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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.

We describe the development of an innovative baccalaureate nursing education strategy for public health nursing. Virtual simulation pedagogy is known to be effective for acute care nursing practice while less known for public health nursing. Three Canadian nursing schools, the Canadian Association of Schools of Nursing (CASN), and the Canadian Alliance of Nurse Educators using Simulation (CAN-Sim) partnered to develop three public health nursing virtual simulation games. Learners work through unfolding population health scenarios, simulating public health nursing practice focused on entry level public health nursing competencies. Each game fosters clinical reasoning and collaborative, community decision-making to respond to population health issues during community assessment, evidence-informed health promotion planning, and evaluation processes. A companion guide was developed to support best practices in implementing virtual simulation and promote optimum student learning using the public health nursing games.

Objectives The purpose of this project was to implement and evaluate the integration of a computer-based virtual simulation program into a community clinical course as an alternative or complement to conventional clinical with agencies or neighbourhoods. Securing quality community health clinical opportunities for undergraduate nursing students remains challenging. In addition, evidence of a theory-practice gap in community clinical education, particularly in non-traditional settings, suggests that nurse educators need to adopt different pedagogies to ensure that students will gain competencies necessary to practice community/population health nursing. In response, we piloted the use of Sentinel City®3.0, a virtual reality simulation program. Method A 5-point Likert-style questionnaire was administered to students randomly assigned to different clinical placements. Results Results indicated that there were no learning outcomes in which students in Sentinel City®3.0 reported percentages lower than students in agencies or geographical neighbourhoods. When there were statistically significant differences, students engaged in Sentinel City®3.0 performed better than students in other experiences. Conclusion We recommend further exploration of multi-contextual pedagogies for community clinical.

Background Sustaining and strengthening nurses ‘contributions to public and population health in the 21st century depends in part on nursing education. Clearly articulated entry-to-practice competencies will contribute to the capacity of undergraduate nursing education programs to prepare graduates to promote local, national and global population health. Objectives The Canadian Association of Schools of Nursing created the Public Health Task Force to develop consensus on core, national entry-to-practice competencies in public health nursing for undergraduate nursing students and to support these competencies with corresponding online teaching strategies. Design Delphi approach. Participants Nurses with public health experience in education and practice, and representatives from other public health professional organizations across Canada. Method The three-phased competency development included: 1) an environmental scan; 2) an iterative process to draft competencies; and 3) a modified Delphi process to confirm the final competency framework using face to face consultations and a survey. The knowledge translation strategy involved soliciting submissions of teaching strategies for peer-review and subsequent inclusion in an interactive online resource. Results 242 public health educators and practitioners participated in the consensus consultation. The final document outlined five competency statements with 19 accompanying indicators. A total of 123 teaching strategies were submitted for the online resource, of which 50 were accepted as exemplary teaching strategies. Conclusion This competency development process can provide guidance for the development of competencies in other countries, thus strengthening public health nursing education globally. The decision to intentionally level the competencies to entry-to-practice, as opposed to an advanced level, enhanced their application to undergraduate nursing education. The development of the additional inventory of teaching strategies created a sustainable innovative resource for public health nursing educators and practitioners world-wide to support the adoption of entry-to-practice public health nursing competencies.

The persistence of health inequities is reflected in repeated calls for intersectoral collaboration on the social determinants of health, specifically through public policy action. Yet, how to do intersectoral collaboration specifically for policy action toward health equity is articulated rather scarcely in the scientific literature. With this scoping review, we intended to generate insight into current peer-reviewed literature to identify gaps about evidence-based approaches to practices of intersectoral collaboration for health equity-oriented policy action. Seven search engines were used: Proquest, Web of Science, CINAHL, Pubmed, Sociological Abstracts, Project Muse and ERIC. Social determinants of health, including public policy and intersectoral collaboration, are related concepts for the health equity agenda and were used as a conceptual framework to map selected literature. Out of 227 articles, our review identified 64 articles describing intersectoral collaboration specifically in relation to pub...

Physical activity and healthy eating have long been promoted as key strategies in tackling the ‘wicked problem’ of obesity. Both practices are assumed to go hand-in-hand, but whether one dominates the other has largely remained unexamined. Moreover, time, a dimension beyond the socio-ecological model, is a critical factor of families' busy lives, but related challenges are rarely articulated. We conducted 47 family interviews as part of a mixed methods study examining environmental influences on youth obesity in Nova Scotia, Eastern Canada. Participants were recruited from six schools at the junior high school level (grades 7–9; age range 12–14 years) based on location (urban, suburban and rural) and neighborhood socioeconomic status (high and low socioeconomic status). Time pressure to meet the demands associated with scheduled physical activity for youth was the dominant theme across interviews from all neighborhoods. Physical activity and healthy eating were valued differently, with greater value placed on physical activity than healthy eating. The pressure to engage youth in organized physical activity appeared to outweigh the importance of healthy eating, which led to neglecting family meals at home and consuming fast food and take out options. Our findings further reinforce the need to move beyond the socio-ecological model and integrate critical dimensions such as ‘time’, its challenges and opportunities, to allow for a more nuanced understanding of contemporary healthy living. It appears ‘timely’ to focus on healthy public policy in support of families, instead of unwittingly supporting a fast food industry that profits from time-pressured families.

