Open research questions in Nursing education and management

What the literature leaves open

• any vocational nursing college that has basic full-time infrastructure, a stable teaching nursing faculty, and established relationships with local tertiary hospitals. to Develop modular DNE teaching packages in collaboration with tertiary hospital emergency departments, including standardized courseware, typical disaster case sets, and low-cost simulation training guidelines. This addresses resource shortages while keeping teaching content clinically relevant.

  Knowledge, Application and Challenges of Vocational Nursing Educators in Disaster Nursing Education in China: An Explanatory Sequential Mixed Methods Study · 2026 · DOI

• Moreover, other limitations of this study were as follows: a cross-sectional design means there were no causal relationships among the variables, possible social desirability bias, possible selection bias, a discrepancy between 200 recruited participants and 196 analyzed questionnaires, a lack of multivariable analysis, and limited generalizability.

  The association between nurses’ personality types and attitudes towards older patients and their clinical decision-making styles · 2026 · DOI

• Future studies are recommended to extend the present analysis by conducting advanced statistical techniques ARTICLE IN PRESS ARTICLE IN PRESS ACCEPTED MANUSCRIPT such as mediation or moderation analysis to better investigate the indirect effects and interaction relationships between the study variables.

  Organizational culture and innovative behavior among nurses: a cross-sectional correlational study · 2026 · DOI

• However, this geographic concentration constitutes a significant limitation, as the competency models and descriptive protocols disseminated in studies may reflect organizational, training, and regulatory contexts specific to the North American system, limiting their direct transferability to other settings. It became evident that in space nursing, conceptual reflection has preceded practical validity, which is consistent with the still restricted nature of human access to the microgravity environment, thus limiting the consolidation of the mapped competencies and supporting the need for further studies on the phenomenon.

  Nursing knowledge, skills, and attitudes in the context of spaceflight: a scoping review · 2026 · DOI

• Another limitation of this study is that, although several significant predictors were identified, the regression model explained only 20% of the variance in attitude scores.

  Attitudes of Turkish Nursing Students Toward Clinical Practices and Factors Influencing Positive Learning: A Cross-Sectional Study · 2026 · DOI

• Future research is recommended to investigate additional factors influencing nurses' compliance, including the planning and organizing functions, and to employ more comprehensive research designs to provide a broader understanding of strategies for improving patient safety.

  Association Between Nursing Management Functions and Nurses' Compliance with Fall Risk Prevention at Islamic Hospital Banjarmasin · 2026 · DOI

• This study, being qualitative and descriptive, provides a rich, in-depth understanding of nurses’ lived experiences, perceptions, and coping strategies regarding irregular sal- ary payments in specific Cameroonian public hospitals. However, its findings are not intended to be statistically generalizable to all nurses in Cameroon or to other health- care systems. The study relied on self-reported data, which, while valuable for exploring lived experiences, may be subject to recall bias, as participants were asked to reflect on past events and emotional states. Furthermore, the focus on public hospitals means the experiences of nurses in private or non-governmental facilities, who might have different compensation structures and challenges, were not captured. A key limitation is the absence of perspectives from hos- pital administrators or policymakers, which would have provided a valuable point of tri- angulation to understand better the systemic and administrative causes of these salary delays. While reflexive practices were employed to mitigate researcher bias, the interpre- tive nature of qualitative analysis always involves a degree of researcher influence. 5.1 Policy implications and recommendations Our findings underscore an urgent need for multifaceted interventions to address the pervasive issue of irregular salary payments and their detrimental impact on nurses and patient care in Cameroon. Our recommendations are not just random suggestions, but they are carefully crafted in alignment with the WHO Global Strategic Directions for Nursing and Midwifery (2021–2025) [58], particularly focusing on the strategic objec- tives of investing in nurses and midwives and strengthening their leadership and compe- tence. These interventions are categorized by their timeframe for implementation. 5.2 Immediate relief: short-Term Interventions (Immediate) Timely and consistent salary disbursement The most direct and immediate intervention must be ensuring predictable and prompt payment of nurses’ salaries. This is founda- tional to alleviating financial stress, improving job satisfaction, and demonstrating insti- tutional respect. The benefits of this intervention include a more motivated nursing workforce, improved patient care, and a positive impact on the overall healthcare sys- tem. This recommendation requires a multi-level approach encompassing policy-level reforms, administrative measures, and financial management strategies. It is directed at government bodies (specifically the Ministry of Public Health and the Ministry of Finance), hospital administrators, and nursing leadership. Providing comprehensive support systems Healthcare institutions should immediately implement support mechanisms such as financial counseling, employee assistance pro- grams, and mental health services to help nurses manage the psychological and emo- tional toll of financial instability and high-stress work environments. 5.3 Medium-term interventions (1–3 years) Addressing systemic administrative inefficiencies: Policy reforms should target the bureaucratic weaknesses, inadequate health funding, and governance issues within the Cameroonian healthcare system that contribute to payment delays. This may involve streamlining payroll processes, enhancing financial oversight, and combating corruption. Chance and Théophile Discover Global Society (2026) 4:5 Page 16 of 20 Fostering supportive work environments: Policies should aim to reduce excessive patient-to-nurse ratios and alleviate staff shortages, which exacerbate the negative impacts of financial stress on patient interaction and care quality. Promoting professional recognition and value: Beyond monetary compensation, estab- lishing clear pathways for professional development, acknowledging nurses’ vital con- tributions, and fostering a culture of appreciation can help restore a sense of fulfillment and reduce professional disillusionment. 5.4 Long-term iterventions (3–5 + years) Context-Specific interventions: Recognizing the unique challenges of urban, regional, and rural hospitals, interventions must be tailored. For instance, rural settings might benefit more from strengthening local administrative autonomy in fund management and supporting community-based informal networks. In contrast, urban settings might require more robust anti-corruption measures and streamlined central bureaucracies. These long-term reforms are critical to building a truly resilient and equitable healthcare system.

