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www.sciedu.ca/jnep Journal of Nursing Education and Practice 2015, Vol. 5, No. 1
ORIGINAL RESEARCH
The power of affective learning strategies on social
justice development in nursing education
Katrina Einhellig ∗
, Faye Hummel, Courtney Gryskiewicz
School of Nursing, University of Northern Colorado, Greeley, United States
Received: July 31, 2014 Accepted: October 19, 2014 Online Published: November 10, 2014
DOI: 10.5430/jnep.v5n1p121 URL: http://dx.doi.org/10.5430/jnep.v5n1p121
Abstract
Nursing professional values are critical for the practice of nurses, yet the development of curricula fundamentally supporting
these values has been slow to develop. The question remains as to the best teaching strategies that foster the integration of
these core values as a key focus for nurses throughout their professional practice. The purpose of this article is to report the
findings of a research project related to an affective learning strategy, and the potential of such strategies to guide undergraduate
nursing students in the development of professionalism. While conducting a study related to the use of poverty simulation
and the attitudes of nursing students, participants provided compelling narratives highlighting a greater understanding of the
constructs of social justice; a potentially more profound purpose for this pedagogical strategy. Focus group narratives revealed
themes focusing on the concepts of professional nursing values, specifically social justice. The themes included: The American
Dream Isn’t for Everyone, Trapped in my Own Life, Completely out of Control, and It’s Just Not Enough. Findings showed that
participants experienced grave realizations regarding not only the experience of poverty, but of the widespread social norms that
contribute to injustices for a vast population in our society. This research contributes to the body of literature regarding the use
of affective learning strategies as an effective way to teach nursing professional values, such as social justice, to enhance nursing
graduates’ ability to integrate these values in their own practice.
Key Words: Nursing undergraduate curriculum, Nursing professional values, Social justice, Affective learning strategies
1 Introduction
In order to adequately prepare the nursing workforce of to-
morrow, educators must be dedicated to the importance of
emphasizing social justice as a value for graduates enter-
ing our profession. The AACN Baccalaureate Essentials
endorse altruism, autonomy, human dignity, integrity, and
social justice as the essential nursing values that “epitomize
the caring, professional nurse”.[1] There currently exists
a lack of information in the literature that establishes best
practice for educational strategies that effectively integrate
nursing professional values into nursing curriculum. The
purpose of this article is to report the qualitative findings
of a research project related to an affective learning strat-
egy. While conducting a study evaluating the effectiveness
of poverty simulation and the attitudes about poverty held
by nursing students, reflections and insights during focus
groups and participant observations provided compelling
narratives which highlighted a greater understanding of the
constructs of social justice; a potentially more profound and
unanticipated outcome of this pedagogical strategy. These
students’ voices subsequently prompted a modification to
the current curriculum to integrate affective learning strate-
gies in an attempt to address the professional value of social
justice. The goal of this curricular shift is to move beyond
∗Correspondence: Katrina Einhellig; Email: katrina.einhellig@unco.edu; Address: School of Nursing, University of Northern Colorado, Greeley,
United States.
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knowledge and comprehension of social justice with the in-
tent to foster reflection, insight and action as a professional
nurse.
Within the past decade, research has evaluated the integra-
tion of professional nursing values, including social justice,
in higher education and reports professional excellence can-
not be achieved without a strong foundation of professional
values.[2] Prior literature identified gaps in nursing cur-
riculum related to nursing professional values and the man-
ner in which this content is being addressed in baccalau-
reate nursing programs.[3] Although the concept of social
justice is found in the learning objectives of many under-
graduate nursing courses, the concern remains that students
are unable to integrate this concept when they transition to
professional practice. It is insufficient to rely on lecture-
based teaching methods to impart the gravity of social jus-
tice to nursing students; alternative pedagogical methods are
necessary to ensure students enter the professional world
equipped with professional values to manage a myriad of
challenges in the healthcare environment.
