Canadian Journal of Nursing Informatics

Where is Nursing Informatics in Undergraduate Nursing Education?

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by Thomas Pilarski, RN, BA, BScN, MN(c)

Princess Margaret Hospital
University Health Network, Toronto, Ontario

MN University Studies:
Lawrence S. Bloomberg Faculty of Nursing
University of Toronto, Toronto, Ontario


The recent information technology revolution in healthcare has created demand for nurses with sound knowledge of Nursing Informatics (NI), however, many undergraduate nursing schools across North America do not offer sufficient informatics education. This could be attributed to the fact that many nursing faculty members have limited NI knowledge, therefore, they pass the knowledge gap on their students. This paper discusses several barriers associated with implementation of essential NI competencies into undergraduate nursing curricula across North America. It also provides valuable approaches based on scholarly evidence that nursing schools and regulatory bodies could utilize to decrease the gap between the actual need for NI proficient nurses currently entering healthcare industry and the actual state of undergraduate NI education at many nursing schools.

An appropriate integration of NI competencies into undergraduate nursing programs could decrease the significant NI knowledge gap between formal nursing education and the needs of the healthcare system. In addition, it could improve expert decision making and clinical reasoning of new nursing graduates, increase nursing work efficiency, improve nurses’ collaboration with other healthcare professionals, reduce clinical errors, and improve the quality of patient care. Keywords: nursing, healthcare, informatics, undergraduate, education, nursing informatics, healthcare informatics, nursing education, undergraduate education, nursing program, undergraduate program, college, university


The information technology revolution is changing the way nurses provide patient care within healthcare organizations across North America. Most healthcare organizations already have implemented sophisticated Hospital Information Systems (HIS) to improve quality and efficiency of patient care and reduce the number of care related errors (Fetter, 2008). The demand for nurses with sound knowledge of Nursing Informatics (NI) constantly increases but many undergraduate nursing schools in North America do not offer sufficient education in informatics as part of their curriculum (Nagle & Clarke, 2004). Staggers, Gassert & Curran (2002) developed a comprehensive set of NI core competencies that could be used to successfully implement informatics education into undergraduate nursing curricula. In addition, the Canadian Nurses Association (2006) expects nursing schools across Canada to incorporate standard NI competencies into their nursing programs. These competencies should include the following:

  1. Basic computer literacy, such as using data management software, email, and other software used to administer, communicate, and document data (Ornes & Gassert, 2007).
  2. Information literacy, including the ability to recognize the need for specific information, locate, retrieve, and analyze the information and interpret it in relation to evidence based practice (Smedley, 2005).
  3. Nursing informatics literacy, including proficiency with nursing informatics applications to interpret clinical information pertaining to patient care, knowledge of nursing data sets, and issues of confidentiality, privacy, and security of patient information (McNeil et al., 2005).

Proficiency in NI should be required from all new nursing graduates. Even though, most healthcare employers across North America expect new nurses to be proficient in NI competencies, new graduates have a limited knowledge about nursing informatics acquired from their respective nursing schools (Ornes & Gassert, 2007). The fact is that many nursing schools do not offer NI education at the undergraduate level and only few schools provide an elective informatics course that many nursing students choose not to take during their studies (Maag, 2006; Thompson & Skiba, 2008). Why is it so difficult to incorporate NI education into existing undergraduate nursing programs? First of all, the lack of undergraduate NI education could be attributed to the fact that many nursing faculty members have limited NI knowledge, therefore, they pass the knowledge gap on to their students (Chastain, 2002; McNeil et al, 2005). To fix this problem, nursing teachers should improve their NI knowledge and incorporate NI competencies into their courses (McDowell & Ma, 2007).

However, this is not an easy task to accomplish because many nursing teachers misinterpret the real meaning of NI. For instance, they believe that knowing how to use computers is the same as being proficient in NI (Thompson & Skiba, 2008). Unfortunately, this misinterpretation is similar to “believing that you are a musician because you know how to play the radio” (Thompson & Skiba, 2008, p. 317). In order to solve this issue, nursing schools should develop a specific approach to improve the NI expertise of their faculty members, which could include participation in various NI workshops, consultations with one another about the assignments for particular NI competencies, and utilization of NI guest instructors (Booth, 2006). Moreover, nursing schools should hire at least one NI faculty expert who would lead other nursing instructors in the quest to improve their NI skills (McNeil et al, 2005).

