“We cannot sit and wait for these things to happen by themselves”: a qualitative study of barriers and enablers for active patient involvement in Norwegian undergraduate nursing education

Scientific abstract Background Active patient involvement in health professions education (HPE) is increasingly recognized to enhance patient-centered care and improve healthcare outcomes. However, in Norway, there are no formal requirements for patient involvement in nursing education, and its implementation remains inconsistent. The study aims to explore the enablers and barriers to active patient involvement in Norwegian undergraduate nursing education, as perceived by nursing students, nurse educators, and patients/family members. Methods A collaborative research methodology was employed, involving three digital workshops and one co-creation workshop with six educators, three senior nursing students, and six patients/family members. Data were analyzed using an iterative qualitative framework to identify key themes. Findings Three main themes were generated: (1) Hesitance toward experiential knowledge were identified as a fundamental barrier, with participants highlighting a perceived hierarchy that undervalues patient expertise. (2) Lack of formal requirements, systems, and structures was seen as a significant limitation, leaving patient involvement dependent on individual educators’ initiatives. (3) Training and competency development were identified as both enablers and barriers, with participants emphasizing the need for training both patients and educators to ensure meaningful and effective involvement. Conclusion The study underscores the need for structural changes, including formal requirements for patient involvement in nursing education, faculty development programs, and training for patient contributors. Addressing epistemic injustice and fostering a culture that values experiential knowledge is critical for advancing patient involvement in HPE.