Understanding the Current State of Community Health Nursing Education in Canada: An Exploration of the Erosion and Devaluation of Community Health Theoretical and Practice Education in Canadian Nursing Programs

Abstract

Background: The Canadian Association of Schools of Nursing (CASN) Community Health Nurse Educators Interest Group has witnessed an erosion of community/population health content in baccalaureate curricula across Canadian schools of nursing in the last decade. A scarcity of community practice placements during the COVID-19 pandemic, with schools opting to prioritize acute care opportunities for students, exacerbated an erosion in practice hours for this important component of baccalaureate nursing education. Community nursing educators across Canada are greatly concerned by the reduction of nursing education content and relational practice framed in health equity; social, ecological, and structural determinants of health; and intersectionality, which are vital to nursing and the health of Canadians. With these concerns in mind, the purpose of this study was to gain an understanding about the current state of community health/population health theoretical and practice education in baccalaureate nursing programs in Canada.

Method: A cross-sectional survey using open- and closed-ended questions was administered to all accredited nursing programs across Canada in November 2021. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using Clarke and Braun’s (2021) thematic analysis.

Results: Data were analyzed from 28 completed surveys submitted from nine provinces. The results showed that community health nursing (CHN) theory and practice opportunities are delivered across all four years of baccalaureate nursing curricula. There is a diversity among the practice experiences, hours, and theoretical frameworks in CHN education. The precarity of community placements and limited opportunities for CHN practice education is a major concern. A variety of simulation opportunities are increasingly being used in schools of nursing in response to this and the COVID-19 pandemic. CHN standards and competencies provide the needed structure and outcomes for nursing programs.

Conclusion: The survey was identified as a helpful way for CHN educators to have their voices heard regarding the troubling trend of eroding CHN education in baccalaureate nursing programs. Given the findings, there is a need for continued advocacy and leadership for CHN education’s place within accredited baccalaureate programs. CHN champions and CHN faculty are needed to advocate for and facilitate quality CHN education opportunities. The development of partnerships with community practice sites and the support for student learning in community health provide transformational experiences for students with diverse populations. These experiences supported the development of learning cultural safety, working with diverse populations, and inclusive practice. However, there was a strong message of concern about the erosion and devaluing of CHN education in Canada—necessitating timely advocacy and collaborative strategizing in order to remedy this troubling trend.