Abstract
Autoethnography is increasingly used in nursing education research to examine the relational, embodied, and often hidden dimensions of teaching, learning, and professional socialization. Yet uneven use of variant-sensitive approaches, quality frameworks, and ethics reporting suggests continuing methodological inconsistency. We conducted an integrative review of autoethnographic nursing education literature published between 2010 and 2025, examining five dimensions: (1) variant definitions and operationalization, (2) quality appraisal frameworks, (3) reflexivity and positionality practices, (4) credibility strategies, and (5) ethical procedures, including attention to implicated others. Systematic searches of CINAHL, MEDLINE, ERIC, Scopus, ScienceDirect, and Web of Science yielded 23 eligible studies. Collaborative autoethnography predominated (56%), and several studies, especially those examining the experiences of racially minoritized faculty, explicitly positioned autoethnography as a decolonizing approach and demonstrated stronger reported reflexive practices. Reflexivity, as represented in published manuscripts, ranged from integrated positionality analyses that informed analytic decisions to brief, largely token acknowledgment. Findings suggest that nursing education scholarship may benefit from a fit-for-variant approach to appraisal and clearer field expectations for relational ethics reporting, especially given power differentials when faculty write about students, colleagues, and institutions. More explicit linking of standpoint to analysis may advance methodological transparency and interpretive credibility.
Keywords
Introduction
Autoethnography has gained traction across qualitative research in education and health professions as a method for examining pedagogical experience, professional identity development, and educational culture from an insider vantage point. By intentionally blending autobiography and ethnography, autoethnography asks researchers to make their own positionality, emotions, and decision-making part of the empirical record, linking personal experiences to broader sociocultural and professional contexts (Ellis et al., 2011). While autoethnography’s prominence has grown substantially in fields such as communication studies, sociology, and general education, its adoption and methodological rigor in nursing education contexts remain underexplored.
Nursing education scholars have begun to employ autoethnographic approaches to examine hidden curricula, professional identity formation, power dynamics in clinical and academic settings, role transitions from clinician to educator, and the cultivation of reflective practice (Garvey et al., 2023; Salzmann-Erikson, 2024; Sheedy, 2024; Wright, 2008). However, the extent to which nursing education autoethnography employs explicit methodological frameworks, adheres to variant-sensitive quality standards, and addresses ethical considerations unique to educational settings has not been systematically evaluated. Questions persist about what counts as autoethnography in nursing education scholarship and how to appraise its quality, credibility, and ethical integrity across different methodological traditions (Peterson, 2015; Salzmann-Erikson, 2024; Wright, 2008).
Autoethnography is an expanding methodology with diverse orientations beyond the three prominent variants examined here (evocative, analytic, collaborative), including layered, performative, critical, Black feminist, community, indigenous, and meta-autoethnography (Martin, 2025; Sparkes, 2020; Stahlke Wall, 2016). Boundaries between approaches are fluid, with studies often blending story-driven, theory-driven, creative, and political emphases (Johnson-Bailey, 2021; Stahlke Wall, 2016). This review focuses on evocative, analytic, and collaborative autoethnography due to their prevalence in nursing education and established methodological guidance (Anderson, 2006; Chang et al., 2016; Ellis et al., 2011), using these approaches as heuristic lenses for mapping reporting patterns rather than as rigid typologies.
Evocative autoethnography privileges aesthetic, affective, and narrative power to evoke recognition and insight in readers, often through literary or arts-based forms (Bochner & Ellis, 2016). In educational contexts, evocative approaches can illuminate the emotional labor of teaching, the embodied experience of learning clinical skills, and the relational dimensions of mentorship. Critics note that sociocultural analysis can be thin when resonance alone becomes the quality marker.
Analytic autoethnography emphasizes the researcher’s complete-member status (for example, a nurse educator studying nursing education culture), sustained analytic reflexivity, dialogue beyond the self, and commitment to developing theoretical understandings that reach past the individual case (Anderson, 2006). In educational research, analytic approaches examine institutional structures, pedagogical practices, and professional socialization processes. Challenges include underreporting of analytic procedures and tensions between personal narrative and theoretical generalization.
Collaborative autoethnography (CAE) organizes inquiry around multivocal dialogue and collective sense-making, distributing interpretive and ethical responsibility among co-researchers (Chang et al., 2016). Some authors use “collective autoethnography” to describe similar approaches; this review uses “collaborative” as the primary term and “collective” only when citing studies that specifically adopted that designation. In education, collaborative approaches often involve faculty teams, student cohorts, or student–faculty partnerships examining shared experiences. This approach can address some limitations of solo autoethnography but requires clear reporting of team processes, power dynamics, and negotiation of meaning.
Despite growing interest in autoethnography as an educational research method, consensus on quality appraisal remains uneven. Authors invoke diverse frameworks, including cross-tradition qualitative criteria (Tracy, 2010), literary criteria (Richardson, 2000), Anderson’s analytic features (Anderson, 2006), and Chang et al.’s (2016) collaborative principles, but application is inconsistent. Articles vary widely in documenting data generation, analytic moves, linkages to educational theory and literature, and ethics decisions, especially when students, colleagues, or clinical partners are implicated in personal narratives. Ethical issues require careful handling, including prospective consent for implicated others, confidentiality protections in small professional communities, and transparent risk–benefit reasoning (Tolich, 2010). Without shared expectations that are sensitive to variant and context, autoethnography’s contributions to nursing education scholarship risk dismissal or inconsistent evaluation.
In nursing education specifically, autoethnography offers particular promise and challenges. The method can illuminate experiences often marginalized in traditional educational research, the emotional dimensions of clinical teaching, the complexities of professional identity formation, the navigation of power in hierarchical settings, and the embodied nature of pedagogical practice (Garvey et al., 2023; Iheduru-Anderson et al., 2024, 2025; Nghitanwa et al., 2025). Yet nursing education’s emphasis on evidence-based practice and outcomes measurement may create tensions with autoethnography’s interpretive, narrative orientation. Understanding how nursing education scholars are actually employing autoethnographic methods, which quality standards they invoke, and how they navigate ethical issues in educational contexts is essential for advancing methodological rigor and legitimacy.
No systematic synthesis has examined autoethnography’s use, quality appraisal, and ethical reporting specifically in nursing education. While methodological guidance exists for autoethnography generally (Anderson, 2006; Chang et al., 2016; Ellis et al., 2011), the application and adaptation of these standards within nursing education contexts, including faculty–student and preceptor–learner power dynamics, professional socialization demands, and regulatory considerations, remains uncharted. A consolidated map of how nursing education scholars are conducting and evaluating autoethnography is therefore both timely and necessary to inform discussions among authors, educators who teach research methods, and institutional review boards.
Purpose
This integrative review systematically evaluates methodological variants of autoethnography, specifically evocative, analytic, and collaborative, in nursing education research from 2010 to 2025. We compare quality appraisal approaches, reflexivity and positionality practices, and credibility/rigor strategies authors and reviewers use. An integrative review design was selected because it uniquely accommodates both empirical autoethnographies and methodological papers specifying quality criteria, enabling comprehensive analysis that a scoping review’s mapping function alone could not support.
The review addresses five research questions:
Definitions & use: How are evocative, analytic, and collaborative autoethnography defined, justified, and operationalized in nursing education?
Quality appraisal: Which appraisal frameworks are used in nursing education autoethnography, and how consistently?
Reflexivity/positionality: What reflexive practices are reported in nursing education autoethnography, and with what depth?
Credibility/rigor: Which strategies are used in nursing education autoethnography, and how often by variant?
Ethics: How are IRB/ethics handled in nursing education autoethnography, including consent for students/colleagues and confidentiality in professional communities?
