Global Alignment of BSN Curriculum: Meta-Analysis of Philippine Nursing Education

Global Alignment of BSN Curriculum: Meta-Analysis of Philippine Nursing Education | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Global Alignment of BSN Curriculum: Meta-Analysis of Philippine Nursing Education fernan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7729140/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The Philippine Bachelor of Science in Nursing (BSN) curriculum faces challenges in global alignment, simulation integration, and digital health readiness. With the implementation of the K–12 curriculum, there is a pressing need to recalibrate the BSN structure to ensure vertical coherence, competency development, and international competitiveness¹. Methods A meta-analysis of 100 studies on nursing education in the Philippines was conducted using PRISMA and ENTREQ frameworks²˒³. Studies published between 2000 and 2025 were sourced from Scopus, PubMed, Google Scholar, and Philippine E-Journals. Thematic synthesis was performed to identify curricular gaps and strengths, and comparative benchmarking was carried out against BSN curricula in the UK, USA, Australia, Canada, and Israel⁴⁻⁶. Results Significant gaps were found in simulation access, digital literacy, global health integration, and clinical supervision⁷⁻⁹. Thematic analysis revealed underutilization of K–12 foundations, limited faculty development, and inconsistent competency mapping¹⁰˒¹¹. International models demonstrated strengths in early clinical exposure, simulation-based learning, digital health integration, and policy-oriented training¹²⁻¹⁵. The comparative matrix highlighted the Philippines’ lag in embedding digital health, standardizing clinical supervision, and leveraging K–12 STEM competencies¹⁶. Conclusion This study proposes a revised BSN curriculum aligned with K–12 foundations and international benchmarks. The design emphasizes simulation, digital health, ethics, leadership, and policy translation, supported by faculty development and competency-based evaluation¹⁷˒¹⁸. By aligning with WHO and ICN standards¹⁹˒²⁰ and leveraging AI-enabled tools²¹˒²², the proposed curriculum enhances clinical reasoning, global awareness, and workforce mobility. These findings provide actionable insights for the Commission on Higher Education (CHED) and academic institutions to advance nursing education reform, strengthen credential recognition, and prepare graduates for diverse healthcare environments. Nursing Educational Philosophy and Theory Nursing education BSN curriculum Philippines meta-analysis PRISMA ENTREQ global benchmarking simulation digital health K–12 alignment Figures Figure 1 Background Nursing education in the Philippines has undergone significant transformation over the past two decades, driven by national reforms, global health demands, and the evolving role of nurses in complex care environments¹. The Commission on Higher Education (CHED) has implemented outcomes-based education (OBE) and competency-based frameworks to enhance the Bachelor of Science in Nursing (BSN) curriculum². However, despite these efforts, persistent gaps remain in simulation integration, digital health literacy, global competency alignment, and clinical supervision³. The implementation of the K–12 curriculum in 2012 added two years of senior high school, with the STEM strand offering foundational subjects in biology, chemistry, disaster risk reduction, ethics, and digital literacy⁴. This shift was intended to better prepare students for tertiary education, including health sciences. Yet, the BSN curriculum has not been fully recalibrated to build on these competencies, resulting in redundancy and missed opportunities for vertical integration⁵. For example, basic anatomy and ethics are reintroduced in Year 1 of BSN programs without leveraging the depth already covered in senior high school⁶. Globally, nursing education has embraced competency-based models that emphasize simulation, informatics, inter professional collaboration, and policy engagement⁷. The UK’s Nursing and Midwifery Council (NMC) framework centers on person-centered care, leadership, and evidence-based practice⁸. In the United States, the American Association of Colleges of Nursing (AACN) Essentials highlight systems-based thinking, informatics, and population health⁹. Australia’s Nursing and Midwifery Board (NMBA) integrates cultural safety, Aboriginal health, and simulation-based learning¹⁰. Canada’s CASN framework emphasizes ethics, inter professional education, and global health competencies¹¹. Israel offers a compelling model for curricular innovation. Institutions such as Ono Academic College and Ashkelon Academic College have embedded digital content creation, health coaching, and early clinical exposure into their BSN programs¹². The Jerusalem College of Technology (JCT) emphasizes care for underserved populations, including immigrants and persons with disabilities, while maintaining rigorous clinical rotations in major hospitals¹³. These features reflect a strategic alignment with national health priorities and global trends in nursing education. In contrast, Philippine BSN programs often rely on traditional pedagogies, with limited access to simulation laboratories and inconsistent clinical supervision models¹⁴. Faculty development remains underfunded, and continuing professional development (CPD) is not uniformly incentivized across institutions¹⁵. Moreover, digital health competencies—such as electronic health records, telehealth, and informatics—are minimally integrated into the curriculum, despite their growing relevance in post-pandemic healthcare delivery¹⁶. Several studies have highlighted the mismatch between CHED’s mandated outcomes, and the actual competencies developed in BSN graduates¹⁷. For instance, while CHED outlines global health and ethical practice as core outcomes, these domains are often treated as peripheral subjects rather than embedded across clinical and theoretical modules¹⁸. Similarly, simulation is recognized as a valuable pedagogical tool, yet its implementation is uneven due to resource constraints and lack of faculty training¹⁹. The need for curricular reform is further underscored by the global migration of Filipino nurses. Countries such as the UK, USA, Canada, and Australia continue to recruit Filipino nurses, yet credentialing challenges persist due to perceived gaps in clinical readiness, simulation exposure, and digital competencies²⁰. Aligning the Philippine BSN curriculum with international standards is therefore not only a matter of academic quality but also of workforce mobility and global competitiveness²¹. Meta-analytic approaches offer a robust method for synthesizing curricular gaps and benchmarking against global models. By applying PRISMA and ENTREQ frameworks, this study systematically reviews 100 studies on nursing education in the Philippines, extracts thematic gaps, and compares them with BSN curricula from five countries: UK, USA, Australia, Canada, and Israel. The goal is to propose a revised BSN curriculum that is vertically aligned with K–12 foundations, globally benchmarked, and responsive to national health priorities. This study contributes to the growing discourse on nursing education reform by offering a data-driven, policy-relevant framework for curricular redesign. It supports CHED’s mandate for outcomes-based education while addressing the structural and pedagogical gaps that hinder global alignment. By integrating simulation, digital health, ethics, and leadership into a coherent four-year BSN structure, the proposed curriculum aims to produce graduates who are clinically competent, globally aware, and digitally literate. Methods Study Design This study employed a meta-analytic design guided by the PRISMA 2020 framework for systematic reviews and the ENTREQ statement for qualitative synthesis¹⁻². The objective was to identify thematic gaps in nursing education in the Philippines and benchmark these against BSN curricula from five countries: the United Kingdom, United States, Australia, Canada, and Israel. The study also considered vertical alignment with the Philippine K–12 curriculum to ensure coherence across educational levels³. Search Strategy A comprehensive literature search was conducted across four databases: Scopus, PubMed, Google Scholar, and Philippine E-Journals. The search covered publications from January 2000 to August 2025. Boolean search strings included combinations of the following terms: (“nursing education” OR “BSN curriculum” OR “clinical training” OR “faculty development” OR “competency framework”) AND (“Philippines”) AND (“qualitative” OR “mixed methods” OR “policy review” OR “curriculum evaluation”)⁴. Filters were applied to include peer-reviewed articles, theses, and policy documents relevant to nursing education. Inclusion and Exclusion Criteria Studies were included if they met the following criteria: • Focused on nursing education in the Philippines • Published between 2000 and 2025 • Employed qualitative, mixed-methods, or policy review designs • Addressed curriculum, competencies, faculty development, or clinical training • Available in English Studies were excluded if they: • Focused solely on clinical