The Globally Competent and Critically Digital Nurse: Preparing for Evolving Healthcare Realities

In today's world, whether you are managing patient care in a busy hospital or simply trying to understand the latest viral health trend, navigating complexity is essential. The future of any profession, especially one built on trust and critical thinking like nursing, demands skills that go far beyond traditional knowledge. It requires Critical Digital Literacies (CDL) and Global Competence (GC).

These concepts, originally developed within educational frameworks like teacher certification redesign in Ontario and the OECD’s global assessment for young people, offer crucial insights for transforming how we educate both student nurses and experienced healthcare professionals.

Part 1: The Digital Nurse: From Consumer to Creator

For too long, being "digitally literate" simply meant knowing how to use a computer. But in the 21st century, literacy and mastery over the processes by means of which culturally significant information is coded. This fundamentally changed learning.

Digital Literacy (DL), a concept widely explored in educational literature (Bawden, 2008), emphasizes navigating technologies. However, the modern nurse must embrace Critical Digital Literacy (CDL) (Bacalja et al., 2021). CDL is not just about using technologies. It involves an analysis and critique of the epistemic relationships among texts, language, social groups, and social practices when using digital tools.

In nursing education, this means going beyond learning how to input data into an Electronic Health Record (EHR). It means ensuring that nurses, who are entering a wired job market where competencies in technology are not merely suggested skills but rather baseline requirements, This ensure tht they are equipped to manage and critically evaluate the vast amount of digital information they encounter.

For Student Nurses (Post-Secondary Education):

Beyond Consumption:
Students must be trained as producers, not just consumers, of digital media. This includes creating patient education materials, utilizing open-source e-learning applications, or even analyzing the ethics of of these digital technologies in health compliance.

Troubleshooting and Confidence:
Educators in other fields have noted that students, even "millennials," are often "alarmingly afraid" of learning new online and offline programs, lacking the confidence to troubleshoot technical issues. Nursing programs should move towards approaches that foster independent problem-solving regarding hardware and software, viewing "mistakes" as part of the learning process.

Critical Evaluation:
Given that access to an unlimited amount of information is often paired with insufficient media literacy, nursing students must be taught how to evaluate the worth, validity, and reliability of online health information, social media trends, and academic research. A core course grounded in CDL pedagogy would challenge assumptions and practices when using digital technologies in
the learning process.

Part 2: The Globally Competent Caregiver

Nursing, whether local or global, is inherently concerned with human issues like poverty, inequality, mental health, and migration. This is why Global Competence (GC) is a necessity. GC is defined as the capacity to examine local, global, and intercultural issues, understand and appreciate different perspectives and world views, interact successfully and respectfully with others, and take responsible action toward sustainability and collective well-being.

For All Nurses (Student and Hospital Settings):
Examine Global and Intercultural Issues:
Nurses must connect local patient situations to broader global patterns. For example, a nurse examining a community health issue should draw on knowledge related to socio-economic development, environmental sustainability, and global health concerns (like epidemics). Critically analyzing how research is funded (e.g., potential "funding bias" in studies sponsored by industry) is a crucial skill for evidence-based practice.

Understand and Appreciate Different Perspectives:
Healthcare professionals regularly interact with diverse populations influenced by unique cultural, religious, and socio-economic contexts. GC requires the capacity to identify and take on conflicting points of view, recognizing that one's own perspective is shaped by cultural affiliation. This capability is vital in avoiding generalizations and stereotypes about patient populations, which can often be driven by "single stories" or prejudice.

Engage in Open, Appropriate, and Effective Interactions:
Nurses need strong intercultural communication skills, including adaptability. When dealing with diverse patient populations or working within multicultural hospital teams, success hinges on the capacity to adapt one’s thinking and behaviours to prevailing cultural environments and recognize communication nuances like non-verbal cues or use of silence. Role-playing and scenario-based learning are encouraged methods for developing GC. They are effective strategies for practicing communication and conflict resolution in nursing education.

Take Action for Collective Well-being:
Globally competent individuals are ready to take informed, reflective action toward sustainable development. In a hospital setting, this translates to advocating for the vulnerable, promoting equitable practices (especially concerning issues like mental health), and contributing to solutions that improve local and global living conditions. All these strategies help with the Social Determinents of Health.

Part 3: Integrating Advanced Literacies into Nursing Education

Redesigning education to include these literacies requires significant shifts, modeling key elements of education at the edge of innovation.

