, and preceptors with the availability and willingness to guide these students and teach them leadership. For example, the RAIN program provides mentoring to American Indian students; staff and leaders are heavily involved in the local American Indian communities, and many are tribal members themselves (Minority Nurse, 2013 ).

Students who represent the first generation in their families to enter a postsecondary institution may face challenges other students do not, and are more likely to graduate if they receive support ( Costello et al., 2018 ). Parents and significant others can be a crucial source of support ( Pritchard et al., 2020 ); socializing and educating family members about the rigors of nursing programs may facilitate their support for students. A variety of programs around the country have succeeded in increasing graduation rates among first-generation students, including pipeline programs that have successfully increased the diversity of candidates entering nursing. These programs include HRSA pipeline programs; HOSA-Future Health Professionals; and university-based programs such as the Niganawenimaanaanig program at Bemidji State University in Minnesota, created to support American Indian nursing students ( HOSA, 2012 ; HRSA, 2017 ; Wilkie, 2020 ). Federal funding is available for these types of programs from sources that include HRSA’s Health Careers Opportunity Program and Nursing Workforce Diversity Grant program. However, the need for such programs exceeds the available funding. Box 7-8 lists some of the ways in which nursing programs can support their students’ success.

Examples of Supports for Nursing Students.

Data on Quality

One important tool for recruiting a more diverse student population is providing relevant data to prospective students so they can make informed decisions about where to study. These data could include NCLEX pass rates; however, these rates alone are insufficient to determine whether a school is likely to have the resources to support a student through to graduation. Data on student retention, graduation by demographic, full cost to attend, tuition, and other quality indicators can signal to both consumers and funders whether a nursing education program has the necessary infrastructure and support to retain students from diverse backgrounds. Pass rates can be reported by race, ethnicity, socioeconomic status, first-time college/university attendees, adult learners with children living at home, and status as an English as a second language (ESL) learner to help students choose a program that best suits their needs. It is also important for schools to provide on their websites demographic information about their current enrollees. As discussed above, NCSBN identified additional quality indicators for nursing education; as these indicators begin to be measured and reported, the data can help prospective students make more informed choices.

Educational Pathways and Options

As nursing education programs adapt their curricula and other learning experiences to better address SDOH and health equity, it will be important to consider the educational pathways students may follow, both in their initial preparation and as they progress in their careers. A key way of strengthening the nursing workforce will be to encourage nurses to pursue the next level of education and certification available to them and to improve access to these educational opportunities, especially for those from underrepresented communities ( Jones et al., 2018 ; Phillips and Malone, 2014 ).

One way to improve access and encourage nurses to take the next step in their education is by offering expedited programs that allow them to complete their degree in less time. For example, there are articulation agreements, either among educational institutions or at the state or regional level, that align the content and requirements of programs. These types of agreements accelerate the RN-to-BSN and RN-to-MSN pathways and allow students to easily transfer credits between community colleges and universities ( AACN, 2019b ). There are also bridge programs available for LPNs who wish to pursue the ADN or BSN degree. Investments in articulation programs have been responsible in part for an increase in the number of employed nurses with a baccalaureate degree, from 49 percent in 2010 to 59 percent in 2019 ( Campaign for Action, n.d. ). Further progress in this area is needed, however, particularly for partnerships between baccalaureate nursing programs and academic institutions that serve underrepresented populations (e.g., tribal colleges, historically Black colleges and universities). A model of this type of partnership can be found in the New Mexico Nursing Education Consortium, 7 which coordinates prelicensure nursing curricula in 16 locations at state, tribal, and community colleges.

Nursing education can also be expedited through the use of a competency-based curriculum that allows students to progress by demonstrating the required competencies rather than meeting specific hour requirements ( U.S. Department of Education, n.d.a ). With this approach, which is currently used, for example, by Western Governors University, students can self-pace their education and potentially save time and money by learning the material quickly or tapping previous knowledge ( WGU, 2020 ). This type of educational approach may be particularly useful for nontraditional students who are entering nursing with other experiences and education. For example, a person with a background as a nursing or medical assistant may find that he or she can quickly master some of the required material for a nursing degree, particularly at the beginning. Workers from other sectors may also be able to pivot to nursing. During the COVID-19 pandemic, a study identified health care jobs, such as nursing assistant, that out-of-work hospitality workers could quickly transition to pursue ( Miller and Haley, 2020 ). While the study did not include jobs that required further education or certification, the shared skill sets that the authors identified include many skills that are central to nursing.

Another approach for increasing access to nursing education is to expand the use of distance learning opportunities. Distance learning gives students flexibility, and may be particularly beneficial for those from rural areas or other areas without a nursing school in the vicinity ( NCSBN, 2020b ). Rural areas face multiple challenges: rural populations have high rates of chronic disease and have difficulty accessing care because of provider shortages in these areas (see Chapter 2 ). Relative to their urban counterparts, rural nurses are less likely to hold a BSN ( Merrell et al., 2020 ). Distance learning has been used for many years to reach rural populations, but there are challenges with respect to regulation and ensuring the quality of education ( NCSBN, 2020a ). Efforts have been made to assess and improve the quality of distance learning; Quality Matters, for example, is an organization that provides peer-reviewed evaluation of distance or hybrid programs using a set of quality standards. 8 While many nursing programs are adhering to these standards ( Quality Matters, 2020 ), many are not, and the quality of distance learning remains uneven. The rapid rollout of distance learning during the COVID-19 pandemic has provided a unique opportunity to evaluate the effectiveness of different strategies for distance learning and to leverage this experience to expand and improve distance learning opportunities in the future.

STRENGTHENING AND DIVERSIFYING THE NURSING FACULTY

A system of nursing education that can prepare students from diverse backgrounds to address SDOH and health equity requires a diverse faculty ( NACNEP, 2019 ; Thornton and Persaud, 2018 ). Unfortunately, the faculty currently teaching in nursing programs is overwhelmingly White and female: as of 2018, full-time faculty in nursing schools were about 93 percent female, and only 17.3 percent were from underrepresented groups, up from 11.5 percent in 2009 ( AACN, 2020c ).

In addition to this lack of diversity, the number of faculty may be inadequate to prepare the next generation of nurses: not only were there 1,637 faculty vacancies in 2019 across 892 nursing schools, but the schools surveyed hoped to create 134 new faculty positions in that year ( AACN, 2020c ). These shortages contributed to decisions to turn away more than 80,000 qualified applicants, although other insufficiencies also played a part. The AACN report cites several key reasons for faculty shortages: increasing average age of faculty members and associated increasing retirement rates, high compensation in other settings that attracts current and potential nurse educators, and an insufficient pool of graduates from master’s and doctoral programs ( AACN, 2020c ; Fang and Bednash, 2017 ). A 2020 NACNEP report calls the faculty shortage a “long-standing crisis threatening the supply, education, and training of registered nurses” and recommends federal efforts as well as a coordinated private–public response to address the shortage ( NACNEP, 2020 ).

Finally, faculty must have the knowledge, skills, and competencies to prepare their students for the challenges of advancing health equity and fully understanding the implications of SDOH for their daily practice ( NACNEP, 2019 ). If health equity and SDOH are to be integrated throughout the curriculum (as discussed earlier in this chapter), all faculty, including tenure-track faculty, clinical instructors, mentors, and preceptors, must have these competencies ( Thornton and Persaud, 2018 ). To develop these competencies, nursing schools must commit resources and support to faculty development ( Thornton and Persaud, 2018 ).

Diversifying the Faculty

As noted, diverse faculty are needed to broaden the perspectives and experiences to which nursing students are exposed and to serve as mentors and role models for diverse students ( Phillips and Malone, 2014 ). Unfortunately, minority faculty members often face barriers similar to those faced by students, including an unwelcoming environment; feeling marginalized, underappreciated, and invisible; a lack of support; feelings of tokenism; and the inability to integrate into existing faculty structures ( Beard and Julion, 2016 ; Hamilton and Haozous, 2017 ; Iheduru-Anderson, 2020 ; Kolade, 2016 ; Salvucci and Lawless, 2016 ; Whitfield-Harris and Lockhart, 2016 ). Faculty from underrepresented groups report feeling isolated, lacking in mentorship and collegial support, and burdened by having to represent the entire underrepresented community ( Kolade, 2016 ; Whitfield-Harris et al., 2017 ). In addition, as discussed in Chapter 9 , faculty from underrepresented racial and ethnic groups face a “diversity tax,” in which they are asked to be part of efforts to improve diversity and inclusion to serve on committees; mentor underrepresented students; and participate in other activities that are uncompensated, unacknowledged, and unrewarded ( Gewin, 2020 ). These demands on underrepresented faculty can lead to frustration, burnout, and a feeling that they have been given responsibility for institutional diversity ( Gewin, 2020 ).

These experiences of minority faculty can result in high attrition and low satisfaction ( Whitfield-Harris et al., 2017 ), and further research is needed on specific ways in which institutions can recruit and support a diverse faculty ( Whitfield-Harris et al., 2017 ). Proposed approaches include cultivating an inclusive educational environment ( Hamilton and Haozous, 2017 ), taking intentional action and holding open discourse to strengthen the institutional commitment to diversity ( Beard and Julion, 2016 ), improving financial assistance and mentorship opportunities for faculty ( Salvucci and Lawless, 2016 ), and conducting climate surveys to better understand the feelings and experiences of underrepresented faculty and using these data to improve the institutional culture ( DeWitty and Murray, 2020 ). The challenges these faculty face and the opportunities to address these challenges highlight the importance of efforts by schools of nursing to recruit, support, and retain diverse faculty.

