Educating nurses for a changing world

To advance competent nurse learners, nursing programs must maintain currency with health care trends in illness management, technological advances, and other health care innovations. In Canada, more than one-third of individuals live with at least one chronic illness, such as diabetes, chronic obstructive pulmonary disease, dementia, mental illness, or cardiovascular diseases.1 With increased prevalence of chronic illnesses and multimorbidities, health care delivery is moving toward expanded practice in primary care.2 Nurses are uniquely positioned to provide a wide range of services in primary care, including triage; medication management; preventive care; sexual health services; self management interventions, such as smoking and weight loss; and secondary care for coronary heart disease.3 At the same time, primary care has shifted to collaborative health models that rely heavily on shared responsibility of care.4 In many ways, primary care is rich with opportunity for optimized nursing scope of practice and fulfilling clinical experiences. Despite this, many prelicensure nursing programs have limited primary care content and clinical exposure, and nurse learners rank primary care placements as one of their least preferred settings.5–7 There is also significant variability in primary care nursing education requirements, limited longitudinal research pertaining to nursing roles in primary care, and significant variation in the definition of primary care nurses worldwide.8 Nurses, in primary care and elsewhere, are also reporting increased care burden, frequent staff shortages, overfilled units, and failing health structures. Burnout and staffing shortages reduce nursing students’ access to preceptors and newly graduated nurses’ access to mentors, and can negatively impact nursing learners.9 The prospect of redesigning the blueprint for nursing education in a changing health climate is both daunting and exciting. Early introduction to digital health education10; incorporation of simulation-based and virtual education into nursing curriculums11,12; and investment in nurses through continuing professional development opportunities, nursing residency programs, and transition to practice initiatives13 not only provide complementary alternatives to current nursing education, but also foster a sense of agency and pride within the nursing field. While there are many exciting opportunities to expand the breadth of nursing education, the commitment to maintaining education standards that are consistent with research and current health trends is critical. Given the trend toward increasing the number of collaborative health teams in primary care and the limited primary care exposure in many nursing programs, the importance of evaluating current nursing education practices in primary care cannot be overstated. In terms of nursing innovation, a scoping review of primary care in nursing education programs is both timely and relevant.6 Mapping primary care education has the potential to advance current nursing education practices, alter the way that nurse learners perceive primary care, and foster highly competent primary care nurse graduates who can contribute meaningfully to primary care collaborative health teams.

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