Nursing Concepts as a Framework for Nursing Education

This post is the first in a series of posts about a nursology study conducted by a student-faculty group from the Online Nursing Education (ONE) program at Teachers College Columbia University. Here I present an overview of the study methods, results, and discussion and the other three members of the research team will each post their thoughts on the study over the next three weeks. We hope the study and our findings lead to further discussion on how and when we teach and promote nursology in nursing education and beyond.

Our research team was curious about whether or not nursing concepts are being used to describe nursing programs and to teach early nursing content in the classroom. We chose four nursing concepts, based on the work of Chinn, et al. (2019) and Smith (2019): context, holism, health, and caring. We explored the following research question: Do these nursing concepts guide nursing education?

Our 4-person research team looked at 300 traditional (four-year, on campus) BSN programs randomly selected from all BSN programs in the United States listed in the Commission on Collegiate Nursing Education Baccalaureate and Graduate Program Directory. We each took one of four regions: Northeast, South, Midwest, and West.

We collected data by examining program websites, specifically, program descriptions (including mission/vision statements and other program information) and the first three nursing course descriptions. We assigned scores from 0 (no concepts) to 4 (all four concepts) based on how many concepts we found.

Out of a possible 4 points, the overall mean score for all 300 program descriptions was 2.51. The mean score for all programs’ first nursing course descriptions was 0.96, and for the second and third nursing courses the mean scores were 1.18 and 1.17, respectively. This tells us that the nursing concepts of context, holism, health, and caring are often missing from these BSN program descriptions and the first three nursing course descriptions.

Not quite 30% of program descriptions included all four concepts, while nursing course descriptions rarely had all four concepts (Course 1 – 3.7%; Course 2 – 1.7%; Course 3 – 1.7%). Context was the concept most likely to show up in program descriptions, and holism was most likely to show up in course descriptions. Caring was the least frequently identified concept in both program and course descriptions.

Looking further into regional differences we found that the Midwest region had a statistically significantly higher program score than the South and West; the Northeast program score was statistically significantly higher than the West program score. For course 1 and 3, there were no regional differences. However, the Midwest and South had statistically significantly higher Course 2 scores than the West.

We acknowledge that context, holism, health, and caring are not the only concepts discussed and/or used in nursing. We do find that these four concepts, or concepts closely related to them, are prevalent in the nursing literature and we believe that they represent what nurses do and what nurses know. Our remaining questions, therefore, include

  • How is nursing knowledge being taught at the BSN level?
  • When are common nursing concepts being introduced to nursing students?
  • Is the NCLEX including foundational nursing concepts, such as the ones we studied, in actual test items?
  • Does evidence-based practice refer only to the concepts and theories from other disciplines, or should it be including and focusing on foundational nursing concepts?

Perhaps it is time to build nursing education on a foundational framework such as these four concepts.

Research Team

Jane K. Dickinson, RN, PhD, CDCES; Senior Lecturer in the Online Nursing Education EdD program at Teachers College Columbia Unversity

Arlene McGuane, EdD Student; Online Nursing Education EdD program at Teachers College Columbia University

Samantha Juan, EdD Student; Online Nursing Education EdD program at Teachers College Columbia University

Isla McKenzie-Henry, EdD Student; Online Nursing Education EdD program at Teachers College Columbia University

Study citation

Dickinson, J.K., Juan, S., McGuane, A., McKenzie-Henry, I.A. (2022). Use of Nursing Concepts in Program and Course Descriptions: An Analysis of Prelicensure Baccalaureate Nursing Programs in the United States. Nurse Educator,


Chinn, P.L., Nicoll, L.H., Carter-Templeton, H.D., & Oermann, M.H. (2019). An analysis of nursing citations and disciplinary characteristics in 79 articles that represent excellence in nursing publication. Nursing Inquiry, 26(3), e12296. doi: 10.1111/nin.12296. Epub 2019 May 22. PMID: 31119839.

Smith, M.C. Regenerating nursing’s disciplinary perspective. Advances in Nursing Science, 42(1), 3-16. doi: 10.1097/ANS.0000000000000241. PMID: 30720511.

9 thoughts on “Nursing Concepts as a Framework for Nursing Education

  1. Thanks for sharing this information! Unfortunately, I am not surprised by your results. Now I am curious about the presence of the 4 concepts in programs not accredited by CCNE!
    We have a long way to go, but it is a journey worth taking!

  2. Thank you for posting the results of this important study. If we are to prepare young nurses to develop a professional identity, they must be introduced to foundational concepts early in the program so that they have the perceptual lens to interpret and develop knowledge of the human health experience and the healing practices of nurses.

  3. I am intrigued to read about your project and findings. Thank you for sharing. Please clarify what similar concepts you included when reviewing program/course descriptions. As I was reading your post, I saw the 4 metaparadigm concepts of nursing reflected in your selections, with context = environment, holism = person, health = health, and caring = nursing. Therefore, I would anticipate that any nursing program that is based on a specific nuirsing model such as the Neuman Systems Model would have scored a 4 in your research. Is this a correct interpretation?

    • We agree that the concepts we chose (based on the work of Chinn, et al. and Smith) align with the four metaparadigm concepts in nursing. We were looking specifically for the four concepts (using our codebook – see below) in program and course descriptions. It is very possible that programs and courses do teach according to the metaparadigm, or a specific theory/model (such as Neuman’s), but unless they used the concepts in those descriptions, they would not have scored a 4. We hope you’ll read the whole article, where we discussed this in the “future research” section :).

      Keywords for each Concept:
      Concept Context
      Social determinants of health
      Concept Holism
      Physical, mental, emotional
      Concept Health
      Health, healing
      Health Promotion
      Concept Caring
      (not healthcare or healthcare system)

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