Faculty Development

Collectively, nursing school faculty need to be prepared to teach their students about the complex linkages among population health, SDOH, and health outcomes ( NLN, 2019 ; Thornton and Persaud, 2018 ). To do so, as discussed above, nurse educators need to move beyond teaching abstract principles to integrating the core concepts and competencies related to these linkages into the entire learning experience across nursing education programs. They also need to create a truly inclusive and safe educational environment and prepare nurses to care for a diverse population, which, as discussed above, requires that they understand issues of racism and systems of marginalization and engage in critical self-reflection ( O’Connor et al., 2019 , Peek et al., 2020 ). Yet, many faculty in nursing schools lack the knowledge and experience needed to develop curricula and strategies for incorporating SDOH into all areas of nursing education ( NACNEP, 2019 ; Valderama-Wallace and Apesoa-Varano, 2019 ).

Several approaches are available for preparing nursing school faculty to teach content related to SDOH and health equity. One approach, discussed above, is to actively recruit more diverse faculty who reflect the nation’s population and provide different perspectives and role models for students ( The Macy Foundation, 2020 ). Another approach is to encourage the development and dissemination of evidence-based methods for teaching nursing students how they can incorporate these core concepts into nursing practice. For example, educators involved in developing innovative models of classroom and experiential learning could focus on disseminating these models with the assistance of nursing associations and organizations, including through publication, continuing education programs, or faculty-to-faculty education and mentoring. Finally, institutions can provide in-depth and sustained learning opportunities for faculty, staff, and preceptors focused on how they can support their students in learning about SDOH and health equity both within and outside of the classroom ( IOM, 2016b ). While some funding sources are available for these types of efforts, including support from private foundations and HRSA grants for faculty development, the critical importance of this content to health outcomes argues for providing more such resources.

IMPLICATIONS OF COVID-19 FOR NURSING EDUCATION

It has been 100 years since a global event has had an impact on nursing education in the United States and around the world equal to that of the COVID-19 pandemic. Both World War I and the influenza pandemic of 1918 to 1920 led to transformations in nursing education, including standardization of training and professionalization of the field. The COVID-19 pandemic has already led to innovations that are likely to shape the future of nursing education. Faculty have adopted new teaching strategies, demonstrating creativity and adaptability, within a span of days or weeks, while such technologies as simulation-based education have quickly been adapted to replace in-person clinical hours ( Jiménez-Rodríguez et al., 2020 ). In one example of a rapid pivot, educators at the University of Pennsylvania School of Nursing transitioned a community immersion course from in-person to virtual form when all in-person classes were canceled. While they faced challenges, the educators found that students were able to remain dedicated to their community partnerships and to think creatively about how to meet their learning objectives ( Flores et al., 2020 ). These and similar innovations may ultimately guide the way to expanding and improving nursing education.

At the same time, however, the pandemic has highlighted challenges and inequities in nursing education. Simulated clinical experiences are practical only if a school and its students have access to computers with enough power to run the software, for example. While online learning has been in use for more than a decade, not all schools or faculty are prepared to deliver content in this way, nor are all students capable of accessing the necessary technology. Moreover, as practice settings have been emptied of non-COVID patients, programs have been facing multiple challenges in providing students with sufficient hours of instruction, training, and clinical practice. These challenges have underscored the limitations of traditional ways of educating nurses even as they have presented unique opportunities for innovation. To translate these short-term challenges into long-term improvements in nursing education will require

evaluation of such practices as distance learning and virtual experiential learning to identify and disseminate best practices;
a sense of urgency in the development of substantial changes, such as modifications of curriculum and the adoption of new technologies; and
partnership with public- and private-sector organizations, associations, and researchers that can bring both resources and expertise to the tasks of strengthening nursing education.
CONCLUSIONS

Currently, most nursing schools tend to cover the topics of SDOH, health equity, and population health in isolated, stand-alone courses. This approach is insufficient for creating a foundational understanding of these critical issues and for preparing nurses to work in a wide variety of settings. This content needs to be integrated and sustained throughout nursing school curricula and paired with community-based experiential opportunities whereby students can apply their knowledge, build their skills, and reflect on their experiences.

Conclusion 7-1: A curriculum embedded in coursework and experiential learning that effectively prepares students to promote health equity, reduce health disparities, and improve the health and well-being of the population will build the capacity of the nursing workforce.

Preparing nursing students to address SDOH and improve health equity will require more than didactic learning and traditional clinical experiences. It will require that students engage actively in experiences that will expand and diversify their understanding of nursing practice, prepare them to care for diverse populations with empathy, and allow them to build the necessary skills and competencies for the nursing practice of tomorrow.

Conclusion 7-2: Increasing the number of nurses with PhD degrees who focus on the connections among social determinants of health, health disparities, health equity, and overall health and well-being will build the evidence base in this area. Building capacity in schools of nursing will require financial resources, including scholarship/loan repayment opportunities; adequate numbers of expert faculty available to mentor; and curriculum revisions to focus more attention on social determinants of health and health equity.

Having more nurses prepared at the PhD level will help build the knowledge base in the nursing profession for other nurses to translate (DNPs) and use in practice settings (LPNs, RNs, APRNs).

Conclusion 7-3: Learning experiences that develop nursing students’ understanding of health equity, social determinants of health, and population health and prepare them to incorporate that understanding into their professional practice include opportunities to learn cultural humility and recognize one’s own implicit biases; gain experience with interprofessional collaboration and multisector partnerships to enable them to address social needs comprehensively and drive structural improvements; develop such technical competencies as use of telehealth, digital health tools, and data analytics; and gain substantive experience with delivering care in diverse community settings, such as public health departments, schools, libraries, workplaces, and neighborhood clinics.

Building a diverse nursing workforce is a critical component of the effort to prepare nurses to address SDOH and health equity. While the nursing workforce has steadily grown more diverse, nursing schools need to continue and expand their efforts to recruit, support, and mentor diverse students.

Conclusion 7-4: Successfully diversifying the nursing workforce will depend on holistic efforts to support and mentor/sponsor students and faculty from a wide range of backgrounds, including cultivating an inclusive environment; providing economic, social, professional, and academic supports; ensuring access to information on school quality; and minimizing inequities.