As the demographic landscape of our society has changed,
it becomes increasingly important that nurses are educated
with the necessary skills and competencies to care for a het-
erogeneous population. Nurses are challenged daily to care
for patients from diverse backgrounds. They will encounter
patient diversity reflected in age, gender, sexual orientation,
cultural and ethnic variations as well as socioeconomic sta-
tus, each with unique values, beliefs and practices. It is es-
sential to set aside personal values and beliefs in order to
provide equitable and respectful care to all patients despite
differences. Current nursing curriculum lacks the ability to
cultivate social justice as a professional standard of nurs-
ing.[4] Therefore, varied, interactive pedagogy must be de-
veloped in order to ensure that nurses are equipped to rec-
ognize systemic barriers within healthcare and advocate on
behalf of vulnerable aggregates.
Review of literature
The definition of the following terms serve as the foundation
of this literature review: professional nursing values, with a
focus on social justice, and affective learning. It is these
concepts that guide this research endeavor and provide nec-
essary guidance from which future nursing curriculum can
be developed.
Professional nursing values are the driving force behind the
ethical actions of nurses within practice. Without a clearly
defined set of values, new graduates enter the ambiguous
world of healthcare ill-equipped to face ethical dilemmas
and advocate for the well-being of patients. Under the guid-
ance of the AACN Baccalaureate Essentials, nurse educa-
tors have created undergraduate curriculum to address the
core professional nursing values. Past research has evalu-
ated the way in which nursing education has integrated these
values and found deficits in curricula[2] which ultimately re-
sulted in the lack of values development among new gradu-
ate nurses.[3]
Within the AACN Baccalaureate Essentials, there is an em-
phasis on the need for social justice as a requisite for the
professional nurse. Although the literature addresses the
essential nature of social justice as a professional nursing
value, there is widespread consensus that nursing education
is lacking in its uniformity and ability to educate gradu-
ate nurses so they can effectively operationalize social jus-
tice.[2–5] Toporek and Vaughn[6] posited that social justice
learning cannot occur without a steadfast commitment by
the faculty and can only happen “within a shared power
paradigm” (p.181). This paradigm creates a learning envi-
ronment in which the faculty does not stand at a podium and
lecture, but rather engage the students in a self-reflective,
experiential model of learning. Within these pedagogical
strategies, students must become innately aware of the in-
terconnectedness between the health issues of the local pop-
ulation and global health; they must also begin to understand
that they have the opportunity to create and implement so-
lutions to these problems as professional nurses.[7]
The use of affective teaching strategies has been shown
to improve nursing students’ understanding and applica-
tion of professional values.[8] Affective learning focuses
on values, attitudes, and behaviors through a combination
of critical-thinking, self-reflection, and evocation of emo-
tion.[9, 10] While cognitive learning focuses on facts, con-
cepts, and principles,[8] affective learning supports the inte-
gration of knowledge with emotion, beliefs, ethics, personal
awareness, and attitude.[10] Inherent in the use of affective
learning strategies, nurse educators must be aware that suc-
cessful affective learning is often accompanied by feelings
of discomfort or anxiety, and it is essential to create a learn-
ing environment in which students feel safe in emotionally-
charged learning activities.[10,11]
Outcomes of successful affective learning include self-
awareness, personal growth, emotional intelligence, acqui-
sition of a self-reflective learning process, flexibility, in-
creased coping and resolution skills, and professional bal-
ance.[12] In a study of pedagogical methods aimed at nursing
students and end-of-life care, affective activities fostered the
students’ compassion in care, and allowed students to expe-
rience a new, realistic understanding of the end-of-life pro-
cess.[10] Affective learning of complex concepts is a long-
term process that must be nurtured with care and attention.
If successful, affective learning has the potential to instill the
professional value of social justice in nursing and ultimately
improve quality of care.
Nursing education should consider the value of affective
learning strategies when creating nursing education curricu-
lum.[11, 13, 14] Doyle et al. posit affective learning impacts
student attitudes toward patient care, and attitudes influ-
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ence professional practice.[13] The increasing patient acu-
ity found in healthcare today demands advanced values-
based learning activities, with emphasis on affective learn-
ing alongside cognitive and psychomotor domains.[14] Han-
son states “Valuing spirituality, tolerating ambiguity, affirm-
ing cultural diversity, and assuming responsibility for thera-
peutic interventions are humanistic characteristics that can
be awakened in nurses through affective learning strate-
gies”.[14] Affective learning has the potential to promote
nursing professional values, such as the concept of social
justice, in nursing students and ultimately improve health
outcomes.
