google scholar research topics in nursing

Best Nursing Research Topics for Students

What is a nursing research paper.

• What They Include
• Choosing a Topic
• Best Nursing Research Topics
• Research Paper Writing Tips

Writing a research paper is a massive task that involves careful organization, critical analysis, and a lot of time. Some nursing students are natural writers, while others struggle to select a nursing research topic, let alone write about it.

If you're a nursing student who dreads writing research papers, this article may help ease your anxiety. We'll cover everything you need to know about writing nursing school research papers and the top topics for nursing research.  

Continue reading to make your paper-writing jitters a thing of the past.

A nursing research paper is a work of academic writing composed by a nurse or nursing student. The paper may present information on a specific topic or answer a question.

During LPN/LVN and RN programs, most papers you write focus on learning to use research databases, evaluate appropriate resources, and format your writing with APA style. You'll then synthesize your research information to answer a question or analyze a topic.

BSN , MSN , Ph.D., and DNP programs also write nursing research papers. Students in these programs may also participate in conducting original research studies.

Writing papers during your academic program improves and develops many skills, including the ability to:

• Select nursing topics for research
• Conduct effective research
• Analyze published academic literature
• Format and cite sources
• Synthesize data
• Organize and articulate findings

About Nursing Research Papers

When do nursing students write research papers.

You may need to write a research paper for any of the nursing courses you take. Research papers help develop critical thinking and communication skills. They allow you to learn how to conduct research and critically review publications.

That said, not every class will require in-depth, 10-20-page papers. The more advanced your degree path, the more you can expect to write and conduct research. If you're in an associate or bachelor's program, you'll probably write a few papers each semester or term.

Do Nursing Students Conduct Original Research?

Most of the time, you won't be designing, conducting, and evaluating new research. Instead, your projects will focus on learning the research process and the scientific method. You'll achieve these objectives by evaluating existing nursing literature and sources and defending a thesis.

However, many nursing faculty members do conduct original research. So, you may get opportunities to participate in, and publish, research articles.

Example Research Project Scenario:

In your maternal child nursing class, the professor assigns the class a research paper regarding developmentally appropriate nursing interventions for the pediatric population. While that may sound specific, you have almost endless opportunities to narrow down the focus of your writing. 

You could choose pain intervention measures in toddlers. Conversely, you can research the effects of prolonged hospitalization on adolescents' social-emotional development.

What Does a Nursing Research Paper Include?

Your professor should provide a thorough guideline of the scope of the paper. In general, an undergraduate nursing research paper will consist of:

Introduction : A brief overview of the research question/thesis statement your paper will discuss. You can include why the topic is relevant.

Body : This section presents your research findings and allows you to synthesize the information and data you collected. You'll have a chance to articulate your evaluation and answer your research question. The length of this section depends on your assignment.

Conclusion : A brief review of the information and analysis you presented throughout the body of the paper. This section is a recap of your paper and another chance to reassert your thesis.

The best advice is to follow your instructor's rubric and guidelines. Remember to ask for help whenever needed, and avoid overcomplicating the assignment!

How to Choose a Nursing Research Topic

The sheer volume of prospective nursing research topics can become overwhelming for students. Additionally, you may get the misconception that all the 'good' research ideas are exhausted. However, a personal approach may help you narrow down a research topic and find a unique angle.

Writing your research paper about a topic you value or connect with makes the task easier. Additionally, you should consider the material's breadth. Topics with plenty of existing literature will make developing a research question and thesis smoother.

Finally, feel free to shift gears if necessary, especially if you're still early in the research process. If you start down one path and have trouble finding published information, ask your professor if you can choose another topic.

The Best Research Topics for Nursing Students

You have endless subject choices for nursing research papers. This non-exhaustive list just scratches the surface of some of the best nursing research topics.

1. Clinical Nursing Research Topics

• Analyze the use of telehealth/virtual nursing to reduce inpatient nurse duties.
• Discuss the impact of evidence-based respiratory interventions on patient outcomes in critical care settings.
• Explore the effectiveness of pain management protocols in pediatric patients.

2. Community Health Nursing Research Topics

• Assess the impact of nurse-led diabetes education in Type II Diabetics.
• Analyze the relationship between socioeconomic status and access to healthcare services.

3. Nurse Education Research Topics

• Review the effectiveness of simulation-based learning to improve nursing students' clinical skills.
• Identify methods that best prepare pre-licensure students for clinical practice.
• Investigate factors that influence nurses to pursue advanced degrees.
• Evaluate education methods that enhance cultural competence among nurses.
• Describe the role of mindfulness interventions in reducing stress and burnout among nurses.

4. Mental Health Nursing Research Topics

• Explore patient outcomes related to nurse staffing levels in acute behavioral health settings.
• Assess the effectiveness of mental health education among emergency room nurses .
• Explore de-escalation techniques that result in improved patient outcomes.
• Review the effectiveness of therapeutic communication in improving patient outcomes.

5. Pediatric Nursing Research Topics

• Assess the impact of parental involvement in pediatric asthma treatment adherence.
• Explore challenges related to chronic illness management in pediatric patients.
• Review the role of play therapy and other therapeutic interventions that alleviate anxiety among hospitalized children.

6. The Nursing Profession Research Topics

• Analyze the effects of short staffing on nurse burnout .
• Evaluate factors that facilitate resiliency among nursing professionals.
• Examine predictors of nurse dissatisfaction and burnout.
• Posit how nursing theories influence modern nursing practice.

Tips for Writing a Nursing Research Paper

The best nursing research advice we can provide is to follow your professor's rubric and instructions. However, here are a few study tips for nursing students to make paper writing less painful:

Avoid procrastination: Everyone says it, but few follow this advice. You can significantly lower your stress levels if you avoid procrastinating and start working on your project immediately.