Aaberg VA. A path to greater inclusivity through understanding implicit attitudes toward disability. Journal of Nursing Education. 2012; 51 (9):505–510. [ PubMed : 22766074 ]
AAC&U (Association of American Colleges & Universities). Majority of college students experience food insecurity, housing insecurity, or homelessness. 2019. [March 29, 2021]. https://www .aacu.org /aacu-news/newsletter /majority-college-students-experience-food-insecurity-housing-insecurity-or .
AACN (American Association of Colleges of Nursing). The essentials of doctoral education for advanced nursing practice. Washington, DC: American Association of Colleges of Nursing; 2006.
AACN. The essentials of master’s education in nursing. 2011. [July 6, 2021]. https://www .aacnnursing .org/portals/42/publications /mastersessentials11.pdf .
AACN. 2018–2019 enrollment and graduations in baccalaureate and graduate programs in nursing. Washington, DC: American Association of Colleges of Nursing; 2019a.
AACN. Articulation agreements among nursing education programs. 2019b. [January 25, 2021]. https://www .aacnnursing .org/News-Information /Fact-Sheets/Articulation-Agreements .
AACN. 2020a. [January 8, 2021]. 2019–2020 enrollment and graduations in baccalaureate and graduate programs in nursing. https://www .aacnnursing .org/Store/product-info /productcd/IDSR_20ENROLLBACC .
AACN. Essentials task force. 2020b. [May 18, 2020]. https://www .aacnnursing .org/About-AACN/AACNGovernance /Committees-and-Task-Forces/Essentials .
AACN. Nursing faculty. 2020c. [March 9, 2021]. https://www .aacnnursing .org/news-information /fact-sheets/nursing-faculty-shortage .
AACN. Curriculum improvement. 2020c. [January 25, 2021]. https://www .aacnnursing .org/Population-Health-Nursing /Curriculum-Improvement .
AACN. Promising practices in holistic admissions review: Implementation in academic nursing. 2020d. [January 25, 2021]. https://www .aacnnursing .org/Portals/42/News /White-Papers/AACN-White-Paper-PromisingPractices-in-Holistic-Admissions-Review-December-2020.pdf .
AACN. Diversity & inclusion offerings. [April 23, 2020]. n.d. https://www .aacnnursing .org/Diversity-Inclusion /HolisticAdmissions /Diversity-and-Inclusion-Offerings .
AAPCHO (Association of Asian Pacific Community Health Organizations). Pipeline programs to improve racial and ethnic diversity in the health professions. 2009. [June 2, 2021]. https://www .aapcho.org /wp/wp-content/uploads /2012/11/PipelineToImproveDiversityInHealthProfessions .pdf .
AARP. Preparation and roles of nursing care providers in America. 2010. [October 28, 2020]. http: //championnursing .org/resources/preparation-and-roles-nursing-care-providers-america .
Ackerman-Barger K, Boatright D, Gonzalez-Colaso R, Orozco R, Latimore D. Seeking inclusion excellence: Understanding racial microaggressions as experienced by underrepresented medical and nursing students. Academic Medicine. 2020; 95 (5):758–763. [ PMC free article : PMC7185051 ] [ PubMed : 31725462 ]
Advisory Committee on Student Financial Assistance. Federal Register. 2013; 78 (152) [June 2, 2021]; https://fsapartners .ed .gov/sites/default /files/attachments/fregisters /FR080713AdvisoryCommitteeonStudentFinancialAssistance.pdf .
Agner J. Moving from cultural competence to cultural humility in occupational therapy: A paradigm shift. American Journal of Occupational Therapy. 2020; 74 (4):7404347010. [ PubMed : 32602456 ]
AHA (American Hospital Association). Screening for social needs: Guiding care teams to engage patients. 2019. [November 11, 2020]. https://www .aha.org/system /files/media/file /2019/09/screening-for-social-needstool-value-initiative-rev-9-26-2019.pdf .
Aiken LH, Sloane D, Griffiths P, Rafferty AM, Bruyneel L, McHugh M, Maier CB, Moreno-Casbas T, Ball JE, Ausserhofer D, Sermeus W. Nursing skill mix in European hospitals: Cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Quality & Safety. 2017; 26 (7):559–568. [ PMC free article : PMC5477662 ] [ PubMed : 28626086 ]
Alleghany College of Maryland. Nurse managed wellness clinic. 2020. [June 2, 2021]. https://www .allegany .edu/health-clinics/nurse-managed-wellness-clinic .
Allen J. Improving cross-cultural care and antiracism in nursing education: A literature review. Nurse Education Today. 2010; 30 (4):314–320. [ PubMed : 19758731 ]
Arcaya MC, Figueroa JF. Emerging trends could exacerbate health inequities in the United States. Health Affairs (Millwood). 2017; 36 (6):992–998. [ PubMed : 28583956 ]
Artinian NT, Drees BM, Glazer G, Harris K, Kaufman LS, Lopez N, Danek JC, Michaels J. Holistic admissions in the health professions: Strategies for leaders. College & University. 2017; 92 (2):65–68. [ PMC free article : PMC5708588 ] [ PubMed : 29200468 ]
Baker C, Cary AH, da Conceicao Bento M. Global standards for professional nursing education: The time is now. Journal of Professional Nursing. 2020; 37 (1):86–92. doi: 10.1016/j.profnurs.2020.10.001. [ PMC free article : PMC7571445 ] [ PubMed : 33674114 ]
Bandy J. Vanderbilt University Center for Teaching. 2011. [March 29, 2021]. What is service learning or community engagement? https://cft .vanderbilt .edu/guides-sub-pages /teaching-through-community-engagement .
Banister G, Bowen-Brady HM, Winfrey ME. Using career nurse mentors to support minority nursing students and facilitate their transition to practice. Journal of Professional Nursing. 2014; 30 (4):317–325. [ PubMed : 25150417 ]
Barton AJ, Murray TA, Spurlock DR Jr. An open letter to members of the nursing education community. Journal of Nursing Education. 2020; 59 (4):183. [ PubMed : 32243547 ]
Batra S, Orban J. Oral presentation at the National Center for Interprofessional Education and Practice NEXUS Summit 2020, October 15, 2020, Virtual. 2020. Social mission and accreditation standards.
Beard KV. How much diversity in nursing is enough? American Journal of Nursing. 2014; 114 (9):11. [ PubMed : 25166226 ]
Beard KV, Julion WA. Does race still matter in nursing? The narratives of African-American nursing faculty members. Nursing Outlook. 2016; 64 :583–596. https://doi .org/10.1016/j .outlook.2016.06.005 . PMID:27432213. [ PubMed : 27432213 ]
Bednash G, Breslin ET, Kirschling JM, Rosseter RJ. PhD or DNP: Planning for doctoral nursing education. Nursing Science Quarterly. 2014; 27 (4):296–301. [ PubMed : 25248773 ]
Befus DR, Kumodzi T, Schminkey D, Ivany AS. Advancing health equity and social justice in forensic nursing research, education, practice, and policy: Introducing structural violence and trauma-and violence-informed care. Journal of Forensic Nursing. 2019; 15 (4):199–205. [ PubMed : 31764523 ]
Bestsennyy O, Gilbert G, Harris A, Rost J. Telehealth: A quarter-trillion-dollar post-COVID-19 reality? 2020. [February 24, 2021]. https://www .mckinsey .com/industries/healthcare-systems-and-services /our-insights /telehealth-a-quarter-trillion-dollar-post-covid-19-reality .
Bjørk IT, Berntsen K, Brynildsen G, Hestetun M. Nursing students’ perceptions of their clinical learning environment in placements outside traditional hospital settings. Journal of Clinical Nursing. 2014; 23 (19–20):2958–2967. [ PMC free article : PMC4263152 ] [ PubMed : 24460862 ]
Blair IV, Steiner JF, Havranek EP. Unconscious (implicit) bias and health disparities: Where do we go from here? The Permanente Journal. 2011; 15 (2):71–78. PMID: 21841929. [ PMC free article : PMC3140753 ] [ PubMed : 21841929 ]
Breen N, Jackson JS, Wood F, Wong D, Zhang X. Translational health disparities research in a data-rich world. American Journal of Public Health. 2019; 109 (S1):S41–S42. [ PMC free article : PMC6356140 ] [ PubMed : 30699034 ]
Brennan AMW, Barnsteiner J, Siantz ML, Cotter VT, Everett J. Lesbian, gay, bisexual, transgendered, or intersexed content for nursing curricula. Journal of Professional Nursing. 2012; 28 (2):96–104. [ PubMed : 22459139 ]
Breslin ET, Nuri-Robins K, Ash J, Kirschling JM. The changing face of academic nursing: Nurturing diversity, inclusivity, and equity. Journal of Professional Nursing. 2018; 34 (2):103–109. [ PubMed : 29703311 ]
Bresnick J. Health IT Analytics. 2017. [November 11, 2020]. Understanding the basics of clinical decision support systems. https: //healthitanalytics .com/features/understanding-the-basics-of-clinical-decision-support-systems .
Brookings Institution. Black-White disparity in student loan debt more than triples after graduation. 2016. [November 11, 2020]. https://www .brookings .edu/research/black-white-disparity-in-student-loan-debt-more-than-triples-after-graduation .
Broome ME, Fairman J. Changing the conversation about doctoral education in nursing. Nursing Outlook. 2018; 66 (2018):217–218. [ PubMed : 29887188 ]
Buhler-Wilkerson K. Bringing care to the people: Lillian Wald’s legacy to public health nursing. American Journal of Public Health. 1993; 83 (12):1778–1786. [ PMC free article : PMC1694935 ] [ PubMed : 7695663 ]
Burnett A, Moorley C, Grant J, Kahin M, Sagoo R, Rivers E, Deravin L, Darbyshire P. Dismantling racism in education: In 2020, the year of the nurse & midwife, “it’s time” Nurse Education Today. 2020; 93 :104532. https://doi .org/10.1016/j .nedt.2020.104532 . [ PMC free article : PMC7354251 ] [ PubMed : 32683224 ]
Campaign for Action. New RN graduates by degree type, by gender. 2019a. [May 13, 2020]. https: //campaignforaction .org/resource/new-rn-graduates-degree-type-gender .
Campaign for Action. Nursing education and the path to population health improvement. 2019b. [March 13, 2020]. https: //campaignforaction .org/wp-content /uploads/2019/03/NursingEducationPathtoHealthImprovement.pdf .
Campaign for Action. Campaign for Action dashboard. 2020. [May 14, 2020]. https: //campaignforaction .org/wpcontent/uploads /2019/07/r2_CCNA-0029 _2019-Dashboard-Indicator-Updates_1-29-20.pdf .