In Post-Secondary Nursing Programs:

The curriculum should be grounded in problem-based inquiry and be constructivist in nature, utilizing online tools for collaboration and knowledge sharing. Specific pedagogical approaches identified in global competence frameworks can be adapted:

Scenario-Based Assessment: Using complex scenarios based on real-life global or intercultural issues (e.g., patient cases involving migration health, environmental risks, or cross-cultural communication breakdowns) can assess students’ capacity to apply knowledge and skills. Integrated Learning: Following models of successful program redesign, courses should integrate topics like Mental Health (which directly impacts student performance and requires specialized knowledge regarding assistive technologies) and digital technologies to foster literacy.

Creating Safe Spaces: Schools must provide a safe space where students can explore complex and controversial issues, developing critical thinking and ethical frameworks grounded in human dignity and rights.

In Hospital/Continuing Professional Development (CPD):

Nurses in practice require continuous development focused on these advanced skills.

Professional Learning Communities (PLCs): PLCs can be highly effective in engaging educators (nurse leaders, preceptors) and facilitating peer learning on integrating global and intercultural topics into daily practice.

Addressing Cultural Bias: Training must help nurses acquire a critical awareness of their own cultural lens and biases, focusing on how to overcome the common tendency to ignore troubling issues such as inequities, injustices and oppression in favour of "safe" topics like customs and cuisine.

Adaptability and Communication:

Dedicated training modules focused on adaptability and respectful communication in cross- cultural interactions (Dimension 3 of GC) should be mandatory, perhaps using methods like Story Circle approach or role-playing complex conflict scenarios.

By embracing Critical Digital Literacies and Global Competence, nursing education prepares professionals who are not only clinically skilled but also critically engaged citizens, ready to meet the complex health challenges of our interconnected world.

Personal Reflection 

Therefore, how can a nurse educator’s real-world experience in clinical care influence the way Critical Digital Literacies (CDL) and Global Competence (GC) are taught in both post-secondary nursing programs and hospital settings, especially as nurses navigate technology, ethics, and cultural diversity in patient care?

In today’s healthcare environment, nurses must be able to navigate constant change, whether that means managing patients with complex needs in a fast-paced hospital or sorting through the latest online health information that patients bring into the conversation. My nursing experience has shown me that technical skills alone are never enough. The ability to think critically, use technology responsibly, and approach patients with cultural humility are just as important as knowing how to start an IV or interpret a lab result.

In the classroom, I’ve seen how student nurses often arrive digitally connected but not digitally critical. Many can scroll endlessly through social media, but they struggle to assess whether an online health claim is credible. When I introduce Critical Digital Literacy into my teaching, I draw from clinical examples. For instance, I once cared for a patient who stopped taking their medication after reading misleading information on social media. Sharing this story helps students understand that digital misinformation can directly affect patient safety. From there, I guide them in evaluating sources, recognizing bias, and even creating their own evidence-based digital content, such as short videos or patient education infographics. This transforms them from passive consumers of information into active, ethical creators of knowledge.

Global Competence naturally connects to this work because nursing is about people, not just processes. My clinical experience with culturally diverse patients constantly reminds me that empathy and adaptability are essential. I remember working with a newcomer family whose health beliefs and communication styles differed from what many staff were used to. It took patience, open dialogue, and cultural awareness to provide effective care. Bringing these stories into class discussions helps students see that healthcare is not only local, it’s global. It challenges them to consider how culture, equity, and access shape every patient interaction.

In the hospital setting, the same principles apply. For example, during a staff debrief after a challenging shift in the ICU, digital storytelling can help nurses reflect on how technology influenced their decisions or communication. When I facilitate these sessions, I ask questions like, “How did the monitor data shape your judgment?” or “Whose perspective might have been missed?” This process builds both CDL and GC by encouraging reflection, teamwork, and ethical awareness.

Ultimately, my experience in both education and clinical leadership has shown me that these literacies are inseparable from compassionate care. By modeling curiosity, humility, and adaptability, educators can help nurses see that technology and global awareness are not only add-ons to nursing.

References

Bacalja, A., Aguilera, E., & Castrillón-Ángel, E. F. (2021). Critical digital literacy. In The handbook of critical literacies (pp. 373-380). Routledge.

Bawden, D. (2008). Origins and concepts of digital literacy. In C. Lankshear & M. Knobel (Eds.), Digital literacies: Concepts, policies and practices (pp. 17–32). Peter Lang Publishing.

Hughes, J., Laffier, J., Mamolo, A., Morrison, L., & Petrarca, D. (2015). Re-imagining pre- service teacher education in Ontario, Canada—A journey in the making. Conference Paper.
https://www.researchgate.net/publication/277947837 

OECD. (2018). Preparing our youth for an inclusive and sustainable world: The OECD PISA global competence framework. OECD Here is a conceptual diagram representing "The Globally Literate Nurse: Intersecting Competencies," designed as a multi-layered visual to show the merger of Critical Digital Literacy (CDL) and Global Competence (GC) as essential for modern nursing.