Norm-critical elements in nursing and healthcare education: a scoping review

Abstract Background Access to healthcare is a fundamental human right that is often influenced by social norms and power structures. Implicit biases in society, healthcare, and education contribute to health inequalities. Incorporating equity and social justice into nursing and healthcare education, through norm-critical pedagogy can empower learners to address and promote social justice and health equity in patient care and community health. Methods The aim of the study was to describe characteristics and recurring elements of norm-critical literature in published research. This study followed Arksey and O’Malley’s scoping review framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews to report the findings. A search was conducted in across five scientific databases – CINAHL, APA PsycINFO, ERIC, Medline, and Web of Science – limiting results to English language articles. Two authors independently screened, extracted, and analysed the data, guided by selected key concepts based on the population, concept, and context framework. The included articles were condensed according to specific characteristics and analysed thematically. Results Sixteen articles were included in the review, and all published from 2017 onwards, primarily in nursing journals. Most of these articles employed qualitative methodologies. A thematic analysis generated three themes: ‘Redesigning education toward norm-critical pedagogy’, ‘Redefining one’s positionality as a teacher’, and ‘Transforming education for a norm-conscious sustainable healthcare future’. Conclusions This scoping review concludes that the characteristics of norm-critical literature, primarily centred on Western nursing education, has limited applicability in other healthcare educations. The literature describes key challenges in integrating norm-criticism into educational structures, often placing undue responsibility on individual teachers to adopt a norm-critical pedagogy. This review calls for further empirical research on norm-criticism to advance its use as a pedagogical model in nursing and healthcare education.