Conceptual Framework
To standardize terminology for eligibility, extraction, and appraisal, we developed working definitions of autoethnography and its three variants alongside typical appraisal foci, reflexivity practices, rigor strategies, and ethical issues, summarized in Table 1 (with detailed framework in Supplemental Table S1). Autoethnography is a qualitative method combining autobiography and ethnography to systematically analyze personal experience for cultural understanding, centering researcher voice and reflexivity while connecting the personal to sociocultural theory (Ellis et al., 2011; Wall, 2006). Variant-specific definitions and distinctions appear in Table 1; the paragraphs below outline the appraisal, reflexivity, credibility, and ethical considerations that recur across variants and informed our extraction and appraisal procedures.
Summary of Definitions, Appraisal, Reflexivity, Rigor, and Ethics in Autoethnography.
Note. Full definitions with common gaps and examples available in online appendix Supplemental Table S1.
Quality appraisal criteria include authenticity, clarity of process, ethical protection of self and others, sociocultural interpretation, and scholarly contribution. Frameworks vary by variant: evocative traditions emphasize aesthetic merit and resonance (Richardson, 2000); analytic traditions stress complete-member status, theoretical development, and transparency (Anderson, 2006); collaborative traditions foreground multivocality, negotiated meaning, and distributed responsibility (Chang et al., 2016).
Reflexivity is central across all variants, requiring interrogation of assumptions, identities, and positionality through narrative, journaling, arts-based methods, or peer dialogue. Depth varies from token disclosure statements to sustained integration throughout methods, analysis, and discussion (Cooper & Lilyea, 2022; Ellis et al., 2011; Mathieu & Hagelsteen, 2025).
Credibility/rigor strategies include thick description, crystallization/triangulation, resonance, audit trails, dialogue beyond self, and member reflections (Anderson, 2006; Chang et al., 2016; Ellis et al., 2011; Wall, 2006). Variant-appropriate strategies differ: evocative work emphasizes resonance and aesthetic coherence; analytic work emphasizes theoretical transparency and dialogue; collaborative work emphasizes multivocal validation.
Ethics issues include consent for implicated others, confidentiality of named places and people, and the unpredictability of narrative effects. Collaborative approaches can distribute ethical agency and responsibility (Lapadat, 2017; Ngunjiri et al., 2010), but consent processes remain inconsistently reported across traditions.
Consistent with the framing introduced earlier, these three variants function as heuristic categories rather than rigid typologies (Wall, 2006); studies in our sample often blended elements across variants, and our analysis treats variant classification as an interpretive lens rather than a fixed assignment.
Methods
Design and Reporting
We conducted an integrative review guided by Whittemore and Knafl’s (2005) five-stage methodology: problem identification, literature search, data evaluation, data analysis, and presentation. We selected an integrative review design rather than a scoping review for three reasons. First, our purpose extends beyond mapping the extent of the literature to synthesizing diverse source types, including both empirical autoethnographies and methodological or theoretical papers specifying appraisal criteria, in order to generate new understanding of quality practices in the field. Scoping reviews typically confine inclusion to a single evidence type and do not perform quality appraisal (Munn et al., 2022; Peters et al., 2020); both are central to our design. Second, we applied variant-appropriate quality appraisal to each included study, a process incompatible with a scoping review’s non-appraisal stance. Third, our synthesis employs a convergent integrated approach combining quantitative descriptive patterning with qualitative interpretive narrative analysis to produce actionable implications, not solely a descriptive map of the terrain. This design is particularly suited to methodologically heterogeneous bodies of literature where both empirical practice and conceptual guidance must be examined together (Dhollande et al., 2021; Whittemore & Knafl, 2005). Study identification and screening decisions are reported using PRISMA 2020 to enhance transparency of the selection process (i.e., counts and reasons for exclusion), not to characterize the review type. As a synthesis of published literature, human-subjects approval was not required. Protocol. Eligibility criteria and the extraction/coding framework were specified a priori by the author team (protocol not registered).
Information Sources and Search Strategy
We searched CINAHL (EBSCO), MEDLINE/PubMed, ERIC, Scopus, Science Direct, and Web of Science Core Collection from database inception through to December 31, 2025, limiting inclusion to publications dated 2010–2025 and published in English. Searches were executed on October 23, 2025 and updated on December 2, 2025. Search strategies combined terms for autoethnography (and its variants: evocative, analytic, collaborative) with nursing education terms; a core string is provided below and full database strategies are available in an online appendix.
Core search string (adapted per database): (autoethnography OR autoethnographic OR “auto-ethnography” OR “evocative autoethnography” OR “analytic autoethnography” OR “collaborative autoethnography”) AND (“nursing education” OR “nurse education” OR “nursing student*” OR “nursing faculty” OR “nurse educator*” OR “nursing pedagogy” OR “nursing curriculum” OR “clinical education” OR “nursing teaching” OR “prelicensure” OR “baccalaureate nursing” OR “graduate nursing education” OR “nursing doctoral” OR “nursing PhD” OR “faculty development” OR “nursing preceptor*”)
Grey literature searching included dissertation indexes within CINAHL and ERIC, hand-searching key nursing education journals, and backward/forward citation chasing of included studies. No additional eligible records were identified.
Eligibility Criteria
Eligibility criteria were defined a priori and are detailed in Table 2. We included: (1) empirical autoethnographies (evocative, analytic, or collaborative) conducted in nursing education contexts and (2) methodological or theoretical papers specifying autoethnography procedures or evaluative criteria for nursing education research.
Eligibility Criteria.
Nursing education context was defined as studies examining: teaching and learning in nursing programs (prelicensure, graduate, doctoral); faculty experiences (role transition, development, scholarship); student experiences (clinical education, identity formation, socialization); curriculum development and evaluation; or educational leadership and innovation. Nursing education context was verified at full text by confirming that the setting, participants, and phenomena centered nursing education (e.g., nursing programs, students, faculty roles, curriculum/teaching/clinical education); studies situated primarily in non-nursing disciplines (even if educational) were excluded as out of scope.
Studies had to be published 2010–2025, in English, and peer-reviewed. Dissertations and theses were eligible for initial screening if methods were explicit, but none met all inclusion criteria at full-text review and the final sample consists entirely of peer-reviewed journal articles. We excluded: editorials, book reviews, commentaries, reflective essays lacking autoethnographic framing and methods, works using “autoethnographic” only metaphorically, and autoethnographies from clinical practice or other non-educational contexts. There will be no restrictions on the geographical location in this review.
Study Selection
Exports from all sources were imported and deduplicated in Zotero, then exported into Covidence for systematic screening. Two reviewers independently screened records in two stages using standardized forms and exclusion codes. Disagreements were resolved through discussion, with a third reviewer consulted when consensus could not be reached.
Title and Abstract Screening
Records were screened against basic eligibility: publication type, timeframe (2010–2025), language (English), explicit autoethnography identification, target domain, and article type (empirical or methodological). Methodological characteristics requiring full-text assessment, variant type, analytic procedures, reflexivity depth, and ethics reporting were not evaluated at this stage, as abstracts rarely contain sufficient detail. Records were excluded if they failed to meet basic inclusion criteria based on title and abstract review.
Stage 2: Full-Text Screening
Records advancing from Stage 1 were assessed against five methodological criteria: (1) explicit autoethnography variant identification; (2) described data sources/materials; (3) described analytic procedures; (4) cultural/theoretical linkage connecting personal experience to sociocultural context; and (5) reflexive/ethical positioning, including positionality disclosure and ethics procedures when others were implicated. Records failing any inclusion criterion were excluded. All screening decisions were documented in standardized forms to ensure transparency and reproducibility. Final selection counts and exclusion frequencies are reported in the PRISMA flow diagram (Figure 1). All screening decisions, exclusion rationale, and reviewer notes were documented in a standardized tracking form to ensure transparency and reproducibility.
Prisma 2020 flow diagram.
