Healthcare Wants Innovation, but Nurses Are Still Not Trained to Lead Change

A global review finds that while nurses are increasingly expected to drive innovation in healthcare, they are rarely given formal training in entrepreneurship, leadership, or innovation skills. The study argues that nursing-specific entrepreneurship education is essential to empower nurses as effective change-makers in overstretched health systems.

Health systems around the world are being pushed to their limits. Budgets are tightening, burnout is widespread, populations are growing older, and digital technologies are transforming how care is organised and delivered. In this environment, innovation has shifted from being a bonus to a necessity. Yet a new review led by researchers at Griffith Business School, Griffith University, reveals a critical disconnect: nurses are increasingly expected to lead change, but are rarely equipped with the skills to do so.

Published in Nurse Education in Practice, the review examines 18 entrepreneurship education programs spanning eight countries. Its conclusion is hard to ignore. As doctors receive growing exposure to training in innovation, leadership, and entrepreneurship, nurses, who represent the largest and most embedded segment of the global healthcare workforce, remain largely excluded. This is despite their central role in frontline care and their daily involvement in adapting systems under pressure.

Rethinking What “Entrepreneurship” Means in Healthcare

For many people, entrepreneurship still sounds like start-ups, private businesses, or profit-making ventures. That misunderstanding has limited its acceptance in nursing education. The researchers argue that this narrow view misses the point.

In healthcare, entrepreneurship is about recognising problems, finding practical solutions, mobilising resources, and making change happen inside complex systems. By that definition, nurses already act entrepreneurially every day, redesigning workflows, improving patient safety, and adapting care to local realities. What they often lack is formal training in how to do this effectively, confidently, and sustainably.

The review shows that entrepreneurship education can help nurses develop skills such as leadership, strategic thinking, collaboration, and innovation, skills that are increasingly essential in modern healthcare.

Who Gets Trained, and Who Gets Left Behind

One of the clearest patterns in the review is for whom entrepreneurship education is designed. Most programs focus on physicians, medical students, or academic faculty. Nursing-focused initiatives are fewer, smaller, and narrower in scope.

Physician programs tend to cover a wide range of topics, including management, finance, strategy, and leadership. Nursing programs, by contrast, focus more on personal skills and creativity, with far less attention to financial literacy or risk management. This imbalance matters. Without understanding budgets, trade-offs, and uncertainty, even good ideas struggle to survive in real healthcare systems.

The authors also note that most programs are based in urban academic hospitals, particularly in the United States, leaving rural settings and low-resource contexts underrepresented.

Learning by Doing Works Best

How entrepreneurship is taught has changed over time, and mostly for the better. Older programs relied heavily on lectures about business or management. Newer initiatives, especially those involving nurses, use hands-on, team-based learning.

These include innovation workshops, entrepreneurship camps, hackathons, and real-world improvement projects. Participants work in teams, receive mentorship, test ideas, and pitch solutions. This practical approach fits well with nursing education, which already values experiential learning and reflection.

However, major gaps remain. Digital health, data skills, and artificial intelligence, now central to healthcare innovation, are barely covered. The review suggests that nurses are being prepared for yesterday’s challenges, not tomorrow’s.

What Actually Changes After the Training

Do these programs make a difference? The evidence is mixed. Many studies promise better patient care, lower costs, or improved population health, but few measure these outcomes clearly.

Where the evidence is strongest is in workforce wellbeing. Entrepreneurship education is linked to higher confidence, stronger leadership identity, better job satisfaction, and reduced burnout. In a global nursing shortage, these outcomes are far from trivial.

Evidence for cost savings and health equity improvements exists, but is limited. The authors argue this is not a reason to abandon entrepreneurship education, but a sign that programs need better design and long-term evaluation.

Why This Matters Now

Healthcare systems increasingly rely on nurses to lead change, often without authority, training, or support. The review warns that if entrepreneurship education remains doctor-focused, it risks reinforcing old hierarchies rather than unlocking the full potential of the workforce.

The authors call for nursing-specific entrepreneurship education that is practical, long-term, and grounded in real clinical settings. They argue for stronger attention to finance, risk, digital innovation, and social impact, especially health equity.

The message is simple. If nurses are expected to help transform healthcare, they must be trained not just as caregivers, but as innovators. Without that investment, health systems will keep asking nurses to fix problems they were never taught how to solve.