Who Does the Nursing Curriculum Produce? Neoliberalism, Coloniality, and Justice in Philippine Nursing Education

Article information

Cleofas, J. V. (2026). Contesting neoliberal-colonial curricular governance: A critical discourse analysis of national nursing education standards in a nurse-exporting state. Nurse Education Today, 162(107046), 107046. https://doi.org/10.1016/j.nedt.2026.107046 

What this study is about

This paper asks a big question about nursing education: What kind of nurse does a national curriculum policy try to produce?

The article analyzes the Philippine national policies, standards, and guidelines for the Bachelor of Science in Nursing program—specifically CHED Memorandum Order No. 15, series of 2017. This document governs how BSN programs in the Philippines should be designed, implemented, monitored, and evaluated. 

At first glance, curriculum standards may look neutral. They specify outcomes, competencies, course requirements, faculty qualifications, learning resources, and quality assurance mechanisms. But this paper argues that such documents do more than organize education. They also shape professional identity. They define what counts as “quality,” what kind of knowledge matters, what kind of graduate is desirable, and what forms of nursing practice become easier—or harder—to teach. 

The paper is especially interested in whether the national BSN standards create space for justice-consciousness: the awareness of social and health injustices, and the commitment to respond to them through nursing education and practice.

Why this matters

Nursing is increasingly being defined as more than technical competence. The paper begins by noting that the 2025 International Council of Nurses definition emphasizes advocacy, compassion, human rights, sustainability, and the highest attainable standard of health. If nursing is understood as a justice-oriented profession, then nursing curricula must also prepare students to recognize and respond to injustice. 

But this is not easy in a country like the Philippines, which is deeply embedded in global nurse migration. The Philippines is one of the world’s major source countries for migrant nurses. This means nursing education is often pulled in two directions: preparing nurses for local health needs while also making them globally legible and employable. 

The paper argues that this creates a curricular problem. If “quality nursing education” becomes too closely tied to international comparability, exportability, auditability, and external standards, then local health priorities, community voices, and Filipino nursing knowledges may be pushed to the margins.

The method: critical discourse analysis

The study uses Faircloughian Critical Discourse Analysis (CDA). This method treats language as a form of social practice. In simple terms: policy language does not only describe what schools should do; it helps govern what schools, faculty, students, and graduates become. 

The analysis moves across three levels:

1. Text — the words, grammar, modality, and evaluative language in the policy.
2. Discursive practice — how the policy draws on other documents and circulates into syllabi, curriculum maps, rubrics, and audits.
3. Social practice — how the policy connects to wider systems of neoliberalism, coloniality, nurse migration, and global health labor. 

The paper focuses on the PSGs as the main document, but it also considers related “authorizing texts,” such as laws, CHED policies, competency standards, qualification frameworks, clinical governance standards, accreditation systems, and international comparability frameworks. 

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What the study found

1) The policy uses a “governing grammar”

The paper finds that the PSGs uses strong regulatory language. It repeatedly uses words such as shall, must, required, secure, adhere, implement, submit, comply, and maintain. 

This kind of language constructs nursing education as a system that must be engineered, monitored, documented, and audited. The policy does not simply invite schools to educate nurses. It organizes education through obligations, documents, matrices, submissions, approvals, and sanctions.

The analytic table on page 6 summarizes how transitivity, dialogicality, modality, and evaluative language work together. These linguistic patterns help normalize outcomes-based education, audit culture, global comparability, and external validation as markers of “quality.” 

2) The document is institutionally crowded but socially narrow

Many institutional voices appear in the policy: CHED, laws, regulatory bodies, professional standards, accreditation systems, qualification frameworks, and external benchmarks. But the paper argues that the document is socially narrowbecause other voices are much less visible. 

Students, communities, local health knowledge holders, structurally marginalized groups, and Filipino nursing epistemologies are not strongly positioned as authorities in curriculum making. They appear more as recipients, clients, or objects of care than as co-producers of knowledge.

This matters because justice-oriented nursing education requires not only teaching students about communities, but also allowing communities and marginalized groups to shape what nursing education values.

