The purpose of this concept analysis is to examine the concept of preparedness as it relates to curricular changes in nursing education. Interest in preparedness as a concept evolved as the author began studying the barriers related to the inclusion of lesbian, gay, bisexual, transgender, and queer (LGBTQ) education inclusion in undergraduate pre-licensure nursing curricula.
There are a variety of quantitative and qualitative studies done via survey tools that examine nursing students and faculty attitudes, beliefs, and readiness to care for LGBTQ individuals. In one study, 62 percent of nursing students reported that they had the knowledge to care for LGBTQ patients but 85 percent reported that their education had not prepared them enough (Carabez, Pellegrini, Mankovitz, Eliason, & Dariotis, 2015). This suggests that the content, if any, that is being included in curricula is not adequate in preparing students for culturally sensitive care. According to the Institute of Medicine (IOM) (2011) nursing education has a mandate to prepare students with competencies that allow them to provide culturally sensitive care and considers the needs of the LGBTQ community a health priority, which in this case would imply the inclusion of LGBTQ health in curricula. Developing curricula that adequately addresses the diverse needs of this population is important in addition to the knowledge of nursing faculty and their readiness to include this content into nursing education (Lim, Johnson, & Eliason, 2015).
Much of the literature that discussed barriers to LGBTQ inclusion described nursing faculty and nursing students who lacked preparedness, readiness, and willingness to include. The vagueness and equivocation of these concepts makes it difficult to analyze what the true meaning of preparedness might be. To produce conceptual clarity of preparedness, it is critical to examine the use of this concept in an analysis of use throughout varying contextual settings.
This analysis investigates the concept of preparedness from within education, nursing, business and economics, and allied health literature. From this, a derived definition of the concept is developed and applied to the preparedness to include LGBTQ education in nursing curricula.
Methods:
The concept of preparedness was analyzed using Rodgers’ evolutionary view (Rodgers & Knafl, 2000) methodology of concept analysis. A literature database search was completed within Education Resources Information Center (ERIC), Cumulative Index of Nursing and Allied Health (CINAHL), and Business Source Elite (BSE) using the search term preparedness. From this search, the first ten full-text available articles were chosen from each discipline, based on their abstracts, for a total of forty articles from the year 2005, to currently published literature.
Results:
A search was conducted in the ERIC database using the search phrase preparedness to teach, which resulted in 58 full-text articles. Within the education literature there was a variety of articles that looked at preparedness in different aspects such as preparedness of educators to teach different courses, different student populations, diverse students, and in different countries.
Two searches were done using the CINAHL database within both nursing and allied health literature. The search of preparednesswithin nursing literature focused primarily on publications within nursing journals and produced 725 articles. Nursing literature uses the concept of preparedness in diverse contexts ranging from disaster preparedness, patient and caregiver preparedness, disease outbreak, staffing and management, and school nursing. Additionally, the search within allied health literature resulted in 278 titles that contained the search term preparednessand therapy. Journals within physical therapy, occupational therapy, and athletic training were selected. Of the ten articles selected, three each were in physical therapy and athletic training and four were in occupational therapy literature. The use of preparedness across the literature was used to describe preparedness to practice in all three disciplines, but also emergency preparedness within physical and occupational therapy literature.
Business and economics literature was reviewed to achieve a different perspective of the conceptual use of preparedness. Within the BSE database, the search term preparednesswas used, resulting in 355 articles. In business and economics literature discussing preparedness, most of the focus was on disaster preparedness in varying contexts such as financial loss and gains, supply chain disruptions, funding, production and inventory, and natural disasters or human created disasters.
When breaking down the concepts as a whole across the evaluated disciplines there are some commonalities and trending areas that will help define the concept for the contextual use within preparedness to include LGBTQ education in nursing curricula. Based on this analysis across this selection of literature, an empirical conceptual definition of preparedness can bedescribed as drawing from prior knowledge and experiences to maintain situational awareness while being resilient and confident in responding. Related concepts seen across disciplines included both awareness and readiness. Antecedents and attributes related to preparedness displayed cohesion across disciplines, and was described well when Guardino (2015) stated preparedness is promoted by education, competence, and effectiveness in addition to Nash (2015) describing preparedness as a continuous cycle of planning, organizing, training, equipping, exercising, evaluating, and taking corrective action. The consequences of preparedness are comfort in practice, resilience, practical understanding, situational responsiveness, and reactionary awareness.
Conclusion:
This concept analysis of preparedness can be applied to nursing education, as it definitively shows the antecedents that are necessary for nursing preparedness to occur, whether it is students or practicing nurses. Achieving preparedness has a strong dependence on education, knowledge development, training, experiences and orientation. Maintaining preparedness is necessary for nursing faculty to teach LGBTQ health content in nursing curricula as well as students and future nurses being prepared to learn and care for LGBTQ patients and assist in decreasing the health disparities that face the LGBTQ population.