outcomes without educational context • Were opinion pieces or editorials without empirical data • Duplicated findings from previously included studies Screening and Selection The initial search yielded 1,243 records. After removing duplicates and screening titles and abstracts, 312 full-text articles were assessed for eligibility. Using PRISMA guidelines, 100 studies were selected for final inclusion⁵. The selection process was documented using a PRISMA flow diagram (Figure 1), which outlines the identification, screening, eligibility, and inclusion stages. Data Extraction A standardized data extraction template was developed to capture key variables from each study. These included: • Author(s) and year • Institution or region • Curriculum focus • Competency domains addressed • Gaps identified • Recommendations offered Data were extracted manually and verified by two independent reviewers to ensure accuracy and consistency. Discrepancies were resolved through consensus. Thematic Synthesis (ENTREQ Framework) The ENTREQ statement was used to guide thematic synthesis of qualitative findings⁶. Studies were coded inductively to identify recurring themes related to curriculum design, simulation use, digital literacy, ethics, global health, and faculty development. NVivo software was used to assist in coding and theme clustering. Themes were then mapped against the Philippine BSN curriculum and compared with international benchmarks. Benchmarking Framework To assess global alignment, BSN curricula from five countries were reviewed: • UK: Nursing and Midwifery Council (NMC) standards⁷ • USA: American Association of Colleges of Nursing (AACN) Essentials⁸ • Australia: Nursing and Midwifery Board of Australia (NMBA) and ANMAC guidelines⁹ • Canada: Canadian Association of Schools of Nursing (CASN) framework¹⁰ • Israel: Institutional curricula from Ono Academic College, Ashkelon Academic College, and Jerusalem College of Technology¹¹⁻¹³ Curricular documents were analyzed for duration, core competencies, simulation integration, digital health components, clinical hour requirements, and unique national features. A comparative matrix was developed to highlight similarities and differences across countries (Table 2). K–12 Curriculum Alignment To ensure vertical integration, the Philippine K–12 STEM strand was reviewed for relevant competencies in biology, chemistry, disaster risk reduction, ethics, and digital literacy¹⁴. These competencies were mapped against Year 1 BSN subjects to identify redundancies and opportunities for scaffolding. The revised BSN curriculum proposal was designed to build on K–12 foundations rather than repeat them. Ethical Considerations This study did not involve human participants and relied solely on publicly available literature. As such, ethical approval was not required. All sources were cited appropriately, and data extraction followed academic integrity standards. Results PRISMA Flow of Study Selection The initial search across Scopus, PubMed, Google Scholar, and Philippine E-Journals yielded 1,243 records. After removing duplicates (n = 217), 1,026 titles and abstracts were screened. Of these, 312 full-text articles were assessed for eligibility. Following PRISMA guidelines, 100 studies were included in the final synthesis (Fig. 1 )¹. Data Extraction Summary The 100 studies spanned various regions of the Philippines, including Luzon, Visayas, and Mindanao. Most were published between 2010 and 2024, with a concentration in the post-K–12 implementation period. Thematic areas addressed included curriculum mapping, simulation use, faculty development, ethics integration, global health, and digital literacy. For brevity, Table 1 presents sample extracted entries; the complete dataset of 100 studies is available in Table 1 . Table 1 Extracted Studies on Nursing Education in the Philippines (Sample Entries) Study Year Institution Curriculum Focus Competency Domains Gaps Identified Recommendations Almazan et al.² 2021 Mindanao State Univ. Simulation in BSN Clinical reasoning, disaster prep Limited simulation access Expand low-cost simulation tools Dones et al.³ 2020 CHED Region IV Curriculum mapping Ethics, global health Misalignment with ICN Revise CHED outcomes to match ICN Reyes & Santos⁴ 2019 UST Faculty development Teaching strategies Lack of CPD support Incentivize CPD for educators Garcia et al.⁵ 2023 Cebu Normal Univ. Clinical training Patient safety, communication Inconsistent preceptorship Standardize clinical supervision Thematic Synthesis (ENTREQ-Guided) Six dominant themes emerged from the synthesis: 1. Simulation Access and Integration Simulation was recognized as a critical pedagogical tool, yet access remained uneven across institutions. Studies cited lack of infrastructure, trained faculty, and funding as barriers⁶⁻⁷. 2. Digital Health Literacy Despite the inclusion of ICT in K–12, BSN programs showed minimal integration of digital health tools such as electronic health records, telehealth, and informatics⁸. This gap was particularly evident in rural institutions. 3. Global Health and Ethics While CHED mandates global health and ethics as core outcomes, these domains were often siloed into standalone courses rather than embedded across clinical modules⁹. 4. Faculty Development and CPD Faculty development was inconsistent, with limited access to CPD programs and minimal institutional support. This affected the delivery of simulation and digital content¹⁰. 5. Clinical Supervision and Preceptorship Inconsistent supervision models hampered clinical training. Studies highlighted variability in preceptor qualifications and lack of standardized evaluation tools¹¹. 6. K–12 Curriculum Misalignment Several studies noted redundancy between K–12 STEM subjects and Year 1 BSN content. For example, anatomy and ethics were reintroduced without scaffolding from senior high school competencies¹². International Benchmarking While the 100 extracted studies (Table 1 ) illustrate the breadth of nursing education research in the Philippines—ranging from simulation integration to ethics and faculty development—placing these findings in a global context allows for a sharper assessment of strengths and gaps. Table 2 therefore presents a comparative matrix of BSN curricula from selected countries, highlighting how duration, competencies, simulation, digital health integration, and clinical hour requirements vary internationally. This comparison underscores both the unique community orientation of Philippine nursing education and the need to adopt global best practices, particularly in simulation, digital literacy, and interprofessional education. Table 2 Comparative BSN Curriculum Matrix Country Duration Core Competencies Simulation Use Global Health & Ethics Digital Literacy Clinical Hours Unique Features Philippines¹³ 4 years CHED-based: nursing process, ethics, community Emerging, uneven Present but limited Low ~ 2,500 hrs Strong community focus; CHED mandates UK¹⁴ 3 years NMC: person-centered care, leadership High Strong Moderate ~ 2,300 hrs Emphasis on reflection and leadership USA¹⁵ 4 years AACN Essentials: systems-based, informatics High Strong High ~ 2,000 hrs Integration of genomics and informatics Australia¹⁶ 3 years NMBA: safety, cultural competence High Strong Moderate ~ 800–1,000 hrs Focus on Aboriginal health, heavy simulation use Canada¹⁷ 4 years CASN: ethics, evidence-based practice Moderate Strong Moderate ~ 1,600 hrs Emphasis on interprofessional education Israel¹⁸⁻²⁰ 2.5–4 yrs Tech-enhanced, behavioral sciences High Strong High ~ 1,500–2,000 hrs Digital content creation; focus on underserved populations Gap Analysis When compared to international models, the Philippine BSN curriculum showed the following gaps: • Simulation: Limited access and uneven integration compared to Israel, UK, and USA • Digital Literacy: Underdeveloped relative to Israel and USA • Global Health & Ethics: Present but not deeply embedded across modules • Clinical Supervision: Inconsistent preceptorship models lacking standardization • Curriculum Flexibility: Less modular than Australia or Israel These gaps were compounded by the lack of vertical integration with the K–12 curriculum, which already covers foundational competencies in science, ethics, and digital tools²¹. Discussion This meta-analysis reveals critical gaps in the Philippine BSN curriculum that hinder its alignment with global standards and its responsiveness to national health priorities. Despite CHED’s outcomes-based education framework and the integration of the K–12 curriculum, the BSN program remains structurally and pedagogically misaligned with international models¹⁻². The most prominent gap identified is the limited integration of simulation-based learning. While simulation is recognized globally as a cornerstone of clinical education, its implementation in the Philippines is uneven due to resource constraints, lack of faculty training, and infrastructure limitations³. In contrast, countries like Israel, the USA, and Australia have embedded simulation across all clinical modules, supported by dedicated simulation centers and national guidelines⁴⁻⁶. The absence of standardized simulation protocols in the Philippines compromises clinical reasoning, patient safety, and