Data Extraction
A structured extraction form was developed and pilot-tested on five diverse studies to ensure consistency. Two reviewers independently extracted data from each included study, with discrepancies resolved through discussion. Extraction captured: study characteristics (author, year, domain, country); autoethnography variant (author-stated or reviewer-classified based on Supplemental Table S1 features). Variant classification was treated as heuristic rather than definitive; studies exhibiting hybrid forms or substantial overlap across variants were noted as such in the synthesis. Quality appraisal frameworks cited; reflexivity and positionality practices; credibility/rigor strategies; ethics and IRB procedures; data sources and analytic approaches; and theoretical frameworks invoked. When information was absent, it was coded as “not reported” and noted as a quality gap.
Reflexivity depth was coded using a three-level rubric developed and calibrated during pilot extraction (Figure 2). Levels ranged from Level 1 (token reflexivity, where positionality was acknowledged in a single paragraph or sentence without linkage to analytical decisions) to Level 3 (integrated reflexivity, where positionality was disclosed across multiple sections, explicitly linked to analytical decisions, and revisited in the discussion). Two reviewers independently applied this rubric, with disagreements resolved through discussion and, when needed, consultation with a third reviewer. We acknowledge that this rubric assesses the transparency and depth of reflexivity as reported in published manuscripts rather than the actual depth of reflection undertaken during the research process, a limitation inherent to synthesis-level appraisal of published texts (Berger, 2015; Cooper & Lilyea, 2022).
Reflexivity depth coding rubric.
We independently appraised the methodological quality of each empirical autoethnography using variant-appropriate criteria: evocative studies were assessed for aesthetic merit, resonance, and cultural linkage (Ellis et al., 2011; Richardson, 2000); analytic studies were assessed against Anderson’s (2006) five features (complete-member status, analytic reflexivity, narrative visibility, dialogue beyond self, theoretical analysis); collaborative studies were assessed for multivocal dialogue, negotiated meaning, and distributed responsibility (Chang et al., 2016). Quality appraisal results contextualized synthesis findings but were not used for post-hoc exclusion.
Data Synthesis
We employed convergent integrated synthesis, combining descriptive statistics with thematic narrative analysis organized by research questions and autoethnography variants. The Quantitative component calculated frequencies and proportions of quality appraisal frameworks cited, credibility/rigor strategies reported, and ethics practices by variant, domain, and time period (2010–2014, 2015–2019, 2020–2025). Subgroup comparisons explored whether explicit framework use was associated with greater methodological transparency.
The qualitative component involved iterative coding of extracted text segments (e.g., variant justifications, reflexivity descriptions, appraisal rationales, ethical reasoning) by two reviewers. Coding categories were derived deductively from the five research questions and conceptual framework (Table 1), addressing: variant definitions and justifications; reflexivity enactment and depth; appraisal logic and language; and ethics operationalization. Final synthesis was organized around the five research questions, integrating quantitative frequencies with qualitative interpretation.
Reviewer Reflexivity and Bias Mitigation
Our team comprises nurse educators and nursing education researchers with experience conducting, teaching, and reviewing autoethnography in nursing contexts. We acknowledge that our insider positions in nursing education might predispose us toward particular interpretations of educational experiences, and that our strong views about quality standards in nursing education scholarship could influence subjective coding decisions (e.g., “integrated” versus “token” reflexivity).
To mitigate bias, we specified eligibility criteria a priori, conducted dual independent screening and extraction with systematic conflict resolution, pilot-tested and calibrated our extraction rubric on diverse nursing education studies, and maintained detailed audit trails of disagreements and rationales. We recognize that complete objectivity is neither possible nor desirable in interpretive synthesis, and that our appraisal is limited to what authors made visible in published manuscripts. Our goal has been to make our standpoint as nursing educators, and our decision-making processes, as transparent and accountable as possible.
Results
Characteristics of Included Studies
Twenty-three studies met inclusion criteria and were retained for synthesis (Figure 1). Included studies were published between 2010 and 2025, with notable temporal clustering: 13 studies (57%) appeared between 2021 and 2025, reflecting accelerating interest in autoethnographic approaches within nursing education. Geographic distribution spanned 11 countries across six continents. The United States contributed the largest share (n = 6, 24%), followed by Australia (n = 4, 16%), Canada (n = 4, 16%), and the United Kingdom (n = 3, 12%). Single studies originated in Ireland, New Zealand, Namibia, and South Africa, with one tri-national collaboration spanning Sweden, Ethiopia, and Tanzania. This distribution reflects continued dominance of Anglophone nursing scholarship while demonstrating emerging uptake in African and Scandinavian contexts.
Study foci encompassed diverse nursing education domains: faculty experiences and professional development (n = 10, 43%), including role transition, mentoring, identity formation, and experiences of marginalized faculty; student experiences and clinical education (n = 5, 22%); teaching practices and pedagogical innovation (n = 5, 22%); and international or cross-cultural nursing education (n = 3, 13%). Publication outlets included nursing education journals (Nurse Education Today, Nurse Educator, Journal of Nursing Education), specialty journals (Journal of Family Nursing, Contemporary Nurse), and interdisciplinary venues (Cogent Education, Global Qualitative Nursing Research). Table 3 presents complete study characteristics.
Characteristics of Included Studies (N = 23).
RQ1: Autoethnography Variant Definitions and Operationalization
Collaborative autoethnography (CAE) was the most frequently explicitly identified variant (n = 13, 56%), followed by solo/individual autoethnography (n = 5, 22%), analytic autoethnography (n = 3, 13%), and studies employing autoethnographic “elements” or “principles” without full methodological commitment (n = 2, 9%) (Table 4). These classifications reflect authors’ self-identification and predominant features rather than rigid genre boundaries; several studies exhibited hybrid characteristics across variants.
Distribution of Autoethnography Variants (N = 23).
Among collaborative autoethnographies, justifications consistently emphasized collective meaning-making and amplification of marginalized voices. Iheduru-Anderson et al. (2024) described CAE as “a decolonizing qualitative research approach” that “empowers marginalized voices through social inquiry” (p. 21). Gamboa et al. (2024) similarly positioned CAE as “a decolonizing qualitative approach to research . . . that contributes to scholarship and practice by cultivating supportive communities” (p. 3). Chang et al.’s (2016) foundational text on collaborative autoethnography was the most frequently cited methodological source, referenced in seven studies examining faculty experiences.
Studies employing evocative approaches emphasized emotional resonance and transformative potential. Kidd and Finlayson (2010) explicitly aligned with Ellis et al. (2011) and Richardson’s (2000) criteria, noting that “evocation of emotion is harnessed through story with the aim of changing our understanding” (p. 23). O’Keeffe (2015) justified autoethnography as providing “a framework to expose the potentially vulnerable self which often remains otherwise hidden” (p. 139). Gardner and Lane (2010) described their dyadic autoethnography as emerging organically: “We had things to say, and wanted to present them in a style that mirrored the multifaceted relationship” (p. 342).
Analytic autoethnographies demonstrated stronger theoretical grounding. Moules et al. (2012) combined autoethnography with interpretive ethnography and philosophical hermeneutics, describing “deliberate and systematic reflexivity of the researcher from within the culture” (p. 267). Bischoff (2016) explicitly addressed Delamont’s (2009) critiques of autoethnography while emphasizing intercultural analysis of a nursing school development project.
Notably, two studies adopted qualified framings. Garvey et al. (2023) described using “elements from autoethnography” and “analytic-interpretive type” (p. 258), while Griffin et al. (2016) stated their paper was “informed by auto-ethnographic principles” rather than constituting full autoethnographic research. These qualified approaches suggest methodological caution or uncertainty about disciplinary acceptance within nursing scholarship.
