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Karla S Kerkove

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Aug 2026

Teaching social and structural determinants of health in nursing: A comparative analysis of microlearning, problem-based learning, and gamification.

THE ISSUE Pre-licensure nursing programs are accountable for preparing nurses who can recognize and address social and structural determinants of health (SSDOH), yet nursing faculty have limited evidence to guide the selection of active-learning strategies that develop this competency. Since the pandemic, microlearning, problem-based learning (PBL), and gamification have been increasingly incorporated into health professions education programs; however, limited guidance exists regarding their relative contributions to SSDOH competency development. This contemporary issue uses Bereday's comparative method to interpret and compare health professions education literature (2022-2025) across five criteria aligned with SSDOH competency frameworks. We argue that these strategies serve distinct educational purposes rather than interchangeable ones: microlearning builds foundational knowledge and shared language, PBL develops systems thinking and ethical reasoning, and gamification promotes engagement with the lived experiences that shape health outcomes. We propose a scaffolded, blended sequence in which microlearning, PBL, and gamification develop complementary dimensions of SSDOH competence that no single strategy can achieve on its own.

Karla S Kerkove, S. Kotcherlakota · 0 citations