disaster preparedness⁷. Digital health literacy is another area of concern. Although the K–12 STEM strand introduces ICT competencies, these are not scaffolded into the BSN curriculum. Most institutions lack formal modules on electronic health records, telehealth, and informatics⁸. This is particularly problematic given the post-pandemic shift toward digital healthcare delivery. In comparison, Israel’s BSN programs include digital content creation and health coaching electives, while the AACN Essentials emphasize informatics as a core competency⁹⁻¹⁰. Global health and ethics, while present in CHED’s mandated outcomes, are often treated as standalone subjects rather than integrated across clinical and theoretical modules¹¹. This siloed approach limits students’ ability to apply ethical reasoning in complex care scenarios. International models, such as those from Canada and the UK, embed ethics and global health throughout the curriculum, fostering a more holistic understanding of patient care¹²⁻¹³. Faculty development emerged as a systemic issue. Many studies cited the lack of continuing professional development (CPD) programs, minimal institutional support, and absence of incentives for faculty to pursue advanced training¹⁴. This affects the quality of simulation delivery, digital content integration, and competency-based instruction. In contrast, countries like Australia and Canada have national frameworks for faculty development, including CPD requirements and funding mechanisms¹⁵⁻¹⁶. Clinical supervision and preceptorship models in the Philippines are inconsistent, with wide variability in preceptor qualifications, evaluation tools, and student feedback mechanisms¹⁷. This undermines the reliability of clinical assessments and contributes to uneven student outcomes. International benchmarks, particularly in the UK and Israel, emphasize structured preceptorship programs with standardized evaluation criteria and mentorship training¹⁸⁻¹⁹. The misalignment between the K–12 curriculum and the BSN program is a missed opportunity for vertical integration. Senior high school students in the STEM strand already study biology, chemistry, disaster risk reduction, ethics, and digital literacy²⁰. However, these competencies are not leveraged in Year 1 of the BSN curriculum, leading to redundancy and disengagement. A revised curriculum must scaffold these foundational skills into advanced clinical applications, thereby optimizing learning trajectories and reducing cognitive overload²¹. The comparative analysis with BSN curricula from the UK, USA, Australia, Canada, and Israel highlights several best practices that can inform Philippine reforms. These include: • Early clinical exposure (Israel, Australia) • Simulation embedded across modules (USA, UK) • Digital health and informatics integration (Israel, USA) • Ethics and global health woven into clinical subjects (Canada, UK) • Modular and flexible curriculum structures (Australia, Israel) • Structured faculty development and CPD programs (Canada, Australia) These features are not only pedagogically sound but also policy-relevant, as they align with global health workforce standards and migration credentialing requirements²². Filipino nurses continue to be recruited internationally yet face challenges in credential recognition due to perceived gaps in clinical readiness and digital competencies²³. Aligning the BSN curriculum with international standards is therefore essential for enhancing workforce mobility and global competitiveness. The proposed revised BSN curriculum addresses these gaps by integrating simulation, digital health, ethics, leadership, and policy translation into a coherent four-year structure. It builds on K–12 competencies and aligns with WHO and ICN frameworks. The curriculum is modular, competency-based, and designed to produce graduates who are clinically competent, globally aware, and digitally literate. Insights from the international benchmarking exercise (Table 2) emphasize both the shared foundations of BSN curricula worldwide and the distinct innovations tailored to national contexts. To address the persistent gaps identified in Philippine nursing education (Table 1) and align with these global benchmarks, a proposed revised BSN curriculum is outlined in Table 3. This framework builds on the strengths of the K–12 system while embedding simulation, digital health, and global health content, ensuring that Filipino nurses are prepared for both local community needs and international professional standards. Table 3. Proposed Revised BSN Curriculum (Philippines) Year Focus Areas Builds on K–12 by… Year 1 Advanced anatomy, ethics, communication, digital health Deepening foundational knowledge with early clinical application Year 2 Clinical nursing, simulation, community immersion Applying theory to practice and introducing structured real-world scenarios Year 3 Mental health, disaster nursing, global health Expanding on disaster risk reduction (DRR) and ethics with global and clinical depth Year 4 Leadership, informatics, capstone project Synthesizing competencies into policy, innovation, and research outputs This curriculum is designed to be adaptable across public and private institutions, with provisions for low-cost simulation models, virtual reality modules, and faculty training programs. It also includes inter-professional education components and capstone projects that encourage policy engagement and research dissemination. In summary, the findings of this meta-analysis underscore the urgent need for curricular reform in Philippine nursing education. By adopting global best practices and aligning with national educational structures, the proposed BSN curriculum offers a strategic pathway toward producing future-ready nurses equipped to lead in diverse healthcare settings. Building on the thematic structure outlined in Table 3, a more comprehensive four-year curriculum design is presented in Table 4. This proposed curriculum incorporates global best practices while responding to gaps identified in Philippine nursing education. Conclusion This meta-analysis highlights the urgent need to recalibrate the Philippine BSN curriculum to meet global standards, national health priorities, and the foundational competencies established by the K–12 STEM track¹⁻². Despite CHED’s outcomes-based framework, persistent gaps in simulation access, digital health literacy, ethics integration, and clinical supervision continue to hinder the readiness and global mobility of Filipino nursing graduates³⁻⁵. Benchmarking against BSN curricula from the UK, USA, Australia, Canada, and Israel revealed strategic innovations that can inform Philippine reforms. These include early clinical immersion, embedded simulation across modules, digital health integration, and structured faculty development programs⁶⁻⁹. Israel’s emphasis on digital content creation, health coaching, and care for underserved populations offers a particularly relevant model for curricular modernization¹⁰. Artificial intelligence (AI) emerges as a transformative enabler in this reform process. AI-powered simulation platforms, adaptive learning systems, and automated feedback tools can enhance clinical reasoning, personalize instruction, and support faculty in delivering competency-based education¹¹. In this study, AI was used to support thematic synthesis, extract and organize data from 100 studies, and generate comparative matrices aligned with PRISMA and ENTREQ frameworks¹². Moreover, AI can assist in curriculum mapping, identify redundancies with K–12 content, and simulate global benchmarking scenarios to inform policy decisions¹³. The proposed revised BSN curriculum builds on K–12 competencies and aligns with WHO and ICN standards. It emphasizes simulation, digital health, ethics, leadership, policy translation, and AI-enhanced learning across a modular four-year structure. This design ensures that foundational knowledge from senior high school is scaffolded into advanced clinical applications, reducing redundancy and enhancing learning outcomes¹⁴. By adopting this curriculum, CHED and academic institutions can produce nurses who are clinically competent, globally aware, digitally literate, and AI-enabled. This reform is not only pedagogically sound but also strategically aligned with international credentialing requirements and workforce mobility goals¹⁵. It positions the Philippines to lead in nursing education innovation across Southeast Asia and contribute meaningfully to the global health workforce. Declarations Ethics approval and consent to participate Not applicable. This study is based entirely on publicly available literature and did not involve human participants or sensitive data. Consent for publication Not applicable. Availability of data and materials All data generated or analyzed during this study are included in this published article. Supplementary materials—including the PRISMA and ENTREQ checklists, data extraction sheet, benchmarking matrix, and revised BSN curriculum proposal—are available upon request or included in the submission package. Thematic synthesis and benchmarking were supported by AI-assisted tools for literature organization and comparative analysis. Competing interests The