RQ2: Quality Appraisal Frameworks
Explicit application of autoethnography-specific quality frameworks was inconsistent across studies. Only eight studies (35%) cited recognized autoethnographic quality criteria, while 15 studies (65%) either applied generic qualitative trustworthiness criteria or provided no systematic quality appraisal (Table 5). However, citation of a framework did not consistently indicate its substantive application. In several studies, quality criteria were named in the methods section without corresponding demonstration in the analysis or discussion. This pattern was observable across variant types. Among collaborative studies, several papers cited Chang et al. (2016) in their methods sections but did not subsequently describe the team dialogue processes, negotiation of meaning, or member-checking procedures that Chang et al. identify as central to collaborative rigor. By contrast, Viveiros et al. (2021) explicitly described structured team debriefs, iterative story-sharing sessions, and a negotiated interpretive process tied directly to Chang et al.’s framework, demonstrating how citation can be translated into enacted methodology.
Quality Appraisal Frameworks Applied (N = 23).
Note. AE = autoethnography; CAE = collaborative autoethnography; CAP = creative analytic practices.
Similarly, among evocative studies, invocations of Richardson’s (2000) criteria for evocative narrative were rarely accompanied by discussion of how aesthetic choices in the writing were made or evaluated. The gap between naming a framework and operationalizing it was most pronounced in studies where quality criteria appeared only in the methods section and were absent from the discussion of findings or limitations. The distinction between invoking a framework and enacting it represents a persistent gap in the sample and limits claims about the actual rigor of the work reviewed.
Chang et al.’s (2016) collaborative autoethnography principles and Ellis et al.’s (2011) foundational autoethnography criteria (n = 4) were the most frequently cited. Notably, Tracy’s (2010) widely cited “big-tent” criteria for qualitative quality and Anderson’s (2006) five key features of analytic autoethnography were not explicitly applied in any study, despite their prominence in methodological literature. Le Roux’s (2017) criteria for autoethnographic rigor, specifically subjectivity, resonance, plausibility, and contribution to social change, were applied only by Viveiros et al. (2021).
Several studies offered innovative alternatives to established frameworks. Salzmann-Erikson et al. (2025) adopted a post-qualitative stance, arguing that “rigor, in this context, was not grounded in procedural systematics but in reflexivity, transparency, and the preservation of multiplicity” (p. 4). Gamboa et al. (2024) explicitly reframed rigor from a decolonizing perspective, “capitalizing on the clarity, strengths, flexibility, and genuine knowledge we possess that diverges from Eurocentric colonial normative notions of rigor” (p. 3, citing Abo-Zena et al., 2022). Iheduru-Anderson et al. (2025) articulated “rigor expressed through relational accountability, transparency, and political purpose” (p. 5). While these reframings represent meaningful scholarly contributions, they also illustrate the challenge facing reviewers and readers: without shared expectations for what constitutes sufficient quality evidence, it becomes difficult to distinguish principled reframings of rigor from the absence of rigor altogether. This ambiguity reinforces the need for variant-sensitive, field-level expectations that can accommodate methodological pluralism while still enabling meaningful evaluation.
RQ3: Reflexivity and Positionality Practices
Reflexivity and positionality were universally invoked as central to autoethnographic work, yet the depth of enactment varied considerably across the 23 included studies. Applying the three-level rubric described in the Methods (Figure 2), nine studies (40%) demonstrated integrated reflexivity where positionality was structural to the research design and central to analytical interpretation. Six studies (24%) showed moderate reflexivity embedded in methodology and findings but not systematically woven throughout. Nine studies (36%) exhibited token or limited reflexivity, typically confined to a single methodological paragraph acknowledging researcher positioning without substantive analysis of how identity shaped interpretation. It is important to note that these classifications reflect the transparency and depth of reflexivity as represented in published text, not a definitive claim about the depth of reflection actually undertaken during the research process. Word limits, editorial conventions, and genre expectations may constrain what authors disclose. This interpretive limitation is a recognized vulnerability of synthesis-level appraisal (Berger, 2015; Cooper & Lilyea, 2022) and is acknowledged here as a boundary of this review’s conclusions.
Collaborative autoethnography more frequently created structural conditions for integrated reflexivity through multivoiced dialogue and negotiated meaning. Studies such as Heidari et al. (2024) and Iheduru-Anderson et al. (2025) reported multiple rounds of collective reflection, structured research meetings, and iterative story-sharing sessions as part of their collaborative design, suggesting that the collaborative structure created recurring opportunities for reflexive engagement among co-researchers. In contrast, some single-author accounts foregrounded educator voice and affect without consistently interrogating social positioning beyond the pedagogical self or describing reflexive procedures beyond narrative presentation (e.g., O’Keeffe, 2015; Sheedy, 2024). In these cases, reflexivity functioned as procedural disclosure rather than analytic tool, satisfying a reporting convention without demonstrating how positionality shaped interpretive decisions.
Studies examining racial equity demonstrated particularly robust reflexive practices, with researchers explicitly positioning their racial and cultural identities as essential interpretive lenses rather than background disclosures. Iheduru-Anderson et al. (2025) articulated: “Our positionalities as Black and South Asian nurse academics are not limitations but essential lenses through which institutional dynamics, structural barriers, and mentorship practices are interpreted and understood” (p. 4). Salzmann-Erikson et al. (2025) extensively examined Global North–South power dynamics, noting that “the partners from the high-income country (Sweden) were inevitably perceived as the donor and conceptualizer . . . while the partners from Ethiopia and Tanzania risked being seen as local implementers” (p. 8). Mayoum et al. (2022) explicitly addressed power differentials between BIPOC students and White faculty researchers throughout the collaborative process. These studies illustrate that reflexivity is strongest when it is not merely declared but actively deployed as an analytical framework shaping interpretation at every stage.
Identity dimensions disclosed varied considerably across studies. Race and ethnicity were explicitly addressed in eight studies (35%), predominantly those focused on BIPOC faculty experiences. Professional role was disclosed in all 23 studies, but only 12 studies (52%) disclosed gender, and fewer still addressed age, class, sexuality, or cultural background. Heidari et al. (2024) provided the most comprehensive positionality disclosure, presenting a table detailing each researcher’s race/ethnicity, gender, immigration status, ability, sexual orientation, and professional role, offering a model for transparent identity disclosure in collaborative work.
Power dynamics were substantively analyzed in 12 studies (52%), while 11 studies (48%) either acknowledged power perfunctorily or did not address it. Gardner and Lane (2010) explicitly discussed “relative power dynamics between myself as an academic/tutor and Hannah as a student and former mental health service user” (p. 344). Moules et al. (2012) acknowledged that “in evaluative supervisory situations and relationships, issues of power are unavoidable” (p. 277), noting the persistent hierarchy despite collaborative intentions. The 48% of studies that did not substantively address power dynamics represent a particularly notable gap given that nursing education contexts are defined by structural hierarchies: faculty over students, preceptors over learners, and senior over junior colleagues. Autoethnography in these settings without explicit power analysis risks reproducing the very dynamics it might otherwise illuminate.
RQ4: Credibility and Rigor Strategies
Studies employed diverse credibility strategies with varying consistency (Table 6). Thick description was the most commonly reported strategy (n = 19, 82%), followed by dialogue beyond self (n = 17, 74%) and crystallization or triangulation (n = 16, 70%). Member reflections were reported in 14 studies (61%), and prolonged engagement in 14 studies (61%), while formal audit trails were less common (n = 9, 39%). Resonance checking, defined as intentionally seeking reader responses to assess evocative impact, was reported in only five studies (22%). As with quality frameworks, reporting of these strategies did not always include sufficient detail to assess how they were enacted in practice, particularly for audit trails and member reflections.
Credibility and Rigor Strategies Reported (N = 23).
