Reflection on 21st Century Competencies in Nursing Education
As a reflective practitioner in nursing, understanding and applying contemporary educational frameworks is essential to preparing future generations of healthcare professionals. The OECD PISA (2018) Global Competence Framework, the University of Ontario Institute of Technology (UOIT) pre-service teacher education redesign, and the conceptual framework of Critical Digital Literacies (CDL) collectively offer transformative insights into the pedagogical and curricular evolution required for modern education. Together, these sources emphasize the integration of critical thinking, digital fluency, and social justice which are cornerstones of a nursing profession equipped to navigate the complexities of today’s healthcare landscape.
The OECD Global Competence Framework
The OECD’s PISA Global Competence Framework defines global competence as a multidimensional ability that enables individuals to examine local, global, and intercultural issues. It also helps with the understanding and appreciation of diverse perspectives and encourages respectfully interactions with others. This ensures that people take responsibility for sustainable the collective well-being of others. The framework outlines four core dimensions supported by key knowledge (e.g., global health, migration, intercultural relations), skills (e.g., reasoning with information, perspective-taking, conflict resolution, adaptability), attitudes (e.g., openness, respect, global-mindedness), and values (e.g., human dignity, cultural diversity).
The OECD asserts that schools play a central role in cultivating these competencies by developing citizens capable of living harmoniously in multicultural societies, contributing meaningfully to an evolving global workforce, and advancing the United Nations’ Sustainable Development Goals (SDGs). In nursing, this translates to the ability to address global health disparities with cultural humility and ethical awareness, positioning nurses as both caregivers and advocates for planetary health.
Critical Digital Literacies and the Role of Technology
Bacalja, Aguilera, and Castrillón-Ángel (2021) describe Critical Digital Literacies as practices that interrogate issues of power, representation, and agency while examining the social implications of digital technologies. Grounded in critical literacy traditions, CDL challenges educators and learners to consider how computational systems and algorithms can perpetuate inequality, racialization, and bias. The framework also addresses structural inequities, such as the digital divide, urging educators to cultivate critical digital awareness even amid unequal access to technology.
For nurses, CDL provides a lens through which to critically evaluate digital health tools, from electronic health records (EHRs) to AI-based clinical decision systems, and to recognize the ethical and equity implications of data use. In doing so, it transforms nurses from passive users of technology into critical agents who safeguard patient welfare within a digitally mediated healthcare ecosystem.
Lessons from the UOIT Teacher Education Redesign
The UOIT teacher education redesign, articulated by Hughes, Laffier, Mamolo, Morrison, and Petrarca (2015), offers a compelling model for educational innovation. Their reimagined program embeds digital pedagogy and social equity throughout the curriculum, integrating Critical Digital Literacy principles into core courses such as Mental Health and Pedagogy of the Land. These additions, along with an extended practicum, reflect a shift toward producing educators prepared to address complex societal and technological challenges.
This model translates effectively to nursing education. Embedding mental health training, reflective practice, and extended clinical placements mirrors UOIT’s holistic approach and aligns with the nursing profession’s focus on person-centered care. By explicitly connecting CDL and global competence, nursing programs can equip graduates to think critically, act ethically, and teach patients and peers to navigate health information responsibly.
Implications for Nursing Education and Practice
Applying these frameworks to nursing education redefines what it means to prepare competent practitioners. In post-secondary programs, fostering global competence involves integrating global health topics, such as epidemics, migration, and environmental determinants of health. In this process, communication, ethical reasoning, and cross-cultural collaboration skills are developed. Nurses must learn to engage in perspective-taking, conflict resolution, and cultural humility, moving beyond tokenistic approaches to diversity toward genuine intercultural understanding.
Simultaneously, embedding Critical Digital Literacies ensures that nurses can evaluate and produce digital content ethically and effectively. They should be equipped to identify misinformation, critique digital health platforms, and advocate for equitable access to reliable resources. In practice, this extends to using technology for mental health support, patient education, and advocacy, while remaining mindful of data privacy and digital ethics.