2 Methods
2.1 Sample
For this article, data were derived from a larger research
project of nursing students’ attitudes toward poor people.
The original research project was designed to assess the
ability of a poverty simulation to affect the attitudes of nurs-
ing students toward people living in poverty. This research
was conducted in a public university in the Rocky Moun-
tain Region with approximately 10,000 undergraduate stu-
dents. As shown in Table 1, a convenience sample of 196
undergraduate nursing students participated in the research
study. Carried out over a two year period, with four cohorts
of undergraduate nursing students, nursing students partic-
ipated in a poverty simulation in which they were asked to
live in poverty for a simulated one month time period. Ap-
proval from the University Institutional Review Board was
received prior to the beginning of data collection.
Table 1: Demographics of sample
Sample Size N = 196
Age x = 27.16 years (SD = 7.89)
Gender
Male 21 (10.7%)
Female 175 (89.3%)
Ethnicity
White 180 (92.3%)
Latino 6 (3.1%)
Black 1 (0.5%)
Asian 3 (1.5%)
Mixed (White/Latino) 3 (1.5%)
No Response 2 (1.0%)
As shown in Table 1, the sample consisted of 196 partici-
pants of varying age, gender and ethnicity.
2.2 Procedure
The Missouri Association for Community Action Poverty
Simulation was used as a learning strategy in which student
participants experience a simulated month where they began
to understand what it is like to have inadequate financial re-
sources and experience the everyday struggles and stressors
of living in poverty. Students become a member of one of
26 families for the course of the simulation experience, dur-
ing which they are expected to accomplish activities of daily
living such as maintaining employment, seeking resources,
caring for children, or shopping for food during the “month”
of the simulated experience. Families were clustered in the
center of the simulation, with various community resources
located on the perimeter of the room, and each family navi-
gated daily life with limited resources. A facilitated debrief-
ing followed the simulation. This article reports the findings
that emerged from researcher observations, field notes, and
student responses and statements during the debriefing ses-
sions that were conducted at the end of each poverty simu-
lation.
2.3 Data collection
Observations of student behaviors and interactions through-
out the simulation were recorded in researchers’ field notes
while students were engaged in the simulation. A debrief-
ing session approximately 60 minutes in duration occurred
after each simulation to provide students the opportunity to
discuss and reflect on their experiences and to explore their
reactions and feelings during the simulation. Each cohort
of students was separated into 5 groups of 8-10 people in
order to begin discussion of their thoughts and experiences
related to the simulation. Subsequently, the groups were
combined to allow for sharing of all groups’ overall impres-
sions. After reflection, students identified opportunities for
integration of their experience in simulated poverty to their
future professional nursing practice. The debriefing sessions
were guided by semi-structured questions (see Table 2) and
participant responses were hand written by the team of re-
searchers at the time of the debriefing.
Table 2: Examples of debriefing questions
Describe the experiences of your family during this month
of poverty.
Discuss the feelings you had while going through the
simulation.
How did other people respond to your needs? How did you
feel about their responses?
What insights or conclusions have you come to about the
life experiences of underserved populations?
2.4 Data analysis
Using the data from focus groups and participant observa-
tions, analysis began after each cohort of students partici-
pated in the simulation/debriefing experience. Individually,
researchers analyzed the data, highlighting significant state-
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ments within the written transcripts. Field notes were used
to give context and meaning to the data analysis. After ini-
tial compilation of those statements, the researchers devel-
oped clusters of meaning by grouping the significant state-
ments into larger themes. These themes were compared by
the researchers and evaluated until consensus of the themes
was established for each cohort. This data analysis was con-
ducted for each of the four simulation debriefing sessions,
and final themes were derived by the researchers through
combined analysis of the four sets of data.
