Curricular integration of the sustainable development goals in nursing education: evidence from the Universidad Técnica del Norte (Ecuador)

Abstract

The purpose of this paper is to examine how the Sustainable Development Goals (SDGs) are integrated into a nursing education program at the Universidad Técnica del Norte (UTN), Ecuador and to identify the institutional, curricular and pedagogical factors associated with their explicit incorporation. The study aims to clarify the gap between SDGs awareness and formal curricular enactment in higher education for the health sciences. The study adopts a sequential mixed-methods design combining qualitative, quantitative and documentary approaches. Data were collected through a faculty focus group, surveys administered to instructors (n = 35) and undergraduate nursing students (n = 498) and a microcurricular review of official course syllabi (n = 45) within the UTN nursing program. Quantitative analyses included nonparametric tests, correlation analyses, clustering techniques and logistic regression, while qualitative and documentary data were integrated through methodological triangulation. Although faculty awareness of the SDGs is relatively high, their translation into explicit curricular practice remains uneven, with fewer than two thirds of instructors reporting formal integration. Faculty engagement is concentrated primarily on SDGs 3 (Good Health and Well-Being) and SDGs 4 (Quality Education), reflecting disciplinary proximity, while broader socio-ecological goals receive limited attention. Logistic regression analysis showed moderate explanatory capacity (McFadden’s pseudo-R2 = 0.429), indicating that structural and curricular factors play a stronger role in explicit SDGs integration than pedagogical activity alone. Among students, exposure to the SDGs is widespread, but levels of deep understanding are modest, and knowledge is only weakly associated with perceived importance. The micro-curricular analysis reveals that explicit SDGs references are largely absent from foundational courses and become more prevalent in professionalizing and practice-based stages, particularly during the Rota. The study is limited by its single-institution design and the small faculty sample size, which may restrict statistical power and generalizability. Future research should adopt multi-institutional and longitudinal designs and incorporate direct measures of sustainability competence development. The findings provide actionable guidance for curriculum governance and faculty development in nursing education. They support the need to institutionalize SDGs integration from early curricular stages, align active pedagogies with explicit learning outcomes and assessment criteria and strengthen program-level mechanisms to ensure coherent and traceable Education for Sustainable Development (ESD). By strengthening the integration of the SDGs in nursing education, higher education institutions can better prepare future nurses to address health inequities, promote preventive and community-based care and contribute to sustainable health systems. Such integration also enhances graduate employability by developing competencies increasingly valued in the global health sector, including sustainability awareness, equity-oriented practice, community engagement and responsible use of health resources. In the Ecuadorian context, and more broadly in the Global South, such curricular alignment has the potential to enhance social justice, public health outcomes and community well-being through professionally trained agents of sustainable development. To the best of the authors’ knowledge, this study provides one of the first empirical, multilevel analyses of SDGs integration in nursing education in Ecuador. By combining faculty and student perspectives with micro-curricular evidence from UTN, it offers an evidence-informed framework for strengthening ESD in health sciences programs, particularly in Global South contexts.