The schools should also implement NI practice component into evaluations of nursing teachers, which would encourage them to incorporate NI competencies in the curriculum and transform the way they teach nursing students (Ornes & Gassert, 2007). In addition, the accrediting agencies should require all undergraduate nursing schools to establish a national nursing curriculum that would incorporate standard NI competencies. This could help to decrease the gap between actual nursing practice and NI education (McNeil et al, 2005). After addressing the NI knowledge gap of faculty members and implementing NI competencies into undergraduate nursing curricula, schools could start administering information technology skill testing to all newly admitted nursing students. This test would assess the students’ basic levels of computer literacy (Maag, 2006). It would also allow faculty members to modify their teaching methods and program content to accommodate the changing needs of students (McDowell & Ma, 2007).

In addition, nursing schools should offer a mandatory NI course at the beginning of all undergraduate programs that would teach students the NI competencies required in their future nursing practice (Maag, 2006). Furthermore, teachers of other nursing courses should implement real life nursing scenarios into their curricula and require students to use scholarly databases to find relevant information sources, analyze the information, and come up with possible solutions to common nursing problems (McDowell & Ma, 2007).

Lastly, nursing schools could choose the option of designing and maintaining their own simple hospital information system (HIS( with a variety of clinical applications, similar to the one used by organizations where undergraduate nursing students attend nursing practice rotations. As part of this initiative, nursing schools could also require all nursing students to purchase personal data assistants (PDAs) that would be linked with the educational version of the HIS via a wireless network. Therefore, nursing students would use their PDAs to learn how to retrieve, document, and manage clinical information while providing direct nursing care at bedside (Maag, 2006; McDowell & Ma, 2007). Furthermore, PDAs could allow nursing students to access various decision support systems that would provide them with expert advice pertaining to specific care and treatment issues at their patient’s bedsides. For instance, PDAs could access a pharmacy database, such as Micromedex®, to provide nursing students with real-time information regarding their patients’ medications and issue alerts about possible drug interactions, thus reducing the number of medication errors and increasing patient safety at the point of care


Nursing schools need encouragement to overcome many barriers to NI implementation to incorporate essential NI competencies into undergraduate nursing programs, allowing nursing students to become proficient in NI (Desjardins et al., 2005). An appropriate integration of NI education into undergraduate nursing programs could improve expert decision making and clinical reasoning abilities in new nursing graduates (Smedley, 2005). In addition, mandatory inclusion of NI competencies into undergraduate nursing programs would help to prepare more NI proficient nurses who would be confident and competent in using available technologies designed to increase nursing work efficiency and collaboration with other healthcare professionals, reduce clinical errors, and improve quality of patient care (Booth, 2006; Simpson, 2007).  (Bakken et al., 2004).


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Author Biographical Statement

Thomas Pilarski received a Bachelor of Science in Nursing Degree with Honors from University of Toronto in 2008. Currently, he works as a Registered Nurse in Oncology at Princess Margaret Hospital in Toronto and at the same time, he continues his nursing education in Master of Nursing program, Administrative Field, at University of Toronto. Furthermore, Thomas holds a 2-year Associate Degree from Joliet Junior College, Illinois, and a Bachelor of Arts in Business Administration Degree with Honors from Governors State University, Illinois. Thomas also received numerous educational honors and awards, including a prestigious 2009 de Souza Fellowship in Oncology from de Souza Institute in Toronto. In addition, Thomas received a number of professional certifications and designations in the field of Information Technology. Presently, as a registered nurse with an extensive technical, administrative, consulting, and teaching background in Information Technology, Thomas has a strong interest in Nursing Informatics.


Carol McKenney

June Kaminski


Pilarski, T. (Fall, 2010). Where is Nursing Informatics in Undergraduate Nursing Education? CJNI: Canadian Journal of Nursing Informatics, 5 (4), Article Two.

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