The researchers attempted to maximize trustworthiness of
this research project by employing several techniques. To
increase credibility, the researchers fully engaged with the
participants of the study and created an atmosphere that
enhanced the participants’ willingness to share their expe-
riences. Credibility was also enhanced by the use of tri-
angulation; researchers used multiple sources of data for
their analysis including observations, field notes, and writ-
ten transcripts of the debriefing sessions. Peer debriefing
was also used to increase the assurance that findings were
plausible based on the information collected. In order to
assure confirmability of the data, the researchers also com-
piled an audit trail for the research data, including how the
data was collected, how categories were generated from the
data, as well as how decisions were made regarding themes
throughout the inquiry process.
3 Results
During the first two weeks of the simulation, students were
composed, organized and polite as they engaged in daily
living. Their children went to school; some went to work
while others sought out assistance at community agencies,
such as social services, or sold a part of their possessions
at the local pawn shop. Week three of the simulation cre-
ated an insurmountable challenge for families with school
aged children because there was a “school holiday”. With
few or no resources for child care, young children were left
at home alone; unsupervised, idle youth engaged in illegal
activities and found themselves in jail. Parents lost their
jobs due to absenteeism or lateness. Rent and utilities were
overdue; families were evicted from their homes, others had
no lights or heat. Food was scarce and children were hun-
gry. During week four, participants’ behavior and mood
changed to one of urgency, desperation and chaos. They
hurried from one resource to another, standing in long lines
only to learn there was no assistance or to be referred to
yet another agency. Anger and frustration permeated partic-
ipants’ communications and interactions. Some participants
persisted and worked through many of their challenges, oth-
ers retreated, overwhelmed by their abysmal situation. The
end of the simulation was met with great relief by the par-
ticipants. Their daily struggles and worries had ended.
Themes that emerged from participants’ experiences in the
poverty simulation demonstrated that this affective learning
strategy transformed views and thoughts regarding issues in-
herent in social justice. Researchers identified four themes:
The American Dream Isn’t for Everybody, Trapped in my
Own Life, It’s Just Not Enough, and Completely out of Con-
trol. Through their dialogue, students began to reflect on so-
cial justice as a moral imperative for the nursing profession
and shape a personal compass for understanding their role
as individuals and professional nurses in promoting equity
and justice. Qualitative statements by the participants post-
simulation emphasized the simulated experience of poverty
created profound thoughts and emotions as they navigated
the world from a different financial perspective. Participants
noted personal attributes are not always the cause of poverty.
An awareness of common struggles and stressors of those
who are poor emerged, illuminating injustice and inequality
in everyday life in our society.
3.1 The American Dream isn’t for everybody
Overall, the themes generated by these participants reflected
a new appreciation for the experience of impoverished peo-
ple and the struggles that they face living day to day. There
were moments of epiphany in which they reported a further
understanding of the realities of poverty and injustice in our
society. One participant stated:
I feel very naïve after going through this ex-
perience. I have known my whole life that, in
our society, people are either the “haves” or the
“have nots”. But I have also believed that we
lived in the land of opportunity. If you wanted
something better for yourself or your family,
those opportunities existed. But, they don’t.
Equality doesn’t really exist, and some people
will never be any better off than they are right
now. . . .and that is not fair. It is a dismal real-
ization.
Perhaps the most pervasive sentiment shared by participants
following the simulation experience was the idea that they
began to lose hope as the reality of poverty began to con-
sume them. Frustration was voiced as the participants ex-
perienced week to week losses in regard to finances, edu-
cational opportunities, and lack of support from their com-
munity. One participant made the decision to pawn his tele-
vision and stereo to ensure that he could provide food for
his family for one more week. As he walked away from
the pawn broker, he shook his head and said to the people
standing in the Pawn Shop line, “So much for the American
dream”.