Collaborative autoethnographies often described structural features that can support credibility, such as multiple researcher-participants, repeated meetings, and shared analytic decision-making. Iheduru-Anderson et al. (2024) described “frequent research meetings” enabling “dynamic sharing of the minds, companionship, and exchange of emotional evaluations” (p. 22), and similar accounts of iterative team dialogue appeared in other collaborative studies. Prolonged engagement ranged from 3 months (Sheedy, 2024) to 2.5 years (Salzmann-Erikson et al., 2025), suggesting that many projects unfolded over substantial periods of time. However, the mere presence of multiple authors or a long project timeline did not, on its own, guarantee transparent reporting of how credibility strategies were planned, negotiated, or evaluated.
Several studies employed creative or variant-sensitive approaches to credibility. O’Keeffe (2015) used poetry, storytelling, and a visual “Personality Garden” tool to evoke the texture of educator experience and invited readers to assess resonance through aesthetic engagement. Kidd and Finlayson (2010) developed composite vignettes and creative non-fiction to capture emotional nuance while protecting individual participants, positioning intimacy and emotional truth as key markers of trustworthiness. These approaches align with criteria for evocative and performative autoethnography, where resonance, aesthetic coherence, and emotional insight function as core indicators of quality rather than add-ons to conventional validity strategies.
At the same time, the overall pattern suggests that many studies blended generic qualitative criteria with autoethnography-specific rationales without fully articulating how the chosen strategies matched the variant and purpose of the work. For example, “member checking” was sometimes described as sharing drafts with co-authors rather than engaging with those represented in the narratives, and “triangulation” was occasionally invoked without clarifying what was being triangulated or why. This blurring of terms can obscure important differences between credibility strategies that are well aligned with autoethnographic variants and those that are carried over from other qualitative traditions without adaptation. The findings therefore support the need for variant-sensitive language about credibility and rigor, so that rigor is not equated with the accumulation of generic strategies but with thoughtful alignment between epistemology, variant, and the specific purposes of each study.
RQ5: Ethics and IRB Procedures
Ethics reporting revealed considerable heterogeneity (Table 7). Twelve studies (48%) reported formal IRB or ethics committee approval. Four studies (17%) were deemed exempt or reported that ethics review was not required under institutional or national regulations. Seven studies (30%) did not report IRB status. The absence of ethics reporting was particularly notable in earlier studies (2010–2016) and in studies framed as methodological reflections rather than empirical research. The lack of clarity about review status in more than one third of the sample raises concerns about how autoethnographic work in nursing education is classified and overseen within institutional ethics systems.
Ethics and IRB Reporting (N = 23).
Relational ethics, defined here as attention to how autoethnographic narratives implicate and potentially harm others who appear in or are affected by the stories, was substantively addressed in only eight studies (35%). Salzmann-Erikson et al. (2025) engaged explicitly with Lapadat’s (2017) framework, describing “relational ethics, an iterative practice of balancing honesty and care in collaborative research” as “a living practice enacted throughout the project” (p. 4). Kidd and Finlayson (2010) explicitly invoked “relational ethics wherein the rights of others who might be present in the stories are respected” (p. 22). In these studies, ethics was treated as an ongoing practice that shaped design, data generation, and writing, rather than a one-time institutional hurdle. By contrast, many other studies confined ethics to a brief statement that IRB approval had been obtained or was not required, without addressing how potential harms to implicated others were anticipated, negotiated, or mitigated.
Consent procedures for implicated others such as students, colleagues, patients, or institutions mentioned in narratives were addressed in only five studies (22%). Kidd and Finlayson (2010) implemented process consent “at multiple time points (before, during, after story submission)” (p. 22). Graham and Johns (2019) obtained permission from students for excerpts shared in publication. Most studies did not specify whether or how consent was sought from individuals who could recognize themselves in the narratives, or from groups and institutions that might be affected by critical portrayals. This omission is especially consequential in small academic and clinical communities where identifiability is high even when names are changed.
Confidentiality strategies varied. Fifteen studies (65%) used pseudonyms, but collaborative autoethnographies faced inherent limitations as all co-authors were typically named, potentially enabling identification despite quote anonymization. Several studies acknowledged that complete anonymity was impossible given distinctive roles, demographic profiles, or institutional contexts, yet they rarely described how that residual risk was weighed against the perceived benefits of publication. Across the sample, ethics reporting focused more on protecting the author-researchers and satisfying institutional requirements than on possible harms to students, junior colleagues, or institutions who might be portrayed as oppressive, unsupportive, or discriminatory. This asymmetry suggests that nursing education autoethnography requires stronger field-level expectations for relational ethics that address not only confidentiality and consent but also the potential for autoethnographic writing to function as public critique, reputational threat, or institutional challenge, particularly in hierarchical educational settings.
Discussion
This integrative review synthesized 23 autoethnographic studies in nursing education published between 2010 and 2025, revealing significant patterns in methodological approaches, quality practices, and ethical considerations. The findings illuminate both the growing sophistication of autoethnographic scholarship in nursing education and persistent methodological gaps requiring attention. In doing so, the review contributes to the field in four interrelated ways. First, it maps autoethnographic practice in nursing education by variant over 15 years, clarifying where and how the method is used. Second, it synthesizes appraisal practice in nursing education literature, identifying which frameworks are most frequently invoked and operationalized. Third, it analyzes reflexivity, credibility, and ethics reporting in nursing education autoethnography, highlighting recurrent strengths and gaps specific to educational settings (e.g., power dynamics with students, confidentiality in small academic communities). Finally, these findings generate field-level observations about variant-sensitive reporting practices that may inform nursing education scholars, methodologists teaching autoethnography, and IRBs reviewing educational research proposals.
The Ascendance of Collaborative Approaches
The predominance of collaborative autoethnography (56%) represents a notable departure from autoethnography’s origins as an introspective, solo methodology (Bochner, 2000). In this sample, that shift appears linked to nursing’s disciplinary emphasis on relational knowing and collaborative practice (Thorne, 2020), as well as contemporary calls for research approaches that amplify marginalized voices within academic structures (Gamboa et al., 2024; Iheduru-Anderson et al., 2024).
The concentration of methodologically robust collaborative autoethnographies among studies examining BIPOC faculty experiences is particularly significant. These studies explicitly positioned collaborative autoethnography as a decolonizing methodology that challenges “positivistic notions of what is or is not worth studying” (Gamboa et al., 2024, p. 3), echoing broader calls for research approaches that center historically marginalized perspectives in nursing scholarship (Thambinathan & Kinsella, 2021). Studies such as Iheduru-Anderson et al. (2024, 2025) reported relatively comprehensive methodological detail across multiple dimensions, including variant justification, reflexivity, and relational ethics. While the reasons for this pattern cannot be determined from our data, it is notable that studies explicitly engaging equity and justice concerns tended to report more transparent methodological procedures.
However, the prominence of collaborative approaches should not be read as evidence that group processes are inherently more rigorous or liberatory than solo inquiry. Critics of collaborative research have cautioned against romanticizing assumptions that view dialogue and multivocality as automatically producing deeper or more trustworthy knowledge (Atkinson, 2006). Complex group dynamics, including personality dominance, strategic self-censorship, and institutional pressures, may be smoothed into performed consensus in published accounts, and pluralizing meaning does not automatically render it more rigorous. The collaborative autoethnographies in this sample reported rich dialogic processes, but published texts necessarily represent these processes selectively, and the extent to which multiplicity was preserved or reduced to unity in the writing cannot be fully assessed from the manuscripts alone. This tension warrants critical attention from nursing education scholars employing collaborative approaches.
Quality Appraisal: Gaps and Innovations
The finding that 65% of studies did not apply autoethnography-specific quality frameworks raises questions about how rigor is being conceptualized and communicated, and aligns with ongoing debates about appropriate evaluation criteria for interpretive inquiry (Le Roux, 2017). The absence of Tracy’s (2010) widely-cited criteria and Anderson’s (2006) analytic autoethnography features from explicit application is notable, suggesting either limited uptake of these frameworks in nursing education or a preference for other ways of signaling quality.