  The ripple effect: irregular salary payments, job satisfaction, and patient safety among nurses in Cameroon · 2026 · DOI

• Healthcare institutions are encouraged to strengthen organizational support systems by improving staffing levels, ensuring manageable workloads, and fostering a safe, supportive work environment. Addressing these factors may help reduce stress and burnout among Generation Z nurses. Hospitals may also implement structured professional development programs, including mentorship, training, and continuing education opportunities, to support the growth and competence of Generation Z nurses. Providing financial and institutional support for these programs may further enhance their accessibility. Healthcare organizations are encouraged to promote work–life balance by offering flexible scheduling, regular rest periods, and wellness programs that support nurses' physical and emotional well-being. Nurse leaders and supervisors may strengthen communication, teamwork, and support within the workplace to foster a more positive and collaborative environment. Recognizing nurses’ efforts and providing guidance may also improve job satisfaction and retention. ACKNOWLEDGMENTS The researcher humbly and faithfully expresses her gratitude and joy to the LORD JESUS CHRIST, our GOD, who gave her light through the Holy Spirit, with all the strength, knowledge, wisdom, courage, and determination to surpass all the hardships and to finally achieve her dream. To SBLC and graduate school, respectively, for the faith and support they have provided while I complete this journey. My thesis advisor, for his untiring support and insightful critiques throughout my research journey. Appreciation is likewise given to the panel members for their constructive feedback and recommendations that helped improve the quality of this study. Gratitude is also extended to participants for their valued time, for my colleagues and friends for their encouragement and support. Most importantly to the researcher’s family for their unwavering support, patience, and understanding throughout the completion of this research. AI DECLARATION STATEMENT AI-supported tools helped with grammar and structure in creating this article. No AI tools were used to collect, analyze, or interpret data; all authors are credited for their academic contributions. REFERENCES Al-Moteri, M., Althobaiti, E., Aljuaid, G. M., Alotaibe, M. F., Alharthi, R. A., Alboqami, S. F., Berdida, D. J. E., & colleagues. (2025). The workplace expectations and preferences of Gen Z nurses: Exploratory factor analysis. BMC Nursing, 24(1).

  Exploring the Lived Experiences of Generation Z Nurses in a Secondary Private Hospital in Quezon City · 2026 · DOI

• ®   Books (/booksbrowse)  Although the Recognition Toolbox led to positive outcomes, several limitations were identified. One challenge was initial resistance from staff, as some perceived the recognition initiatives as additional administrative responsibilities rather than meaningful ways to support workplace acknowledgment and culture of appreciation.

  The role of meaningful recognition in improving nurse retention · 2026 · DOI

• "Perceptions" serve as a potent gauge for evaluating the preparedness of the workforce to employ AI and their interest in further research on user-friendly technology.