3.2 Trapped in my own life
A misconception that participants may have brought with
them to the poverty simulation was the idea that there are
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personal attributes which predispose people to a life of
poverty. It may be easier to consider a person living in
poverty is lazy or lacking intelligence than it is to understand
the various societal institutions make it increasingly difficult
for a poor person to overcome financial impediments and
increase overall quality of life. One participant provided
his thoughts on the societal attributes that contributed to his
“impoverished family”:
I realized that people aren’t poor because they
are lazy, or unwilling to work. In the case of our
family, I worked and my spouse stayed home
and took care of our young children. But at the
end of the week we didn’t have enough money
to pay the bills. So, regardless of our efforts, it
didn’t matter in the end.
Participants also began to understand planning and thought-
ful consideration about their circumstances did very little
to change the end result. They could discuss the various
options that they had for “getting ahead” or “overcoming
poverty”, but often their plans were thwarted by situations
over which they had very little power.
My family had a plan in place to get ourselves
out of our financial hole, but our child was sent
home sick from school, and we didn’t have day
care. We had to choose to allow her to stay
home by herself, or for me not to go to work.
So, I didn’t go to work. After a day or so, I
got fired. Then, there wasn’t much we could
do. . . .we were stuck. We had no money to pay
our mortgage, our utilities, and eventually we
started pawning stuff so we could eat. I can’t
imagine how trapped people feel in their own
lives.
3.3 It’s just not enough
The participants emphasized that the various resources
available to them throughout the simulation experience were
inadequate to help them overcome their poverty state. One
participant stated that she needed, “more money, more time,
and more people that cared” if she ever hoped to “leave
poverty in the rearview mirror”. At the beginning of the
poverty simulation, students were introduced to the various
institutions around the room that exist to provide assistance
for them throughout the experience. A participant shared
her perspective on the resources available for the poor:
As I looked around the room, we were told that
there were many agency resources to assist us
throughout the simulation. But, I also knew that
the Pawn Shop and Quick Cash locations were
not really there to help us. They are predators
and we (poor people) are perfect targets.
Another participant discussed her frustrations at the attitude
of the people she encountered throughout her experience:
The person at the bank was arrogant and con-
descending. I didn’t feel as if he cared about
me at all. He stood there looking at me with
that smug look on his face and I wanted to yell
at him, but I knew it wouldn’t do me any good.
It was almost worse talking with the social ser-
vices representative. Her job is really to help
people and create more opportunities for us, but
she seemed clueless as how to do that.
Participants also discussed time as a commodity in their
daily lives within this experience. Each week did not pro-
vide them ample opportunity to accomplish the various tasks
they felt were necessary in order to stabilize their financial
situation. One student explained:
I spent almost the entire day waiting to meet
with the social service representative. I felt like
she was my last hope to get more food stamps,
or something that would help my family. When
I finally got a chance to talk with her, she said
she could give me $38. It was ridiculous. How
long do you think $38 is going to feed a family
of five people? I thought it was a huge waste of
my time.
Another participant discussed that it felt like a “pressure
cooker” within the room as the poverty simulation pro-
gressed. He felt time was his greatest need, but there was
“no way to increase the minutes in a 24 hour day”. He said:
The first week, we were fairly relaxed because
we didn’t really know what we were doing. By
the third week, I literally ran to the Community
Action Agency. I probably looked stupid, but I
didn’t care because I knew I wanted to be first
in line. It was the only way that I was going to
have time to get everything done I needed to in
order to feel some level of success.
An additional resource that participants perceived as a ne-
cessity was the idea of education as a way to create more
opportunities. They understood being educated helped them
in devising plans that ensure success in overcoming poverty.
They also began to see education as difficult to achieve for
people living in poverty because it is often “given up” in the
process of “surviving”. One family had a college student at
the beginning of the simulation and said,
Our oldest ‘daughter’ started out going to col-
lege for the first few weeks, but we soon real-
ized that this was a luxury that we could not af-
ford. We completely understand the importance
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of education, but we couldn’t make it happen.
As soon as we figured out that we couldn’t fi-
nancially get by without her help, she had to
drop out of school to start babysitting other
simulation children so that we had a little ex-
tra money. It is defeating to know that educa-
tion was something that she would need to get
ahead, but yet we couldn’t figure out a way to
make it happen.