When authors do not articulate variant-appropriate criteria, evaluation may default to generic qualitative checklists that fit unevenly with autoethnographic aims. Evocative work tends to privilege resonance and aesthetic coherence; analytic autoethnography emphasizes complete-member status, theoretical development, and dialogue beyond self; collaborative approaches foreground negotiated meaning, polyphony, and distributed responsibility. The predominant application of generic trustworthiness criteria (credibility, transferability, dependability, confirmability) across all variants can obscure these distinctions and may invite reviewers to evaluate evocative work by analytic standards or vice versa. For example, several solo autoethnographies, including O’Keeffe’s (2015) exploration of teacher self-concept and Sheedy’s (2024) account of multicultural nursing education, articulated clear thematic procedures but offered little detail on how alternative interpretations were considered or how narrative authority was checked beyond the author’s own reflections, despite drawing exclusively on personal memory and self-generated artifacts.
Several recent studies offer noteworthy reframing of rigor. Salzmann-Erikson et al.’s (2025) post-qualitative stance and Gamboa et al.’s (2024) decolonizing perspective on rigor challenge Eurocentric assumptions embedded in conventional quality frameworks (Abo-Zena et al., 2022; Andrew, 2020). These approaches resonate with broader scholarship questioning whether criteria developed within positivist or post-positivist paradigms can adequately evaluate transformative, interpretive research (St. Pierre, 2021). At the same time, the lack of shared expectations around such alternative framings may contribute to the inconsistent quality practices observed across the sample.
Taken together, these findings are consistent with a fit-for-variant orientation: rather than positioning any single framework as universally “best,” they point toward field-level dialogue about how appraisal and reporting expectations might be aligned with specific autoethnographic traditions. Such alignment could facilitate more appropriate peer review, support methodological transparency, and clarify what counts as quality within different autoethnographic approaches, without reducing evaluation to the technical application of fixed checklists together, these findings support a fit-for-variant stance: rather than endorsing any single framework as universally “best,” they suggest a need for field-level dialogue about how appraisal and reporting expectations can be aligned with specific autoethnographic traditions. Such alignment may facilitate more appropriate peer review, strengthen methodological transparency, and clarify what counts as quality within different autoethnographic approaches, without reducing evaluation to the technical application of fixed checklists.
Reflexivity: Depth as Distinguishing Feature
The substantial variation in reflexivity depth, from integrated analysis of positionality to brief acknowledgment, reflects broader tensions in qualitative nursing research between methodological ideals and practical constraints (Berger, 2015). Studies coded as demonstrating integrated reflexivity made their analytical reasoning more transparent by disclosing positionality across multiple manuscript sections and linking identity dimensions to specific interpretive decisions, thereby enabling readers to assess the relationship between standpoint and analytical choices.
It is important to acknowledge, however, that reflexivity carries epistemological tensions that this review cannot resolve. Critics have described autoethnography’s reliance on self-referential positioning as a potential “house of mirrors” in which standpoint replaces rather than enriches empirical engagement (Atkinson, 2006; Sparkes, 2020). If taken to its extreme, reflexivity risks becoming hyper-reflexivity, a paralyzing self-consciousness that substitutes introspection for analysis (Delamont, 2009). Similarly, the assumption that researchers have transparent access to their own motivations, assumptions, and positioning warrants scrutiny; unconscious needs, institutional pressures, and desire for professional legitimacy may shape what is surfaced and what remains hidden, even within collaborative groups of trusted colleagues. These critiques do not invalidate reflexivity as a quality practice, but they caution against treating reflexive disclosure as sufficient evidence of analytical rigor. In the studies reviewed here, reflexivity appeared most productive when it served as a tool for making analytical reasoning visible to readers, not as a demonstration of self-knowledge per se.
Collaborative designs appeared to create structural conditions that could support reflexivity through dialogue, negotiated meaning, and accountability to co-authors, though such conditions do not guarantee deeper reflection in practice. This pattern was evident in studies that explicitly reported collective reflection and shared interpretation processes (for example, Heidari et al., 2024; Iheduru-Anderson et al., 2025). The multivoiced format creates opportunities for co-researchers to challenge assumptions, surface blind spots, and negotiate interpretations in ways less available to solo autoethnographers who rely primarily on internal dialogue. At the same time, collaborative settings can also reproduce power asymmetries, encourage conformity, or privilege certain voices within the group, and published accounts may not capture the full complexity of these dynamics.
The stronger reflexive practices observed in studies addressing racial equity may reflect both the methodological commitments of critical race and feminist traditions (Adams et al., 2017) and the lived imperative for researchers navigating systems of oppression to articulate their standpoint (Collins, 2000). This pattern suggests that substantive reflexivity may be particularly visible when researchers examine phenomena directly connected to their own marginalized identities, although all autoethnographers can engage in comparable depth regardless of topic.
For nursing education scholarship, where race, power, evaluation, and institutional hierarchy frequently shape experience, minimal or token reflexivity may be especially limiting because it can obscure how standpoint influenced what was noticed, narrated, and theorized. When authors offer only brief declarations of professional role without examining how their positioning shaped analytical choices, readers may have difficulty assessing the relationship between researcher identity and knowledge claims. The patterns observed here suggest that, in nursing education autoethnography, reflexivity tends to be most analytically informative when it attends to role and power dynamics, relational positioning within the educational community, and the consequences of narrating shared professional spaces, with explicit linkage to analytic decisions.
Beyond field-level patterns, several limitations within the included autoethnographies themselves warrant attention. Many solo or evocative studies relied heavily on retrospective personal memory and single-participant data, with limited triangulation or engagement with external stakeholders, even when authors explicitly acknowledged recall bias or the partial nature of memory-based narratives (e.g., O’Keeffe, 2015; Gardner et al., 2014). Collaborative and collective autoethnographies offered richer data sources and more explicit reflexive dialogue, yet often drew on self-selected groups of faculty from a single institution, program, or professional association, which constrains transferability and may mute dissenting voices (e.g., Gamboa et al., 2024; Iheduru-Anderson et al., 2024, 2025; Salzmann-Erikson et al., 2025). Even among methodologically sophisticated studies, ethics discussions tended to focus on consent and confidentiality for co-authors, with less systematic consideration of students, colleagues, and institutions who appeared in narratives but were not themselves part of the research team. These patterns reinforce the need for nursing education autoethnography to pair variant-appropriate quality frameworks with fuller reporting of sampling boundaries, data limitations, and the relational risks that accompany writing from within tightly knit educational communities.
Autoethnography and Nursing Epistemological Traditions
The patterns identified in this review also invite reflection on how autoethnography aligns with established nursing epistemologies. Carper’s (1978) foundational ways of knowing in nursing, particularly personal knowing (self-awareness and the capacity to encounter others as persons) and aesthetic knowing (the perception of meaning in immediate experience), resonate closely with autoethnography’s emphasis on embodied, relational, and experiential inquiry. Thorne (2020) has argued that nursing scholarship must find ways to honor forms of knowledge that emerge from practice relationships, emotional attunement, and embodied engagement, precisely the dimensions that autoethnography makes central. The growing adoption of autoethnographic methods in nursing education may thus reflect not merely methodological fashion but a disciplinary alignment between autoethnography’s epistemological commitments and nursing’s longstanding attention to relational practice, caring, and embodied ways of knowing. This alignment also carries implications for how autoethnographic quality is understood within nursing: criteria that privilege abstract theoretical contribution may not fully capture the forms of insight, including emotional resonance, relational understanding, and transformative self-awareness, that nursing epistemologies value. Nursing education scholars are well positioned to contribute to methodological discussions about how autoethnographic quality can be evaluated in ways that honor disciplinary epistemological commitments while maintaining scholarly rigor.