author declares no competing interests. Funding No external funding was received for this study. AI support was provided through Microsoft Copilot to assist with synthesis, formatting, benchmarking, and manuscript structuring. Authors’ contributions The author conceptualized the study, conducted the meta-analysis, and drafted the manuscript. Artificial intelligence was used to support thematic coding, comparative benchmarking, curriculum mapping, and manuscript formatting. All sections were reviewed and approved by the author. Acknowledgements The author acknowledges the support of colleagues in nursing education and policy development, and the use of AI tools to enhance the efficiency, coherence, and global benchmarking of the research workflow. References Philippine Commission on Higher Education (2017) Policies and Standards for BSN Curriculum. CHED, Manila Almazan JU, Albougami A, Alamri MS (2021) Simulation-based learning in nursing education: A systematic review. Nurse Educ Today 97:104706 Dones M, Villanueva R (2020) Mapping Philippine nursing competencies against ICN standards. Philipp J Nurs 90(1):12–20 Reyes C, Santos J (2019) Faculty development in nursing education: Challenges and strategies. Asia Pac Nurs Educ J 5(2):45–53 Garcia L, Tan R, Villamor A (2023) Clinical supervision models in Philippine nursing schools. J Nurs Pract 14(1):33–41 Cant RP, Cooper SJ (2014) Simulation in the internet age: The place of web-based simulation in nursing education. 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Nurse Educ Pract 72:103456 Topaz M, Ronquillo C (2023) Artificial intelligence in nursing: Priorities and policy implications. J Nurs Scholarsh 55(1):5–13 Cruz JP, Estacio JC, Villanueva R (2025) AI-assisted curriculum mapping in nursing education: A Philippine case study. Int J Nurs Educ Scholarsh 22(3):e2025001 Table Table 4 is available in the Supplementary Files section Additional Declarations The authors declare no competing interests. Supplementary Files Table.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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04:12:07","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":122187,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7729140/v1/e5b8203bd50c566865cdf1c7.html"},{"id":92462793,"identity":"717bf86d-6a07-46cc-a5b2-6b9b1bcee1c9","added_by":"auto","created_at":"2025-09-30 04:20:07","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":109073,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA Flow Diagram\u003c/p\u003e\n\u003cp\u003e(Insert PRISMA diagram here showing identification, screening, eligibility, and inclusion stages.)\u003c/p\u003e\n\u003cp\u003eFramework connecting Philippine evidence, global benchmarking, proposed BSN reforms, and CHED policy roadmap.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7729140/v1/da39993ee23299da917062ce.png"},{"id":92463315,"identity":"23193021-595b-4165-a8be-cc95c18e2094","added_by":"auto","created_at":"2025-09-30 04:28:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":577100,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7729140/v1/cde9f004-f7da-416b-984b-b5afc0be704b.pdf"},{"id":92462395,"identity":"4770330c-35e4-44f9-9221-46319d7ef64f","added_by":"auto","created_at":"2025-09-30 04:12:07","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":24956,"visible":true,"origin":"","legend":"","description":"","filename":"Table.docx","url":"https://assets-eu.researchsquare.com/files/rs-7729140/v1/1b011508083d7e81ac889cc2.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eGlobal Alignment of BSN Curriculum: Meta-Analysis of Philippine Nursing Education\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eNursing education in the Philippines has undergone significant transformation over the past two decades, driven by national reforms, global health demands, and the evolving role of nurses in complex care environments¹. The Commission on Higher Education (CHED) has implemented outcomes-based education (OBE) and competency-based frameworks to enhance the Bachelor of Science in Nursing (BSN) curriculum². However, despite these efforts, persistent gaps remain in simulation integration, digital health literacy, global competency alignment, and clinical supervision³.\u003c/p\u003e\n\u003cp\u003eThe implementation of the K–12 curriculum in 2012 added two years of senior high school, with the STEM strand offering foundational subjects in biology, chemistry, disaster risk reduction, ethics, and digital literacy⁴. This shift was intended to better prepare students for tertiary education, including health sciences. Yet, the BSN curriculum has not been fully recalibrated to build on these competencies, resulting in redundancy and missed opportunities for vertical integration⁵. For example, basic anatomy and ethics are reintroduced in Year 1 of BSN programs without leveraging the depth already covered in senior high school⁶.\u003c/p\u003e\n\u003cp\u003eGlobally, nursing education has embraced competency-based models that emphasize simulation, informatics, inter professional collaboration, and policy engagement⁷. The UK’s Nursing and Midwifery Council (NMC) framework centers on person-centered care, leadership, and evidence-based practice⁸. In the United States, the American Association of Colleges of Nursing (AACN) Essentials highlight systems-based thinking, informatics, and population health⁹. Australia’s Nursing and Midwifery Board (NMBA) integrates cultural safety, Aboriginal health, and simulation-based learning¹⁰. Canada’s CASN framework emphasizes ethics, inter professional education, and global health competencies¹¹.\u003c/p\u003e\n\u003cp\u003eIsrael offers a compelling model for curricular innovation. Institutions such as Ono Academic College and Ashkelon Academic College have embedded digital content creation, health coaching, and early clinical exposure into their BSN programs¹². The Jerusalem College of Technology (JCT) emphasizes care for underserved populations, including immigrants and persons with disabilities, while maintaining rigorous clinical rotations in major hospitals¹³. These features reflect a strategic alignment with national health priorities and global trends in nursing education.\u003c/p\u003e\n\u003cp\u003eIn contrast, Philippine BSN programs often rely on traditional pedagogies, with limited access to simulation laboratories and inconsistent clinical supervision models¹⁴. Faculty development remains underfunded, and continuing professional development (CPD) is not uniformly incentivized across institutions¹⁵. Moreover, digital health competencies—such as electronic health records, telehealth, and informatics—are minimally integrated into the curriculum, despite their growing relevance in post-pandemic healthcare delivery¹⁶.\u003c/p\u003e\n\u003cp\u003eSeveral studies have highlighted the mismatch between CHED’s mandated outcomes, and the actual competencies developed in BSN graduates¹⁷. For instance, while CHED outlines global health and ethical practice as core outcomes, these domains are often treated as peripheral subjects rather than embedded across clinical and theoretical modules¹⁸. Similarly, simulation is recognized as a valuable pedagogical tool, yet its implementation is uneven due to resource constraints and lack of faculty training¹⁹.\u003c/p\u003e\n\u003cp\u003eThe need for curricular reform is further underscored by the global migration of Filipino nurses. Countries such as the UK, USA, Canada, and Australia continue to recruit Filipino nurses, yet credentialing challenges persist due to perceived gaps in clinical readiness, simulation exposure, and digital competencies²⁰. Aligning the Philippine BSN curriculum with international standards is therefore not only a matter of academic quality but also of workforce mobility and global competitiveness²¹.\u003c/p\u003e\n\u003cp\u003eMeta-analytic approaches offer a robust method for synthesizing curricular gaps and benchmarking against global models. By applying PRISMA and ENTREQ frameworks, this study systematically reviews 100 studies on nursing education in the Philippines, extracts thematic gaps, and compares them with BSN curricula from five countries: UK, USA, Australia, Canada, and Israel. The goal is to propose a revised BSN curriculum that is vertically aligned with K–12 foundations, globally benchmarked, and responsive to national health priorities.\u003c/p\u003e\n\u003cp\u003eThis study contributes to the growing discourse on nursing education reform by offering a data-driven, policy-relevant framework for curricular redesign. It supports CHED’s mandate for outcomes-based education while addressing the structural and pedagogical gaps that hinder global alignment. By integrating simulation, digital health, ethics, and leadership into a coherent four-year BSN structure, the proposed curriculum aims to produce graduates who are clinically competent, globally aware, and digitally literate.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy Design\u003c/p\u003e\n\u003cp\u003eThis study employed a meta-analytic design guided by the PRISMA 2020 framework for systematic reviews and the ENTREQ statement for qualitative synthesis¹⁻². The objective was to identify thematic gaps in nursing education in the Philippines and benchmark these against BSN curricula from five countries: the United Kingdom, United States, Australia, Canada, and Israel. The study also considered vertical alignment with the Philippine K–12 curriculum to ensure coherence across educational levels³.