Campaign for Action. Transforming nursing education. [May 14, 2020]. n.d. https: //campaignforaction .org/issue/transforming-nursing-education .
Campinha-Bacote J. Cultural competemility: A paradigm shift in the cultural competence versus cultural humility debate—part I. The Online Journal of Issues in Nursing. 2018; 24 (1)
Castro-Sánchez E, Russell AM, Dolman L, Wells M. International Nursing Review. 2021. What place does nurse-led research have in the COVID-19 pandemic? pp. 1–5. [ PMC free article : PMC8013712 ] [ PubMed : 33565619 ]
CCNE (Commission on Collegiate Nursing Education). Standards for accreditation of baccalaureate and graduate nursing programs. 2018. [September 29, 2020]. https://www .aacnnursing .org/Portals/42/CCNE /PDF/Standards-Final-2018.pdf .
CDC (Centers for Disease Control and Prevention). Health care provider/clinician apps. 2018. [November 11, 2020]. https://www .cdc.gov/mobile /healthcareproviderapps.html .
Center for Health Affairs. LPNs crucial to nursing workforce diversity. 2018. [May 14, 2020]. https: //neohospitals .org/TheCenterForHealthAffairs /MediaCenter /NewsReleases/2018 /August/Nursing-WorkforceDiversity .
Cho I, Kim E, Choi WH, Staggers N. Comparing usability testing outcomes and functions of six electronic nursing record systems. International Journal of Medical Informatics. 2016; 88 :78–85. [ PubMed : 26878766 ]
Costello M, Ballin A, Diamond R, Gao ML. First generation college students and non-first generation college students: Perceptions of belonging. Journal of Nursing Education and Practice. 2018; 8 (12):59–65.
Devine PG, Forscher PS, Austin AJ, Cox WT. Long-term reduction in implicit race bias: A prejudice habit-breaking intervention. Journal of Experimental Social Psychology. 2012; 48 (6):1267–1278. https://doi .org/10.1016/j .jesp.2012.06.003 . [ PMC free article : PMC3603687 ] [ PubMed : 23524616 ]
DeWitty VP. What is holistic admissions review, and why does it matter? Journal of Nursing Education. 2018; 57 (4):195–196. [ PubMed : 29614186 ]
DeWitty VP, Murray TA. Influence of climate and culture on minority faculty retention. Journal of Nursing Education. 2020; 59 (9):483–484. [ PubMed : 32865579 ]
DiAngelo R. White fragility. International Journal of Critical Pedagogy. 2011; 3 (3):54–71.
DiAngelo RJ. White fragility: Why it’s so hard for White people to talk about racism. Boston, MA: Beacon Press; 2018.
Diefenbeck C, Michalec B, Alexander R. Lived experiences of racially and ethnically underrepresented minority BSN students: A case study specifically exploring issues related to recruitment and retention. Nursing Education Perspectives. 2016; 37 (1):41–44. [ PubMed : 27164777 ]
Duffy MT, Friesen MA, Speroni KG, Swengros D, Shanks LA, Waiter PA, Sheridan MJ. BSN completion barriers, challenges, incentives, and strategies. The Journal of Nursing Administration. 2014; 44 (4):232–236. [ PubMed : 24662693 ]
Effland KJ, Hays K, Ortiz FM, Blanco BA. Incorporating an equity agenda into health professions education and training to build a more representative workforce. Journal of Midwifery & Women’s Health. 2020; 65 (1):149–159. [ PubMed : 31957220 ]
El-Sayed M, El-Sayed J. Achieving lifelong learning outcomes in professional degree programs. International Journal of Process Education. 2014; 6 (1):37–42.
Fairman JA, Giordano NA, McCauley K, Villaruel A. Invitational summit: Re-envisioning research focused PHD programs of the future. Journal of Professional Nursing. 2020; 37 doi: 10.1016/j.profnurs.2020.09.004. [ PubMed : 33674099 ]
Fang D, Bednash GD. Identifying barriers and facilitators to future nurse faculty careers for DNP students. Journal of Professional Nursing. 2017; 33 (1):56–67. doi: 10.1016/j.profnurs.2016.05.008. [ PubMed : 28131149 ]
FDA (U.S. Food and Drug Administration). Digital health. 2020. [May 14, 2020]. https://www .fda.gov/medicaldevices /digital-health .
Fee E, Bu L. The origins of public health nursing: The Henry Street Visiting Nurse Service. American Journal of Public Health. 2010; 100 (7):1206–1207. [ PMC free article : PMC2882394 ] [ PubMed : 20466947 ]
FitzGerald C, Hurst S. Implicit bias in healthcare professionals: A systematic review. BMC Medical Ethics. 2017; 18 (1):19. [ PMC free article : PMC5333436 ] [ PubMed : 28249596 ]
Flores DD, Bocage C, Devlin S, Miller M, Savarino A, Lipman TH. Pedagogy in Health Promotion. Epub October 16, 2020. 2020. [November 11, 2020]. When community immersion becomes distance learning: Lessons learned from a disrupted semester. https://journals .sagepub .com/doi/pdf/10.1177 /2373379920963596 .
Forman TM, Armor DA, Miller AS. A review of clinical informatics competencies in nursing to inform best practices in education and nurse faculty development. Nursing Education Perspectives. 2020; 41 (1):E3–E7. [ PubMed : 31860501 ]
Foronda C, Liu S, Bauman EB. Evaluation of simulation in undergraduate nurse education: An integrative review. Clinical Simulation in Nursing. 2013; 9 (10):E409–E416.
Foronda C, Baptiste DL, Reinholdt MM, Ousman K. Cultural humility: A concept analysis. Journal of Transcultural Nursing. 2016; 27 (3):210–217. [ PubMed : 26122618 ]
Foronda CL, Baptiste DL, Pfaff T, Velez R, Reinholdt M, Sanchez M, Hudson KW. Cultural competency and cultural humility in simulation-based education: An integrative review. Clinical Simulation in Nursing. 2018; 15 :42–60.
Gaines K. Why nursing school accreditation matters. [April 30, 2020]. n.d. https://nurse .org/education /nursing-school-accreditation .
Gallagher RW, Polanin JR. A meta-analysis of educational interventions designed to enhance cultural competence in professional nurses and nursing students. Nurse Education Today. 2015; 35 (2):333–340. [ PubMed : 25466790 ]
Gewin V. The time tax put on scientists of colour. Nature. 2020; 583 :479–481. [ PubMed : 32647354 ]
Giddens JF. Changing paradigms and challenging assumptions: Redefining quality and NCLEX-RN pass rates. Journal of Nursing Education. 2009; 48 (3):123–124. [ PubMed : 19297961 ]
Giovenco DP, Spillane TE. Improving efficiency in mobile data collection for place-based public health research. American Journal of Public Health. 2019; 109 (S2):S123–S125. [ PMC free article : PMC6383969 ] [ PubMed : 30785801 ]
Glazer G, Clark A, Bankston K. Holistic admissions in nursing: We can do this. Journal of Professional Nursing. 2016; 32 (4) [ PMC free article : PMC4955639 ] [ PubMed : 27424931 ]
Glazer G, Tobias B, Mentzel T. Increasing healthcare workforce diversity: Urban universities as catalysts for change. Journal of Professional Nursing. 2018; 34 (4):306–313. [ PMC free article : PMC6069531 ] [ PubMed : 30055674 ]
Graham CL, Phillips SM, Newman SD, Atz TW. Baccalaureate minority nursing students perceived barriers and facilitators to clinical education practices: An integrative review. Nursing Education Perspectives. 2016; 37 (3):130–137. [ PubMed : 27405193 ]
Greene MZ, FitzPatrick MK, Romano J, Aiken LH, Richmond TS. Clinical fellowship for an innovative, integrated BSN-PhD program: An academic and practice partnership. Journal of Professional Nursing. 2017; 33 (4):282–286. [ PMC free article : PMC5523847 ] [ PubMed : 28734488 ]
Hamilton N, Haozous EA. Retention of faculty of color in academic nursing. Nursing Outlook. 2017; 65 (2):212–221. https://doi .org/10.1016/j .outlook.2016.11.003 . PMID: 28087139. [ PubMed : 28087139 ]
Hayden J, Smiley R, Alexander M, Kardong-Edgren S, Jeffries P. The NCSBN national simulation study: A longitudinal, randomized, controlled study replacing clinical hours with simulation in prelicensure nursing education. Journal of Nursing Regulation. 2014; 5 (2S):S1–S64.
Heath S. Health IT Analytics. 2019. [April 21, 2021]. Top considerations for SDOH screening, referral technologies. https: //patientengagementhit .com/news/top-considerations-for-sdoh-screening-referral-technologies .
Hermer J, Hirsch A, Bekemeier B, Nyirati C, Wojnar D, Wild L, Oneal G. Integrating population health into nursing education: The process of gaining commitment from Washington’s nursing deans and directors. Journal of Professional Nursing. 2020; 36 (2):6–12. [ PubMed : 32204862 ]
Higgins LW, Shovel JA, Bilderback AL, Lorenz HL, Martin SC, Rogers DJ, Minnier TE. Hospital nurses’ work activity in a technology-rich environment: A triangulated quality improvement assessment. Journal of Nursing Care Quality. 2017; 32 (3):208–217. [ PubMed : 28541263 ]
Horn C. University of South Carolina. 2020. [April 28, 2021]. COVID-19 response: Virtual simulation keeps nursing students on track for graduation. https://www .sc.edu/uofsc /posts/2020/04/covid _resilience_virtual _simulation_nursing.php#.X5S1e0JKjfY .
HOSA (Future Health Professionals/Health Occupations Students of America). About HOSA. 2012. [March 30, 2020]. http://www .hosa.org/about .
HRSA (Health Resources and Services Administration). Health careers pipeline and diversity programs. 2017. [April 30, 2020]. https://bhw .hrsa.gov /sites/default/files /bhw/health-workforce-analysis /programhighlights /diversity-and-pipeline-training-programs-2017.pdf .
HRSA. Strategic plan FY 2019–2022. 2019. [April 30, 2020]. https://www .hrsa.gov /about/strategic-plan/index.html .
HRSA. 2018 national sample survey of registered nurses. 2020. [April 30, 2020]. https://data .hrsa.gov /DataDownload/NSSRN /GeneralPUF18/2018_NSSRN _Summary_Report-508.pdf .
HRSA. HRSA National Health Service Corps. 2021. [March 29, 2021]. NHSC loan repayment program. https://nhsc .hrsa.gov /loan-repayment/nhsc-loan-repayment-program.html .
Ibrahim SA, Charlson ME, Neill DB. Health Equity I. 1. 2020. Big data analytics and the struggle for equity in health care: The promise and perils; pp. 99–101. [ PMC free article : PMC7133425 ] [ PubMed : 32258961 ]
