The use of community problem solving in undergraduate nurse education: A literature review

Background To effectively realise their role in health promotion nurses need a clear understanding of the social determinants of health. In 1987 the WHO recommended that students participate in meaningful community based problem-solving to prepare them for health promotion practice, including actual or simulated community health projects. Objective To explore the use of community problem-solving in undergraduate nurse education and its impact on students' understanding of population health. Method This literature review used a five-stage iterative method, to explore the following research question; how is community problem-solving being used in undergraduate nurse education and to what effect? Following a systematic database search (CINAHL, MEDLINE, ERIC and ProQuest BNI), forward citation and snowballing, 82 studies were screened against the inclusion and exclusion criteria. A critical appraisal of the studies was conducted using COREQ and data was extracted using a summary table. Thematic analysis was used to identify major themes from the literature. Results Ten studies were identified which explore the use of community problem-solving these provide some useful insight into the design, application and the apparent benefits of the approach in undergraduate nurse education. Three key themes emerge: students develop a broader vison of their future role in health promotion, a deeper understanding of community and social determinants, as well as identifying the role of community assets for health. Only one of the studies included in the review evaluated the impact of community problem-solving on health promotion practice after graduation. Conclusion The concept of CPS in undergraduate nurse education has been around for many years, but there has never been a comprehensive review of its implementation or effectiveness. Research into its impact is needed to examine whether it increases students' understanding of their future role in health promotion. If nurses are expected to play a key role in public health, nurse educators need research evidence to support the design and delivery of CPS to implement a population health approach to undergraduate nurse education.