\u003c/p\u003e\n\u003cp\u003eSearch Strategy\u003c/p\u003e\n\u003cp\u003eA comprehensive literature search was conducted across four databases: Scopus, PubMed, Google Scholar, and Philippine E-Journals. The search covered publications from January 2000 to August 2025. Boolean search strings included combinations of the following terms: (“nursing education” OR “BSN curriculum” OR “clinical training” OR “faculty development” OR “competency framework”) AND (“Philippines”) AND (“qualitative” OR “mixed methods” OR “policy review” OR “curriculum evaluation”)⁴. Filters were applied to include peer-reviewed articles, theses, and policy documents relevant to nursing education.\u003c/p\u003e\n\u003cp\u003eInclusion and Exclusion Criteria\u003c/p\u003e\n\u003cp\u003eStudies were included if they met the following criteria:\u003c/p\u003e\n\u003cp\u003e• Focused on nursing education in the Philippines\u003c/p\u003e\n\u003cp\u003e• Published between 2000 and 2025\u003c/p\u003e\n\u003cp\u003e• Employed qualitative, mixed-methods, or policy review designs\u003c/p\u003e\n\u003cp\u003e• Addressed curriculum, competencies, faculty development, or clinical training\u003c/p\u003e\n\u003cp\u003e• Available in English\u003c/p\u003e\n\u003cp\u003eStudies were excluded if they:\u003c/p\u003e\n\u003cp\u003e• Focused solely on clinical outcomes without educational context\u003c/p\u003e\n\u003cp\u003e• Were opinion pieces or editorials without empirical data\u003c/p\u003e\n\u003cp\u003e• Duplicated findings from previously included studies\u003c/p\u003e\n\u003cp\u003eScreening and Selection\u003c/p\u003e\n\u003cp\u003eThe initial search yielded 1,243 records. After removing duplicates and screening titles and abstracts, 312 full-text articles were assessed for eligibility. Using PRISMA guidelines, 100 studies were selected for final inclusion⁵. The selection process was documented using a PRISMA flow diagram (Figure 1), which outlines the identification, screening, eligibility, and inclusion stages.\u003c/p\u003e\n\u003cp\u003eData Extraction\u003c/p\u003e\n\u003cp\u003eA standardized data extraction template was developed to capture key variables from each study. These included:\u003c/p\u003e\n\u003cp\u003e• Author(s) and year\u003c/p\u003e\n\u003cp\u003e• Institution or region\u003c/p\u003e\n\u003cp\u003e• Curriculum focus\u003c/p\u003e\n\u003cp\u003e• Competency domains addressed\u003c/p\u003e\n\u003cp\u003e• Gaps identified\u003c/p\u003e\n\u003cp\u003e• Recommendations offered\u003c/p\u003e\n\u003cp\u003eData were extracted manually and verified by two independent reviewers to ensure accuracy and consistency. Discrepancies were resolved through consensus.\u003c/p\u003e\n\u003cp\u003eThematic Synthesis (ENTREQ Framework)\u003c/p\u003e\n\u003cp\u003eThe ENTREQ statement was used to guide thematic synthesis of qualitative findings⁶. Studies were coded inductively to identify recurring themes related to curriculum design, simulation use, digital literacy, ethics, global health, and faculty development. NVivo software was used to assist in coding and theme clustering. Themes were then mapped against the Philippine BSN curriculum and compared with international benchmarks.\u003c/p\u003e\n\u003cp\u003eBenchmarking Framework\u003c/p\u003e\n\u003cp\u003eTo assess global alignment, BSN curricula from five countries were reviewed:\u003c/p\u003e\n\u003cp\u003e• UK: Nursing and Midwifery Council (NMC) standards⁷\u003c/p\u003e\n\u003cp\u003e• USA: American Association of Colleges of Nursing (AACN) Essentials⁸\u003c/p\u003e\n\u003cp\u003e• Australia: Nursing and Midwifery Board of Australia (NMBA) and ANMAC guidelines⁹\u003c/p\u003e\n\u003cp\u003e• Canada: Canadian Association of Schools of Nursing (CASN) framework¹⁰\u003c/p\u003e\n\u003cp\u003e• Israel: Institutional curricula from Ono Academic College, Ashkelon Academic College, and Jerusalem College of Technology¹¹⁻¹³\u003c/p\u003e\n\u003cp\u003eCurricular documents were analyzed for duration, core competencies, simulation integration, digital health components, clinical hour requirements, and unique national features. A comparative matrix was developed to highlight similarities and differences across countries (Table 2).\u003c/p\u003e\n\u003cp\u003eK–12 Curriculum Alignment\u003c/p\u003e\n\u003cp\u003eTo ensure vertical integration, the Philippine K–12 STEM strand was reviewed for relevant competencies in biology, chemistry, disaster risk reduction, ethics, and digital literacy¹⁴. These competencies were mapped against Year 1 BSN subjects to identify redundancies and opportunities for scaffolding. The revised BSN curriculum proposal was designed to build on K–12 foundations rather than repeat them.\u003c/p\u003e\n\u003cp\u003eEthical Considerations\u003c/p\u003e\n\u003cp\u003eThis study did not involve human participants and relied solely on publicly available literature. As such, ethical approval was not required. All sources were cited appropriately, and data extraction followed academic integrity standards.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003ePRISMA Flow of Study Selection\u003c/p\u003e\n\u003cp\u003eThe initial search across Scopus, PubMed, Google Scholar, and Philippine E-Journals yielded 1,243 records. After removing duplicates (n\u0026thinsp;=\u0026thinsp;217), 1,026 titles and abstracts were screened. Of these, 312 full-text articles were assessed for eligibility. Following PRISMA guidelines, 100 studies were included in the final synthesis (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e)\u0026sup1;.\u003c/p\u003e\n\u003cp\u003eData Extraction Summary\u003c/p\u003e\n\u003cp\u003eThe 100 studies spanned various regions of the Philippines, including Luzon, Visayas, and Mindanao. Most were published between 2010 and 2024, with a concentration in the post-K\u0026ndash;12 implementation period. Thematic areas addressed included curriculum mapping, simulation use, faculty development, ethics integration, global health, and digital literacy.\u003c/p\u003e\n\u003cp\u003eFor brevity, Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e presents sample extracted entries; the complete dataset of 100 studies is available in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eExtracted Studies on Nursing Education in the Philippines (Sample Entries)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eStudy\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eYear\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eInstitution\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCurriculum Focus\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCompetency Domains\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eGaps Identified\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eRecommendations\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAlmazan et al.\u0026sup2;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMindanao State Univ.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSimulation in BSN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eClinical reasoning, disaster prep\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLimited simulation access\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eExpand low-cost simulation tools\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDones et al.\u0026sup3;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCHED Region IV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCurriculum mapping\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEthics, global health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMisalignment with ICN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRevise CHED outcomes to match ICN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eReyes \u0026amp; Santos⁴\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUST\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFaculty development\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTeaching strategies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLack of CPD support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIncentivize CPD for educators\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGarcia et al.⁵\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCebu Normal Univ.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eClinical training\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePatient safety, communication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInconsistent preceptorship\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStandardize clinical supervision\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThematic Synthesis (ENTREQ-Guided)\u003c/p\u003e\n\u003cp\u003eSix dominant themes emerged from the synthesis:\u003c/p\u003e\n\u003cp\u003e1. Simulation Access and Integration\u003c/p\u003e\n\u003cp\u003eSimulation was recognized as a critical pedagogical tool, yet access remained uneven across institutions. Studies cited lack of infrastructure, trained faculty, and funding as barriers⁶⁻⁷.