Currently used audiovisual (AV) teaching tools to teach health and physical assessment reflect a Eurocentric bias using the biomedical model. The purpose of our study was to (a) identify commonly used AV teaching tools of Canadian schools of nursing and (b) evaluate the identified tools. A two-part descriptive quantitative method design was used. First, we surveyed schools of nursing across Canada. Second, the identified AV teaching tools were evaluated for content and modeling of cultural competence. The majority of the schools (67%) used publisher-produced videos associated with a physical assessment textbook. Major findings included minimal demonstration of negotiation with a client around cultural aspects of the interview including the need for an interpreter, modesty, and inclusion of support persons. Identification of culturally specific examples given during the videos was superficial and did not provide students with a comprehensive understanding of necessary culturally competent skills.

SUMMARY This paper explores why Canadian government policies, particularly those related to obesity, are ‘stuck’ at promoting individual lifestyle change. Key concepts within complexity and critical theories are considered a basis for understanding the continued emphasis on lifestyle factors in spite of strong evidence indicating that a change in the environment and conditions of poverty isare needed to tackle obesity. Opportunities to get ‘unstuck’ from individual-level lifestyle interventions are also suggested by critical concepts found within these two theories, although getting ‘unstuck’ will also require cross-sectoral collective action. Our discussion focuses on the Canadian context but will undoubtedly be relevant to other countries, where health promoters and others engage in similar struggles for fundamental government policy change.

This theoretical exploration is an attempt to conceptualize the link between gender and urban environmental health. The proposed ecofeminist framework enables an understanding of the link between the urban physical and social environments and health inequities mediated by gender and socioeconomic status. This framework is proposed as a theoretical magnifying glass to reveal the underlying logic that connects environmental exploitation on the one hand, and gendered health inequities on the other. Ecofeminism has the potential to reveal an inherent, normative conceptual analysis and argumentative justification of western society that permits the oppression of women and the exploitation of the environment. This insight will contribute to a better understanding of the mechanisms underlying gendered environmental health inequities and inform healthy public policy that is supportive of urban environmental health, particularly for low-income mothers.

As the demand for cultural awareness in the provision of nursing care continues to increase, nursing programs must develop creative and effective teaching strategies and curricula to address this need. The evaluation of a five year, funded, North American nursing exchange project developed and implemented by six partner universities in Canada, Mexico and the United States of America is described in this article. The project was designed to enable nursing students to increase cultural awareness, redefine their role relationships with nurses from the partner countries, and increase knowledge regarding the health care systems and role of the nurse in those countries. Findings provide evidence that teaching nursing through a prism of cultural awareness, using both a jointly taught online course and student and faculty exchanges across the three countries is an effective strategy to increase the level of cultural awareness in nursing students.

This qualitative study identified influences on participation in physical activity among seniors living in the community and in long-term care facilities. A total of 24 seniors participated in individual face-to-face interviews. Through thematic analysis, the overarching theme identified that past experiences, life transitions, and future concerns influence seniors’ participation in physical activity. This overarching theme helps explain the complexity of physical activity participation in later life. The subthemes included intergenerational influences, establishment of early physical activity patterns, family transitions over the life course, changing health status over the life course, and future health concerns. A greater understanding of an individual’s life history is paramount for nurses to help increase participation in physical activity among seniors.

To examine how empowerment, as an ideology and a practice of teaching and learning, was understood and applied by public health nurses (PHNs) in health education with child bearing and child rearing families.Feminist poststructuralism was used to guide data collection and analysis. In-depth, individual interviews were conducted with three mothers and three PHNs and explored the different perspectives held by mothers and PHNs during a home visit.Moments of conflict, contradiction, affirmation, and agreement highlighted various empowering relations. Individual choice and recognition of knowledge and power exemplified how both mothers and PHNs used their "agency" to position themselves into a particular relationship. The analysis includes five sections: (a) mother's perceptions of PHNs, (b) normalization as problematic: the good/bad dichotomy, (c) professional/expert: the balance of power, (d) working the relationship, and (e) reflections on empowerment.The information gathered from this studyprovides a rich understanding of the nurses' educational practices with new mothers.

We used a case study approach to explore the experiences of 4 women who live with environmental illness (EI). From the unstructured interviews we found a variety of themes that pointed to the complexity of EI and its severe impact on the lives of these women, their families, and their significant others. The methodology was guided by an ecofeminist approach, which enabled a critical analysis of the data to move beyond the personal to the broader sociopolitical forces shaping society. We identified the following themes from the women's stories: indirect exposure to incitants through people with whom these women come in close physical contact; the phenomenon of burden of proof, meaning that these women are forced to explain and legitimize their illness on a continuous basis; taking refuge from a hostile environment in social isolation to a more controlled environment, not as a matter of choice, but because of the severity of the illness; and, finally, a change in value system was integral to the entire process of living with EI.

Professional nurses are challenged by the increasing complexity of their own healthcare delivery systems and by the growing interconnectivity of healthcare systems worldwide. There are increasing calls for practice across boundaries; however, the role and scope of nursing practice within individual countries are often unclear, ill-defined, and misunderstood by nurses from other countries. In this collaborative educational project among six schools of nursing located in Canada, México, and the United States, nursing students and faculty are exploring the role of the nurse within each country's healthcare system while striving to develop their multicultural awareness. Participating faculty describe the process, challenges, and keys to success found in creating and living this international project. They share strategies for addressing challenges, which included meeting deadlines, time differences, differing academic schedules, writing joint documents in two languages, designing and presenting a shared course, and creating an exchange process between the six partner schools. They describe the evolution of their working relationships, the language challenges, and the joy of coming together as newfound colleagues and friends.