Plan Ahead: Break down the writing process into smaller sections, especially if it seems overwhelming. Give yourself time for each step in the process.

Research: Use your resources and ask for help from the librarian or instructor. The rest should come together quickly once you find high-quality studies to analyze.

Outline: Create an outline to help you organize your thoughts. Then, you can plug in information throughout the research process. 

Clear Language: Use plain language as much as possible to get your point across. Jargon is inevitable when writing academic nursing papers, but keep it to a minimum.

Cite Properly: Accurately cite all sources using the appropriate citation style. Nursing research papers will almost always implement APA style. Check out the resources below for some excellent reference management options.

Revise and Edit: Once you finish your first draft, put it away for one to two hours or, preferably, a whole day. Once you've placed some space between you and your paper, read through and edit for clarity, coherence, and grammatical errors. Reading your essay out loud is an excellent way to check for the 'flow' of the paper.

Helpful Nursing Research Writing Resources:

Purdue OWL (Online writing lab) has a robust APA guide covering everything you need about APA style and rules.

Grammarly helps you edit grammar, spelling, and punctuation. Upgrading to a paid plan will get you plagiarism detection, formatting, and engagement suggestions. This tool is excellent to help you simplify complicated sentences.

Mendeley is a free reference management software. It stores, organizes, and cites references. It has a Microsoft plug-in that inserts and correctly formats APA citations.

Don't let nursing research papers scare you away from starting nursing school or furthering your education. Their purpose is to develop skills you'll need to be an effective nurse: critical thinking, communication, and the ability to review published information critically.

Choose a great topic and follow your teacher's instructions; you'll finish that paper in no time.

Joleen Sams is a certified Family Nurse Practitioner based in the Kansas City metro area. During her 10-year RN career, Joleen worked in NICU, inpatient pediatrics, and regulatory compliance. Since graduating with her MSN-FNP in 2019, she has worked in urgent care and nursing administration. Connect with Joleen on LinkedIn or see more of her writing on her website.

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Current Trends in Critical Care Nursing Research

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Cindy L. Munro , Aluko A. Hope; Current Trends in Critical Care Nursing Research. Am J Crit Care 1 May 2023; 32 (3): 150–152. doi: https://doi.org/10.4037/ajcc2023943

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Critical care has faced unprecedented challenges in the recent past, including the COVID-19 pandemic and deterioration of the health care work environment. Research is crucial in discovering innovative solutions to these challenges, but the pandemic made critical care nursing research more difficult. Increased demands of caring for patients with high acuity and high mortality resulted in less time and energy for nurses at the bedside to participate in research. Nurse researchers had reduced access to critically ill patients, and medical studies of COVID-19 treatments often were prioritized over studies focused on nursing care or the work environment.

Despite these complicated constraints, researchers have persisted. And, as the research journal for the American Association of Critical-Care Nurses (AACN), the American Journal of Critical Care ( AJCC ) has continued to publish research of relevance to critical care nursing and interdisciplinary teamwork. Our primary goal is to provide our readers with reports of high-quality, timely clinical research that can inform and improve the care of critically ill patients and their families. In this editorial, we reflect on recent themes in research published in AJCC and provide examples from 2023 papers. We also alert readers to research events that will be offered at this month’s National Teaching Institute (NTI 2023) meeting in Philadelphia, Pennsylvania, May 22-24, 2023.

Between January 2022 (Volume 31, Issue 1) and the current May 2023 journal issue (Volume 32, Issue 3), AJCC published 71 reports of original research. These recent papers addressed a wide range of research topics, including bedside patient care, palliative and end-of-life care, intensive care unit (ICU) survivorship, measurement and prediction of patient problems, family concerns, communication, moral distress, and healthy work environment. The needs of patients across the lifespan were represented.

From a topical review of these recently published research papers, 3 overarching focal areas of high interest to bedside care emerged as themes. The first theme, improving patient care, was the predominate focus of many papers. The second theme, family well-being, remained an important concern. The third theme, understanding and improving the critical care work environment, was also well represented among recent papers. Appropriately, each of these themes is well aligned with the AACN vision, which states “AACN is dedicated to creating a healthcare system driven by the needs of patients and families where acute and critical care nurses make their optimal contribution.” 1  

Research to improve patient care at the bedside is foundational to nursing research. This focus has always been a primary emphasis for AJCC , and recent papers reflect the journal’s commitment to publishing rigorous clinical research that is applicable to bedside care. As an example, a paper in the March 2023 issue of AJCC reports the results of a randomized controlled trial of a live music intervention in the ICU. 2   The trial demonstrated that a 30-minute live music intervention provided by a board-certified music therapist significantly reduced agitation, pain, and heart rate in a group of adults receiving mechanical ventilation, compared with a usual care group who did not receive the live music intervention. Notably, this nurse-led research was conducted in a Beacon unit of a Magnet-designated community hospital, and the collaboration between nursing and music therapy highlighted the power of interdisciplinary care in improving patient outcomes. Because providing evidence of the effectiveness of nonpharmacologic interventions in reducing agitation and pain is crucial to informing practice, this article was selected as a continuing education offering.

“Recent papers reflect the journal’s commitment to publishing rigorous clinical research that is applicable to bedside care.”

