Development of a training programme to improve health literacy and respectful compassionate care competencies among undergraduate student nurses: a quantitative study

Background Tanzania has embarked on health service developments advancing the quality of respectful and compassionate nursing care provision through training in health literacy and respectful and compassionate care. The undergraduate nursing program, while technically sound is inadequate in these areas. Through an EU + funded collaborative partnership between universities in Europe and Tanzania with associated training hospitals, modules in the topic areas were developed, implemented, and clinical learning environments assessed. The study aim was to ascertain the development of compassionate and respectful nursing care and health literacy competencies of undergraduate nursing students in Tanzania following completion of an education program. A secondary aim was to evaluate the suitability and capacity of the clinical learning environment to optimize the learning process for student nurses undertaking the program. Methods A pragmatic approach was used, drawing on formative evaluation through the phased development and implementation of an education program for undergraduate student nurses using a pretest-posttest design. A questionnaire survey was undertaken with student nurses ( n = 151) in three Tanzanian universities before and after the education program was delivered. Results Nursing students’ knowledge, skills and attitudes related to Health Literacy all showed statistically significant improvement two weeks after the education program. For Respectful and Compassionate Care, no statistically significant difference was found. In the referral hospitals clinical learning environments, nursing students rated the overall subcategory “Satisfaction” at 41,6% on Strongly Agree/Agree. Conclusions The development and implementation of an education program for undergraduate nursing students in Tanzania resulted in improved health literacy competencies. However, it did not produce the same outcome in competency development for respectful and compassionate care. Active inclusion and integration of respectful and compassionate care into the hospital setting with development of the learning environment can facilitate nurse’s competency development. Supportive clinical learning environment boost students in their learning process. Supplementary Information The online version contains supplementary material available at 10.1186/s12909-025-06894-5.