Iheduru-Anderson KC. Journal of Professional Nursing. 2020. The White/Black hierarchy institutionalizes White supremacy in nursing and nursing leadership in the United States. Advance online publication. https://doi .org/10.1016/j .profnurs.2020.05.005 . [ PubMed : 33867099 ]
Iheduru-Anderson KC, Wahi MM. Prevention of lateral violence in nursing through education: The bullying awareness seminar. The Journal of Nursing Education. 2017; 56 (12):762–763. [ PubMed : 29206270 ]
IOM (Institute of Medicine). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: The National Academies Press; 2003. [ PubMed : 25032386 ]
IOM. Redesigning continuing education in the health professions. Washington, DC: The National Academies Press; 2010. [ PubMed : 25032352 ]
IOM. The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press; 2011. [ PubMed : 24983041 ]
IOM. Interprofessional education for collaboration: Learning how to improve health from interprofessional models across the continuum of education to practice: Workshop summary. Washington, DC: The National Academies Press; 2013. [ PubMed : 24901189 ]
IOM. Assessing progress on the Institute of Medicine report The Future of Nursing. Washington, DC: The National Academies Press; 2016a. [ PubMed : 27010049 ]
IOM. A framework for educating health professionals to address the social determinants of health. Washington, DC: The National Academies Press; 2016b. [ PubMed : 27854400 ]
IPEC (Interprofessional Education Collaborative). Core competencies for interprofessional collaborative practice: 2016 update. Washington, DC: Interprofessional Education Collaborative; 2016. [June 2, 2021]. https://ipec .memberclicks .net/assets/2016-Update.pdf .
Jamshidi N, Molazem Z, Sharif F, Torabizadeh C, Najafi Kalyani M. The challenges of nursing students in the clinical learning environment: A qualitative study. Scientific World Journal. 2016; 2016 :1846178. [ PMC free article : PMC4913003 ] [ PubMed : 27366787 ]
Jiménez-Rodríguez D, Torres Navarro MDM, Plaza Del Pino FJ, Arrogante O. Simulated nursing video consultations: An innovative proposal during COVID-19 confinement. Clinical Simulation of Nursing. 2020; 48 :29–37. doi: 10.1016/j.ecns.2020.08.004. [ PMC free article : PMC7425773 ] [ PubMed : 32837633 ]
Johansson P, Jones DE, Watkins CC, Haisfield-Wolfe ME, Gaston-Johansson F. Physicians’ and nurses’ experiences of the influence of race and ethnicity on the quality of healthcare provided to minority patients, and on their own professional careers. Journal of National Black Nurses Association. 2011; 22 (1):43–56. [ PubMed : 21888150 ]
Jones CB, Toles M, Knafl GJ, Beeber AS. An untapped resource in the nursing workforce: Licensed practical nurses who transition to become registered nurses. Nursing Outlook. 2018; 66 (1):46–55. [ PubMed : 29306576 ]
Permanente Kaiser. Kaiser Permanente launches social health network to address needs on a broad scale. 2019. [November 11, 2020]. https://permanente .org /kaiser-permanente-launches-social-health-network-to-address-needs-on-a-broad-scale .
Kamau-Small S, Joyce B, Bermingham N, Roberts J, Robbins C. The impact of the care equity project with community/public health nursing students. Public Health Nursing. 2015; 32 (2):169–176. [ PubMed : 24850360 ]
Katz JR, Barbosa-Leiker C, Benavides-Vaello S. Measuring the success of a pipeline program to increase nursing workforce diversity. Journal of Professional Nursing. 2016; 32 (1):6–14. [ PMC free article : PMC4724384 ] [ PubMed : 26802586 ]
Kleinman A, Benson P. Anthropology in the clinic: The problem of cultural competency and how to fix it. PLoS Medicine. 2006; 3 (10) [ PMC free article : PMC1621088 ] [ PubMed : 17076546 ]
Kolade FM. The lived experience of minority nursing faculty: A phenomenological study. Journal of Professional Nursing. 2016; 32 (2):107–114. https://doi .org/10.1016/j .profnurs.2015.09.002 . [ PubMed : 27000195 ]
Kononowicz AA, Woodham LA, Edelbring S, Stathakarou N, Davies D, Saxena N, Tudor Car L, Carlstedt-Duke J, Car J, Zary N. Virtual patient simulations in health professions education: Systematic review and meta-analysis by the digital health education collaboration. Journal of Medical Internet Research. 2019; 21 (7):e14676. https://doi .org/10.2196/14676 . [ PMC free article : PMC6632099 ] [ PubMed : 31267981 ]
Koschmann KS, Jeffers NK, Heidari O. “I can’t breathe”: A call for antiracist nursing practice. Nursing Outlook. 2020; 68 (5):539–541. doi: 10.1016/j.outlook.2020.07.004. [ PMC free article : PMC7428668 ] [ PubMed : 32811661 ]
Kumm S, Godfrey N, Martin D, Tucci M, Muenks M, Spaeth T. Baccalaureate outcomes met by associate degree nursing programs 2014. Nurse Education. 2014; 39 (5):216–220. PMID: 24978014. doi: 10.1097/NNE.0000000000000060. [ PubMed : 24978014 ]
Lake ET. How effective response to COVID-19 relies on nursing research. Research in Nursing and Health. 2020; 43 (3):213–214. [ PMC free article : PMC7264727 ] [ PubMed : 32306403 ]
Larsen R, Reif L, Frauendienst R. Baccalaureate nursing students’ intention to choose a public health career. Public Health Nursing. 2012; 29 :424–432. https://doi .org/10.1111/j .1525-1446.2012.01031.x . [ PubMed : 22924565 ]
Laternman The New York Times. May 2, 2019. [March 29, 2021]. Tuition or dinner? Nearly half of college students surveyed in a new report are going hungry. https://www .nytimes.com /2019/05/02/nyregion /hunger-college-food-insecurity.html .
LCME (Liaison Committee on Medical Education). Functions and structure of a medical school: Standards for accreditation of medical education programs leading to the MD degree. 2018. [November 16, 2020]. http://lcme .org/wp-content /uploads/filebase /standards/2019-20 _Functions-and-Structure_2018-09-26 .docx .
Levine S, Varcoe C, Browne AJ. “We went as a team closer to the truth”: Impacts of interprofessional education on trauma-and violence-informed care for staff in primary care settings. Journal of Interprofessional Care. 2020; 35 (1):46–54. [ PubMed : 31928247 ]
Lewis and Clark Community College. Lewis and Clark mobile health unit. [February 21, 2021]. n.d. https://www .lc.edu/Mobile_Clinics .
Lim F, Johnson M, Eliason M. A national survey of faculty knowledge, experience, and readiness for teaching lesbian, gay, bisexual, and transgender health in baccalaureate nursing programs. Nursing Education Perspectives. 2015; 36 :144–152.
Linden MA, Redpath SJ. A comparative study of nursing attitudes towards young male survivors of brain injury: A questionnaire survey. International Journal of Nursing Studies. 2011; 48 (1):62–69. [ PubMed : 20965077 ]
Loftin C, Newman SD, Dumas BP, Gilden G, Bond ML. Perceived barriers to success for minority nursing students: An integrative review. International Scholarly Research Network Nursing. 2012; 2012 :806543. [ PMC free article : PMC3369480 ] [ PubMed : 22701183 ]
Love R, Carrington JM. Journal of the American Association of Nurse Practitioners. 2020. Introducing telehealth skills into the doctor of nursing practice curriculum. Epub ahead of print. doi: 10.1097/JXX.0000000000000505. [ PubMed : 33038114 ]
Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education: A systematic review. Advances in Health Sciences Education Theory and Practice. 2009; 14 (4):595–621. [ PubMed : 18034364 ]
Marion-Martins AD, Pinho DLM. Interprofessional simulation effects for healthcare students: A systematic review and meta-analysis. Nurse Education Today. 2020; 94 :104568. [ PubMed : 32932058 ]
Marken PA, Zimmerman C, Kennedy C, Schremmer R, Smith K. Human simulators and standardized patients to teach difficult conversations to interprofessional health care teams. American Journal of Pharmaceutical Education. 2010; 74 (7):120. [ PMC free article : PMC2972514 ] [ PubMed : 21088725 ]
Massachusetts Department of Higher Education Nursing Initiative. Massachusetts nursing of the future nursing core competencies. 2016. [January 12, 2021]. https://www .mass.edu /nahi/documents/NOFRNCompetencies _updated_March2016.pdf .
McCue PL. Open Access Dissertations. 2017. The pre-collegiate pipeline to diversify the nursing workforce. Paper 575.
McMenamin P. ANA Community blog. 2015. [June 2, 2021]. Diversity among registered nurses: Slow but steady progress. https://community .ana .org/blogs/peter-mcmenamin /2015/08/21/rn-diversity-note?ssopc=1 .
Menzel N, Willson LH, Doolen J. International Journal of Nursing Education Scholarship. 11. 2014. Effectiveness of a poverty simulation in Second Life®: Changing nursing student attitudes toward poor people; p. 11. doi: 10.1515/ijnes-2013-0076. [ PubMed : 24615491 ]
Merrell M, Probst J, Crouch E, Abshire D, McKinney S, Haynes E. A national survey of RN-to-BSN programs: Are they reaching rural students? Journal of Nursing Education. 2020; 59 (10):557–565. [ PMC free article : PMC8641547 ] [ PubMed : 33002161 ]
Metzger M, Taggart J. A longitudinal mixed methods study describing 4th year baccalaureate nursing students’ perceptions of inclusive pedagogical strategies. Journal of Professional Nursing. 2020; 36 (4):229–235. [ PubMed : 32819549 ]
Metzger M, Dowling T, Guinn J, Wilson DT. Inclusivity in baccalaureate nursing education: A scoping study. Journal of Professional Nursing. 2020; 36 (1):5–14. [ PubMed : 32044053 ]
Miller S, Haley P. Federal Reserve Bank of Atlanta. 2020. [February 24, 2021]. Transitioning from hospitality to health care occupations. https://www .frbatlanta .org/cweo/workforce-currents /2020/08/28 /transitioning-from-hospitality-to-health-care-occupations .
Minority Nurse. Mentors to the max. 2013. [November 11, 2020]. https: //minoritynurse .com/mentors-to-the-max .