The work of the critical care team encompasses meeting the needs of patients’ families, and effective teams understand that the well-being of the family is intricately linked to the patient’s outcomes. The experiences and concerns of families, and measures to alleviate their ICU-related stress and suffering, are important areas of research that are well represented in AJCC . In a qualitative study reported in the January 2023 issue of AJCC , Blok and colleagues described the multiple factors that contribute to distress of family caregivers; the concerns were wide ranging and included factors related to the ICU environment as well as stressors external to the ICU. 3   In order to disseminate these findings more broadly, this article was featured as a continuing education offering, and an interview with the nurse researcher who led the study was featured as a video on the AJCC website. 4  

AACN has been a leader in building and disseminating evidence about healthy work environments, including advocating for nurse well-being as a prerequisite for safe, high-quality patient care. AACN has published data about nurses’ well-being and about the positive effects of healthy work environments. 5 , 6   AACN was the convener for the Partners for Safe Staffing, a multiorganizational effort to address health care team staffing solutions that led to the initiation of both a Nurse Staffing Think Tank and a Nurse Staffing Task Force. 7   The importance of nurse well-being was explicitly noted in The Future of Nursing 2020-2030 ; recommendation 3 of that report states,

By 2021, nursing education programs, employers, nursing leaders, licensing boards, and nursing organizations should initiate the implementation of structures, systems, and evidence based interventions to promote nurses’ health and well-being, especially as they take on new roles to advance health equity. 8(p13)  

Building the evidence to support the health and well-being of critical care nurses and ICU team members is an important priority for AJCC and is reflected in the research we publish in this focal area. This issue of AJCC includes exciting results from long-term longitudinal follow-up of participants in the Mindful Ethical Practice and Resilience Academy (MEPRA). 9 , 10   MEPRA is an experiential educational program designed to improve nurses’ skills in mindfulness, resilience, and competence to confront ethical challenges. In an earlier AJCC publication, the researchers reported that MEPRA was effective in the period immediately following the intervention. 9   New results demonstrate that the positive benefits of MEPRA continued to persist at the longest follow-up measurement— 6 months after the intervention. 10   This research is important; it provides evidence and direction for health care systems to improve nurse well-being in alignment with AACN healthy work environment standards and the recommendation from The Future of Nursing 2020-2030 . It is also featured as a continuing education offering.

The needs of COVID-19 patients have appropriately garnered much attention during the pandemic. Between January 2022 and May 2023, 16 AJCC papers (23%) specifically focused on COVID-19. Interestingly, although focused on COVID-19, these papers aligned well with the 3 general themes previously described. COVID-19 patient problems and care were examined in 5 papers, 5 concerned the needs of family members of COVID-19 patients, and 6 studied work environment issues (4 describing nurses’ and staff experiences related to the pandemic, and 2 describing risks of transmission of COVID-19 infection to health care workers). These papers most likely have relevance beyond COVID-19. Conversely, research studies that were not specific to COVID-19 patients might have broad applicability to their care as well. Elements of care that are unique to COVID-19, and how care of these patients is similar to or different from care of other critically ill patients, are topics that require further delineation.

“Overarching themes of AJCC articles published since January 2022 are improving patient care, family well-being, and healthy work environment.”

There is more to come at NTI 2023. The research that will be presented there promises to be engaging, motivating, and useful for practice. On Monday afternoon, May 22, 2023, Dr Cynthia Rushton will highlight her long and successful research trajectory as she presents the 2023 AACN Distinguished Research Lecture, “Transforming Moral Suffering by Cultivating Moral Resilience and Ethical Practice.” NTI attendees can find her lecture on the conference schedule as activity #C75M412. As is customary for AACN Distinguished Research Lectures, the abstract for the presentation is published in this issue of AJCC and available before her lecture. 11   The complete Distinguished Research Lecture paper will be published in the July issue of AJCC .

It is also customary that the May issue of AJCC includes an online article containing all of the research abstracts to be presented at that year’s NTI; the research abstracts can be accessed on the AJCC website ( ajcconline.org ) via the May issue’s table of contents. We encourage NTI attendees to review the research abstracts in advance of the meeting as they plan their NTI schedules. At NTI 2023, 4 award-winning research abstracts will be featured in 2 oral presentation sessions (Tuesday, May 23, activity #C60M406 and Wednesday, May 24, activity #C60M407). An additional 20 research abstracts will be presented as posters in the Research Poster session on Monday, May 22 (activity #POS115). As might be expected, the research abstracts to be presented at NTI 2023 also fit nicely into the overarching themes of improving patient care, family well-being, and healthy work environment.

Every year, NTI offers a celebration of nursing practice and research. If you are able to join the exceptional community of nurses who attend NTI 2023, we hope that you will choose to experience the Distinguished Research Lecture and other research presentations. Nonetheless, you can always find research that underpins the practice of acute and critical care nurses and the interdisciplinary team in the pages of AJCC .

The statements and opinions contained in this editorial are solely those of the coeditors in chief.

FINANCIAL DISCLOSURES

None reported.

To purchase electronic or print reprints, contact American Association of Critical-Care Nurses, 27071 Aliso Creek Road, Aliso Viejo, CA 92656. Phone, (800) 899-1712 or (949) 362-2050 (ext 532); fax, (949) 362-2049; email, [email protected] .

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Online Research Guide for Nursing Students

• Conducting Online Research
• Research Tools

Evaluating Sources

• Organizing Research

Are you ready to earn your online nursing degree?

Effective online nursing research skills can make a tremendous difference for your academic success in nursing school and throughout your career. Medicine and nursing change rapidly, and knowing how to conduct nursing research online keeps your skills and knowledge current.

Successful research includes both how to use nursing literature search engines and how to analyze the information you find. This helps you distinguish between reliable information that supports evidence-based nursing and misleading information that can influence your ability to care for patients.

This guide can help you find and effectively use the best nursing research websites and other research tools, whether you need a writing guide for nurses , continuing education coursework, or just hope to increase your knowledge in the field.

Conducting Online Research for Nursing Students

You can conduct most of your nursing research online, but some sources may not be available online. For example, your school library may subscribe to print journals not published on the internet. Many important books only exist in print.

Your school or hospital librarian is an invaluable resource to help you find materials online or in print. If your school or hospital doesn’t have a specific book or article, the librarian might be able to get it through an interlibrary loan service.

You can use only online nursing research tools if the most significant publications on a topic are available online. Otherwise, consider using print resources too.

