Opportunities for Nursing Education Advancement in Primary Health Care Des ouvertures pour la formation en sciences infirmières en soins de santé primaires

For decades, we have envisioned the central role of registered nurses in advancing the vision of primary health care (PHC) for communities. The historical policy references on models of PHC reform, situating nursing and interdisciplinary teams at the centre of community care, are numerous and multi-jurisdictional and span decades (Hastings, 1972; National Expert Commission, 2012; World Health Organization [WHO], 2008, 2020). Today, it looks as if the policy goalposts are moving as governments respond to the PHC crisis in Canadian health systems. Canadian provinces and territories have recently taken steps to renew a vision for health promotion and for how people access essential health care beyond the family physician office model. Former federal minister of health Dr. Jane Philpott recognizes the central role of education of health care students, including nurses, where the primary care settings offer rich and badly needed opportunities for team-based practice education. The International Council of Nurses (ICN) further recognizes how the education of nursing students can advance PHC at system and policy levels. Alongside the opportunities for advancing PHC, there are imminent threats to global health equity. The ICN has released a statement clarifying what the withdrawal of the United States from the WHO means for universal health coverage and the health of all. Social justice and health equity are the pillars of PHC, and these must be the foundation of our teaching and practice. Our world and our immediate priorities are shifting dramatically as we seek ways to engage students in deep understanding and advocacy for global health equity and PHC. We must therefore consider what this means for our pedagogy and research programs. This is the time to showcase the academic preparation of nurses as foundational to PHC and public health, and to project a vision in which primary care centres include research and teaching, testing the pedagogical and practice models needed to shift health and health care paradigms, roles, and relationships. Teachers’ and researchers’ innovation and evaluation are pivotal. Populations need primary care, and students need opportunities to engage with communities in the full meaning and values of PHC. Knowledge is needed to advance roles and demonstrate contributions to care and systems. The implementation of roles must be supported by rigorous research and dissemination in action, and we project that the six interdependent learning domains of the Canadian Association of Schools of Nursing’s National Nursing Education Framework (2022) will become a foundation of inquiry into baccalaureate and graduate education in emerging systems. How do nursing knowledge and practice contribute within collaborative team environments? To the health of communities? What is the synergy of core registered nurse and advanced practice competencies needed to fulfill practice and research needs? Papers in this issue of Quality Advancement in Nursing Education - Avancées en formation infirmière address research questions pertaining to student practice experiences, acknowledging the need for larger sample sizes to generate evidence for systems change. The momentum towards primary care models across the country may just be that opportunity for expanding our research repertoire through access to teaching and research centres if they are implemented. The interview with Dr. Tanya Sanders conveys a sense of what is possible when nurses engage with communities in PHC. We welcome a dynamic exchange of ideas for how our work can make a difference now as we act locally and globally, with hope and strength in these perilous times. Historian Timothy Snyder’s (2024) treatise On Freedom situates knowing ourselves as essential to a self-determined future: “Freedom is about knowing what we value and bringing it to life” (p. xv). To know ourselves in nursing currently depends on rigorous …