Morton JL, Weierbach FM, Sutter R, Livsey K, Goehner E, Liesveld J, Goldschmidt MK. New education models for preparing pre-licensure students for community-based practice. Journal of Professional Nursing. 2019; 35 (6):491–498. [ PubMed : 31857060 ]
Mosher DK, Hook JN, Captari LE, Davis DE, DeBlaere C, Owen J. Cultural humility: A therapeutic framework for engaging diverse clients. Practice Innovations. 2017; 2 (4):221.
Murray TA, Pole DC, Ciarlo EM, Holmes S. A nursing workforce diversity project: Strategies for recruitment, retention, graduation, and NCLEX-RN success. Nursing Education Perspectives. 2016; 37 (3):138–143. PMID: 27405194. [ PubMed : 27405194 ]
NACNEP (National Advisory Council on Nurse Education and Practice). Preparing nurses for new roles in population health management. 2016. [May 15, 2020]. https://www .hrsa.gov /sites/default/files /hrsa/advisory-committees /nursing/reports /2016-fourteenthreport.pdf .
NACNEP. Integration of social determinants of health in nursing education, practice, and research. 2019. [March 29, 2021]. https://www .hrsa.gov /sites/default/files /hrsa/advisory-committees /nursing/reports /nacnep-2019-sixteenthreport.pdf .
NACNEP. Preparing nurse faculty, and addressing the shortage of nurse faculty and clinical preceptors. 2020. [March 29, 2021]. https://www .hrsa.gov /sites/default/files /hrsa/advisory-committees /nursing/reports /nacnep-17report-2021.pdf .
NASEM (National Academies of Sciences, Engineering, and Medicine). Big data and analytics for infectious disease research, operations, and policy: Proceedings of a workshop. Washington, DC: The National Academies Press; 2016a. [ PubMed : 27977088 ]
NASEM. Developing a national STEM workforce strategy: A workshop summary. Washington, DC: The National Academies Press; 2016b.
NASEM. Communities in action: Pathways to health equity. Washington, DC: The National Academies Press; 2017. [ PubMed : 28418632 ]
NASEM. Proceedings of a workshop. Washington, DC: The National Academies Press; 2018a. Exploring a business case for high-value continuing professional development: [ PubMed : 29757596 ]
NASEM. How people learn II: Learners, contexts, and cultures. Washington, DC: The National Academies Press; 2018b.
NASEM. Improving health professional education and practice through technology: Proceedings of a workshop. Washington, DC: The National Academies Press; 2018c. [ PubMed : 30407779 ]
NASEM. Integrating social care into the delivery of health care: Moving upstream to improve the nation’s health. Washington, DC: The National Academies Press; 2019. [ PubMed : 31940159 ]
NCDHHS (North Carolina Department of Health and Human Services). North Carolina health atlas. 2020. [November 11, 2020]. https://schs .dph.ncdhhs.gov/data/hsa .
NCSBN (National Council of State Boards of Nursing). NCLEX-RN examination. 2019. [May 1, 2020]. https://www .ncsbn.org /2019_RN_TestPlan-English.pdf .
NCSBN. Number of candidates taking NCLEX examination and percent passing, by type of candidate. 2020a. [May 1, 2020]. https://www .ncsbn.org /Table_of_Pass_Rates_2019_Q4.pdf .
NCSBN. Distance education. 2020b. [November 11, 2020]. https://www .ncsbn.org/6662.htm .
NEJM (New England Journal of Medicine) Catalyst. Healthcare big data and the promise of value-based care. 2018. [November 11, 2020]. https://catalyst .nejm .org/doi/full/10.1056/CAT.18.0290 .
New York State. Leading the way to college affordability. [May 15, 2020]. n.d. https://www .ny.gov/programs /tuition-free-degree-program-excelsior-scholarship .
NLN (National League for Nursing). Interprofessional education and healthcare simulation symposium. 2013. [February 24, 2021]. http://www .nln.org/docs /default-source/professional-development-programs /white-papersymposium-ipe-in-healthcare-simulation-2013-(pdf) .pdf?sfvrsn=0 .
NLN. A diving Document from the National League for Nursing NLN Board of Governors. 2015a. [January 25, 2021]. A vision for the changing faculty role: Preparing students for the technological world of health care. http://www .nln.org/docs /default-source/about /nln-vision-series- %28position-statements%29 /nlnvision_8.pdf?sfvrsn=4 . [ PubMed : 29194143 ]
NLN. Interprofessional collaboration in education and practice. 2015b. [January 25, 2021]. http://www .nln.org/docs /default-source/default-document-library/ipe-ipp-vision .pdf?sfvrsn=14 .
NLN. Accreditation standards for nursing education programs. 2016. [January 10, 2020]. http://www .nln.org/docs /default-source/accreditation-services /cnea-standards-final-february-201613f2bf5c78366c709642ff00005f0421 .pdf?sfvrsn=12 .
NLN. A vision for integration of the social determinants of health into nursing education curricula. 2019. [January 10, 2020]. http://www .nln.org/docs /default-source/default-document-library /social-determinantsof-health .pdf?sfvrsn=2 . [ PubMed : 31644458 ]
NONPF (National Organization of Nurse Practitioner Faculties). NONPF supports telehealth in nurse practitioner education 2018. 2018. [January 18, 2020]. https://cdn .ymaws.com/www .nonpf.org/resource /resmgr/2018_Slate /Telehealth_Paper_2018.pdf .
NYSIM (City University of New York Grossman School of Medicine). NYSIM Center. 2017. [May 18, 2020]. http://nysimcenter .org .
O’Connor MR, Barrington WE, Buchanan DT, Bustillos D, Eagen-Torkko M, Kalkbrenner A, de Castro AB. Short-term outcomes of a diversity, equity, and inclusion institute for nursing faculty. Journal of Nursing Education. 2019; 58 (11):633–640. [ PubMed : 31665527 ]
O’Lynn C. Rethinking indicators of academic quality in nursing programs. Journal of Nursing Education. 2017; 56 (4):195–196. [ PubMed : 28383741 ]
Peek ME, Vela MB, Chin MH. Practical lessons for teaching about race and racism: Successfully leading free, frank, and fearless discussions. Academic Medicine. 2020; 95 (12S):S139–S144. [ PubMed : 32889939 ]
Periyakoil VS. Building a culturally competent workforce to care for diverse older adults: Scope of the problem and potential solutions. Journal of the American Geriatrics Society. 2019; 67 (2):S423–S432. [ PubMed : 31074850 ]
Phillips JM, Malone B. Increasing racial/ethnic diversity in nursing to reduce health disparities and achieve Health Equity. Public Health Reports. 2014; 129 (Suppl 2):45–50. [ PMC free article : PMC3863700 ] [ PubMed : 24385664 ]
Phillips KE, Roberto A, Salmon S, Smalley V. Nursing student interprofessional simulation increases empathy and improves attitudes on poverty. Journal of Community Health Nursing. 2020; 37 (1):19–25. [ PubMed : 31905301 ]
Poore JA, Cullen DL, Schaar GL. Simulation-based interprofessional education guided by Kolb’s experiential learning theory. Clinical Simulation in Nursing. 2014; 10 (5):e241–e247.
Porter K, Jackson G, Clark R, Waller M, Stanfill AG. Applying social determinants of health to nursing education using a concept-based approach. Journal of Nursing Education. 2020; 59 (5):293–296. [ PubMed : 32352547 ]
Pritchard TJ, Perazzo JD, Holt JA, Fishback BP, McLaughlin M, Bankston KD, Glazer G. Evaluation of a summer bridge: Critical component of the Leadership 2.0 Program. Journal of Nursing Education. 2016; 55 (4):196–202. [ PubMed : 27023888 ]
Pritchard TJ, Glazer G, Bankston KD, McGinnis K. Leadership 2.0: Nursing’s next generation: Lessons learned on increasing nursing student diversity. The Online Journal of Issues in Nursing. 2020; 25 (2)
Purnell TS, Marshall JK, Olorundare I, Stewart RW, Sisson S, Gibbs B, Cooper LA. Provider perceptions of the organization’s cultural competence climate and their skills and behaviors targeting patient-centered care for socially at-risk populations. Journal of Health Care for the Poor and Underserved. 2018; 29 (1):481–496. [ PubMed : 29503313 ]
Quality Matters. QM-Certified Programs. 2020. [November 11, 2020]. https://www .qualitymatters .org/qm-membership /faqs/qm-certified-programs .
Richmond TS, Foman M. Firearm violence: A global priority for nursing science. Journal of Nursing Scholarship. 2019; 51 :229–240. https://doi .org/10.1111/jnu.12421 . [ PMC free article : PMC6417970 ] [ PubMed : 30215887 ]
RINIMC (Rhode Island Nurses Institute Middle College Charter High School). RINIMC Charter High School. [March 29, 2021]. n.d. https://rinimc .org/rinimc-charter-high-school .
Rosa WE, Ojemeni MT, Karanja V, Cadet G, Charles A, McMahon C, Davis S. Education equity in nursing: A cornerstone of sustainable development goal attainment. Public Health Nursing. 2019; 36 (4):447–448. [ PubMed : 31309621 ]
Rutledge CM, Kott K, Schweickert PA, Poston R, Fowler C, Haney TS. Telehealth and eHealth in nurse practitioner training: Current perspectives. Advances in Medical Education and Practice. 2017; 8 :399–409. https://doi .org/10.2147/AMEP.S116071 . [ PMC free article : PMC5498674 ] [ PubMed : 28721113 ]
RWJF (Robert Wood Johnson Foundation). Future of nursing scholars: PhD nurse profiles. 2020. [November 11, 2020]. http: //futureofnursingscholars .org/phd-nurse-profiles .
RWJF. Future of nursing scholars. 2021. [June 2, 2021]. http: //futureofnursingscholars.org .
Sabin JA, Rivara FP, Greenwald AG. Physician implicit attitudes and stereotypes about race and quality of medical care. Medical Care. 2008; 46 (7):678–685. [ PubMed : 18580386 ]
Sabio C, Petges N. Understanding the barriers to BSN education among ADN students: A qualitative study. Teaching and Learning in Nursing. 2020; 15 (1):45–52.
Salvucci C, Lawless CA. Nursing faculty diversity: Barriers and perceptions on recruitment, hiring, and retention. Journal of Cultural Diversity. 2016; 23 (2):65–75. PMID: 27439233. [ PubMed : 27439233 ]
Sanner S, Baldwin DEE, Cannella KA, Charles J. The impact of cultural diversity forum on students’ openness to diversity. Journal of Cultural Diversity. 2010; 17 (2) [ PubMed : 20586367 ]