  Empowering Surgical Training through Artificial Intelligence: A Cross-Sectional Study on Residents’ Acceptance and Perceived Usefulness of AI-Based Simulation · 2026 · DOI

• Six themes emerged: (1) the pandemic did not dissuade students from becoming nurses; (2) career trajectories were altered; (3) institutional and peer support were insufficient; (4) practical readiness was diminished; (5) rifts within the nursing workforce intensified; and (6) media shaped perceptions of nursing.

  Exploring RN Resignation Experiences · 2026 · DOI

• Continuously provide preceptors with guidance, feedback, and support via mentoring. Preceptors will require training, and new nurses need to be actively involved in learning and receiving feedback. Policymakers can establish standards for preceptorship practice, and warrant more extensive sampling of preceptors in multiple environments for future studies. ACKNOWLEDGMENTS To everyone who provided assistance with this project, I want to thank them from the bottom of my heart! To my colleagues, family, and friends who provided words of support https://epublications.myeduheart.com/index.php/ijnhha/index E-ISSN: 3116-5974 P-ISSN: 3116-5966 281 and feedback during this journey, there are no words to express my gratitude. All of you played a key role in the success of this research. AI DECLARATION STATEMENT AI tools were used only for editing, summarizing, and improving clarity of the manuscript. The researcher remains fully responsible for all data, analysis, and final content. AI was not used to generate or modify research data or results. REFERENCES Bandura, A. (1977). Social learning theory. Prentice-Hall Benner, (1982).

  The Influence of Preceptors on The Professional Skills, Personality Development, and Growth of Novice Renal Nurses at Selected Dialysis Centers in Davao Del Norte · 2026 · DOI

• This study employed a convenience sampling method and only selected nursing interns from a tertiary hospital in Zhengzhou as the research subjects. As a non-probability sampling approach, convenience sampling may introduce selection bias and limit the inferential generaliz- ability of the findings to broader nursing intern populations. Future research should consider adopting probability-based sampling strategies across multiple institutions and regions to enhance representativeness. Additionally, the use of multiple data collection methods is recommended to facilitate study replication and validation. Furthermore, as a cross- sectional study, this research only collected data at a single time point and cannot capture changes in variables over time. Future studies could adopt longitudinal designs to track the dynamic relationships between intoler- ance of uncertainty, career resilience, and professional identity among nursing interns.

  The impact of nursing interns’ intolerance of uncertainty on professional identity: the mediating role of career resilience · 2026 · DOI

• This study employed a cross-sectional design and convenience sampling to examine the psychometric properties of the "Perception of Workplace Gender Discrimination for Women in Nursing - PWGDWN" among nurses working in western Iran. Consequently, the findings are generalizable only to the studied population and may not extend to other settings or nursing populations due to differences in cultural, organizational, and professional contexts. Furthermore, it should be noted that the PWGDWN is a self-report tool, with assessments based on participants’ own perceptions and interpretations. Differing work and cultural conditions may influence responses to the questions, potentially altering the validity and reliability of the results. The tool’s validity was assessed through content validity and construct validity; however, criterion validity, including concurrent and predictive validity, was not examined. It is recommended that future research evaluate the applicability of the PWGDWN in diverse cultural contexts and countries to further validate and adapt the tool for measuring perceptions of workplace gender discrimination across a broader range of nurses.

  Cross cultural adaptation and psychometric validation of the Persian version of a scale measuring perception of workplace gender discrimination among women nurses · 2026 · DOI