3) The policy constructs four versions of the “ideal BSN graduate”

The paper identifies four overlapping subject positions, summarized in Table 2 on page 7. These are not separate types of nurses. Rather, they are co-existing images of the “ideal graduate” built into the policy. 

The audit-ready nurse

This nurse is safe, quality-focused, documentation-oriented, and able to participate in audits, quality improvement, risk management, and compliance systems. This is important for patient safety, but it can also turn care into measurable evidence: rubrics, forms, charts, checklists, portfolios, and reports. 

The globally competent nurse

This nurse is prepared for local and global practice, aligned with qualification frameworks, and made comparable with regional or international standards. This can support mobility and global practice, but it can also reinforce the idea of the Filipino nurse as an exportable worker for transnational labor markets. 

The techno-intelligent entrepreneurial nurse

This nurse is expected to use technology, informatics, systems thinking, efficiency, and entrepreneurship in nursing care. The paper warns that this can support innovation, but may also privilege market and technology logics over local, low-resource, and Indigenous health knowledge systems. 

The moral-civic Filipino nurse

This nurse is expected to show responsible citizenship, Filipino pride, good moral character, love for God and people, and a positive professional image. This can support ethical and culturally grounded nursing, but it can also discipline nurses into respectability, obedience, and image management. 

4) The PSGs functions as a “translation node”

The paper’s Figure 1 on page 4 maps the governance text ecology of the PSGs. The figure shows how broad ideological forces—neoliberalism and coloniality—flow through laws, qualification frameworks, competency standards, accreditation systems, and regulatory documents into the PSGs. The PSGs then flows downward into curriculum maps, syllabi, course outcomes, rubrics, checklists, portfolios, affiliation agreements, and audit documents. 

In plain language: the policy sits in the middle of a larger system. It translates big political and economic forces into everyday classroom and clinical requirements.

This is why curriculum governance matters. What looks like a syllabus requirement or assessment rubric may actually carry much larger assumptions about quality, professionalism, employability, and global recognition.

5) Neoliberalism appears through audit culture

The paper argues that neoliberalism appears in the PSGs through outcomes, performance indicators, continuous quality improvement, accreditation, monitoring, sanctions, resource management, efficiency, employability, and customer-care language. 

This does not mean quality assurance is bad. Patient safety and educational quality are important. The problem is when quality becomes too narrowly defined as what can be measured, documented, compared, and audited.

When that happens, values like solidarity, moral courage, political advocacy, community accountability, and justice-consciousness may become harder to teach unless educators intentionally make space for them.

6) Coloniality appears through external validation and global comparability

The paper argues that coloniality appears in the PSGs when external standards and global comparability are treated as neutral signs of quality. In a nurse-exporting country, this can make curricula more oriented toward global legibility than local health needs. 

This is not simply about foreign influence. It is about whose knowledge becomes authoritative. If Euro-American or Global North standards are treated as universal, then Filipino, Indigenous, community-based, and local health knowledges may be treated as secondary or optional.

7) The policy still has openings for justice

The paper does not say the PSGs is hopeless. It identifies important policy openings that educators can use to strengthen justice-consciousness.

These include references to:

• ethics and moral dilemmas,
• informed consent,
• rights protection,
• humane and holistic care,
• culturally competent care,
• participation,
• empowerment,
• advocacy,
• curricular flexibility,
• mission-related outcomes,
• community health,
• decent work,
• transcultural nursing,
• disaster nursing,
• and electives. 

The paper’s key practical argument is that educators can use the PSGs’ own language as leverage. Justice-oriented teaching can be framed not as “extra,” but as compliant with the policy’s deeper ethical commitments.

Bottom line

This paper shows that nursing curriculum policies are not neutral technical documents. They carry assumptions about what nurses should become and what nursing education should value. In the Philippine BSN standards, neoliberal and colonial logics appear through audit culture, global comparability, market readiness, technological modernization, and moral respectability. But the same policy also contains openings for advocacy, rights, empowerment, local knowledge, and justice-oriented education. 