Scheel LS, Peters MD, Møbjerg ACM. Reflection in the training of nurses in clinical practice settings: A scoping review protocol. JBI Database of Systematic Reviews and Implementation Reports. 2017; 15 (12):2871–2880. [ PubMed : 29219871 ]
Schmidt S, George M, Bussey-Jones J. Welcome to the neighborhood: Service-learning to understand social determinants of health and promote local advocacy. Diversity Equality Health Care. 2016; 13 (6):389–390.
Schroeder C, DiAngelo R. Addressing whiteness in nursing education: The sociopolitical climate project at the University of Washington School of Nursing. Advances in Nursing Science. 2010; 33 (3):244–255. PMID: 20693833. doi: 10.1097/ANS.0b013e3181eb41cf. [ PubMed : 20693833 ]
Schroeder K, Garcia B, Phillips RS, Lipman TH. Addressing social determinants of health through community engagement: An undergraduate nursing course. Journal of Nursing Education. 2019; 58 (7):423–426. [ PubMed : 31242312 ]
Sharma M, Pinto AD, Kumagai AK. Teaching the social determinants of health: A path to equity or a road to nowhere? Academic Medicine. 2018; 93 (1):25–30. [ PubMed : 28445214 ]
Shiffrin RM. Drawing causal inference from big data. Proceedings of the National Academy of Sciences. 2016; 113 (27):7308–7309. [ PMC free article : PMC4941473 ] [ PubMed : 27382143 ]
Shin S, Park JH, Kim JH. Effectiveness of patient simulation in nursing education: Meta-analysis. Nurse Education Today. 2015; 35 (1):176–182. doi: 10.1016/j.nedt.2014.09.009. [ PubMed : 25459172 ]
Siegel J, Coleman DL, James T. Integrating social determinants of health into graduate medical education: A call for action. Academic Medicine. 2018; 93 (2):159–162. [ PubMed : 29140918 ]
Spector N, Silvestre J, Alexander M, Martin B, Hooper J, Squires A, Ojemeni M. NCSBN regulatory guidelines and evidence-based quality indicators for nursing education programs. Journal of Nursing Regulation. 2020; 11 (2S):S1–S64.
Spetz J. Projections of progress toward the 80% bachelor of science in nursing recommendation and strategies to accelerate change. Nursing Outlook. 2018; 66 (4):394–400. [ PubMed : 29903501 ]
Squires A, Kovner C, Faridaben F, Chyun D. Assessing nursing student intent for PhD study. Nurse Education Today. 2013; 34 (11):1405–1410. [ PubMed : 24080267 ]
SSIH (Society for Simulation in Healthcare). About simulation. [January 12, 2021]. n.d. https://www .ssih.org /About-SSH/About-Simulation .
Storfjell J, Winslow B, Saunders J. Catalysts for change: Harnessing the power of nurses to build population health in the 21st century. Princeton, NJ: Robert Wood Johnson Foundation; 2017.
Strauss V. Housing and food insecurity affecting many college students, new data says. 2020. [January 12, 2021]. https://www .washingtonpost .com/education /2020/02/20/housing-food-insecurity-affecting-many-college-students-new-data-says .
Sukhera J, Wodzinski M, Rehman M, Gonzalez CM. The implicit association test in health professions education: A meta-narrative review. Perspectives in Medical Education. 2019; 8 (5):267–275. [ PMC free article : PMC6820611 ] [ PubMed : 31535290 ]
Sullivan LW. A report of the Sullivan Commission on Diversity in the Healthcare Workforce. The Sullivan Commission. 2004. [March 29, 2021]. Missing persons: Minorities in the health professions. https: //campaignforaction .org/wp-content /uploads/2016/04/SullivanReport-Diversity-inhref="https: //campaignforaction .org/wp-content /uploads/2016 /04/SullivanReport-Diversity-inHealthcare-Workforce1 .pdfHealthcare-Workforce1.pdf .
Szanton SL, Wolff JW, Leff B, Thorpe RJ, Tanner EK, Boyd C, Xue Q, Guralnik J, Bishai D, Gitlin LN. CAPABLE trial: A randomized controlled trial of nurse, occupational therapist and handyman to reduce disability among older adults: Rationale and design. Contemporary Clinical Trials. 2014; 38 (1):102–112. https://doi .org/10.1016/j .cct.2014.03.005 . [ PMC free article : PMC4074085 ] [ PubMed : 24685996 ]
Taylor H, Loftin C, Reyes H. First-time NCLEX-RN pass rate: Measure of program quality or something else? Journal of Nursing Education. 2014; 53 (6):336–341. [ PubMed : 24855991 ]
The Macy Foundation. Conference recommendations February 24–27, 2020. Atlanta, GA: Josiah Macy Jr. Foundation; 2020. Addressing harmful bias and eliminating discrimination in health professions learning environments. [ PubMed : 32889942 ]
The Poverty Simulation. The Poverty Simulation. [May 14, 2020]. n.d. http://www .povertysimulation.net/about .
ThinkTank. The cost of poverty experience. [November 11, 2020]. n.d. https: //thinktank-inc.org/cope .
Thornton M, Persaud S. Preparing today’s nurses: Social determinants of health and nursing education. The Online Journal of Issues in Nursing. 2018; 23 (3)
Tilden VP, Cox KS, Moore JE, Naylor MD. Strategic partnerships to address adverse social determinants of health: Redefining health care. Nursing Outlook. 2018; 66 (3):233–236. [ PubMed : 29685323 ]
Topaz M, Pruinelli L. Big data and nursing: Implications for the future. Studies in Health Technology and Informatics. 2017; 232 :165–171. [ PubMed : 28106594 ]
Turk MT, Colbert AM. Using simulation to help beginning nursing students learn about the experience of poverty: A descriptive study. Nurse Education Today. 2018; 71 :174–179. Epub September 29, 2018. PMID: 30292059. doi: 10.1016/j.nedt.2018.09.035. [ PubMed : 30292059 ]
Tyczkowski BL, Reilly J. DNP-prepared nurse leaders: Part of the solution to the growing faculty shortage. The Journal of Nursing Administration. 2017; 47 (7–8):359–360. [ PubMed : 28678051 ]
UND (University of North Dakota). RAIN: No excuses orientation. 2020. [November 11, 2020]. https://cnpd .und.edu/rain/no-excuses .html .
U.S. Department of Education. Competency-based learning or personalized learning. [November 11, 2020]. n.d.a. https://www .ed.gov/oii-news /competency-based-learning-or-personalized-learning .
U.S. Department of Education. Public service loan forgiveness. [September 2, 2020]. n.d.b. https://studentaid .gov /manageloans/forgiveness-cancellation /public-service .
Valderama-Wallace CP, Apesoa-Varano EC. “Social justice is a dream”: Tensions and contradictions in nursing education. Public Health Nursing. 2019; 36 (5):735–743. [ PubMed : 31168869 ]
Velasquez D, Mehrotra A. Health Affairs Blog. 2020. Ensuring the growth of telehealth during COVID-19 does not exacerbate disparities in care. doi: 10.1377/hblog20200505.591306.
Villarruel AM, Broome ME. Beyond the naming: Institutional racism in nursing. Nursing Outlook. 2020; 68 (4):375–376. [ PMC free article : PMC7473708 ] [ PubMed : 32896302 ]
von Wendt CEA, Niemi-Murola L. Simulation in interprofessional clinical education. Simulation in Healthcare. 2018; 13 (2):131–138. [ PubMed : 29117089 ]
Waite R, Nardi D. Nursing colonialism in America: Implications for nursing leadership. Journal of Professional Nursing. 2019; 35 (1):18–25. doi: 10.1016/j.profnurs.2017.12. [ PubMed : 30709460 ]
Walker K, Arbour M, Waryold J. Educational strategies to help students provide respectful sexual and reproductive health care for lesbian, gay, bisexual, and transgender persons. Journal of Midwifery and Women’s Health. 2016; 61 (6):737–743. [ PubMed : 27783889 ]
Wallace J, Decosimo K, Simon M. Applying data analytics to address social determinants of health in practice. North Carolina Medical Journal. 2019; 80 :244–248. [ PubMed : 31278189 ]
WGU (Western Governors University). Competency-based education. 2020. [November 11, 2020]. https://www .wgu.edu/about /competency-based-education.html .
Whitfield-Harris L, Lockhart JS. The workplace environment for African American faculty employed in predominantly White institutions. The Association of Black Nursing Faculty Journal. 2016; 27 (2):28–38. PMID: 27263232. [ PubMed : 27263232 ]
Whitfield-Harris L, Lockhart JS, Zoucha R, Alexander R. The lived experience of Black nurse faculty in predominantly White schools of nursing. Journal of Transcultural Nursing. 2017; 28 (6):608–615. [ PubMed : 28826318 ]
WHO (World Health Organization). Regional Office for the Eastern Mediterranean. The growing need for home health care for the elderly: Home health care for the elderly as an integral part of primary health care services. 2015. [March 29, 2021]. https://apps .who.int /iris/handle/10665/326801 .
Wilkie ML. Empowered by cultural identity and catalyzed by resilience: A path to support American Indian nursing student success. Creative Nursing. 2020; 26 (1):43–47. [ PubMed : 32024738 ]
Williams SD, Hansen K, Smithey M, Burnley J, Koplitz M, Koyama K, Bakos A. Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing. Public Health Reports. 2014; 129 (1):32–36. [ PMC free article : PMC3863698 ] [ PubMed : 24385662 ]
Wilson AH, Sanner S, McAllister LE. An evaluation study of a mentoring program to increase the diversity of the nursing workforce. Journal of Cultural Diversity. 2010; 17 (4) [ PubMed : 22303649 ]
Wise PH. The Future of Children. 2012. Emerging technologies and their impact on disability; pp. 169–191. [ PubMed : 22550690 ]
Yale School of Nursing. Simulation technology redirects nursing curriculum during COVID-19. 2020. [January 12, 2021]. https://nursing .yale .edu/news/simulation-technology-redirects-nursing-curriculum-during-covid-19 .
Yen PY, Bakken S. Review of health information technology usability study methodologies. Journal of the American Medical Informatics Association. 2012; 19 (3):413–422. [ PMC free article : PMC3341772 ] [ PubMed : 21828224 ]
Yoder CM, Pesch MS. An academic–fire department partnership to address social determinants of health. Journal of Nursing Education. 2020; 59 (1):34–37. [ PubMed : 31945173 ]
Zandee G, Bossenbroek D, Friesen M, Blech K, Engbers R. Effectiveness of community health worker/nursing student teams as a strategy for public health nursing education. Public Health Nursing. 2010; 27 (3):277–284. [ PubMed : 20525101 ]