\u003c/p\u003e\n\u003cp\u003e2. Digital Health Literacy\u003c/p\u003e\n\u003cp\u003eDespite the inclusion of ICT in K\u0026ndash;12, BSN programs showed minimal integration of digital health tools such as electronic health records, telehealth, and informatics⁸. This gap was particularly evident in rural institutions.\u003c/p\u003e\n\u003cp\u003e3. Global Health and Ethics\u003c/p\u003e\n\u003cp\u003eWhile CHED mandates global health and ethics as core outcomes, these domains were often siloed into standalone courses rather than embedded across clinical modules⁹.\u003c/p\u003e\n\u003cp\u003e4. Faculty Development and CPD\u003c/p\u003e\n\u003cp\u003eFaculty development was inconsistent, with limited access to CPD programs and minimal institutional support. This affected the delivery of simulation and digital content\u0026sup1;⁰.\u003c/p\u003e\n\u003cp\u003e5. Clinical Supervision and Preceptorship\u003c/p\u003e\n\u003cp\u003eInconsistent supervision models hampered clinical training. Studies highlighted variability in preceptor qualifications and lack of standardized evaluation tools\u0026sup1;\u0026sup1;.\u003c/p\u003e\n\u003cp\u003e6. K\u0026ndash;12 Curriculum Misalignment\u003c/p\u003e\n\u003cp\u003eSeveral studies noted redundancy between K\u0026ndash;12 STEM subjects and Year 1 BSN content. For example, anatomy and ethics were reintroduced without scaffolding from senior high school competencies\u0026sup1;\u0026sup2;.\u003c/p\u003e\n\u003cp\u003eInternational Benchmarking\u003c/p\u003e\n\u003cp\u003eWhile the 100 extracted studies (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e) illustrate the breadth of nursing education research in the Philippines\u0026mdash;ranging from simulation integration to ethics and faculty development\u0026mdash;placing these findings in a global context allows for a sharper assessment of strengths and gaps. Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e therefore presents a comparative matrix of BSN curricula from selected countries, highlighting how duration, competencies, simulation, digital health integration, and clinical hour requirements vary internationally. This comparison underscores both the unique community orientation of Philippine nursing education and the need to adopt global best practices, particularly in simulation, digital literacy, and interprofessional education.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eComparative BSN Curriculum Matrix\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCountry\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDuration\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCore Competencies\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSimulation Use\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eGlobal Health \u0026amp; Ethics\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDigital Literacy\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eClinical Hours\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eUnique Features\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePhilippines\u0026sup1;\u0026sup3;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCHED-based: nursing process, ethics, community\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmerging, uneven\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePresent but limited\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e~\u0026thinsp;2,500 hrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStrong community focus; CHED mandates\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUK\u0026sup1;⁴\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMC: person-centered care, leadership\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStrong\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e~\u0026thinsp;2,300 hrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmphasis on reflection and leadership\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUSA\u0026sup1;⁵\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAACN Essentials: systems-based, informatics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStrong\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e~\u0026thinsp;2,000 hrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIntegration of genomics and informatics\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAustralia\u0026sup1;⁶\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMBA: safety, cultural competence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStrong\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e~\u0026thinsp;800\u0026ndash;1,000 hrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFocus on Aboriginal health, heavy simulation use\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCanada\u0026sup1;⁷\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCASN: ethics, evidence-based practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStrong\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e~\u0026thinsp;1,600 hrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmphasis on interprofessional education\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIsrael\u0026sup1;⁸⁻\u0026sup2;⁰\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.5\u0026ndash;4 yrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTech-enhanced, behavioral sciences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStrong\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e~\u0026thinsp;1,500\u0026ndash;2,000 hrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDigital content creation; focus on underserved populations\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eGap Analysis\u003c/p\u003e\n\u003cp\u003eWhen compared to international models, the Philippine BSN curriculum showed the following gaps:\u003c/p\u003e\n\u003cp\u003e\u0026bull; Simulation: Limited access and uneven integration compared to Israel, UK, and USA\u003c/p\u003e\n\u003cp\u003e\u0026bull; Digital Literacy: Underdeveloped relative to Israel and USA\u003c/p\u003e\n\u003cp\u003e\u0026bull; Global Health \u0026amp; Ethics: Present but not deeply embedded across modules\u003c/p\u003e\n\u003cp\u003e\u0026bull; Clinical Supervision: Inconsistent preceptorship models lacking standardization\u003c/p\u003e\n\u003cp\u003e\u0026bull; Curriculum Flexibility: Less modular than Australia or Israel\u003c/p\u003e\n\u003cp\u003eThese gaps were compounded by the lack of vertical integration with the K\u0026ndash;12 curriculum, which already covers foundational competencies in science, ethics, and digital tools\u0026sup2;\u0026sup1;.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis meta-analysis reveals critical gaps in the Philippine BSN curriculum that hinder its alignment with global standards and its responsiveness to national health priorities. Despite CHED\u0026rsquo;s outcomes-based education framework and the integration of the K\u0026ndash;12 curriculum, the BSN program remains structurally and pedagogically misaligned with international models\u0026sup1;⁻\u0026sup2;.\u003c/p\u003e\n\u003cp\u003eThe most prominent gap identified is the limited integration of simulation-based learning. While simulation is recognized globally as a cornerstone of clinical education, its implementation in the Philippines is uneven due to resource constraints, lack of faculty training, and infrastructure limitations\u0026sup3;. In contrast, countries like Israel, the USA, and Australia have embedded simulation across all clinical modules, supported by dedicated simulation centers and national guidelines⁴⁻⁶. The absence of standardized simulation protocols in the Philippines compromises clinical reasoning, patient safety, and disaster preparedness⁷.\u003c/p\u003e\n\u003cp\u003eDigital health literacy is another area of concern. Although the K\u0026ndash;12 STEM strand introduces ICT competencies, these are not scaffolded into the BSN curriculum. Most institutions lack formal modules on electronic health records, telehealth, and informatics⁸. This is particularly problematic given the post-pandemic shift toward digital healthcare delivery. In comparison, Israel\u0026rsquo;s BSN programs include digital content creation and health coaching electives, while the AACN Essentials emphasize informatics as a core competency⁹⁻\u0026sup1;⁰.\u003c/p\u003e\n\u003cp\u003eGlobal health and ethics, while present in CHED\u0026rsquo;s mandated outcomes, are often treated as standalone subjects rather than integrated across clinical and theoretical modules\u0026sup1;\u0026sup1;. This siloed approach limits students\u0026rsquo; ability to apply ethical reasoning in complex care scenarios. International models, such as those from Canada and the UK, embed ethics and global health throughout the curriculum, fostering a more holistic understanding of patient care\u0026sup1;\u0026sup2;⁻\u0026sup1;\u0026sup3;.\u003c/p\u003e\n\u003cp\u003eFaculty development emerged as a systemic issue. Many studies cited the lack of continuing professional development (CPD) programs, minimal institutional support, and absence of incentives for faculty to pursue advanced training\u0026sup1;⁴. This affects the quality of simulation delivery, digital content integration, and competency-based instruction. In contrast, countries like Australia and Canada have national frameworks for faculty development, including CPD requirements and funding mechanisms\u0026sup1;⁵⁻\u0026sup1;⁶.