I. Introduction
Information and communication technologies (ICTs) are rapidly transforming human interactions across various domains, including healthcare, education, and commerce. In healthcare, mobile technologies offer physicians and nurses real-time access to patient data, thereby improving clinical decision-making [1,2]. Similarly, ICT supports telehealth services and facilitates the use of applications that provide health information, including self-care instructions [3], and targeted tools for specific population groups via social networks [4].
This interdisciplinary area, known as health informatics, focuses on the effective use of biomedical data for research, problem-solving, and decision-making [5]. In other words, health informatics is not merely a science, but rather an information science providing technology-supported tools and solutions for delivering and managing healthcare. It encompasses various thematic areas, including telehealth, electronic medical records, health information systems, and mobile health.
Health informatics is subdivided according to specific health professions, resulting in specialized fields such as medical informatics, dental informatics, and nursing informatics (NI). The American Medical Informatics Association, the Healthcare Information and Management Systems Society (HIMSS), and the American Nursing Informatics Association collectively define NI as the integration of nursing science with information sciences for managing and analyzing information in nursing practice [5].
NI programs encourage nurses to gain deeper insights into patient needs and concerns and develop essential ICT skills for both learning and clinical practice [6]. Research indicates that nurses knowledgeable in ICT management adapt more effectively to digital environments and technological tools, contributing significantly to improved patient care quality [7,8]. Consequently, ICT education is critical for enhancing nursing care and overall healthcare delivery, implying that future nurses must possess these skills to function effectively in increasingly digitalized healthcare environments [9].
To improve nursing competencies, universities must integrate NI into their curricula, ensuring graduates possess the necessary digital skills and competencies aligned with societal demands and contemporary technological innovations [10]. A comprehensive NI course should cover fundamental concepts and practical informatics applications in healthcare delivery.
In 2022, HIMSS outlined five specific roles for NI professionals: clinician, quality manager, interprofessional care coordinator, nursing manager, and NI manager. Key competencies required for these roles include understanding NI principles, Information and Communication Systems (including interoperability), data protection and security, standardized terminologies, computing ethics, telehealth, ICT-supported clinical decision-making, technological assistance for older adults, quality and process management, research information management, and patient care information and knowledge management [11].
In several countries, NI has already been integrated into nursing education programs, sometimes mandated for academic accreditation [12]. African nations have initiated various healthcare technology projects reflecting this trend [13]. In Latin America and the Caribbean (LAC), significant experiences include Brazil, where NI has been mandated by national curricular guidelines since 2001 [14]. Reviews of undergraduate health informatics curricula in Peru [15] and educational pathways in NI in Argentina [16] further illustrate regional interest and development in this area.
Thus, it is essential to characterize NI courses using various factors, such as language uniformity, which enhances the precision of data analysis and minimizes potential interpretation errors arising from multilingual comparisons. Feasibility of analysis is also crucial, as additional challenges may emerge when translating and processing information in different languages. Finally, representativeness is important, given the significant proportion of Spanish-speaking countries within the LAC region. This approach ensures methodological uniformity during information extraction and analysis.
Given these considerations, it is important to identify the characteristics of NI within undergraduate curricula at LAC universities. The central research question of this study is: What are the characteristics of NI subjects at universities in the LAC region? Consequently, the primary objective of this study is to identify and characterize the NI subjects currently integrated into nursing degree curricula at Spanish-speaking universities in Latin America and the Caribbean.
II. Methods
This was a descriptive cross-sectional study conducted through a systematic search for NI or health informatics courses in the c–rricula (also referred to as the pensum) of Spanish-speaking universities in the LAC region offering undergraduate nursing degree programs. The inclusion criteria consisted of universities providing professional nursing education spanning 4 to 5 academic years. A course qualified if it lasted at least one academic semester, if the institution offering it was accredited by a recognized national governing body, and if an active nursing degree webpage was accessible to evaluate the curriculum presented online (Table 1). Universities offering subjects focused solely on “office automation or Office IT,” defined as courses dealing specifically with software and ICT applications aimed at automating and enhancing administrative tasks, were excluded, as these differ substantially from NI or health informatics guidelines [11]. Additionally, universities were excluded if their curricula did not indicate an approval date, as such a date verifies whether the information provided is current and aligns with contemporary nursing education standards, particularly relevant in rapidly evolving fields such as NI.
Extracted data included variables such as the country where the university is located, the type of institution (public or private), the curriculum approval year (specifically, the plan taught during the 2022 academic year), course title, the academic year in which it is taught, prerequisites (if any), whether it serves as a prerequisite for other courses, whether it is optional, total academic hours, and detailed course content (if the syllabus was available).
