Nursing research is widely endorsed yet rarely embedded as a sustained institutional function. Organisational priorities privileging efficiency over reflection risk marginalising nursing's epistemic agency and weakening the moral foundations of knowledge production. To present the Leadership-Structure-Culture (LSC) Theory of Nursing Research Advancement, a middle-range conceptual model that situates research as an ethical and institutional responsibility of nursing practice. Using abductive reasoning informed by autoethnography and the Gioia methodology, the theory integrates moral philosophy and organisational science. Conceptual derivation yielded seven propositions and two analytical tools: the LSC Maturity Scale and the Empirical Indicator Matrix. LSC reframes healthcare organisations as epistemic ecosystems in which leadership, structural integrity, and culture interact to sustain inquiry as care-based knowledge work. The LSC Theory advances an institutional paradigm in which nursing research is recognised as a matter of epistemic justice, professional dignity, and moral responsibility.

Quizartinib is a tyrosine kinase inhibitor with single agent activity in patients with relapsed or refractory (R/R) acute myeloid leukemia (AML) and has demonstrated efficacy in first‐line therapy when combined with intensive chemotherapy in both FLT3 ITD‐negative and positive AML. The FLAG‐QUIDA trial was a multicenter phase 1/2 study of quizartinib combined with FLAG‐IDA in adult patients with first R/R AML. The primary objectives were to determine the recommended phase 2 dose (RP2D) in phase 1 and to establish the complete remission (CR) and CR with incomplete hematologic recovery (CRi) rates in phase 2. Nine patients were included in phase 1 and 52 in phase 2. Eighteen out of 61 (30%) patients were FLT3 ‐ITD‐positive. The RP2D of quizartinib was established at 60 mg/day for 14 days per 28‐day cycle. Overall, the CR/CRi rate was 56% ( n = 34), and the CR/CRi plus morphologic leukemia free state (MLFS) rate was 66% ( n = 40), without differences across genetic subgroups. Measurable residual disease negativity was achieved in 38% ( n = 13) of CR/CRi patients. Thirty‐one patients (51%) were bridged to allogeneic stem cell transplantation after FLAG‐QUIDA, 28 in CR/CRi and 3 in MLFS. Median relapse‐free survival was 17 months as compared to 7.6 months in a cohort of matched patients treated with FLAG‐IDA without quizartinib ( p = 0.028), and median overall survival was 15.8 months in the FLAG‐QUIDA cohort and 8.6 months in the matched cohort ( p = 0.09). No safety concerns were raised. FLAG‐IDA with quizartinib demonstrated promising efficacy in R/R AML, supporting future investigations. Trial Registration: EudraCT number: 2019‐001976‐12; ClinicalTrials.gov identifier: NCT04112589

This discussion paper examines how care‐based nursing judgement becomes recognised, narrowed or excluded as professional knowledge within healthcare organisations. Nursing care is often described as relational, ethical, practical or compassionate, yet these descriptions may obscure its epistemic content: trained perception, contextual interpretation, anticipatory reasoning, moral judgement, continuity work and practical synthesis under uncertainty. Drawing on epistemic injustice, nursing knowledge development, care ethics and organisational governance, the paper argues that injustice in nursing knowledge is not only interpersonal but organisational. It identifies three mechanisms through which care‐based nursing knowledge may be downgraded: credibility distortion, interpretive narrowing and restricted epistemic uptake. The paper further develops the idea of reductive recognition: care may become visible in organisational systems only after being translated into categories that diminish its nursing rationality. Five organisational conditions are proposed for recognising care as knowledge: credible reception, hermeneutic infrastructure, shared knowledge governance, educational preparation and balanced standardisation. The central contribution is to shift the question from whether nurses possess knowledge to how healthcare organisations decide which forms of nursing knowledge are allowed to count.

This paper argues that competence in nursing education is ethically incomplete without epistemic agency. Contemporary nursing programmes are increasingly shaped by competencies, assessment rubrics, curriculum mapping and audit-ready evidence. These mechanisms are legitimate and necessary for accountability, but they may become ethically insufficient when they make professional formation visible mainly as performance, compliance or documentation. Epistemic agency refers to the capacity to interpret experience, justify claims, question assumptions and participate as a legitimate knower in nursing practice. Although the term may be unfamiliar to some nurse educators, its absence is visible when students are trained to enact standards without being equally supported to reason about uncertainty, credibility, patient testimony and the knowledge claims embedded in care. Existing commitments to reflection, critical thinking, evidence-based practice, person-centred care and student voice provide important educational values, yet they often lack a sufficiently explicit account of the epistemic harms that occur when credibility, intelligibility and authority are unequally distributed. They do not fully explain how some knowers are believed while others are doubted, how some forms of knowledge become authoritative while others are treated as anecdotal and how nursing knowledge itself may be positioned as practical implementation rather than disciplinary contribution. Epistemic agency cannot be secured merely by asking students to think critically or nurses to listen more attentively. Such responses underestimate the social, institutional and curricular conditions through which knowledge is made credible, intelligible and actionable. Drawing on social epistemology, nursing ethics and nursing knowledge development, this discussion paper reframes epistemic agency as a condition of ethical professional formation beyond competence alone. No empirical data are reported. Practical reflexive prompts are offered for curriculum leaders, nurse educators, clinical supervisors and students.

Professional education asks learners to act under consequential uncertainty while judgment and professional identity are still developing. Scholarship on emotion, identity formation, reflection, psychological safety, ethics, and agency has expanded, yet these literatures seldom explain how affectively charged experience becomes accountable professional action. This critical integrative review develops INTEGRAL (INTegrated Emotional Growth for Responsible Agency and Leadership), a cross-professional framework for health sciences and engineering education. A purposive, theory-led synthesis of 47 peer-reviewed sources was assembled through targeted searches, citation tracing, abductive construct comparison, negative-case analysis, and contrastive examination of two consequential professional fields; the retained corpus comprised 25 health-sciences sources, 13 engineering sources, and 9 cross-disciplinary, general-education, or methodological sources. Because the iterative search was not an exhaustive database export, no valid total-hit denominator was generated, and this reporting boundary is stated explicitly. INTEGRAL distinguishes event-in-context exposure (D1) from learner appraisal and identity-relevant processing (D2). Structured curricular scaffolding (D3) is specified as a multilevel configuration that shapes the exposure learners encounter, influences early processing, and moderates whether D2 becomes observable, reason-giving, accountable action under constraint (D4). Leadership and stewardship (D5) are repositioned as a conditional long-term extension rather than a mandatory stage. The framework is theoretical, identifies rival explanations and disconfirmation conditions, and derives testable propositions and multi-source indicators without treating adversity as inherently beneficial or emotional display as competence.