Refining Your Search Results

When conducting online research, you must filter out unreliable sources and locate search results relevant to your topic. Fortunately, Google searches and other nursing literature search engines have tools to help you narrow your research to get the most reliable results.

In addition to open web searches, you can use the specialty nursing literature search engines listed below.

Google Scholar

Google Scholar has special features to make it easier to find the most relevant professional literature on a topic. Besides letting you refine your search by date, it displays related articles or other articles by the author. If the piece is available in full-text online, Google Scholar links to the page. If not, you can search to see if your library has the article or can get you a copy.

Google Scholar also tells you how many other papers cite a particular source. While this doesn’t necessarily mean that an article has reliable and current information, it does demonstrate the article’s influence.

The search engine also offers tools to help you manage your research projects and write papers. You can create a citation in several standard formats and save an article to a list. You can make as many lists as you like, such as one for different topics or assignments.

If you want to follow a specific topic, refine your search to give you preferred results, and then select “create alert.” You will then receive emails with new articles as Google Scholar indexes them.

Online Research Tools

Google reigns as the most popular search engine, but many other online resources exist. Students may use several search engines and databases geared specifically toward academic searches. Many of these sites offer free or discounted services to students. Your school’s library may also provide access.

The list below describes some of the most common resources for academic research, including some sites that focus on online research for nurses.

General Academic Research Tools

• BASE : Bielefeld Academic Search Engine offers results in a variety of academic disciplines. About 60% of the indexed documents are available for free. Results must meet BASE’s high academic standards for relevance and quality.
• CGP : The Catalog of U.S. Government Publications allows users to search official documents published by the U.S. government, including current and historical sources.
• CIA World Factbook : The Central Intelligence Agency’s World Factbook provides information on 267 countries and other entities around the world. This information includes maps and data on each entity’s history, people, geography, government, and economy.
• ERIC : The U.S. Department of Education’s Institute of Education Sciences hosts ERIC. This database uses a formal review process to decide which scholarly articles, papers, reports, and other documents to include in its index.
• iSeek Education : This resource compiles scholarly materials from noncommercial providers, including university and government sources. The searchable service allows users to bookmark items they wish to refer to later.
• National Archives : This searchable catalog includes descriptions for 85% of the National Archives’ holdings, including documents, web pages, pictures, audio files, and videos. Users can also view more than two million digitized copies of government records.
• OCLC : The OAIster catalog pools open-access resources from libraries, museums, archives, and cultural heritage organizations.
• CORE : CORE collects open-access research materials from sources around the world and indexes them in a searchable database. The public can use CORE free of charge.

Nursing Research Tools

• CINAHL Complete : The Cumulative Index of Nursing and Allied Health Literature offers a large database of research material for nurses and students. The site provides full-text access to resources, including journals, care sheets, and continuing education modules.
• MedScape : Medscape provides the latest medical news, research updates, case studies, continuing education opportunities, and disease and drug information for healthcare professionals around the world.
• National Institute of Nursing Research : Part of the National Institutes of Health, the NINR provides support for nursing research. The website hosts information on research conducted through their programs.
• Nursing Reference Center : The Nursing Reference Center features various resources for nurses, including care sheets about diseases and treatment options, drug information, information on treating patients from diverse cultural backgrounds, patient handouts, and lessons about diseases and conditions.
• PubMed : PubMed is a searchable database operated by the U.S. National Library of Medicine at the National Institutes of Health. The site provides abstracts and full-text articles from journals, books, and other publications about life science and medicine.
• Sigma Repository : The Sigma Repository boasts an open-access database of nursing research and practice materials created by nurses. Sigma Theta Tau International, the nursing honor society, sponsors this free resource.

When you conduct research on the web, you must evaluate the reliability of your sources. If your information comes from an untrustworthy source, the quality of your research will suffer and the data you gather may lead to incorrect conclusions.

When you need to determine an online information source’s reputation, you can ask yourself some questions to help evaluate its quality. The questions below include tips from Georgetown University and the University of Chicago Press.

Who Is the Author?

Find the name of the article’s author or creator. Then locate the author’s credentials to determine whether their education and experience qualifies them to speak as an authority on the topic. You also can search for the author’s other works or more information about them.

If the source does not list an author, look at the domain to see whether it belongs to a reputable entity.

What Is Its Purpose?

Look at the article and the hosting site. Who is the intended audience? Is the information for academics and experts or the general public? Why was it written and posted? Is it intended to inform or educate the reader, or does it attempt to persuade the reader to view a topic in a certain way? Is it meant to sell a product or service?

A noncommercial source that intends to educate the reader without persuasion is most likely to be reliable.

Does It Look Professional?

When you view the website and read the article, take note of any errors in grammar or spelling. The site’s content should appear clean and organized. Poorly organized content and errors in the text indicate unprofessionalism, as does the use of profanity.

If the site emphasizes images over text or appears to focus on selling products or services, it may not be a reliable source for scholarly information.

Is It Objective?

Academic sources should show objectivity and must not present opinions as hard data. Consider whether the information is fact or opinion. Does the author show any bias? Is the information officially endorsed or approved by an organization? If so, determine whether the organization takes an official position on the issue at hand.

Is It Current?

When researching science and medical topics, students must find the most current information. Scientific knowledge progresses rapidly, and new research appears frequently.

Check the publishing date listed on your source. If it is more than a few years old, look for more current sources on the same topic. If a website has not been updated recently, this also may indicate information is outdated.

What Sites Does It Link To?

The links featured in your source may provide clues about the information’s reliability. The links should relate to the site’s purpose or the topic at hand. In most cases, a source should link back to research which supports the text. Students may find this information within the text or in a references list.

Test the links to make sure they work. If the links are broken, the information may be old or outdated.

Organizing Your Research

You will most likely browse a large amount of information as you conduct research online. To avoid becoming overwhelmed, you must remain organized before, during, and after your search. Remember that you must cite all your sources accurately.