Three reviewers—a Bachelor of Science in Nursing with expertise in NI, a physician holding a master’s degree in health informatics, and a Doctor of Nursing—independently reviewed and validated each record, analyzed findings, and updated the database as necessary. Any discrepancies were resolved through consensus among reviewers, with two additional reviewers—a nurse holding a master’s degree in health informatics and another Doctor of Nursing—providing further input when required.
III. Results
A total of 400 accredited universities offering nursing degrees were initially identified, of which 23 offered courses in NI or health informatics. Forty-eight universities were excluded due to inactive webpages, 55 did not publish the curriculum on their webpages, 123 did not offer any NI courses, 134 offered only office IT courses, and 17 did not specify the approval date of their curricula.
The universities offering NI courses were distributed across seven countries (Argentina, Chile, Colombia, Ecuador, Mexico, Peru, and the Dominican Republic), offering a comprehensive representation of the regional educational landscape. Argentina had the highest representation, with eight universities (34.80%), followed by Ecuador with five (21.70%). Additionally, 16 institutions (69.60%) were private, and seven universities (30.24%) had curricula updated in 2018 (Figure 1).
NI courses were predominantly offered in the third year of study at 10 universities (43.50%), and 21 universities (82.61%) offered the course only once during the academic program. The course was optional at six universities (26.10%), had no prerequisites at 18 institutions (78.30%), and was not a prerequisite for subsequent courses at 17 universities (73.90%). At institutions where the NI course was a prerequisite, it generally served as a foundation for more advanced NI courses or other subjects, including biostatistics, leadership in health management, surgical nursing, quality management, and clinical practice. Regarding course duration, four universities did not specify academic hours, while the remaining 19 universities reported an average of 75.40 academic hours per course (range, 30–160 hours) (Table 2).
The course names were diverse, including terms such as “Nursing Informatics,” “Informatics Applied to Health,” “Informatics Applied to Nursing,” “Telehealth,” “ICTs in Health,” and “ICTs and Advanced Practice Nursing,” among others (Table 3).
Only four universities made syllabi publicly available, featuring content focused on topics including health informatics and nursing informatics fundamentals, health information systems, database usage, standardized terminology, regulations in health informatics, and practical NI applications (Table 4).
IV. Discussion
This study aimed to identify and characterize NI courses offered by universities in Spanish-speaking countries within the LAC region. Most of these courses were provided by public institutions and taught only once during the nursing program. Moreover, these courses typically were neither prerequisites for other subjects nor mandatory components of the curriculum.
Our findings highlight a concerning situation: the educational offering of NI within nursing degree curricula across the analyzed universities was significantly limited. Out of 400 accredited institutions in the examined countries, only 23 universities offered NI courses. While the possibility exists that many institutions might not have published their curricula online, the scarcity of NI courses across the LAC region remains evident. The dissemination and integration of NI training programs in nursing education—and broadly within the health sciences—are not yet widespread. This scarcity underscores an urgent need for initiatives to improve the current educational landscape.
Regarding course content, the analyzed syllabi align well with the guidelines and recommendations of the HIMSS [11]. NI courses in LAC reflect competencies similar to those proposed in Austria, Germany, and Switzerland [17]. Course content is consistent with the competencies established by HIMSS’s Technology Informatics Guiding Educational Reform (TIGER) initiative [11] and its ongoing updates. This alignment is essential since future nursing professionals must be proficient in emerging healthcare technologies. NI courses foster the digital skills and competencies required by future nurses [10,12], covering contemporary care models used in complex, digitally driven healthcare environments [8]. It should be emphasized that most LAC countries already possess regulations governing the use and implementation of ICTs in healthcare, particularly Electronic Health Records and Telehealth [18]. Moreover, the global health and social crisis precipitated by the COVID-19 pandemic required widespread adoption of ICT across various sectors. However, many nurses lacked the necessary competencies and knowledge to effectively respond [19]. This situation strongly supports incorporating NI courses to adequately prepare future nursing professionals according to current and anticipated technological needs.
Within the LAC region specifically, Argentina and Ecuador have a notably higher number of universities offering NI courses, and the implementation of NI curricula in these countries has been well-documented [16].
In 2018, Argentina approved its National Digital Health Strategy 2018–2024 [20], designed to reduce healthcare quality gaps, implement comprehensive health information systems, facilitate patient monitoring, and equip health professionals with innovative digital tools. Similarly, Ecuador’s Digital Transformation Agenda 2022–2025 aims to integrate ICTs into sectors such as health, enhancing medical care delivery and advancing digital competencies [21]. These national initiatives underscore the imperative of equipping healthcare professionals with ICT competencies for effective use within health systems.
