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How did nursing education move from hospital schools to colleges and universities?

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A young doctor or nurse uses a blood pressure cuff and stethoscope to measure the blood pressure of an elderly man seated at a clinic office desk. — Nursing A nurse uses a sphygmomanometer to check a patient's blood pressure.

The transition of nursing education from hospital-based training to collegiate programs was a gradual process that spanned much of the 20th century.

Initially, hospitals established their own training schools where students provided years of skilled, free labor in exchange for clinical instruction. This model effectively bound nursing education to hospitals rather than academic institutions, a tie that persisted for decades.1

The shift toward university-based education was significantly influenced by the 1923 Winslow-Goldmark report, titled Nursing and Nursing Education in the United States. As the principal investigator for the Rockefeller Foundation’s committee, Josephine Goldmark examined over 70 nursing schools, providing evidence that prompted the upgrading of educational standards and the establishment of university affiliations.2

By the latter half of the 20th century, the dependence on hospital-based training declined as these programs were replaced by collegiate curricula in community colleges, technical colleges, and universities. This evolution allowed for more systematic education, including the development of graduate programs and doctoral degrees in nursing, which emphasized the research and scientific knowledge necessary to address complex modern health care demands.1