From leadership research to district action: Underrepresentation of Nurses in Croatian Graduate Nursing Programs: Implications for Academic Equity in Nursing Education

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

Read source Search paper agent CC BY 4.0

Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

ABSTRACT Aim To examine the representation of nurses in Croatian graduate nursing programs and to explore its implications for academic equity, professional development, and nursing leadership. Design Cross‐sectional descriptive study using document analysis. Methods Data on lecturers and course leaders for the 2022/2023 academic year were retrieved from all graduate and specialist nursing programs in Croatia. A total of 694 lecturers and 545 course leaders were analysed by professional background. Results Nurses accounted for 19% of lecturers in university graduate programs and 14% in specialist studies. As course leaders, they represented 11% in specialist studies and only 4% in university graduate programs. Thirty courses lacked assigned lecturers. The findings demonstrate a strong dominance of medicine and other professions in teaching roles. Conclusion Nurses remain markedly underrepresented in academic positions, which may limit their ability to shape curricula, influence educational standards and strengthen professional identity. Implications for the Profession and/or Patient Care Improving the academic presence of nurses could be important for advancing leadership capacity, curriculum relevance and professional equity. Stronger representation may help enhance the profession's authority and indirectly benefit patient care. Impact What problem did the study address?: The study explored limited nurse representation in graduate nursing education and its implications for equity and autonomy. What were the main findings?: Nurses are a small minority in lecturer and course leader roles, with most positions occupied by non‐nursing professionals. Where and on whom will the research have an impact?: The findings are relevant to educators, regulators and policymakers in Croatia and internationally, particularly in countries where nurses face barriers to academic participation. The study supports ongoing policy efforts to strenghten nurses' academic representation and leadership in higher education. Patient or Public Contribution No patient or public contribution. This study relied exclusively on publicly available academic data and did not involve patients, service users or members of the public. Keywords: academic representation, faculty development, gender and nursing, graduate programs, higher education, nursing education, nursing leadership, nursing workforce, professional equity

Study methods

The aim of this study was to describe and explore the representation of nurses in academic roles within Croatian graduate nursing programs. Specifically, the study examined both university graduate programs and specialist professional graduate studies, focusing on the distribution of lecturers and course leaders by professional background. The study is descriptive and exploratory in nature, based on publicly available data, and does not test formal hypotheses. Ethical approval was obtained from the School of Medicine, University of Zagreb. No interviews were conducted, and no personal data were collected.

Limitations

This study has several limitations that should be acknowledged. First, the analysis relied exclusively on publicly accessible information from university websites and study plans, which may contain discrepancies or incomplete records. For example, 30 courses were listed without designated lecturers or course leaders. It is possible that these positions were filled but not published, which could have influenced the results. Similarly, some lecturers were responsible for multiple courses, but in the analysis each individual was counted only once to avoid overrepresentation.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Select one recurring district decision. Publish the decision owner, evidence requirements, consultation process and appeal route; test the process on a bounded low-risk decision. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Track decision time, unresolved objections, documented reasons, appeals and access differences. Review whether the process changes who can participate and who carries the burden. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Ivana Žilić; Sanda Franković; Hana Brborović; Marko Marelić; Ognjen Brborović. Underrepresentation of Nurses in Croatian Graduate Nursing Programs: Implications for Academic Equity in Nursing Education. Journal of Advanced Nursing (2025-11-17). https://doi.org/10.1111/jan.70388

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.