• For Nursing Educational Institutions • Introduce a structured academic orientation programme for all Year I students at the commencement of each semester, covering time management, examination strategies, and study skills. • Constitute a Student Academic Support Cell offering regular tutorial sessions, doubt-clearing clinics, and peer mentoring to reduce examination-related anxiety and workload burden. • Review and rationalise the clinical posting schedule to ensure that mandatory clinical hours are not compromised by examination preparations, and that adequate supervision is maintained during all postings. • Establish or strengthen college counselling services, making professional psychological support accessible and destigmatised for nursing students. • Augment library holdings, subscribe to relevant nursing and health sciences e-databases (e.g., CINAHL, PubMed, Cochrane Library), and expand study infrastructure proportional to enrolment. Dhiraj Lakshakar, Meenakshi Regmi Page | 688 The Academic Volume 4 | Issue 4 | April 2026 9.2 For University and Regulatory Bodies (INC/MPNC) • Conduct a formal, multi-site, state-level review of the semester system's implementation in nursing colleges, with particular attention to compliance with prescribed student-to-faculty ratios, clinical hours, and examination schedules. • Consider phasing examination dates to provide adequate inter-semester preparation time, and regulate the minimum gap between internal and external examinations. • Introduce mandatory faculty development programmes focused on student-centred pedagogical approaches, formative assessment design, and student welfare within the semester framework. • Develop differentiated guidelines for government and private nursing colleges to address their disparate resource capacities and student support requirements. 9.3 For Future Research • Longitudinal studies tracking the evolution of student perceptions across all four years of the B.Sc. Nursing programme are warranted to examine adaptation patterns and long-term academic outcomes. • Qualitative or mixed-methods studies exploring the lived experiences of nursing students within the semester system would provide richer contextual understanding. • Comparative studies between nursing colleges with and without structured student support systems would provide robust evidence for the effectiveness of specific interventions. • Multi-centre studies spanning multiple states of India would enhance the generalisability of findings and inform national nursing education policy. 9.4 Limitations of the Study • The use of convenience sampling limits the generalisability of findings beyond the selected colleges of Gwalior. • Self-reported data may be subject to social desirability bias and recall limitations. • The study captures perceptions at a single point in time; longitudinal measurement would offer a more complete picture. • The absence of faculty and administrator perspectives represents a gap that future qualitative components could address.

  Perception of B.Sc. Nursing Students towards Challenges of the Semester System in Colleges of Nursing, Gwalior, Madhya Pradesh · 2026 · DOI

• Author contributions Future studies could strengthen the credibility and depth of findings by incorporating methodological triangulation. For example, non-participant observation of nursing practice could be used to directly examine how nursing assessments and workload pressures are managed in real time, providing insight beyond self-reported experiences. In addition, reviewing patient records and clinical documentation could help verify reported challenges related to assessment completeness, documentation practices, and continuity of care. Combining these approaches would allow for cross-validation of findings, reduce reliance on self-report data, and enhance the overall trustworthiness and robustness of future research outcomes. GH: Software, Methodology, Writing – review & editing, Supervision, Investigation, Writing – original draft, Funding acquisition, Data curation, Validation, Resources, Visualization, Formal analysis, Project administration, Conceptualization. TM: Methodology, Validation, Software, Data curation, Supervision, Visualization, analysis, Resources, Conceptualization, Project administration, Writing – review & editing, Writing – original draft, Funding acquisition. LM: Resources, administration, Visualization, Formal analysis, Validation, Writing – original draft, Data curation, Supervision, Investigation, Writing – review & editing, Conceptualization, Software, Methodology.

  Exploring professional nurses’ perceptions of structural, organizational, and workplace constraints affecting nursing assessment in a selected public hospital in South Africa: a qualitative study · 2026 · DOI

• Despite its contributions, this study has certain limitations. First, this study adopted a cross-sectional design, which only reflects variables at a single time point and thus cannot establish causality. Specifically, the cross-sectional nature makes it impos- sible to determine the temporal and causal relationship between change fatigue and work engagement. To address this, future lon- gitudinal studies (e.g., cross-lagged panel models, cohort studies) are needed to further confirm their temporal and causal relation- ship. Second, the convenience sampling method may restrict the sample’s representativeness. This study was conducted exclusively in Ningxia Hui Autonomous Region, with geographical limitations that require caution when generalizing results to other regions of China. Future study should employ randomized, stratified sam- pling across multiple centers. Besides, nurses with <1 year of clini- cal experience were excluded, so the change fatigue characteristics of this early-career group are not captured. Furthermore, key vari- ables including specific management characteristics of organiza- tional change and nurse psychological resources were not included, limiting the explanatory power of the model. Finally, the assessment of change fatigue still relies on generic management- oriented scales. Future research should develop and validate instruments specific to different types of change in nursing practice.

  Latent profile analysis of change fatigue among clinical nurses: a cross-sectional study · 2026 · DOI

• Several limitations of this study warrant acknowledgment and suggest directions for future inquiry. First, the operationalization of nurse retention through the RN Staffing Rating serves as an institutional-level proxy rather than a direct measure of individual turnover behavior. While this approach enables large-scale analysis of administrative data, future studies would benefit from linking such datasets with longitudinal staff records to strengthen construct validity and capture micro-level retention dynamics. Second, the cross-sectional design of our analysis captures associations at a single time point, limiting our ability to infer temporal precedence or causal pathways; panel data analyses tracking facilities over multiple periods could better elucidate how changes in workload, financial constraints, or quality metrics dynamically influence staffing outcomes.

