A Case Study
Cole Edmonson, DNP, RN, NEA-BC, FAAN, FNAP, FAONL – CEO NOBC, Michael Evans, PhD, RN, FAAN – Grover E. Murray Professor and Dean Emeritus Texas Tech University Health Sciences Center School of Nursing
Overview
This case study examines how a graduate nursing program successfully incorporated “Nurses on Boards” education into its core curriculum. Drawing on a detailed conversation between Texas Tech faculty teaching the content and the NOBC CEO, it illustrates the structure, teaching strategies, experiential learning opportunities, and curricular evolution that support preparing graduate nursing students for roles in governance and board leadership.
Background: The Expanding Role of Nurses in Governance
Historically, nurses were perceived as suitable primarily for nursing‑specific boards, this belief has shifted significantly. Nurses today serve not only on healthcare-related boards but also on broader organizational boards because health intersects with nearly every sector—public, policy, business, technology, education, and community development boards.
Nurses on Boards Coalition (NOBC) has elevated awareness of the impact nurses can have in policy and governance spaces. Nurses lived experience in patient care, operations, systems thinking, and community needs allows them to contribute meaningfully to decision-making. Nurse representation on boards is now considered not just helpful, but essential, for high-quality governance.
Curriculum Integration Strategy
Placement of “Nurses on Boards” Education in the Core Curriculum
Described a program in which graduate nursing students complete required core courses early in their program of study. One of these courses, Leadership in Healthcare, includes a dedicated Nurses on Boards module. This early placement ensures that students receive governance concepts.
The three graduate tracks (nurse educator, nurse administrator, and nurse informaticist) all build from this shared foundation. The universal inclusion of board education underscores that governance literacy is relevant to every nursing role, especially advanced nursing roles.
Teaching Strategies Supporting Board Governance Education
Faculty outlined a highly structured pedagogical approach that mirrors best practices used in clinical and simulation learning—leveraging experiential immersion as a core learning strategy.
Immersive Learning
- Students engage in leadership assessments and develop personal leadership statements, anchoring their governance learning in self-awareness.
- Early exposure to health policy modules helps students understand the mechanisms by which boards influence systems and populations.
Use of Digital and Online Resources
The curriculum incorporates:
- NOBC-produced resources
- Online videos and board simulations
- Modules illustrating governance processes and board group dynamics
This combination prepares students to understand not only what boards do, but how they function.
Experiential Board Practicum
Students are required to:
- Select a policy-promulgating board relevant to their interests.
- Identify and interview a sponsor, ideally a nurse, who serves on that board.
- Attend a board meeting—either in-person or virtually, whichever is the established mode for that board.
- Submit a reflective summary analyzing:
- The board’s mission and composition
- The decision-making dynamics
- The role and impact of nurse participation
The practicum was designed to be a career transforming part of the curriculum.
The Practicum: Structure and Learning Outcomes
Stepwise Approach
The practicum unfolds in stages:
- Leadership self-assessment and reflection
- Health policy exploration and policy paper development
- Creation of a one-page elevator speech
- Board selection and faculty approval
- Sponsor interview and governance observation
- Reflective summary and evaluation
This sequencing ensures that students progress from self-insight → policy literacy → governance participation → systems-level reflection.
Student Transformation
Students often begin the course skeptical of the value of governance education. However, several reflective summaries reveal:
- Surprise at how accessible board service can be
- Recognition of nurses’ influence on policy and organizational direction
- A growing sense of leadership identity
- Newly formed aspirations for future board service
Multiple students who previously dismissed governance later expressed interest in pursuing board roles after graduation.
Impact of Virtual Board Participation
The program underwent a significant shift during the COVID era. Initially, students were required to attend board meetings in person, with no exceptions. Over the last several years, the curriculum adapted to allow virtual participation, recognizing benefits such as:
- Greater accessibility for rural and remote students
- Expanded board opportunities (e.g., national organizations, FQHCs, urban systems)
- Reduced travel and cost barriers
- Increased alignment with modern governance practices, where virtual meetings are ow common
This change substantially broadened students’ access to boards across Texas and beyond.
Evaluation of Student Learning
The primary mechanism for evaluating learning outcomes is the concluding section of the reflective summary, where students articulate:
- What they observed
- What they learned about governance
- How the experience changed their perspective
- How they envision their future role in leadership and board service
Emphasis on these reflections consistently demonstrate deep learning, personal growth, and heightened understanding of nurses’ potential influence on governance.
Advice for Nursing Programs Seeking Integration
Advice for other educators or administrators seeking to integrate board education. Several key principles are highlighted:
1. Leadership Exposure Is Essential
Students must see themselves as leaders early in their education, not after graduation.
2. Governance Literacy Creates System-Level Thinkers
Exposure to governance strengthens professional identity and expands career horizons.
3. Immersive Experience
Just as with clinical education, students learn best by doing – attending meetings, interviewing leaders, and observing real board dynamics.
4. Use National Resources
Organizations like the Nurses on Boards Coalition offer tools and models that support curriculum integration.
Conclusion
This case study illustrates a successfully implemented curricular model in which “Nurses on Boards” education is:
- Embedded early in the core curriculum
- Reinforced through leadership and policy instruction
- Experienced through experiential governance immersion
- Strengthened by actual participation
- Evaluated through structured reflective learning
Over 1000 graduate students have successfully completed the module. Student comments about the experience have been very positive.
Students have chosen a variety of boards, including city councils. public health boards, school boards, hospital boards, professional associations boards, and church boards. Students consistently report that they feel welcome, valued and included in the board experience.
Many students have stated that they intend to seek out board experiences in the future because of the need for nurse input into policy decisions. Students have commented that the experience broadened their thinking on a variety of issues and topics.
A knowledge of healthcare and the healthcare delivery system inform discussions, even on seemingly unrelated topics. This case study provides another example of boards flourishing with nurse presence and nurses flourishing in a wide variety of board settings.
The result is a program that not only teaches governance but inspires nurses to see themselves as influential leaders, capable of shaping the future of healthcare and communities through board service.