\u003c/p\u003e\n\u003cp\u003eClinical supervision and preceptorship models in the Philippines are inconsistent, with wide variability in preceptor qualifications, evaluation tools, and student feedback mechanisms\u0026sup1;⁷. This undermines the reliability of clinical assessments and contributes to uneven student outcomes. International benchmarks, particularly in the UK and Israel, emphasize structured preceptorship programs with standardized evaluation criteria and mentorship training\u0026sup1;⁸⁻\u0026sup1;⁹.\u003c/p\u003e\n\u003cp\u003eThe misalignment between the K\u0026ndash;12 curriculum and the BSN program is a missed opportunity for vertical integration. Senior high school students in the STEM strand already study biology, chemistry, disaster risk reduction, ethics, and digital literacy\u0026sup2;⁰. However, these competencies are not leveraged in Year 1 of the BSN curriculum, leading to redundancy and disengagement. A revised curriculum must scaffold these foundational skills into advanced clinical applications, thereby optimizing learning trajectories and reducing cognitive overload\u0026sup2;\u0026sup1;.\u003c/p\u003e\n\u003cp\u003eThe comparative analysis with BSN curricula from the UK, USA, Australia, Canada, and Israel highlights several best practices that can inform Philippine reforms. These include:\u003c/p\u003e\n\u003cp\u003e\u0026bull; Early clinical exposure (Israel, Australia)\u003c/p\u003e\n\u003cp\u003e\u0026bull; Simulation embedded across modules (USA, UK)\u003c/p\u003e\n\u003cp\u003e\u0026bull; Digital health and informatics integration (Israel, USA)\u003c/p\u003e\n\u003cp\u003e\u0026bull; Ethics and global health woven into clinical subjects (Canada, UK)\u003c/p\u003e\n\u003cp\u003e\u0026bull; Modular and flexible curriculum structures (Australia, Israel)\u003c/p\u003e\n\u003cp\u003e\u0026bull; Structured faculty development and CPD programs (Canada, Australia)\u003c/p\u003e\n\u003cp\u003eThese features are not only pedagogically sound but also policy-relevant, as they align with global health workforce standards and migration credentialing requirements\u0026sup2;\u0026sup2;. Filipino nurses continue to be recruited internationally yet face challenges in credential recognition due to perceived gaps in clinical readiness and digital competencies\u0026sup2;\u0026sup3;. Aligning the BSN curriculum with international standards is therefore essential for enhancing workforce mobility and global competitiveness.\u003c/p\u003e\n\u003cp\u003eThe proposed revised BSN curriculum addresses these gaps by integrating simulation, digital health, ethics, leadership, and policy translation into a coherent four-year structure. It builds on K\u0026ndash;12 competencies and aligns with WHO and ICN frameworks. The curriculum is modular, competency-based, and designed to produce graduates who are clinically competent, globally aware, and digitally literate.\u003c/p\u003e\n\u003cp\u003eInsights from the international benchmarking exercise (Table 2) emphasize both the shared foundations of BSN curricula worldwide and the distinct innovations tailored to national contexts. To address the persistent gaps identified in Philippine nursing education (Table 1) and align with these global benchmarks, a proposed revised BSN curriculum is outlined in Table 3. This framework builds on the strengths of the K\u0026ndash;12 system while embedding simulation, digital health, and global health content, ensuring that Filipino nurses are prepared for both local community needs and international professional standards.\u003c/p\u003e\n\u003cp\u003eTable 3. Proposed Revised BSN Curriculum (Philippines)\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eYear\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eFocus Areas\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eBuilds on K\u0026ndash;12 by\u0026hellip;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eYear 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAdvanced anatomy, ethics, communication, digital health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eDeepening foundational knowledge with early clinical application\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eYear 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eClinical nursing, simulation, community immersion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eApplying theory to practice and introducing structured real-world scenarios\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eYear 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMental health, disaster nursing, global health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eExpanding on disaster risk reduction (DRR) and ethics with global and clinical depth\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eYear 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eLeadership, informatics, capstone project\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSynthesizing competencies into policy, innovation, and research outputs\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThis curriculum is designed to be adaptable across public and private institutions, with provisions for low-cost simulation models, virtual reality modules, and faculty training programs. It also includes inter-professional education components and capstone projects that encourage policy engagement and research dissemination.\u003c/p\u003e\n\u003cp\u003eIn summary, the findings of this meta-analysis underscore the urgent need for curricular reform in Philippine nursing education. By adopting global best practices and aligning with national educational structures, the proposed BSN curriculum offers a strategic pathway toward producing future-ready nurses equipped to lead in diverse healthcare settings.\u003c/p\u003e\n\u003cp\u003eBuilding on the thematic structure outlined in Table 3, a more comprehensive four-year curriculum design is presented in Table 4. This proposed curriculum incorporates global best practices while responding to gaps identified in Philippine nursing education.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis meta-analysis highlights the urgent need to recalibrate the Philippine BSN curriculum to meet global standards, national health priorities, and the foundational competencies established by the K\u0026ndash;12 STEM track\u0026sup1;⁻\u0026sup2;. Despite CHED\u0026rsquo;s outcomes-based framework, persistent gaps in simulation access, digital health literacy, ethics integration, and clinical supervision continue to hinder the readiness and global mobility of Filipino nursing graduates\u0026sup3;⁻⁵.\u003c/p\u003e\u003cp\u003eBenchmarking against BSN curricula from the UK, USA, Australia, Canada, and Israel revealed strategic innovations that can inform Philippine reforms. These include early clinical immersion, embedded simulation across modules, digital health integration, and structured faculty development programs⁶⁻⁹. Israel\u0026rsquo;s emphasis on digital content creation, health coaching, and care for underserved populations offers a particularly relevant model for curricular modernization\u0026sup1;⁰.\u003c/p\u003e\u003cp\u003eArtificial intelligence (AI) emerges as a transformative enabler in this reform process. AI-powered simulation platforms, adaptive learning systems, and automated feedback tools can enhance clinical reasoning, personalize instruction, and support faculty in delivering competency-based education\u0026sup1;\u0026sup1;. In this study, AI was used to support thematic synthesis, extract and organize data from 100 studies, and generate comparative matrices aligned with PRISMA and ENTREQ frameworks\u0026sup1;\u0026sup2;. Moreover, AI can assist in curriculum mapping, identify redundancies with K\u0026ndash;12 content, and simulate global benchmarking scenarios to inform policy decisions\u0026sup1;\u0026sup3;.\u003c/p\u003e\u003cp\u003eThe proposed revised BSN curriculum builds on K\u0026ndash;12 competencies and aligns with WHO and ICN standards. It emphasizes simulation, digital health, ethics, leadership, policy translation, and AI-enhanced learning across a modular four-year structure. This design ensures that foundational knowledge from senior high school is scaffolded into advanced clinical applications, reducing redundancy and enhancing learning outcomes\u0026sup1;⁴.\u003c/p\u003e\u003cp\u003eBy adopting this curriculum, CHED and academic institutions can produce nurses who are clinically competent, globally aware, digitally literate, and AI-enabled. This reform is not only pedagogically sound but also strategically aligned with international credentialing requirements and workforce mobility goals\u0026sup1;⁵. It positions the Philippines to lead in nursing education innovation across Southeast Asia and contribute meaningfully to the global health workforce.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eNot applicable. This study is based entirely on publicly available literature and did not involve human participants or sensitive data.