  Machine learning insights into nurse retention through job satisfaction and financial incentives · 2026 · DOI

• Although references discuss measurement scale development and testing, there is no explicit mention of whether the Indonesian WRQoLS-2 has been validated in other non-hospital healthcare settings (e.g., primary care, community health).

  Can the Indonesian Version of the Work-Related Quality of Life Scale-2 (WRQoLS-2) Be Used to Measure Quality of Work Life Among Hospital Personnel? · 2026 · DOI

• While content validity index and reliability testing are referenced, the excerpt does not clarify whether longitudinal validation or responsiveness to change over time has been established for the Indonesian version of the WRQoLS-2.

  Can the Indonesian Version of the Work-Related Quality of Life Scale-2 (WRQoLS-2) Be Used to Measure Quality of Work Life Among Hospital Personnel? · 2026 · DOI

• The references discuss cross-cultural adaptation processes and validation methodologies for measurement instruments, but the excerpt does not explicitly state whether the Indonesian WRQoLS-2 was tested across different hospital settings or healthcare worker categories beyond the sample studied.

  Can the Indonesian Version of the Work-Related Quality of Life Scale-2 (WRQoLS-2) Be Used to Measure Quality of Work Life Among Hospital Personnel? · 2026 · DOI

• PROBLEM: The scope of educational preparation within NP populations is poorly defined, resulting in institutional variability of graduate preparedness.

  Defining Population-Specific Nurse Practitioner Educational Parameters · 2025 · DOI

• DISCUSSION: They face multifaceted constraints that limit their effectiveness, yet evidence shows that targeted investments in training, infrastructure, and community collaboration can enhance their role in delivering equitable healthcare CONCLUSION: Community health nurses are critical actors in the health system but are often underrecognized due to structural, educational, cultural, and policy-related barriers.

  Community Health Nurses in Low‐ and Middle‐Income Countries: A Systematic Integrative Review of Roles, Barriers, and Improvement Perspectives · 2025 · DOI

• Future research should focus analysis efforts across the same organizations between HEI and Magnet® data collection points and assess LGBTQ+-inclusive care and employment practices and organizational nursing excellence with tools external to the HEI and Magnet® recognition.

  The Relationship Between Healthcare Organizational Magnet® Status and Scores on the Human Rights Campaign <i>Healthcare Equality Index</i> : A Comparative Temporal Analysis · 2024 · DOI

• To overcome this, recently, some medical schools offer patient-facing nurse training for the Care Certificate (CC) in the first year, but as yet little is known about how this is being received by nurses.

  Tensions and Possibilities: A qualitative study of the views of nurse faculty training medical students to be Health Care Assistants · 2023 · DOI

Most-cited papers in Nursing education and management

• Educational Levels of Hospital Nurses and Surgical Patient Mortality · JAMA · 2003 · 1,245 citations
• Experiencing Transitions: An Emerging Middle-Range Theory · Advances in Nursing Science · 2000 · 1,184 citations
• Concepts, analysis and the development of nursing knowledge: the evolutionary cycle · Journal of Advanced Nursing · 1989 · 471 citations
• Nurse Staffing and Patient Outcomes · Nursing Research · 1998 · 329 citations
• Focus groups as a research method: a critique of some aspects of their use in nursing research · Journal of Advanced Nursing · 2001 · 306 citations
• Variations in Nursing Practice Environments · Nursing Research · 2006 · 283 citations
• Professional identity and nursing: contemporary theoretical developments and future research challenges · International Nursing Review · 2012 · 282 citations
• Nursing workload, nurse staffing methodologies and tools: A systematic scoping review and discussion · International Journal of Nursing Studies · 2019 · 268 citations
• Concepts of caring and caring as a concept · Advances in Nursing Science · 1990 · 256 citations
• The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership · International Journal of Nursing Studies · 2020 · 248 citations

Most recent work

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• Attitudes of Turkish Nursing Students Toward Clinical Practices and Factors Influencing Positive Learning: A Cross-Sectional Study · Yuksekogretim Dergisi · 2026
• Can the Indonesian Version of the Work-Related Quality of Life Scale-2 (WRQoLS-2) Be Used to Measure Quality of Work Life Among Hospital Personnel? · Biomedical Sciences and Clinical Medicine · 2026
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