If you develop a consistent system for locating and organizing your information, your research efforts will be more efficient and accurate. Below are a few basic tips to help you manage and organize your online research.

Online Tools to Manage Your Research

• EasyBib : This tool helps you improve your writing, take notes, avoid unintentional plagiarism, and add citations in your choice of style. Options include MLA, APA, and Chicago. EasyBib offers basic services and MLA citations for free. Users pay a monthly fee for additional access.
• Endnote : This software package manages references and bibliographies. EndNote provides research tools and allows teams to share documents, files, and other materials. The software offers student pricing.
• Mendeley : Designed for science and technology research, Mendeley helps store and organize research documents and files. Mendeley manages citations and lets users connect with others in a research network.
• RefWorks : This web-based reference management tool stores the user’s reference database in an online portal. Some universities grant their students free access to RefWorks.
• Zotero : This free, open-source software helps users find research materials and organize their information. Zotero manages citations, documents, and other research materials.

Citing Online Resources for Nursing Students

When you write a research paper or create a research presentation, you must follow a consistent format and include a bibliography of all the sources you used. Several popular editorial styles exist. Science and social science disciplines, including nursing, most frequently use the Publication Manual of the American Psychological Association, commonly known as APA style .

Alternatively, some institutions require AMA style , created by the American Medical Association. The style you use depends on the institution you attend. These editorial styles establish a consistent format for researchers to follow when publishing their work. They cover aspects of writing, such as punctuation, accepted abbreviations, headings, and formatting for statistics and tables.

Style also dictates a specific format for listing citations, including the order in which the information must appear and the punctuation required. This formatting makes it easy for readers to retrieve sources that may interest them.

Several examples of APA style from the Purdue Online Writing Lab appear below. You can find an expanded list of such examples on the Purdue website.

Articles From Online Periodicals

What is a doi.

When an article is published electronically, the publisher assigns a unique digital object identifier (DOI) to it. The DOI provides a permanent identification code and internet link for the article. APA style recommends that you include the DOI in any citation for which it is available. See the examples below.

Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number , page range. doi:0000000/000000000000 or http://doi.org/10.0000/0000

Brownlie, D. (2007). Toward effective poster presentations: An annotated bibliography. European Journal of Marketing, 41 , 1245-1283. doi:10.1108/03090560710821161

Without DOI

Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number . Retrieved from https://www.journalhomepage.com/full/url/

Kenneth, I. A. (2000). A Buddhist response to the nature of human rights. Journal of Buddhist Ethics, 8 . Retrieved from https://www.cac.psu.edu/jbe/twocont.html

Newspaper Articles

Author, A. A. (Year, Month Day). Title of article. Title of Newspaper . Retrieved from https://www.homeaddress.com/

Parker-Pope, T. (2008, May 6). Psychiatry handbook linked to drug industry. The New York Times . Retrieved from https://well.blogs.nytimes.com/

Electronic Books

Last name, A. A. (n.d.). Title . Available from https://www.urlofebook.com/full/url/

Davis, J. (n.d.). Familiar birdsongs of the Northwest . Available from https://www.powells.com/cgi-bin/biblio? inkey=1-9780931686108-0

The AMA Manual of Style details official guidelines for writing and citing medical research. The style is maintained by the American Medical Association. The examples below originate from the Arizona Health Sciences Library website and the USciences website .

No Author Name Provided

Name of organization. Title of specific item cited. URL. Accessed date.

International Society for Infectious Diseases. ProMED-mail Website. https://www.promedmail.org. Accessed April 29, 2004.

Author Name Provided

Author A. Title. Name of website. URL. Updated date. Accessed date.

Sullivan D. Major search engines and directories. SearchEngineWatch Website. https://www.searchenginewatch.com/links/article.php/2156221. Updated April 28, 2004. Accessed December 6, 2005.

Online Journal Article With Six or Fewer Authors — DOI Included

Author A. Title. Name of online journal. URL. Publication year;volume(issue):page numbers. doi.

Florez H, Martinez R, Chakra W, Strickman-Stein M, Levis S. Outdoor exercise reduces the risk of hypovitaminosis D in the obese. J Steroid Biochem Mol Bio . 2007;103(3-5):679-681. doi:10.1016 /j.jsbmb.2006.12.032.

Online Journal Article With Six or More Authors — DOI Not Included

Author A. Title. Name of online journal. URL. Publication year;volume(issue):page numbers. Access date.

Siris ES, Miller PD, Barrett-Connor E, et al. Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA. 2001;286(22):2815-2822. https://jama.ama-assn.org/cgi/reprint/286/22 /2815. Accessed April 4, 2007.

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Methods of increasing cultural competence in nurses working in clinical practice: A scoping review of literature 2011–2021

Training for the development of cultural competence is often not part of the professional training of nurses within the European Economic Area. Demographic changes in society and the cultural diversity of patients require nurses and other medical staff to provide the highest quality healthcare to patients from different cultural backgrounds. Therefore, nurses must acquire the necessary cultural knowledge, skills, and attitudes as part of their training and professional development to provide culturally competent care to achieve this objective.

This review aims to summarize existing methods of developing cultural competence in nurses working in clinical practice.

A scoping review of the literature.

The following databases were used: PubMed, ScienceDirect, ERIH Plus, and Web of Science using keywords; study dates were from 2011 to 2021.

The analysis included six studies that met the selection criteria. The studies were categorized as face-to-face, simulations, and online education learning methods.

Educational training for cultural competence is necessary for today’s nursing. The training content should include real examples from practice, additional time for self-study using modules, and an assessment of personal attitudes toward cultural differences.