Ethical Complexity in Autoethnographic Research
The limited attention to relational ethics (35%) and consent for implicated others (about one quarter of studies) represents a substantial gap with implications for research integrity and the wellbeing of those appearing in autoethnographic narratives. As Ellis (2007) observes, autoethnographers often write about “intimate others who are often identifiable” (p. 13), creating ethical obligations that extend beyond traditional IRB parameters focused on formally recruited participants (Andrew, 2020; Tolich, 2010).
Ethics is particularly consequential for nursing education autoethnography because educators and faculty write from within communities where students, colleagues, and institutions may be recognizable even when pseudonyms are used. The variability in IRB reporting observed in this sample may partially reflect jurisdictional differences in how self-study research is classified: in some institutions and countries, autoethnography involving only the researcher’s own experience may be deemed exempt from formal ethics review, while in others, the potential to implicate identifiable colleagues or students triggers full review requirements. These regulatory differences do not excuse inadequate ethics reporting, but they provide important context for understanding the variability observed. In this review, inconsistent reporting of IRB or ethics review status, consent logic, and relational protections indicates a vulnerability that can undermine trust in the method, even when narratives are compelling and insights are valuable.
The collaborative autoethnography format introduces additional ethical complexities. While co-researchers can consent to their own participation, their narratives inevitably implicate colleagues, students, and institutions who may be recognizable despite anonymization (Lapadat, 2017). The creative strategies employed by Kidd and Finlayson (2010), including composite vignettes, offer promising approaches for balancing narrative richness with protection of others. Studies such as Iheduru-Anderson et al. (2025) and Salzmann-Erikson et al. (2025), included explicit consent procedures for implicated others, described specific confidentiality strategies, and addressed relational risks in their ethics reporting, offering concrete examples of how ethical considerations can be made transparent in autoethnographic writing. Even in studies that modelled strong relational ethics among co-authors, such as collective explorations of international course co-design or BIPOC faculty mentoring, ethics procedures for students, colleagues, and institutions mentioned in the narratives were less consistently explicated, leaving readers to infer how relational risks were weighed and mitigated.
Overall, the patterns observed here suggest that field-specific dialogue about how relational ethics is reported in nursing education autoethnography could be valuable, particularly when power differentials exist (for example, faculty writing about students or supervisors writing about trainees). Such dialogue would not preclude critical or decolonizing uses of autoethnography, but could support more explicit reasoning about potential harms and benefits for those who are, or might feel, written about.
Field-Level Observations for Nursing Education Scholarship
For Nursing Education Researchers
The patterns observed suggest that researchers employing autoethnography may strengthen their work by explicitly identifying their chosen variant and providing substantive justification for methodological decisions linking variant selection to research aims. Studies that named quality criteria appropriate to their variant, whether drawing on established frameworks such as Chang et al. (2016), Le Roux (2017), or Tracy (2010), or articulating alternative approaches with transparent rationale, tended to demonstrate greater methodological clarity. Nursing education scholars may find that explicitly aligning credibility strategies and quality criteria with their chosen variant facilitates clearer communication with readers and reviewers. For example, foregrounding resonance and aesthetic coherence in evocative work, theoretical contribution and complete-member status in analytic work, and polyphony and negotiated meaning in collaborative work may better match field expectations for variant-appropriate rigor. Reflexivity appeared most analytically productive when it moved beyond token acknowledgment to integrated analysis of how researcher positionality, including but not limited to professional role, shaped interpretation throughout the research process.
Across the sample, routine reporting of ethical considerations was uncommon. Studies that addressed (a) IRB/ethics status and rationale for the determination; (b) who was implicated in narratives and what consent was sought, or justification for why consent was not obtained; (c) masking and confidentiality strategies employed and their limitations; and (d) consideration of role power dynamics, particularly in faculty–student or supervisor–colleague relationships, offered greater transparency about their ethical decision-making. Explicit attention to relational ethics, particularly consent procedures for implicated students, colleagues, or institutions, and consideration of how power dynamics shape narrative representation, may support manuscript transparency for review while offering examples of ethical practice for the field. Such reporting may strengthen trust in the method and offer concrete examples for emerging scholars learning to navigate relational ethics in autoethnographic work.
For Nursing Education Programs and Methodologists
Graduate nursing programs may find value in including autoethnographic methods in research curricula, addressing variant selection, quality criteria, and ethical considerations specific to self-study and collaborative approaches. Faculty development initiatives could support educators in employing autoethnography for reflective practice while attending to the ethical complexities of writing about students and colleagues. Institutional review boards may benefit from developing guidance specific to autoethnographic research that clarifies when self-study requires formal approval, addresses legitimate methodological debates (Lapadat, 2017; Tullis, 2021), and balances protection of implicated others with recognition of the methodology’s transformative potential.
The observed variability in quality criteria, reflexivity depth, and ethics reporting across evocative, analytic, and collaborative approaches suggests that nursing education scholarship could be enriched by field-level dialogue about variant-sensitive evaluation practices. Evocative work appeared strongest when resonance, aesthetic coherence, and transformative potential were foregrounded. Analytic autoethnography appeared strongest when theoretical contribution, complete-member researcher status, and dialogue with existing scholarship were evident. Collaborative approaches appeared strongest when polyphony, negotiated meaning, and distributed analytical responsibility were transparent. These patterns highlight opportunities for methodological discussion rather than uniform application of generic qualitative standards.
Nurse educators teaching qualitative research methods may find these findings useful for structuring curriculum around autoethnographic inquiry. Specific pedagogical applications include teaching variant selection as a deliberate methodological choice with epistemic consequences, using case studies from the reviewed literature to illustrate the range of reflexivity depth and its analytical implications, and facilitating ethics deliberation exercises in which students practice navigating relational risks in autoethnographic scenarios. Faculty mentoring novice autoethnographers can draw on the patterns identified here to model how variant identification, quality framework selection, and relational ethics reporting can be integrated from the earliest stages of research design.
Implications for Nursing Research More Broadly
While this review focused specifically on nursing education contexts, the patterns identified, particularly regarding variant-sensitive appraisal, relational ethics in hierarchical settings, and the gap between reported and enacted reflexivity, likely have relevance for nursing research more broadly. Clinical nursing contexts share many of the power dynamics and relational complexities identified in educational settings, including hierarchical relationships, small professional communities where identifiability is high, and the ethical tensions of writing about colleagues and patients. Nurse researchers employing autoethnographic methods in clinical practice, leadership, or community health contexts may benefit from the same attention to variant-appropriate quality criteria and relational ethics reporting that this review highlights. These observations are offered as extensions of our findings rather than conclusions directly supported by our nursing education-specific data.
Limitations and Future Research Directions
Review Limitations
Several limitations warrant consideration when interpreting these findings. First, restriction to English-language publications may have excluded autoethnographic scholarship from non-Anglophone nursing education contexts, potentially underrepresenting methodological innovations in non-Western traditions. Given autoethnography’s emphasis on cultural context, this linguistic limitation may have meaningful implications for the scope of practices identified. Autoethnographic traditions in non-Anglophone contexts may draw on different epistemological roots and reporting conventions, and variant use or appraisal practices may differ across regions in ways our sample could not capture.
Second, our focus on evocative, analytic, and collaborative autoethnography as the primary heuristic lenses, while grounded in established methodological literature, may not capture the full diversity of autoethnographic practice in nursing education. Studies employing feminist, narrative, performative, indigenous, or other variant orientations may offer insights not represented in our analysis. This boundary reflects a pragmatic decision to focus on variants with the most developed methodological guidance, but it constitutes a limitation that future reviews might address.
Third, classification of reflexivity depth and quality framework application involved interpretive judgment; researchers may have engaged in reflexive practices or quality considerations not fully captured in published reports. Word limits and genre conventions may constrain methodological reporting in ways that underrepresent actual practice. The same constraint applies to ethics and relational risk: because we relied on what authors chose to report, we could not directly observe how they weighed potential harms and benefits to implicated others, nor could we determine when robust but unreported ethical deliberation occurred.
