Abstract: Primary care nursing competencies in Canadian undergraduate nursing programs: A national cross-sectional survey

To what extent have the Canadian undergraduate nursing programs integrated the national competencies for registered nurses in primary care?

In August 2023, the article Primary care nursing competencies in Canadian undergraduate nursing programs: A national cross-sectional survey was published. Several colleagues from the Unité de soutien SSA Québec were part of the team that produced this publication. This page contains a summary of this scientific article. To read the full article, click here.


Julia Lukewich, Maria Mathews, Marie-Eve Poitras, Joan Tranmer, Ruth Martin-Misener, Denise Bryant-Lukosius, Kris Aubrey-Bassler, Treena Klassen, Deanne Curnew, Donna Bulman, Toni Leamon, and Dana Ryan.



Primary care is the entry point into the healthcare system but faces accessibility challenges. Nurses have been shown to bring many benefits when part of a primary care team. Presently, there is no nursing training specific to the primary care field. In 2019, a Canadian competency guide for registered nurses in primary care was developed (ACIMF 2019). In this guide, 47 competencies have been identified and divided into six domains. These national competencies facilitate the teaching of primary care in undergraduate nursing programs and, consequently, improve students’ preparation for the specificities of this practice.


The study aimed to determine the extent to which Canadian undergraduate nursing programs have integrated the national competencies for registered nurses in primary care. A better understanding of the content related to primary care nursing practice included in undergraduate programs will inform future planning and contribute to developing a more competent nursing workforce.


A national cross-sectional survey of undergraduate nursing programs was conducted. The survey consisted of the demographic section and a modified version of the “Community Health Nurse Continuing Education Needs Questionnaire,” which included competency statements for primary care nurses. For each of the six competency domains, respondents indicated their level of agreement regarding the integration of each competency into their program on a 6-point Likert scale. A higher score indicates better integration of the competency into nursing curricula. It was distributed between April and May 2022. Descriptive statistical analyses and t-tests were conducted to compare competency scores across study programs.


The survey response rate was 51.4% for a total of 38 programs (36 English and 2 French). Respondents were mainly coordinators or professors/instructors in nursing programs or courses. Of the nursing programs evaluated, 45% included a course specific to primary care (n=17), 66% a clinical placement (n=25) and 79% educational content specific to primary care (n=30). The data show that nursing competencies are, for the most part, integrated into undergraduate nursing programs. Most students were exposed to all six domains of primary care competency during their training. Mean scores ranged from 4.23/6.00 (Domain 5 – Quality assurance, evaluation and research) to 5.17/6.00 (Domain 3 – Communication). There was no statistically significant difference in the overall mean score between the 17 programs with all three components of primary care education (mean = 4.83, SD 0.73) and the 21 programs with two or fewer components of primary care education (mean = 4.71, SD 0.78; mean difference = 0.12, p = 0.63, 95% CI -0.38, 0.62).


Findings indicate that opportunities for nursing students to learn primary care nursing competencies and nursing practice in primary care settings are not consistently integrated across curricula. This research represents a crucial step in strengthening the education of this growing workforce in Canada. It highlights the need for further research, particularly exploring the barriers and facilitators to integrating primary care into nursing programs.