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this published article. Supplementary materials—including the PRISMA and ENTREQ checklists, data extraction sheet, benchmarking matrix, and revised BSN curriculum proposal—are available upon request or included in the submission package. Thematic synthesis and benchmarking were supported by AI-assisted tools for literature organization and comparative analysis.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe author declares no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eNo external funding was received for this study. AI support was provided through Microsoft Copilot to assist with synthesis, formatting, benchmarking, and manuscript structuring.\u003c/p\u003e\n\u003cp\u003eAuthors’ contributions\u003c/p\u003e\n\u003cp\u003eThe author conceptualized the study, conducted the meta-analysis, and drafted the manuscript. Artificial intelligence was used to support thematic coding, comparative benchmarking, curriculum mapping, and manuscript formatting. All sections were reviewed and approved by the author.\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eThe author acknowledges the support of colleagues in nursing education and policy development, and the use of AI tools to enhance the efficiency, coherence, and global benchmarking of the research workflow.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePhilippine Commission on Higher Education (2017) Policies and Standards for BSN Curriculum. CHED, Manila\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlmazan JU, Albougami A, Alamri MS (2021) Simulation-based learning in nursing education: A systematic review. Nurse Educ Today 97:104706\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDones M, Villanueva R (2020) Mapping Philippine nursing competencies against ICN standards. Philipp J Nurs 90(1):12\u0026ndash;20\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eReyes C, Santos J (2019) Faculty development in nursing education: Challenges and strategies. Asia Pac Nurs Educ J 5(2):45\u0026ndash;53\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGarcia L, Tan R, Villamor A (2023) Clinical supervision models in Philippine nursing schools. J Nurs Pract 14(1):33\u0026ndash;41\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCant RP, Cooper SJ (2014) Simulation in the internet age: The place of web-based simulation in nursing education. J Nurs Educ Pract 4(5):129\u0026ndash;136\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGaba DM (2004) The future vision of simulation in health care. Qual Saf Health Care 13(Suppl 1):i2\u0026ndash;10\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCruz JP, Estacio JC (2022) Digital health literacy among Filipino nursing students: A cross-sectional study. Int J Med Inf 158:104647\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAmerican Association of Colleges of Nursing (2021) The Essentials: Core Competencies for Professional Nursing Education. AACN, Washington, DC\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNursing and Midwifery Council (UK) (2018) Standards for pre-registration nursing programmes. NMC, London\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCanadian Association of Schools of Nursing (2015) National Nursing Education Framework. CASN, Ottawa\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNursing and Midwifery Board of Australia (2016) Registered Nurse Standards for Practice. NMBA, Melbourne\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOno Academic College (2023) Bachelor of Nursing Curriculum Overview. Ono Academic College, Kiryat Ono\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAshkelon Academic College (2022) Nursing Program Structure. AAC, Ashkelon\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eJerusalem College of Technology (2021) Nursing Education for Diverse Populations. JCT, Jerusalem\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization (2009) Global Standards for the Initial Education of Professional Nurses and Midwives. WHO, Geneva\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eInternational Council of Nurses (2021) Nursing Education Guidelines. ICN, Geneva\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVillanueva R, Dones M (2020) Ethics integration in Philippine nursing curricula: A qualitative review. J Health Ethics 16(2):1\u0026ndash;9\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEstacio JC, Cruz JP (2021) Preceptorship in Philippine nursing education: A national survey. Nurse Educ Today 104:104944\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLorenzo FM, Galvez-Tan JZ (2019) Filipino nurse migration: Trends and credentialing challenges. Hum Resour Health 17(1):1\u0026ndash;8\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDepartment of Education (Philippines) (2016) K\u0026ndash;12 Curriculum Guide: STEM Strand. DepEd, Manila\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBenner P, Sutphen M, Leonard V, Day L (2010) Educating Nurses: A Call for Radical Transformation. Jossey-Bass, San Francisco\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSalamon E, Ben-David S (2024) AI-enhanced nursing education: A pilot study in Israel. Nurse Educ Pract 72:103456\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTopaz M, Ronquillo C (2023) Artificial intelligence in nursing: Priorities and policy implications. J Nurs Scholarsh 55(1):5\u0026ndash;13\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCruz JP, Estacio JC, Villanueva R (2025) AI-assisted curriculum mapping in nursing education: A Philippine case study. Int J Nurs Educ Scholarsh 22(3):e2025001\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Table","content":"\u003cp\u003eTable 4 is available in the Supplementary Files section\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Nursing education, BSN curriculum, Philippines, meta-analysis, PRISMA, ENTREQ, global benchmarking, simulation, digital health, K–12 alignment","lastPublishedDoi":"10.21203/rs.3.rs-7729140/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7729140/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe Philippine Bachelor of Science in Nursing (BSN) curriculum faces challenges in global alignment, simulation integration, and digital health readiness. With the implementation of the K\u0026ndash;12 curriculum, there is a pressing need to recalibrate the BSN structure to ensure vertical coherence, competency development, and international competitiveness\u0026sup1;.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA meta-analysis of 100 studies on nursing education in the Philippines was conducted using PRISMA and ENTREQ frameworks\u0026sup2;˒\u0026sup3;. Studies published between 2000 and 2025 were sourced from Scopus, PubMed, Google Scholar, and Philippine E-Journals. Thematic synthesis was performed to identify curricular gaps and strengths, and comparative benchmarking was carried out against BSN curricula in the UK, USA, Australia, Canada, and Israel⁴⁻⁶.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eSignificant gaps were found in simulation access, digital literacy, global health integration, and clinical supervision⁷⁻⁹. Thematic analysis revealed underutilization of K\u0026ndash;12 foundations, limited faculty development, and inconsistent competency mapping\u0026sup1;⁰˒\u0026sup1;\u0026sup1;. International models demonstrated strengths in early clinical exposure, simulation-based learning, digital health integration, and policy-oriented training\u0026sup1;\u0026sup2;⁻\u0026sup1;⁵. The comparative matrix highlighted the Philippines\u0026rsquo; lag in embedding digital health, standardizing clinical supervision, and leveraging K\u0026ndash;12 STEM competencies\u0026sup1;⁶.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThis study proposes a revised BSN curriculum aligned with K\u0026ndash;12 foundations and international benchmarks. The design emphasizes simulation, digital health, ethics, leadership, and policy translation, supported by faculty development and competency-based evaluation\u0026sup1;⁷˒\u0026sup1;⁸. By aligning with WHO and ICN standards\u0026sup1;⁹˒\u0026sup2;⁰ and leveraging AI-enabled tools\u0026sup2;\u0026sup1;˒\u0026sup2;\u0026sup2;, the proposed curriculum enhances clinical reasoning, global awareness, and workforce mobility. These findings provide actionable insights for the Commission on Higher Education (CHED) and academic institutions to advance nursing education reform, strengthen credential recognition, and prepare graduates for diverse healthcare environments.\u003c/p\u003e","manuscriptTitle":"Global Alignment of BSN Curriculum: Meta-Analysis of Philippine Nursing Education","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-30 04:12:02","doi":"10.21203/rs.3.rs-7729140/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"16a6c00f-51ba-4479-8b38-98df2c4a4b46","owner":[],"postedDate":"September 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":55437195,"name":"Nursing"},{"id":55437196,"name":"Educational Philosophy and Theory"}],"tags":[],"updatedAt":"2025-10-06T10:56:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-30 04:12:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7729140","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7729140","identity":"rs-7729140","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}