Structuring higher-order thinking: a national analysis of learning outcomes in Swedish undergraduate nursing thesis courses.

Background: Higher-order thinking is a central objective in nursing education, particularly within thesis courses where students are expected to demonstrate analytical reasoning and scholarly autonomy.

Aim: The aim of this study is to examine the structure, cognitive complexity, and knowledge domain classification of learning outcomes in degree project courses within Swedish undergraduate nursing education.

Methods: This national cross-sectional study examined the cognitive structure of 236 intended learning outcomes derived from 23 universities and university colleagues offering undergraduate nursing thesis courses across all Swedish higher education institutions (N = 25). Active verbs were extracted and analyzed using manifest content analysis, descriptive statistics, Mann-Whitney U tests, and Spearman's rank correlation.

Results: Using Bloom's revised taxonomy as the analytical framework, we identified 58 unique active verbs. All institutions included outcomes at multiple taxonomic levels, with "Analyzing" and "Applying" most frequently used. In contrast, "Understanding" was rarely represented, despite its foundational role in cognitive progression. Lexical diversity and alignment with higher-order thinking varied significantly across institutions. One-third of the verbs were not included in Bloom's taxonomy, highlighting the interpretive challenges in applying taxonomic models to curriculum analysis.

Conclusion: These findings suggest divergent pedagogical assumptions underlying outcome design and underscore the need for more coherent, epistemologically informed approaches to ensure thesis courses truly support academic development. The results may inform quality assurance practices and contribute to ongoing debates about the role of research training in undergraduate nursing education.