Introduction

Current demographic changes mean that nurses need to provide quality nursing care for patients from different cultural backgrounds. Horvat et al. (2014) report that health workers will increasingly be obliged to provide healthcare to patients from different cultural groups. Eurostat (2019) states that 4.2 million people from other countries migrated to the European Union in 2019. Germany (88,630), France (29,910), Spain (29,620), and Romania (23,370) reported the largest number of immigrants. Cruz et al. (2017a) draw attention to the fact that every population group has unique norms, values, and practices that determine the group’s perception of health, which is why it is important to implement the principles of culturally specific healthcare.

Cultural competence in nursing

Cultural competence ( Ahn, 2017 ) in nursing care is essential for providing quality care for patients from different cultural backgrounds. It is a specific concept related to transcultural nursing and contains a wealth of skills and knowledge regarding cultural values, health beliefs, religion, and human philosophy. It is a concept linked to culturally specific nursing care ( Leininger and McFarland, 2002 ). Cultural competence in nursing has been defined as a set of knowledge, skills, and attitudes applied in the clinical practice of nursing in an intercultural context ( Cerezo et al., 2014 ; Paric et al., 2021 ).

Development of cultural competence of nurses

According to Horvat et al. (2014) , the development of cultural competencies is a crucial component for addressing health disparities and strategies to improve culturally competent care, and many experts agree ( Harkess and Kaddoura, 2016 ; Mariño et al., 2018 ; Curtis et al., 2019 ; Červený et al., 2020 ; Swihart et al., 2021 ). Faber (2021) adds that the education of health professionals is also a method of addressing racial and ethnic discrimination resulting from structural inequality. According to Carey (2011) , nursing schools should provide adequate opportunities to develop cultural competence. Cruz et al. (2017b) recommend that nursing schools include international standards for culturally competent nursing care.

Moreover, teaching standards should be adapted to local cultural diversity within each country. This ensures that nurses have a proper cultural context that can promote the development of cultural sensitivity, cultural adaptability, and cultural motivation. This type of education is demanding for teachers, who need to have the most up-to-date information from professional literature, constantly evaluate self-esteem, and modify educational methods to develop cultural competence ( Prosen and Bošković, 2020 ). However, according to Faber (2021) , there is a wealth of evidence in literature where researchers present the effectiveness of cultural competence training in individual health professions to be more linguistically and culturally aware. Farber also states that there are no coherent sector-wide standards for defining cultural competence, educational practice, evaluation measures, or target results.

Why is a literature review essential?

Accelerating globalization and demographic changes in society, the incidence of patients from different cultural backgrounds, language barriers, discrimination, racism, prejudice, and stereotypes are all factors that affect the quality of nursing care ( Červený et al., in press ; Shepherd et al., 2019 ; Williams et al., 2019 ; Joo and Liu, 2020 ). Prosen (2018) states that providing culturally competent nursing care for patients from different cultural backgrounds should not be seen as a privilege but as a human right. In order to eliminate barriers to quality care, it is necessary to find the best possible methods for developing cultural competence in nurses in clinical practice.

Research question

• What methods are effective at increasing the level of cultural competence?
• What factors can improve existing methods of increasing the level of cultural competence?

Aim of literature overview

The main objective of the review was to summarize the existing methods of developing cultural competence in nurses working in clinical practice.

• Determine which educational methods effectively increase cultural competence in clinical practice.
• Identify the impact of education on cultural competence.
• Identify potential opportunities to improve the development of cultural competence.

Materials and methods

This study is based on a qualitative scoping review using the Preferred Reporting Items for Systematic Reviews and a Meta-Analyses Extension for Scoping review ([PRISMA-ScR], Tricco et al., 2018 ; Page et al., 2021 ; Figure 1 ) and the Participants, Interventions, Comparison, and Outcomes (PICO) listed in Table 1 .

PRISMA flow diagram of the scoping review.

Inclusion and Exclusion criteria for the scoping review.

Methods of searching the literature

The analyzed publications were collected from the PubMed, ScienceDirect, ERIH Plus, and Web of Science databases using keywords and Booleans operatives: (“transcultural education”) OR (“training”) AND (“culturally competence”) AND (“nurses”) AND (“clinical practice”). All sources were academic publications that went through the peer-review process. The focus of this review was on the following elements:

• Population: Clinical practice nurses
• Intervention: Education to increase cultural competences
• Related: Clinical practice nurses
• Outcome: Increasing cultural competencies in clinical practice nurses through education (training)

The criteria for the selection of resources are presented in Table 1 . We searched for resources dated from 01.12.2011 to 31.12.2021.

Data charting, extraction, and quality evaluation

We used a 3-step screening process that was evaluated in MS Excel. In the first step, we searched the article’s title and abstract. In the second step, we identified and sorted articles that met the outline ranking criteria and assessed their quality. To evaluate the articles’ quality, two co-authors independently used the Critical Appraisal Skills Programe (2018) . This general tool evaluates any qualitative methodology. It has 10 questions asking the researcher to assess whether appropriate research methods were used and whether the findings were presented meaningfully ( Červený et al., 2020 ; Long et al., 2020 ). The results of the quality assessment are presented in Table 2 . In the third step, the data were extracted.

Results of critical appraisal checklist results.

Questions of quality, author(s), year, country

Y, Yes; N, No; CT, Cannot tell; ROK, Republic of South Korea; ISR, Israel; SWE, Sweden; AUS, Australia; NDL, Netherlands (the); FIN, Finland.

A total of 548 articles were identified based on database searches, and two other articles were added to the analysis because they met the criteria for selecting articles. After removing duplicates, we approached the analysis of titles and abstracts of individual articles. Based on the analyses of abstracts, we discarded 500 articles. Forty-two articles were selected for full-text analysis, but we discarded another 36 articles after analysis. The articles included in the scoping review were re-analyzed a week after the first reading to avoid erroneous conclusions. The data were sorted, encoded, and categorized into three themes: (1) Methods of increasing cultural competence, (2) The impact of education on the cultural competence of participants, and (3) Possibilities for developing educational programs in the field of cultural competence.