Globally, significant developments in NI education have occurred in other regions. African countries such as Malawi, Ghana, and Nigeria have reformed university nursing curricula to incorporate NI competencies [13,22]. In Asia, the Republic of Korea has integrated NI courses at the undergraduate level since 2014 [23] and developed a standardized curriculum [24]. China has extensively studied NI’s impacts and implementation recommendations [25], along with its integration into clinical practice since 2013 [26]. In the United Kingdom, the Nursing and Midwifery Council introduced nursing education standards, including digital literacy and ICT skills, beginning in 2018 [27]. Additionally, countries such as Denmark, Canada, Australia, New Zealand, and the United States have implemented NI courses within undergraduate nursing programs, with reports on such initiatives dating back to 2013. The number of academic hours allocated varies considerably, and in some instances, the course is elective rather than mandatory [12]. These international experiences partially align with our findings, particularly regarding the timing of NI courses within curricula, the absence of prerequisites, and the fact that these courses are not typically prerequisites for other subjects. Although NI course implementation is progressively increasing globally [11,14,16], progress in the LAC region remains comparatively slow. Challenges faced by LAC universities include insufficiently trained teaching staff [24], as well as limitations in educational materials and practical equipment [19].
It is necessary to consider the recommendations issued by governing bodies such as the International Council of Nursing, which emphasizes, in its code of ethics, the appropriate and ethical use of technologies in patient care, along with the necessity of educating oneself and others about global health using current technological resources [28]. Likewise, regarding the training of future nurses, the use of online learning platforms is suggested; however, such approaches should be evaluated and adapted according to each country’s specific characteristics and available resources. Thus, establishing the availability of Nursing Informatics (NI) courses within undergraduate nursing programs would be beneficial to ensure students learn to utilize ICT effectively in patient care prior to engaging in direct patient interactions during clinical training. To enhance technology-based learning in nursing care, NI courses should be mandatory and systematically integrated into the curricula.
Analyzing curricula or course syllabi enables identification of the specific content covered in NI courses. Notably, topics such as health information systems, database management, standardized terminologies, regulations related to health informatics, and practical applications of NI are mentioned, aligning with the recommendations outlined in the TIGER initiative (3 out of 4 analyzed syllabi) [11]. This document defines specific roles for healthcare professionals, particularly those involved in direct patient care, such as nurses and physicians. Furthermore, it is highlighted that student engagement with ICT improves their digital literacy and boosts their confidence when utilizing technological tools [29,30]. Consequently, NI courses must cultivate competencies in nursing students that enable them to use diverse ICT applications proficiently in patient care contexts. Currently, NI courses remain in a stage of progressive implementation both in the LAC region and globally. Given the complexity and evolving nature of nursing care, educators must carefully determine curriculum content to ensure it remains updated on essential topics such as ICT utilization in nursing practice and health data management. Ongoing evaluation of these curriculum changes is also necessary to support continuous updates and improvements [11].
Concerning study limitations, many LAC institutions have yet to digitize and publish their curricula online; consequently, some NI courses may not have been identified through the methodology applied in this study. Moreover, excluding curricula lacking an explicit approval date might inadvertently omit relevant NI courses; however, this criterion was employed to enhance the replicability and feasibility of the study. Additionally, focusing exclusively on Spanish-speaking countries may exclude universities offering NI courses in other languages; however, this methodological choice does not preclude expanding analyses to include non-Spanish-speaking institutions in future research. At this initial stage, concentrating on Spanish-speaking universities enables more manageable analysis and ensures comparability across institutions. Furthermore, most universities identified as offering NI courses did not make their syllabi publicly available online, restricting a comprehensive characterization of course contents. Therefore, the results presented should be interpreted as reflective only of the available online curricular information.
In conclusion, the availability of NI courses in Spanish-speaking universities within the LAC region remains limited. Such courses typically appear midway through undergraduate nursing curricula and do not usually form part of a sequential course structure; they neither require prerequisites nor serve as prerequisites for subsequent subjects. Additionally, public universities tend to offer more NI-related courses compared to private institutions.
Future studies investigating NI courses in LAC might adopt methodologies such as surveys and interviews with instructors or university administrators to collect and comprehensively analyze course curricula, enabling a deeper characterization of NI course contents.
This study lays the groundwork for digital health education and highlights the critical necessity of integrating NI training into higher education. Furthermore, it serves as a valuable reference for educational policymakers by underscoring the importance of equipping nurses with health informatics competencies, essential for their effective integration into national digital health strategies and broader health system modernization initiatives.
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