An examination of nurse educators' Knowledge, Attitudes, Instructional Beliefs, and Instructional Practices of human trafficking

Human trafficking, a global epidemic of exploitation and enslavement, threatens the health and safety of millions of innocent people every day. The Victims of Trafficking and Violence Protection Act of 2000 (2000) and its subsequent reauthorizations define human trafficking as:

Sex trafficking in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age; or the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude peonage, debt bondage, or slavery.

(p. 1470)

Perpetrators of human trafficking, known as traffickers, use threats, intimidation, and violence to obtain sex or labor often in unstable, unhealthy living conditions (United States Department of State, 2017). Persons victimized by human trafficking remain at high risk to develop severe health conditions including but not limited to fractures, burns, contusions, dental trauma, infectious diseases, unplanned pregnancies, chronic pain, depression, substance use disorders, and/or addiction (United States Department of Health and Human Services, 2020). Given the wide-ranging negative health consequences, patient encounters in various settings may offer health care providers the opportunity to identify those exploited by trafficking and assist them out of a trafficking situation.

Growing evidence suggests that persons exploited through human trafficking encounter health care providers while under a trafficker's control, but many remain unidentified (Baldwin et al., 2011; Goldberg et al., 2016; Katsanis et al., 2019; Lederer & Wetzel, 2014; Polaris, 2023). Nurses practicing in direct patient care settings are ideally positioned to identify, assist, and refer trafficked persons to safety. Unfortunately, due to inconsistent and unstandardized execution of human trafficking awareness programs, training mandates, and victim screening tools among health care organizations nationwide, research demonstrates that nurses lack awareness and understanding of human trafficking (Beck et al., 2015; Chisolm-Straker et al., 2012; Coppola et al., 2019; Dols et al., 2019; Fraley et al., 2018; Long & Dowdell, 2018; Lutz, 2018; Peck & Meadows-Oliver, 2019; Ramnauth et al., 2018; Ross et al., 2015; Viergever et al., 2015). Failure to recognize signs of human trafficking undeniably leads to missed opportunities to assist trafficked persons away from a life of exploitation and abuse.

Teaching undergraduate and graduate nursing students about human trafficking may improve their ability to identify and care for trafficked persons in health care settings. The first step to improving nurses' awareness of human trafficking is to educate the nurse leaders and faculty members who train students (Drake, 2016). A dearth of research exists regarding academic nurse educators' understanding and teaching practices of human trafficking.

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