Characteristics of articles

The articles included in the analysis were published from 2011 to 2021. The articles came from 6 countries: South Korea ( Ahn, 2017 ), Israel ( Slobodin et al., 2021 ), Sweden ( McDonald et al., 2021 ), Australia ( Perry et al., 2015 ), the Netherlands ( Celik et al., 2012 ), and Finland ( Kaihlanen et al., 2019 ). Three articles used a mixed-method method ( Celik et al., 2012 ; Perry et al., 2015 ; McDonald et al., 2021 ). One article was based on a cross-sectional study ( Ahn, 2017 ), and one article used an online education intervention study ( Slobodin et al., 2021 ). Only one article utilized a qualitative study ( Kaihlanen et al., 2019 ).

In terms of study participants, in the study by Celik et al. (2012) , there were 31 paramedics, two psychiatric hospital nurses, six hospital nurses, and four nursing home nurses. Kaihlanen et al. (2019) included 20 nurses in their training program. Nurses were explicitly included in all analyzed articles, except for the study by Slobodin et al. (2021) , in which participants were described as healthcare professionals, but no further details were provided. Table 3 provides an overview of the studies included in this scoping review.

Characteristics of included studies.

Theme 1: Methods of increasing cultural competence

Methods for developing cultural competencies in nurses are presented in Table 3 .

An online educational program was used in the study by Perry et al. (2015) and Slobodin et al. (2021) . Slobodin et al. (2021) divided their training sessions into eight modules lasting about 30 min. Their training was linked to the pandemic situation; therefore, the online training course included a historical review of the pandemic and its impact on the social fabric of society. The study by Perry et al. (2015) included modules lasting about 60 min that focused on understanding the importance of language in the healthcare environment, using interpreters in clinical practice, and addressing linguistic and cultural issues during patient discharge from the hospital. Celik et al. (2012) used a modified six-phase Deming cycle during four training sessions. As the authors stated, the first phase was an attention-free phase (Unawareness), where health professionals were unaware of diversity factors in healthcare and thought these factors or questions were irrelevant to clinical practice. The second phase was the phase of ‘limited” awareness, where healthcare workers realize that diversity factors exist but do not implement them in clinical practice. The first two phases, which the authors added, were followed by the usual phases of the Deming cycle (Plan, Do, Study or Check, and Act). The (Plan) in their study means: deliberately paying attention to diversity in clinical practice, the (Do) means to implement knowledge into clinical practice, the (Study or Check) means evaluating the results after implementation of culturally diverse care, and the (Act) means the implementation of modified nursing care based on that process.

McDonald et al. (2021) used Comprehensive Cross-Cultural Training (CCCT), developed in 2016, in response to a health crisis. The authors carried out 12 all-day training and two half-day interventions in this study. In the Kaihlanen et al. (2019) study, training included 16 h of full-time teaching, divided into four, 4-h modules, which ran once a week for 4 weeks. The training timing encouraged trainees to implement the acquired knowledge into practice quickly. The first training focused on the issue of culture (What is culture), the second training involved awareness of one’s own culture (Culture in me), the third training covered communication, and the last training focused on understanding attitudes (Meaning of conviction). The teaching method was “storytelling,” where the lecturer used real-life experiences from practice and images to demonstrate the cultural aspects of diversity. The image presentation was intended to make participants realize that people with different cultural backgrounds perceive the same image differently. After each module, there was a discussion to assess cultural features and understand why it is essential to apply culturally specific facts to the care of patients. Participants were given access to a Web-based learning platform where they could anonymously share their thoughts with others.

Theme 2: Impact of cultural competence education on participants

Kaihlanen et al. (2019) used three semi-structural small-group interviews, which focused on the general usefulness of training, personal usefulness, usefulness for patients, quality of training, and suggestions for improvement. The participants in the training welcomed the fact that the training was not entirely focused only on cultural competence in healthcare. The lecturer was not a healthcare professional and integrated new ideas and insights into actual clinical practice in the hospital. A positive impact can be seen as a general and open debate on cultural issues, which are often not part of the general working culture. Small training groups also facilitated participant involvement in the discussion. After completing the training, participants felt more open-minded and focused on caring for patients with different cultural backgrounds. The training also drew the attention of participants to inappropriate communication skills. The training also benefited patients since participants exited the training with better attitudes, awareness, and ability to recognize and respect the cultural background of the patient without imposing stereotypes and prejudices. After completing the training, most participants stated that they no longer had to use checklists or guidance for treating patients from different cultural backgrounds; however, they continued to express uncertainty regarding religious issues.

Celik et al. (2012) , McDonald et al. (2021) , and Slobodin et al. (2021) used pre and post-tests to determine the effect of individual training on cultural competence. Perry et al. (2015) used only post-testing. The post-test used by McDonald et al. (2021) statistically confirmed that participants who had experience with patients from different cultural backgrounds had higher cultural assessments than participants who did not. A similar relationship was seen regarding the use of interpreting services. The study Focus-Group showed that CCCT training significantly contributed to a better understanding of cultural competence, cultural viewpoints, and cultural phrases in patients from different cultural backgrounds.

The trainees received important information about migration and being an immigrant and understood that they needed to act to benefit the patient ( McDonald et al., 2021 ). The use of eSimulations also significantly impacted the cultural awareness of graduates ( Perry et al., 2015 ). After completing eSimulation training, post-survey questionnaires reported better communication and a better understanding of language and culture in the context of healthcare, as well as the benefits of using an interpreter when talking to patients from different cultural backgrounds. Participants also expressed new awareness of their assumptions about patients and the dangers of hasty conclusions involving cultural issues in patient care and planning. An online training study by Slobodin et al. (2021) found that only two independent variables had a statistically significant impact on cultural competence (1) the pre-intervention level of self-reported cultural competence ( p  = 0.005) and (2) exposure to previous cultural competence training as part of their overall educational framework. After completing training, the most significant gains were seen relative to culturally competent attitudes, meetings, and skills, and the smallest gains were seen in overall knowledge.

