Teaching healthcare history in the curriculum

By Gerard Fealy

Elsewhere, I have differentiated the terms ‘nursing history’ and ‘the history of nursing’ (Fealy 2008). Like labour history, women’s history, or military history, the former term refers to a field of study within the discipline of history, while the latter refers to the past of nursing, and may include the history of the writing of nursing history. Defined in this way, nursing history may be considered as a field of academic study, and as such, may be developed as a topic to be taught in a curriculum, including, but not exclusively, in a nursing curriculum. As a curricular topic in the academy, the content of nursing history courses should be developed from published research, especially research published by those trained in the theory and method of historical research. This research-teaching nexus is a fundamental requirement for teaching in the academy.

Teaching nursing history

Teaching nursing history in the curriculum has long been debated in policy on nursing education, particularly policy related to undergraduate preparatory education (Lewenson 2004; Kelly & Watson 2015). Despite it being mandated as a topic by nursing regulatory authorities, empirical and anecdotal evidence indicates that nursing history gets little space in the curriculum due to competing demands for the inclusion of, presumed, more important subjects, limited timetable capacity, or a lack of teacher expertise (Kelly & Watson 2015).

Arguments for the inclusion of nursing history, either as a distinct course or integrated across the curriculum, are posited on the perceived importance of teaching students about the origins and development of the discipline, such as the contribution of nursing to organised care systems in hospitals and communities and in military conflicts, the role of historical nursing leaders, and so forth. Other arguments include the need to facilitate students’ understanding of nursing history in its wider social and political contexts, such as women’s history and gendered work, social relationships, and nursing advocacy in healthcare. These arguments are typically couched in the notion that placing nursing within its particular clinical and wider historical contexts offers a basis for understanding the present context. Another implicit rationale for teaching nursing history is that it is a necessary part of the process of socialising students into the discipline; hence, where it is taught, nursing history tends to get included early in the curriculum. A more fundamental justification for teaching nursing history is concerned with the very notion of disciplinary identity, and as a subject that can be taught in the academy. Hence, for those practicing and professing the discipline, a criterion for disciplinary distinctness and disciplinary maturity is having a shared and explicit understanding of history of the discipline and especially its practice history (Fealy et al. 2013).

Teaching history: An alternative to teaching nursing history in the curriculum

My own experience of teaching history in the curriculum was to adopt a strategy that did not focus solely on nursing history or, indeed, on nursing students as the audience. The strategy was developed directly from a major curriculum reform initiative that University College Dublin (UCD) introduced in 2005. Branded as ©UCD Horizons, this university-wide initiative offered students the opportunity to study up to thirty ECTS credits in their programme major, through elective modules, with the aim of either broadening or deepening their knowledge. On that basis, a student could take one or more electives offered by other schools and other disciplines in the University.

It was within that context that I developed and offered a module entitled A social history of Irish healthcare (©UCD), a module that examined aspects of the history of healthcare in Ireland in the nineteenth and twentieth centuries. Set against the background of social and economic developments in Ireland in the period, the module explored the subject through four themes: ‘Institutions: Hospitals and workhouses; ‘Public health and sanitation’; ‘Health care in military conflicts’; and ‘Health professionals and their patients’. The module introduced students to early examples of organised healthcare in Ireland, including charity and state hospitals, asylums, and workhouse infirmaries, and it discussed methods of treatment and care in these institutions. The module also highlighted significant developments in scientific medicine, including theories of physiology and health, contagion and disease, and the relationship between urban sanitation and public health. In the theme ‘Health professionals and their patients’, the module examined the disciplines of medicine, nursing, and radiography, and examined the history of care systems in mental illness, tuberculosis, ageing, childhood disability, intellectual disability, HIV-AIDS and hospital acquired infections.

The module was designed for students of all healthcare disciplines, and students studying courses in the arts and humanities and the social sciences. The aim of the module was to introduce students to a range of topics in the history of Irish healthcare, using the lens of social history, and thereby offer the students a wider historical context for understanding how modern health systems developed and currently operate. For the most part, I prepared the teaching content from my own research. The module offered students from several disciplines an opportunity to engage in a shared learning experience. Over fifteen years of teaching the module, my experience showed that students from several disciplines elected to study the module, and each year, students attended in considerably large numbers. Formative and summative evaluative data indicated the module’s effectiveness, in terms of student learning and satisfaction with module content and teaching.


Fealy GM (2008) Historical research, In Watson R, McKenna H, Cowman S and Keady J (eds), Nursing Research: Design and Methods, Edinburgh: Elsevier, pp. 45–53.

Fealy GM, Kelly J, Watson R (2013) Legitimacy in legacy: A discussion paper of historical scholarship published in the Journal of Advanced Nursing, 1976–2011, Journal of Advanced Nursing 69 (8), pp. 1881–1894, DOI: 10.1111/jan.12048

Kelly J and Watson R (2015) ‘An integrative review of the literature on the teaching of the history of nursing in pre-registration adult nursing education in the UK, Journal of Advanced Nursing, An integrative review of the literature on the teaching of the history of nursing in pre-registration adult nursing education in the UK’, Nurse Education Today, 35(2), pp. 360–365. DOI: 10.1016/j.nedt.2014.10.015

Lewenson S (2004) ‘Integrating nursing history into the curriculum’, Journal of Professional Nursing, 20 (6), pp 374–380, DOI: 10.1016/j.profnurs.2004.08.003