Jessica Prothe, MSN, RN, of Northern Illinois University School of Nursing, and colleagues conducted the study and published their findings in Teaching and Learning in Nursing.
Ms. Prothe and colleagues explained that inequities in breast cancer care that are experienced by Black women are “driven by complex structural, social, and clinical factors that shape access to high quality care.”
The study authors highlighted that oncology nursing education plays a key role in teaching nurses how to “recognize and respond to the multilevel contributors that sustain these disparities.” The 5W organizational tool includes five core questions—Who, What, Where, When, and Why—to analyze individual patient experiences and guide care decision-making.
The authors performed a “comprehensive literature search” to obtain evidence to inform the study, collecting data from CINAHL, PubMed, Google Scholar, and Medline. The search criteria included the following terms:
“Advocacy,”
“Nursing education,”
“Equity-focused teaching strategies,”
“Nursing curriculum,”
“Health equity,”
“Organizational strategies,” and
“5W strategy.”
Upon data collection, “iterative refinement” was employed to “ensure inclusive coverage of the evidence base.”
Findings from the study determined that the 5W organizational tool was an optimal strategy that can be used to help oncology nurses implement and integrate “equity-focused concepts across academic and clinical environments to strengthen equity-centered decision making.”
Ms. Prothe and colleagues explained that leveraging the 5Ws in clinical practice helps oncology nurses assess gaps and barriers to breast cancer care, identify patients who are most affected by disparities in care, uncover what occurs as a result of these disparities, examine why inequities within this patient population persist, and determine “where nursing interventions can be implemented.”
Investigators also highlighted potential “barriers to implementation,” which they wrote continue at the “interpersonal, cultural, institutional, and societal levels.” They explained that persistent gaps and barriers to equitable breast cancer care emphasize the need for improvements in nursing education, including “the need for intentional curricular design, alignment with equity-focused competencies, and incorporation of policy-relevant content within nursing programs.”
“Equipping nurses with equity-centered competencies are essential for addressing breast cancer disparities among Black women and strengthening health equity across the cancer care continuum,” they concluded.