Celik et al. (2012) reported that the degree of cultural awareness improved significantly in mental health workers ( p  = 0.026) and hospital workers ( p  < 0.005). Improvements for those working in nursing homes were not statistically significant ( p  = 0.749). Participants said they became more critical of a neutral approach to diversity and had not previously considered diversity relevant to healthcare, although they reported that they better perceived each patient as unique, with each having specific health needs.

Theme 3: Opportunities for the development of cultural competence education

The research by Ahn (2017) used a questionnaire investigation to verify the hypothetical model of cultural competence in nurses. The following measuring tools were used: Multicultural Experiences Questionnaire, a Generalized Ethnocentrism Scale, a Cultural Competence Assessment Instrument, the Low and High Context Measure of Attributional Confidence Scale, the Intergroup Anxiety Scale, the Cybernetic Coping Scale, and the Cultural Competence Scale for Clinical Nurses. The authors found that multicultural experience, ethnocentric attitudes, organizational competence support, intercultural anxiety, and coping strategies have statistically significant direct and indirect impacts on cultural competence.

Coping strategies were seen to have a direct impact on cultural competence. Kaihlanen et al. (2019) examined methods for developing cultural competence training. They suggested using real examples, open discussion, and the lecturer’s expertise. However, training participants noted that trainers with other cultural backgrounds should also be included. Trainees suggested that (1) materials should be available online, (2) training should take less time, and (3) each training should be followed by a one-week break (participants said they felt time pressure to complete the assigned tasks). Additionally, more time between training would allow time for reflection on training content. Participants in the study by Celik et al. (2012) also suggested that there be more time between training sessions, again to provide more time to reflect on the concepts of cultural diversity.

This scoping review summarizes the available resources on developing cultural competence in nurses in clinical practice. Using the analyzed studies, we identified that attendance and distance training methods could impact the development of cultural competencies in nurses. Participants were offered several methods, such as face-to-face training, simulation training, eSimulation methods, and web-based learning.

The findings of this scoping review suggest that appropriate educational training can increase the cultural competence of nurses. These findings are supported by Cicolini et al. (2015) , Yilmaz et al. (2017) , Červený et al. (2020) , and Antón-Solanas et al. (2021) . Marja and Suvi (2021) report that simulations allow the integration of cultural elements into different vocational training and deepen the overall understanding of patient-centered cultural practices among simulation participants.

Workshops aimed at shaping culturally sensitive and competent attitudes, intensive and in-depth interactions with patients from different cultures, increasing knowledge of cultural issues, and intercultural communication training also strengthen the levels of cultural competence. There is a need to create smaller groups and increase practical hours to develop cultural competence ( Majda et al., 2021 ).

Changing demographics make it necessary to prepare nurses to better meet the healthcare needs of patients from different cultural backgrounds. Cultural diversity in healthcare requires healthcare professionals to be aware of cultural needs and provide culturally appropriate healthcare ( Turale et al., 2020 ). Cultural competence is essential in nursing since nurses spend more time in direct patient care than other medical staff ( Gallagher and Polanin, 2015 ). Young and Guo (2016) report that cultural competencies develop through internal reflection and awareness over time. Findings of this review have shown that coping strategies are also an appropriate means of developing cultural competence.

According to Berlin et al. (2010) , educational training should also include information on the cultural challenges and concerns of nurses and patients in the context of healthcare. Addressing these problems could improve daily clinical practice. Cultural competence in healthcare professionals improves patient satisfaction ( Govere and Govere, 2016 ; Watt et al., 2016 ). Tosun (2021) add that integrating cultural education as an optional subject is insufficient because if nursing students did not choose the subject, they would not get the necessary information and skills to improve their culturally competent care.

This scoping review also shows the importance of overcoming language barriers and the role of interpreters in clinical practice. A systematic review by Govere and Govere (2016) recommends that training aimed at developing cultural competence includes the following topics or focuses: race, religion, sexual orientation, gender, and disability; vocal tones and nonverbal communication; and Latina Cultural Competence, Cultural Sensitivity program, Medical Spanish course, and Cultural Competencemodule.

Cai et al. (2021) draw attention to the need for practical cultural training. They note the need to identify and examine the factors that determine cultural competence. When offering training for cultural competence, there is often a risk of stereotyping since the training content often emphasizes minority groups and draws attention to the differences between minorities and the majority population. Such an approach should include a “do and do not” approach that defines how a nurse should treat a patient from each cultural background ( Dogra, 2010 ).

Limits of literary overview

This scoping review has several limits. The small number of studies analyzed is the main limitation of the study. Additionally, only studies available in English were included in the analysis. Moreover, studies from the “Grey literature” were not included, which may have led to the omission of some relevant studies.

The increasing cultural diversity within global societies has created the need for cultural competence education in clinical practice nurses. The results of this scoping review point to possible methods for increasing cultural competencies among nurses. We report on several methods that can positively impact the development of cultural competence. Furthermore, the rapidly changing cultural demographics mean that societies need to constantly reassess the content of cultural diversity training so that participants are always prepared to provide culturally competent care. Cultural competence training greatly benefits nurses since it improves nurse–patient communication; however, it also benefits patients from different cultural backgrounds via improved healthcare and feelings of greater acceptance in society.

Author contributions

MČ and VT: conception and design. MČ: data analysis and interpretation and manuscript draft. IK and VH: critical revision of the manuscript. MČ, IK, VH, and VT: final approval of the manuscript. All authors contributed to the article and approved the submitted version.

This paper relates to the grant project 046/2021/S, supported by the Grant Agency of the University of South Bohemia in České Budějovice.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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