See https://www .aacnnursing .org/Education-Resources /AACN-Essentials (accessed April 13, 2021).

See Chapter 3 for demographic information on employed nurses in the United States.

For further discussion of domains and competencies, see AACN, 2020b ; Campaign for Action, 2019b ; IOM, 2016b ; NACNEP, 2019 ; NLN, 2019 ; Thornton and Persaud, 2018 .

Not all courses are open to students from all schools.

Brief and commonplace daily indignities (see Chapter 10 ).

See https://www .ohiohighered .org/collegecreditplus (accessed April 13, 2021).

See https://www .nmnec.org (accessed April 13, 2021).

See https://www .qualitymatters.org (accessed April 13, 2021).

Cite this Page National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on the Future of Nursing 2020–2030; Flaubert JL, Le Menestrel S, Williams DR, et al., editors. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington (DC): National Academies Press (US); 2021 May 11. 7, Educating Nurses for the Future.
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Incorporating evidence-based practice education in nursing research curriculum of undergraduate nursing students: A quasi-experimental study

Affiliations.

1 School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, Jiangsu Province 210023, China. Electronic address: [email protected].
2 School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, Jiangsu Province 210023, China. Electronic address: [email protected].
3 School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, Jiangsu Province 210023, China. Electronic address: [email protected].
4 School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, Jiangsu Province 210023, China. Electronic address: [email protected].
5 School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Avenue, Qixia District, Nanjing, Jiangsu Province 210023, China. Electronic address: [email protected].
PMID: 37245347
DOI: 10.1016/j.nepr.2023.103671

Aim: To examine the effect of incorporating evidence-based practice (EBP) in Nursing Research curriculum on undergraduate nursing students.

Background: The competence of EBP is essential for nurses and it is an essential task for educators to implement EBP education in nursing students.

Design: A quasi-experimental study.

Methods: Based on Astin's Input-Environment-Outcome model, the study was conducted among 258 third-grade students of a four-year nursing bachelor's program between September through December 2022. The students were divided into two groups. Students in the intervention group received innovative teaching where EBP elements were incorporated in Nursing Research course in a natural, gradual and spiral way, while students in the control group attended conventional teaching. Effect of EBP teaching was examined in terms of students' EBP competence, learning experience and satisfaction and score of team-based research protocol assignment.

Results: Compared with conventional teaching, the innovative teaching characterized by EBP improved students' EBP competence in terms of attitudes and skills and enhanced student's comprehensive ability in nursing research. Students' learning experience and satisfaction were similarly favorable between the two groups.

Conclusions: For undergraduate nursing students, the teaching strategy characterized by EBP is an appropriate and effective way to improve their EBP competence of attitudes and skills, as well as their nursing research ability.

Keywords: Evidence-based practice; Integrated curriculum; Nursing research curriculum; Teaching strategies; Undergraduate nursing students.

Education, Nursing, Baccalaureate* / methods
Evidence-Based Nursing / education
Evidence-Based Practice
Nursing Research*
Students, Nursing*

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The unfolding case study was first presented in an unstructured format in a 3-hour didactic synchronous online class. The unfolding case study replaced lectures on SDOH, population health, the health care system, and most of the content on community assessment and analysis. The unfolding case study replaced a major assignment to apply SDOH ...
Nursing Education Practice Update 2022: Competency-Based Education in
As nursing education programs begin to shift towards competency-based education (CBE), it is important to understand the impetus for this curricular transformation. Nursing roles are evolving in response to changes in healthcare delivery emphasizing health equity, improving population health, and caring for an increasingly diverse and aging ...
A Case-Centered Approach to Nursing Ethics Education: A Qualitative
2.1. Study Design. This is a qualitative study that aimed to explore nursing students' experiences of ethics education using the four topics method, and we conducted it in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) [].The research team consisted of four researchers: two with a Ph.D. in Nursing and two with a Ph.D. in Public Health focusing on medical ...
Nursing Case Study Examples and Solutions
Mental Health Nursing Case Study Examples . Mental health nursing plays a crucial role in promoting emotional well-being and providing care for individuals with mental health conditions. Immerse yourself in our mental health nursing case studies, which encompass a wide range of psychiatric disorders, therapeutic approaches, and psychosocial ...
An Exploration of Nursing Students' Experiences Using Case Report
A case study, also known as a case report, is an in-depth study of a particular individual or group. The report will often use the terms: "review of a specific condition, disease, or problem [2, 3]. Case studies in nursing practice and health education promote active learning.
Faculty Case Studies
The case studies are contained in 4 categories: Family (13 case studies), Fundamentals and Mental Health (14 case studies) and Medical Surgical (20 case studies). In addition the folder labeled minireviews contains PowerPoint sessions with combinations of case studies and standalone items.
Case Library
The Harvard Chan Case Library is a collection of teaching cases with a public health focus, written by Harvard Chan faculty, case writers, and students, or in collaboration with other institutions and initiatives. Use the filters at right to search the case library by subject, geography, health condition, and representation of diversity and identity to find cases to fit your teaching needs.
ACE.S Unfolding Cases
ACE.S Unfolding Cases. An unfolding case is one that evolves over time in a manner that is unpredictable to the learner. New situations develop and are revealed with each encounter. Every ACE unfolding case uses the highly regarded unfolding case model developed for Advancing Care Excellence for Seniors (ACE.S). Each case includes the following:
Teaching Social Determinants of Health Through an Unfolding Case Study
The impact of social determinants of health (SDOH) was developed to educate nursing students through the use of an unfolding case study. Problem: SDOH and population health are critical components of prelicensure nursing education. Unfolding case studies are a strategy to develop critical thinking and teach SDOH to nursing students.
Bridging didactic and clinical in nursing education: An innovative
Students also voiced that the activity provided opportunities to think critically through patient case study scenarios, which helped bridge the lab and classroom content to patient care. The findings support the use of CBL-SCT in nursing education to develop clinical judgment and enhance student learning through active participation with content.
Nurses' roles in health promotion practice: an integrative review
General health promoters. Health promotion by nurses is associated with common universal principles of nursing. The most common health promotion intervention used by nurses is health education (Robinson and Hill, 1998; Whitehead, 2001, 2007, 2011; Runciman et al., 2006; Witt and Puntel de Almeida, 2008; Parker et al., 2009).General health promoters are expected to have knowledge of health ...
Health education: A Rogerian concept analysis
2 Flinders University, College of Nursing Health Sciences, Bedford Park, 5042, Adelaide, South Australia, Australia. Electronic address: [email protected]. ... Results: Based on the review of 31 studies on health education, the attributes are a learning process, health-oriented, multidimensional, person-centred and partnership. The ...
The roles of nurses in supporting health literacy: a scoping review
Therefore, health literacy education in the nursing process is essential: Age, language, language ability, and risk groups ... Three studies found that health literacy affects healthy lifestyle behaviors, as well as improves the quality of life and care (11, 31, 36). Health literacy is a strategy employed by nurses to meet this need.
What is a case study?
Case study is a research methodology, typically seen in social and life sciences. There is no one definition of case study research.1 However, very simply… 'a case study can be defined as an intensive study about a person, a group of people or a unit, which is aimed to generalize over several units'.1 A case study has also been described as an intensive, systematic investigation of a ...
PDF Health education: theoretical concepts, effective strategies education
reviews health education theories and definitions, identifies the components of evidence-based health education and outlines the abilities necessary to engage in effective practice. Much has been written over the years about the relationship and overlap between health education, health promotion and other concepts, such as health literacy.
Viterbo doctor of nursing student takes studies to the next level
Students in Viterbo University's doctor of nursing practice program undertake projects or research focused on improving patient and population health outcomes. In the case of student Zuri ...
Educating Nurses for the Future
Throughout the coming decade, it will be essential for nursing education to evolve rapidly in order to prepare nurses who can meet the challenges articulated in this report with respect to addressing social determinants of health (SDOH), improving population health, and promoting health equity. Nurses will need to be educated to care for a population that is both aging, with declining mental ...
Incorporating evidence-based practice education in nursing ...
Background: The competence of EBP is essential for nurses and it is an essential task for educators to implement EBP education in nursing students. Design: A quasi-experimental study. Methods: Based on Astin's Input-Environment-Outcome model, the study was conducted among 258 third-grade students of a four-year nursing bachelor's program ...