It is of utmost importance to recognise biases and limitations throughout the project that may have influenced the way the project was implemented and what it achieved.
While the project focused particularly on gender issues, recognising the small number of male students in nursing education and later in the profession, ethnic background and age also emerged as important diversity factors. While an increasing number of images of men in the role of nurses were addressed in study materials, only limited action was taken to increase representation of older, ethnically diverse individuals in nursing educational materials, for example.
A useful study to illustrate this bias is one that examines the portrayal of male nurses in 130 professional nursing texts. It reveals that they are often presented as a "missing" and necessary group whose inclusion would enhance workforce diversity (Cottingham, 2019). Although such framing employs rhetoric of equality and diversity, it unintentionally perpetuates gender inequalities by failing to acknowledge the systemic advantages that men, particularly white men, often possess in nursing. The findings of Cottingham (2019) indicate that nursing texts perpetuate a gender binary, categorising women's issues as private and men's as public. Additionally, they frequently use the language of oppressed groups without adequately addressing the specific challenges faced by men in nursing. That underscores a bias in the recruitment rhetoric, emphasising the need for a more comprehensive and inclusive approach to attract men to the profession in an effective manner (Cottingham, 2019). It should be noted that when reviewing recruitment materials and faculty communication, the focus of the current project extended beyond highlighting men as the "missing minority" and tried to emphasised diversity as a whole.
Bias in relation to the status of the nursing profession was also prevalent. That relates to the low pay of nurses and the view of nursing education as an alternative if “things do not go to plan careerwise”, focusing on unemployed men in particular. However, the current project findings highlighted that nursing can be seen as a “meaningful and purposeful profession” that contributes to the well-being and mental health of various social groups. That aspect of a meaningful and purposeful career was somewhat overshadowed by the illustration of practical, hands-on experience and the encouragement of careers counsellors to promote this particular educational option more actively to prospective male students.
Another significant shortcoming of the study is that, despite the attempt to implement similar interventions in the three countries, the structural differences among them led to substantial variations in outcomes. Those disparities make it difficult to compare the countries regarding impact of the interventions. In other words, the differences between the countries are related to many factors. That also influenced the ability to implement specific intervention features consistently.
Additional critical limitation of the project is that, while an attempt was made to track the number of male students over time, we cannot draw conclusions about causality. Numerous factors influence enrolment and completion rates in nursing studies, making it challenging to attribute changes directly to the interventions. This is also related to the generalisability of the results (for example the results derived from two online surveys in Finland) which are restricted by the relatively small sample sizes. As a result, it is possible that these findings only represent a narrow aspect of the broader issue, which could lead to discrepancies when compared with data from other Nordic countries.
Finally, the literature reviewed in this study is primarily composed of sources written in the Nordic languages and English. That linguistic focus may introduce bias into the research, potentially leading to the exclusion of significant perspectives and insights available in research published in other languages. Consequently, the conclusions may be limited by the lack of inclusivity of non-Nordic and non-English academic contributions, which could result in critical viewpoints and data from a broader international context being overlooked.