Integration of social determinants of health, disparity, and diversity concepts into baccalaureate nursing curricula in Puerto Rico: Nurse faculty perceptions

Nurse educators have the responsibility to prepare curriculum by which students acquire competencies; therefore, it must include concepts reflecting current trends in nursing practice. One of these trends is an increasing amount of diverse patients who are impacted by social determinants of health experiencing health disparity. Thus, the integration of diversity, disparity and social determinants of health (SDOH) concepts into nursing curricula is crucial. The purpose of this basic qualitative study was to understand nurse educator's perspective as to why diversity, disparity, and SDOH concepts have not been integrated into prelicensure baccalaureate nursing curricula in Puerto Rico. The research questions were the following: What factors are taken into consideration by nurse educators for the selection of curriculum concepts? How do nurse educators in Puerto Rico describe their process for determining which concepts are to be included in prelicensure baccalaureate nursing curricula? What do nurse educators believe are the main factors for the absence of SDOH, disparity and diversity concepts in prelicensure baccalaureate nursing curricula in Puerto Rico? The study was done with focus groups using an interview guide with three open ended questions Findings revealed participants agreed diversity, disparity, and SDOH concepts are not fully integrated into the curriculum of the program in which they work and that there are no specific teaching learning or assessment strategies to develop students' knowledge regarding diversity, disparity and SDOH concepts. Participants reported one of the reasons for the absence of these concepts into curriculum was that that the integration of these concepts has not been emphasized by nurse educators and nurse leaders in Puerto Rico. They also reported that the factors taken into consideration to select curricular concepts. Although participants did not agree on a step-by-step process for determining which concepts are to be included in the curriculum. Findings from this study adds to the current literature as no previous studies have been performed on the integration of diversity, disparity and SDOH concepts into pre licensure BSN programs in Puerto Rico. Implications for nursing education and recommendations for future research are included.