3.4 Completely out of control
The final theme that emerged was the array of emotions
elicited through this simulation experience. Most of the par-
ticipants voiced at least some degree of uncertainty, skep-
ticism, or confusion throughout the simulation. Some de-
scribed these emotions becoming even more heightened as
the simulation experience progressed, and they began to
doubt whether or not they would be successful in their
ability to financially support their family. One participant
laughed as she said,
We were completely out of control for the first
two weeks. We were disorganized in our ef-
forts. I didn’t make it to work, so I got fired.
My child only made it to school one day. We
weren’t exactly sure what to do. We went from
resource to resource, trying to figure out where
we could get assistance. It felt like an exercise
in frustration.
Another participant echoed her remarks:
I stood in line at Social Services for half the
day, and when I finally got to talk with the rep-
resentative, she informed that there was very
little that she could do for me. It was frustrat-
ing. I could actually feel myself getting angry,
and then had to remind myself that it wasn’t
real.
Finally, participants voiced a sense of desperation when they
realized they could not readily change their circumstances.
One student stated,
There was a sense of doom and gloom as we
neared the end of the month. We just sat in
our ‘house’ and tried to figure out some way to
dig ourselves out of this financial hole. We dis-
cussed several options, but you could tell that
we didn’t even believe things were going to get
better. So, we entered the last week with a sense
of apathy because we were not going to change
our circumstances and we had given up.
The themes that emerged from debriefing provide rich infor-
mation about participants’ perceptions of this poverty ex-
perience and the potential of this teaching strategy to im-
pact knowledge regarding poverty, but also a more profound
understanding of the underlying concepts of social justice.
While going through this experience, participants expressed
an affective component of simulation that allowed them to
empathize more closely with people that suffer from dispar-
ities and injustice.
4 Discussion
One of the difficulties in teaching social justice concepts
within nursing education is the dearth of literature available
regarding effective pedagogy that support the development
of social justice thinking in nursing graduates. Although
the AACN Baccalaureate Essentials[1] have identified social
justice as one of five professional values, the development
of curricula that integrates this value has been slow to de-
velop. The question remains as to the best teaching strate-
gies to foster the growth of social justice as a key concern for
nurses throughout their professional practice. Based on the
information gleaned from the current study, the researchers
sought to develop new pedagogy that has a greater potential
to assist in the development of social justice as a profes-
sional nursing framework as well as educate nursing gradu-
ates with the necessary advocacy skills to make a difference
for vulnerable populations.
The first step in renewing the commitment to a social jus-
tice paradigm is a frank assessment of how and where infor-
mation is in nursing curriculum. It is inadequate to merely
discuss or define the concept of social justice within one
particular course in a nursing program; this approach is inef-
fective at instilling the ultimate importance of this key lead-
ership construct in nursing students. Rather, social justice
should be integrated as a threaded concept throughout every
semester of the nursing curriculum. In this manner, students
are introduced to social justice early in their nursing edu-
cation, with increasing opportunities for affective learning
and professional nursing development with each subsequent
semester of the program. This important endeavor cannot
proceed in a haphazard manner; careful consideration and
planning must take place prior to curricular modification.
The implementation of varied pedagogy is essential in en-
hancing social justice content within nursing programs. The
literature demonstrates that traditional lecture is inadequate
in cultivating social justice in nursing graduates. Affective
learning strategies have potential for creating new nurses
who grasp the essential nature of social justice for our so-
ciety, as well as prepare them to advocate for the necessary
changes within healthcare systems and the political arena.
Affective learning strategies have a greater propensity to-
ward fostering personal growth and self-reflection for indi-
vidual students. Affective learning strategies are effective
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and successful in learning environments in which students
perceive safety in voicing their beliefs, without fear of judg-
ment. A potential strategy with beginning nursing students
is the use of a “Media Blitz” exercise where students are ex-
posed to pop culture movie clips that portray injustices in
society. The students are asked to view select scenes from
various movies with social injustice represented and then
discuss the emotions that are conjured up while watching
these scenes. They are then asked to reflect how these injus-
tices align with the realities of our culture.