Fourth, the heterogeneity of included studies, spanning discussion papers, research briefs, and full empirical reports, complicates direct comparison of methodological rigor across publication types. Some publication formats provide limited space for methods and ethics reporting, which may partially account for the variability observed. Fifth, our review team’s positions as nursing educators with experience in autoethnographic research may have influenced interpretation. While we implemented systematic procedures to mitigate bias, including dual independent extraction, calibrated coding, and documented disagreement resolution, complete objectivity is neither possible nor epistemologically desirable in interpretive synthesis. We have sought transparency about our standpoint and decision-making rather than claims of neutrality.
Sixth, our treatment of ethics in autoethnography is itself bounded by the literature we reviewed. Tolich (2010) argues that no story should harm others and emphasizes that ethical responsibility extends beyond the self to all those implicated in the narrative. Andrew (2020) similarly highlights the potential for autoethnographic writing in academic contexts to expose colleagues, students, and institutions to reputational or relational harm when critique becomes public. Our synthesis shows that explicit engagement with these risks was relatively uncommon in nursing education autoethnography. This limits our ability to determine how often authors meaningfully grappled with the potential for autoethnographic work to function as grievance, critique, or institutional challenge, particularly in small, hierarchical nursing education communities.
Finally, our appraisal of methodological quality, reflexivity depth, and ethics reporting in included studies reflects one team’s interpretation based on published manuscripts. This review does not purport to establish universal standards for evaluating autoethnographic work, nor does it prescribe how reviewers should assess manuscripts. Rather, it maps patterns in current practice to stimulate field-level dialogue about what constitutes sufficient transparency and rigor in nursing education autoethnography. The prescriptive development of shared evaluation criteria remains an important area for future methodological work.
Identified Gaps and Future Research Recommendations
This review identified several gaps warranting future scholarship. First, the limited application of established quality frameworks (Anderson, 2006; Tracy, 2010) suggests need for nursing-specific guidance on evaluating autoethnographic rigor. Development and validation of evaluation criteria tailored to nursing education contexts, potentially integrating discipline-specific values such as caring, relational ethics, and transformative learning—would support both researchers and reviewers. Future research should examine whether existing frameworks adequately capture quality dimensions valued in nursing scholarship or whether discipline-specific criteria are needed.
Second, relational ethics in autoethnographic nursing research remains substantially under-theorized. Future scholarship should examine how autoethnographers navigate responsibilities to students, colleagues, patients, and institutions appearing in their narratives. Development of consent processes appropriate to autoethnographic methodology—addressing both co-researchers and implicated others—represents an important direction. Empirical investigation of how those portrayed in autoethnographic accounts experience their representation would inform ethical guidance.
Third, the concentration of methodologically sophisticated collaborative autoethnographies among studies of BIPOC faculty experiences suggests potential for extending these rigorous approaches to other equity-focused nursing education research. Future studies might examine how CAE can amplify student voices, particularly those from underrepresented backgrounds, or explore faculty experiences of other marginalized identities. Comparative research examining whether the methodological rigor observed in equity-focused CAE reflects researcher training, critical consciousness, or other factors would advance understanding.
Fourth, the innovative quality reframings from decolonizing perspectives (Gamboa et al., 2024) and post-qualitative stances (Salzmann-Erikson et al., 2025) merit further development and empirical evaluation. Research examining whether these alternative criteria produce scholarship that achieves transformative aims while maintaining scholarly credibility would advance methodological discourse. Development of practical guidance for applying decolonizing quality frameworks in autoethnographic nursing research represents an important future direction.
Finally, the geographic concentration of included studies in Anglophone nations (64%) indicates need for expanded autoethnographic scholarship examining nursing education in diverse global contexts. Comparative studies examining how autoethnographic approaches translate across cultural and educational systems would enrich methodological understanding while amplifying currently underrepresented perspectives. Attention to how autoethnography might be adapted for cultural contexts with different traditions of self-disclosure and narrative inquiry would advance global applicability.
Additionally, the epistemological tensions identified by critics of autoethnographic reflexivity, including concerns about hyper-reflexivity, the limits of self-knowledge, and the potential for collaborative processes to perform consensus rather than preserve multiplicity, warrant sustained theoretical attention in nursing-specific contexts. Future work might examine how nursing’s disciplinary epistemologies, including personal knowing and relational ethics traditions, offer distinctive resources for navigating these tensions, and whether discipline-specific guidance can help nursing education autoethnographers engage reflexivity as an analytical tool without falling into circularity or self-referential excess.
Conclusion
Autoethnography has emerged as a valuable methodology for examining the complex, relational, and often hidden dimensions of nursing education. The 23 studies synthesized in this review demonstrate the methodology’s capacity to illuminate faculty experiences, pedagogical practices, and institutional dynamics that resist capture through conventional approaches. The dominance of collaborative variants reflects nursing’s relational epistemology while advancing methodological innovation in service of equity and transformation.
However, inconsistent application of quality frameworks, variable reflexivity depth, and limited attention to relational ethics indicate that autoethnographic practice in nursing education has not yet achieved the methodological maturity observed in disciplines where autoethnography has longer history. Addressing these gaps through explicit quality criteria, substantive reflexivity, and ethical frameworks responsive to the methodology’s unique demands will strengthen autoethnography’s contribution to nursing education scholarship. As the discipline continues grappling with questions of diversity, equity, and pedagogical transformation, autoethnographic approaches offer powerful tools for centering lived experience in the pursuit of understanding and change.
Supplemental Material
sj-docx-1-gqn-10.1177_23333936261450825 – Supplemental material for Autoethnography in Nursing Education: An Integrative Review of Methodological Variants, Quality Practices, and Ethical Considerations (2010–2025)
Supplemental material, sj-docx-1-gqn-10.1177_23333936261450825 for Autoethnography in Nursing Education: An Integrative Review of Methodological Variants, Quality Practices, and Ethical Considerations (2010–2025) by Kechi C. Iheduru-Anderson, Valeria A. Ramdin, Christiana O. Akanegbu, Ednah Madu, Julia U. Ugorji, Vanessa A. Johnson, Nisha Mathews, Karen E. Alexander, Benita N. Chatmon, Danielle McCamey and Agnes T. Deleawe in Global Qualitative Nursing Research
Footnotes
Acknowledgements
The authors acknowledge the University of Texas at Arlington (UTA) Library for providing institutional access to Covidence, which supported study screening and data management for this review.
ORCID iDs
Ethical Considerations
Not applicable. Institutional Review Board review was not required because this study synthesized data from publicly available, published sources only.
Consent to Participate
No individual-level identifiable participant data were collected, and all information was derived from published sources.
Author Contributions
Lead author KI conceived the study and invited the author team to collaboratively refine the scope and objectives of the integrative review. KI led the overall design and coordination of the review, oversaw the review processes, and drafted the initial manuscript. Coauthors (A2–A11) contributed to scope refinement and methodological decisions and participated in review tasks including screening/selection, data extraction, quality appraisal, and/or synthesis and interpretation of findings, as assigned. All authors participated in initial discussions to refine the scope of the integrative review, contributed to interpretation of findings, critically revised the manuscript for important intellectual content, approved the final version, and agree to be accountable for all aspects of the work.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
Data sharing is not applicable to this article, as no new datasets were generated beyond the synthesis presented in the article and supplementary materials.
Supplemental Material
Supplemental material for this article is available online.
AI Disclosure Statement
AI-assisted tools (Claude and ChatGPT) were used during search development to refine keywords and adapt search strings across databases. AI tools were not used to make eligibility decisions, extract data, appraise study quality, or generate analytic conclusions; all review steps and final decisions were completed and verified by the author team.
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References
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