Researchers at Northern Illinois University School of Nursing have published a new study in Teaching and Learning in Nursing, proposing the 5W organizational tool to help oncology nurses address breast cancer care disparities among Black patients through equity-focused nursing education.
While oncologic care continues to advance across clinical settings, persistent disparities in breast cancer treatment and outcomes continue to affect Black patients. Addressing these gaps requires more than clinical technology alone. According to researchers at the Northern Illinois University School of Nursing, these inequities are driven by complex structural, social, and clinical factors that shape access to high quality care.
To tackle these systemic challenges, investigators examined how academic programs prepare future clinicians. Their findings point directly to oncology nursing education as a critical lever for change, emphasizing that nurses must be equipped to recognize and respond to the structural forces that sustain unequal care delivery. The study authors highlighted that oncology nursing education plays a key role in teaching nurses how to recognize and respond to the multilevel contributors that sustain these disparities.
Deploying the 5W Tool in Clinical and Academic Settings
The study highlights the 5W organizational tool—encompassing Who, What, Where, When, and Why—as a practical strategy for analyzing individual patient experiences and guiding care decision-making. Jessica Prothe, MSN, RN, of Northern Illinois University School of Nursing, and colleagues conducted the study and published their findings in Teaching and Learning in Nursing. The authors performed a comprehensive literature search
to obtain evidence to inform the study, collecting data from CINAHL, PubMed, Google Scholar, and Medline. The search criteria included the following terms: “Advocacy,” Nursing education,
Equity-focused teaching strategies,
Nursing curriculum,
“Health equity,” Organizational strategies,
and “5W strategy.” Upon data collection, iterative refinement
was employed to ensure inclusive coverage of the evidence base.
Findings from the study determined that the 5W organizational tool was an optimal strategy that can be used to help oncology nurses implement and integrate equity-focused concepts across academic and clinical environments to strengthen equity-centered decision making.
Ms. Prothe and colleagues explained that leveraging the 5Ws in clinical practice helps oncology nurses assess gaps and barriers to breast cancer care, identify patients who are most affected by disparities in care, uncover what occurs as a result of these disparities, examine why inequities within this patient population persist, and determine where nursing interventions can be implemented.
Structural Barriers and Curricular Design
Integrating equity-focused concepts into nursing programs is not without friction. Investigators also highlighted potential barriers to implementation,
which they wrote continue at the interpersonal, cultural, institutional, and societal levels.
These deep-seated hurdles underscore why superficial updates to clinical training fall short. They explained that persistent gaps and barriers to equitable breast cancer care emphasize the need for improvements in nursing education, including the need for intentional curricular design, alignment with equity-focused competencies, and incorporation of policy-relevant content within nursing programs.
Equipping nurses with equity-centered competencies are essential for addressing breast cancer disparities among Black women and strengthening health equity across the cancer care continuum,
they concluded.
Funding Community Education and Grassroots Action
Beyond academic curricula, expanding breast cancer awareness requires direct community engagement. The Oncology Nursing Foundation offers grants to increase breast cancer awareness in communities by supporting nurse-directed and community-focused educational programs. Up to $1,000 is available to qualified ONS Chapters across the United States to plan and implement patient/community-focused breast cancer education/awareness programs.
Eligibility requirements stipulate that the program must be an ONS Chapter activity and focus on community education. The grant is not intended to support work-based community education programs, and the program cannot limit attendance to an institution, hospital, hospital network, or nurse work setting. Individual programs and/or Chapters can only receive one grant. Open applications are accepted but must be received by the Oncology Nursing Foundation no later than two weeks prior to the program start date, and applications will remain open until funds are expended.
Applicants are advised that a quality and competitive application will take time to complete, suggesting they get a head start and collect any additional required items such as the name and email address of someone writing a letter of recommendation before beginning. Essay responses should be of good quality in terms of grammar, punctuation, syntax, conciseness, and ability to answer the question, using the word count to advantage. To strengthen applications, the guidance suggests using free online tools such as Grammarly and having someone read over the application to ensure accurate spelling, punctuation, and grammar.