The challenge for nurse educators is to recode compliance toward justice: to use curriculum maps, syllabi, portfolios, assessments, and quality assurance tools not only to prove technical competence, but also to cultivate empathy, critical consciousness, structural analysis, and commitment to health justice.

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Policy/practice recommendations

1. Make justice-consciousness an explicit curriculum outcome
   Nursing regulators and schools should name rights-based care, advocacy, structural vulnerability, and critical health literacy as formal quality criteria, not optional add-ons. 
2. Recode compliance tools toward justice
   Curriculum maps, syllabi, rubrics, portfolios, and audits can include evidence of student learning on community voice, patient dignity, power relations, labor rights, and health inequities. 
3. Center local and Filipino nursing knowledges
   BSN programs can strengthen local health knowledge, Filipino nursologies, Indigenous and community-based healing practices, and Philippine health priorities alongside global standards.
4. Use policy openings creatively
   Topics such as ethics, informed consent, empowerment, advocacy, humane care, holistic care, transcultural nursing, decent work, and disaster nursing can become entry points for justice-oriented teaching. 
5. Include communities as knowledge partners
   Communities should not only be “clients” or sites for student exposure. They should help define learning priorities, evaluate student projects, and shape what counts as meaningful care.
6. Teach students to analyze nursing labor and migration critically
   In a nurse-exporting country, students should learn how global labor markets, domestic working conditions, remittances, migration, and care extractivism shape nursing education and practice.
7. Balance global comparability with local accountability
   International standards can be useful, but they should not override local health needs, local languages, Filipino values, and community-defined priorities.

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Glossary of key terms

• Curricular governance — The systems, policies, standards, and documents that shape what is taught, assessed, monitored, and valued in education.
• Policies, standards, and guidelines / PSGs — The CHED document governing the Bachelor of Science in Nursing program in the Philippines, analyzed in this paper. 
• Critical discourse analysis / CDA — A method that studies how language produces power, authority, identity, and social meanings in texts.
• Faircloughian CDA — A three-level approach to discourse analysis focusing on text, discursive practice, and social practice. 
• Neoliberalism — A political-economic logic that emphasizes markets, competition, efficiency, performance, managerialism, and measurable outputs.
• Coloniality — The continuing power of colonial hierarchies after formal colonial rule, especially in knowledge, culture, institutions, and global standards.
• Outcomes-based education / OBE — An educational approach organized around measurable outcomes or competencies that students must demonstrate.
• Audit culture — A system where quality is proven through documentation, indicators, monitoring, reports, accreditation, and compliance evidence.
• Governing grammar — The paper’s way of describing how policy language governs action through obligation, evaluation, classification, and implementation language.
• Transitivity — A discourse analysis concept about who is made to act, what actions are emphasized, and how responsibility is distributed in language.
• Dialogicality — The range of voices, perspectives, and authorities included or excluded in a text.
• Modality — Language that expresses obligation, permission, certainty, or requirement, such as “must,” “shall,” or “may.”
• Intertextuality — The way one text draws on, cites, echoes, or depends on other texts.
• Re-entextualization — The process by which policy language is transformed into other documents, such as syllabi, rubrics, curriculum maps, and assessment tools.
• Governance text ecology — The network of texts that govern education, from laws and standards to syllabi and student assessment artifacts. 
• Justice-consciousness — Awareness of and commitment to addressing social and health injustices.
• Care extractivism — The extraction of care labor and expertise from less powerful countries to supply health systems in more powerful countries.
• Nurse-exporting state — A country whose nursing education and labor systems are strongly connected to the migration of nurses abroad.
• Market-modern nurse — The paper’s term for the nurse shaped as employable, globally comparable, and legible to labor markets.
• Audit-ready nurse — The nurse shaped to document, report, comply, and participate in quality assurance systems.
• Techno-intelligent entrepreneurial nurse — The nurse shaped as technologically competent, systems-oriented, efficient, and entrepreneurial.
• Moral-civic Filipino nurse — The nurse shaped through moral character, Filipino pride, responsible citizenship, and professional image.