With each subsequent semester, students can be further im-
mersed in the concept of social justice. This professional
nursing value should be incorporated in every course across
the curriculum. Social justice elements can be integrated in
a medical-surgical high fidelity patient simulation and de-
briefing. Within public health courses, the poverty simula-
tion is a valuable tool in creating greater empathy in nursing
students and raising collective awareness of social justice as
a professional imperative. Clinical faculty also plays a key
role in highlighting injustices inherent in healthcare during
post-clinical conferences. Students can be encouraged to
reflect on the inequities they see in their everyday interac-
tions with patients and examine their own beliefs and bi-
ases. Clinical educators must mentor advocacy for patients
and raise awareness of systemic barriers that influence the
health status of patients. Regardless of the patient care en-
vironment in which they are practicing, students must be
encouraged to think beyond the individual patient, to focus
on the potential for their leadership to improve the systems
that contribute to health disparities for so many.[4] There
are innumerable opportunities for social justice integration
in nursing curriculum.
The findings of this investigation provide strong evidence
about the effectiveness of one affective learning strategy; the
Missouri Association for Community Action Poverty Simu-
lation fostered the potential to change nursing students’ per-
ceptions and attitudes regarding the persistent and pervasive
inequities in society, and shape their roles and practice as
future nurses. This affective learning experience stimulated
reflection by the students in which they expressed power-
ful emotions and feelings. These insightful student voices
enlightened and prompted nursing faculty to explore and
incorporate course specific affective learning strategies re-
garding social justice issues across the curriculum. Future
research must evaluate the effectiveness of affective strate-
gies in fostering, not only social justice awareness, but also
the perceptions of nursing graduates that they can make a
difference; with the ultimate goal that they will enter prac-
tice prepared to advocate for patients.
5 Conclusion
Implications for nursing practice
Findings from this research provide nurse educators with
an understanding of the need to critically examine under-
graduate nursing curriculum related to social justice. It is
necessary to assess baccalaureate nursing education and de-
termine the adequacy of emphasis on the integration of in-
formation to create a social justice framework for nurses.
This appraisal of curriculum should also examine the ped-
agogical strategies employed to teach this content with an
understanding traditional lecture is insufficient when teach-
ing these essential professional nursing concepts. Teaching
strategies must facilitate integration of social justice in the
thoughts and actions of new nursing graduates.
Affective learning strategies provide the optimal pedagogy
to evoke emotions that foster empathy for social injustice
and human inequities. These strategies create an environ-
ment in which students not only learn about the constructs
of social justice, but they also are able to incorporate these
into their own values and beliefs and apply those princi-
ples in their daily interactions as a professional nurse. Fu-
ture research should measure the ability of affective learning
strategies to foster a social justice platform by which new
graduates base their professional actions. The ultimate ob-
jective should not only be on the development of knowledge
related to social justice, but also focus on the application of
social justice in the practice setting.
As healthcare reform moves forward, it is imperative that
we educate the next generation of nurses to be proponents
for the marginalized of our society. Nursing students enter
the professional world with an opportunity to provide advo-
cacy one patient encounter at a time. Further these future
nurses must be prepared to guide policies to promote a just
society with equity in opportunities for health and quality
of life for all. Nurses are poised to push the social justice
agenda forward, but only if they are provided with the nec-
essary education and experience to overcome the realities of
healthcare and inequities of society. With a renewed com-
mitment to social justice, nurse educators have the potential
to instill nursing students with the necessary skills and com-
mitment to fundamental human rights and enrich the future
practice of tomorrow’s professional nurses.
Acknowledgements
We would like to acknowledge and thank Rose Macalister,
Graduate Assistant, for her extraordinary contributions for
a successful launching of the poverty simulation and her as-
sistance with other aspects of this project. Also, we thank
the University of Northern Colorado - School of Nursing for
the support of this project.
Published by Sciedu Press 127
www.sciedu.ca/jnep Journal of Nursing Education and Practice 2015, Vol. 5, No. 1
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