In hospital environments, these competencies become essential for safe, inclusive, and sustainable care. Nurses interact daily with diverse populations and advanced digital systems, from EHRs to telehealth technologies. Global competence supports respectful, empathetic care across cultures, while CDL empowers nurses to question how data systems shape decisions and patient outcomes. By recognizing digital inequities, nurses can adapt education and communication strategies to ensure all patients receive equitable care.
Conclusion
Collectively, the OECD framework, the UOIT redesign, and the CDL model establish a blueprint for transformative nursing education, one that integrates global citizenship, ethical technology use, and critical reflection. Nursing education must evolve beyond procedural instruction toward cultivating critically engaged professionals capable of navigating and shaping the sociotechnical systems of healthcare. Through these frameworks, nurses become not only providers of care but also architects of a more equitable, informed, and compassionate healthcare future.
My experience as a nurse and educator has shown me that caring for people is no longer limited to the bedside or even to the hospital walls. It now extends into global networks of information, technology, and culture. I’ve seen firsthand how the ability to think critically, communicate across differences, and question the influence of technology has become just as vital as clinical skill. The OECD’s Global Competence Framework, the University of Ontario Institute of Technology’s teacher education redesign, and the principles of Critical Digital Literacies all speak directly to these realities in nursing.
In the classroom, I often notice that nursing students are deeply empathetic but not always globally aware. Many have not considered how issues like climate change, migration, or global disease patterns influence the patients they see locally. To bring these concepts to life, I use real examples from my own practice. For instance, I once cared for a patient who had recently immigrated to Canada and struggled to access health information in their first language. Discussing this experience with students opens meaningful conversations about global health inequities, cultural humility, and communication barriers. It also encourages them to think about their role not just as caregivers, but as global citizens contributing to equitable healthcare.
The same kind of reflective teaching applies when addressing technology and Critical Digital Literacies. I recall a time when a patient came into the emergency department convinced they had a serious illness based on what they’d read online. The information they found wasn’t completely wrong, but it was taken out of context and amplified by algorithms that reward fear and emotion. I now use this story in class to help students analyze digital health content critically, exploring who creates it, what biases exist, and how it can shape patient behaviour. This type of activity aligns closely with the UOIT model of embedding critical literacy into every subject, connecting technology use directly to professional ethics and patient education.
In clinical practice, global competence and digital literacy merge every day. During the COVID-19 pandemic, I watched nurses from many backgrounds collaborate using telehealth platforms to manage patient care while also trying to protect their own families and communities. It made me realize that global competence isn’t theoretical, it’s lived. It shows up when nurses adapt to patients’ cultural needs, negotiate language barriers, or reflect on how their decisions impact others far beyond their local unit. These experiences now inform how I guide continuing education sessions for hospital staff, where we explore how technology and culture intersect in care delivery.
In these sessions, I also highlight ethical dilemmas around data use and digital documentation. Nurses often assume that electronic records are neutral tools, but they’re not. The data we enter can be repurposed for analytics or research in ways we don’t always control. Understanding this complexity gives nurses agency and awareness. They begin to see themselves as active participants in how digital systems shape healthcare policy and equity.
From my perspective, integrating these frameworks into nursing education and hospital learning is about nurturing both competence and conscience. Nurses must be able to navigate technology confidently, communicate across cultures respectfully, and question systems that may reinforce inequity. By sharing real stories and examples from practice, educators can bridge theory and reality, helping students and professionals see how global competence and digital literacy directly affect patient care.
In the end, the goal is to prepare nurses who are not only skilled in procedures and technology, but also grounded in ethics, empathy, and awareness of the world they serve. This combination of humanity and critical thinking, is what truly defines a nurse in the digital and global age.
Bacalja, A., Aguilera, E., & Castrillón-Ángel, E. (2021). Critical Digital Literacy. In JZ Pandya (Ed.), R Mora (Ed.), J Alford (Ed.), N Golden (Ed.), & R De Roock (Ed.), The Handbook of Critical Literacies (Vol. 1, pp. 373-380). Routledge.
Hughes, J., Laffier, J., Mamolo, A., Morrison, L., & Petrarca, D. (2015, January). Re-imagining pre-service teacher education in Ontario. Conference Paper.
Organisation for Economic Co-operation and Development (OECD). (2018). PISA 2018 Global Competence Framework.
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