Creativity in Entrepreneurship Education among Nursing Students: A Narrative Review of Attitude, Self-Efficacy, and Self-Employment Outcomes for Policy and Practice

Unemployment and underemployment among qualified nurses remain persistent challenges, particularly in low- and middle-income contexts where formal-sector absorption is limited. Entrepreneurship education has increasingly been integrated into nursing programmes to promote self-employment, yet the role of creativity in shaping employment-related outcomes remains insufficiently synthesised. This study adopted a narrative review design to synthesise empirical literature published between 2015 and 2025 on creativity in entrepreneurship education among nursing students. The review drew on peer-reviewed studies and policy-relevant literature from education, entrepreneurship, and nursing, and was theoretically informed by Social Cognitive Theory, the Theory of Planned Behaviour, and Human Capital Theory. The findings indicate that creativity is most effectively developed through experiential and practice-based pedagogies and plays a significant mediating role in shaping entrepreneurial attitudes and entrepreneurial self-efficacy among nursing students. However, direct empirical evidence linking creativity-enhanced entrepreneurship education to actual self-employment outcomes among qualified nurses remains limited, with most studies relying on intention-based measures. Structural and contextual constraints, including regulatory barriers, limited access to finance, and conservative professional norms, further restrict the translation of creative capability into self-employment. The review demonstrated that creativity influences self-employment outcomes through psychologically mediated, context-dependent pathways rather than through direct causal effects. These findings underscore the need for curriculum reform, supportive institutional and policy environments, and longitudinal research to strengthen sustainable self-employment pathways for qualified nurses.