Public health in undergraduate nursing education and workforce readiness

Abstract

Student engagement with the community is a cornerstone of undergraduate nursing education in Canada. Working with community from perspectives of social justice, health equity, advocacy, and political action are essential for workforce readiness. We suggest that the erosion of public health theory and clinical courses in baccalaureate nursing programs undermines the potential capability of nurses to address the intersectionality of the social determinants of health. The impact of the COVID‐19 pandemic on populations further demonstrates inequities, particularly among marginalized populations. Public health nursing education supports students’ understanding about the health impacts of social injustice, how systemic racism is embedded in colonial and Eurocentric structures, and practices of superiority and privileges.We, as a national group of public health nursing educators, set out to investigate how existing guidelines and competencies support public health in undergraduate education across Canada. Results from a national questionnaire of educators, and of PHN leaders on new graduate practice readiness are presented. Questionnaire responses confirm an erosion of PHN theory and practice in baccalaureate nursing education (BNE) curricula. The results of the questionnaires combined with evidence of PHN since the global pandemic provide educators and practitioners more insight to inform future directions to respond to workforce readiness.

The development and challenges of public health nursing education in China from 1912 to 1949: A historical study

“…The COVID‐19 pandemic has emphasized the crucial role of a strong, effective public health nursing workforce (Cygan et al., 2022), and the importance of public health in nursing practice has been highlighted. Both nursing educators and public health nursing practitioners call for revised nursing curricula to focus on public health nursing competencies and enhance public health nursing practice preparation (Larsen & Reif, 2019; Schofield et al., 2022). Current national standards for undergraduate nursing education in China do not include specific public health nursing theory and practice requirements (Higher Education Professional Teaching Committee, 2018); however, standards for public health nursing curricula were issued in the Republic of China (Ministry of Health & Ministry of Education, 1935), and nursing students engaged in practices oriented toward families and communities.…”

“…Both historically and currently, the integration of public health and nursing education faces challenges. Schofield et al (2022) noted the erosion of public health nursing theory and practice in baccalaureate degree programs, such as the decline of qualified public health nursing educators, emphasis on acute care practice, and lack of appropriate practice placements. The challenges of conducting public health programs in nursing education historically may provide a lens for understanding current challenges.…”

Striving for Health Equity Through Nursing Education: A Critical Examination of Non-traditional Community Health Placements

“…Undergraduate nursing education is essential in supporting student development in the knowledge, attitudes, and skills necessary to engage in this challenging work (Schofield et al, 2022). However, the theory-to-practice gap in community health nursing education is well established, with some researchers suggesting there is a need to improve the quality of community health (CH) clinical placements to align with the Canadian Association of Schools of Nursing (CASN) Guidelines for Quality Community Health Nursing Clinical Placements for Baccalaureate Nursing Students (CASN, 2010;Pijl-Zieber et al, 2015;Schofield et al, 2022). Recently, we (two of the authors of this discussion paper) piloted an initiative for undergraduate nursing students enrolled in their CH placement, where we partnered with organizations that work with people who are experiencing homelessness and use substances.…”

“…Our reason for pursuing partnerships with these organizations was based on our belief it is necessary to work with communities that are marginalized to provide high-quality clinical experiences that allow students to engage in praxis, linking concepts such as health equity, social justice, and the structural determinants of health to their nursing practice (Cohen & Gregory, 2009;Schofield et al, 2022). Recognizing many people with lived and living experiences of substance use and homelessness report negative experiences with the healthcare system, we also hoped our partnerships with these organizations might increase student empathy, leading to better care and improved health outcomes (Rajab et al, 2023;Ramsay et al, 2019).…”

“…Cohen and Gregory (2009) and Reimer-Kirkham et al (2005) suggest clinical placements in non-traditional settings can provide students with the "real world" experience necessary to bridge theory to practice. However, others have challenged this assumption, suggesting the theory-to-practice gap persists in non-traditional CH placements, with students feeling unprepared to practice as CHNs (Pijl-Zieber et al, 2015;Schofield et al, 2022). In addition to promoting knowledge development of community concepts, nontraditional CH placements can challenge students' biases and assumptions, reducing stigmatizing and discriminatory attitudes (Gardner & Emory, 2018;Laliberte et al, 2017;Richmond & Noone, 2020;Snyder et al, 2022;Zeien et al, 2021).…”