Introduction

Healthcare organizations are complex, dynamic systems undergoing continuous transformation. Within these environments, nurses’ professional identity is central to effective practice. The International Society for Professional Identity in Nursing (ISPIN) defines professional identity as “a sense of oneself, and in relationship with others, that is influenced by characteristics, norms, and values of the nursing discipline, resulting in an individual thinking, acting, and feeling like a nurse” [1, p.201]. Conceptualized as a dynamic and evolving construct, professional identity is shaped through interpersonal interactions, leadership discourse, and institutional narratives [2,3]. It underpins outcomes such as job satisfaction, resilience, interprofessional collaboration, and workforce retention [4,5]. Conversely, organizational change processes that fail to support professional identity may contribute to dissonance, disengagement, and resistance to innovation [6,7]. Yet, the mechanisms through which professional identity is reinforced during cultural transformation remain insufficiently examined.

Cultural transformation involves both structural dimensions (e.g., leadership, policies, governance) and symbolic ones (e.g., language, values, symbols) [8]. Strategic communication functions as a primary symbolic driver by aligning messaging with institutional goals and stakeholder interests to create shared meaning, strengthen symbolic coherence, and embed new practices [9–12]. While leadership models, organizational structures, and outcome metrics in healthcare change have been extensively studied [13–16], there is a lack of practical guidance on how strategic communication is operationalized to support professional narratives, stakeholder engagement, and cultural alignment.

Despite theoretical acknowledgment of communication’s role in organizational change, healthcare research has paid limited attention to strategic communication as an enabler of cultural transformation. The American Nurses Credentialing Center’s Magnet Recognition Program exemplifies this gap. Evidence shows that Magnet-designated hospitals strengthen nursing professional identity through structural empowerment, transformational leadership, and professional practice excellence [17–20]. These organizations demonstrate enhanced professional autonomy, nursing status, and engagement [21–23]. However, the literature focuses largely on structural and outcome indicators, with minimal exploration of the communicative processes that embed and sustain these transformations.

The intersection between strategic communication and nurses’ professional identity is therefore poorly conceptualized and empirically underdeveloped. This review positions itself at the crossroads of nursing, health communication, and organizational development—domains that remain rarely integrated. A scoping review is well suited to map available evidence, clarify conceptual frameworks, and synthesize practices that reinforce nursing identity during organizational change [24].

This study is grounded in the ISPIN-IBIN framework, which emphasizes embracing professional identity, communicating a unified brand image, and fostering brand awareness to promote accurate, consistent, and empowering representations of nursing—both within healthcare organizations and in the broader public sphere [25]. Building on this perspective, the review examines how strategic communication contributes to identity reinforcement during cultural transformation. While the framework highlights the importance of unified brand imagery, empirical evidence documenting its implementation in cultural transformation processes remains limited.

Accordingly, this review will include empirical and conceptual studies (qualitative, quantitative, mixed-methods), theoretical literature and grey sources. Based on the PCC (Participants–Concept–Context) framework, inclusion criteria are defined as follows:

1. Participants: Nurses in clinical, managerial, educational, leadership roles, and professionals (e.g., communication specialists, consultants, leaders) working with or on behalf of nurses to support their professional identity during cultural transformation.
2. Concept: Professional identity shaped through strategic communication, understood as institution-aligned process that reinforces professional identity and drives cultural transformation.
3. Context: Healthcare organizations undergoing professional or cultural transformation.

In summary, healthcare organizations require a clearer understanding of how strategic communication strengthens nurses’ professional identity during cultural transformation. Without such insights, change initiatives risk misalignment and weakened professional cohesion. This scoping review will systematically chart the extent, range, and nature of evidence on strategic communication in nursing cultural change, with attention to the ISPIN-IBIN Framework’s domain “Communicate a Unified Brand Image”. Findings will contribute to theoretical development and provide practical guidance for embedding communication strategies that reinforce nursing identity and enable sustainable organizational transformation.

Context

The review will include studies conducted in healthcare organizations —hospitals, clinics, primary care centers, and other institutional settings— undergoing or planning cultural organizational change. Both public and private contexts will be considered.

For clarity, the eligibility criteria derived from these conceptual foundations are summarised in Table 1 following the PCC framework.

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Table 1. PCC inclusion and exclusion summary.

https://doi.org/10.1371/journal.pone.0359546.t001

Methods

This review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews [35,36] and report according to PRISMA-ScR [37]. The protocol is registered on the Open Science Framework, with any amendments documented publicly [38]. Relevant PRISMA-P items [39] have been adapted to improve transparency (see S4 Appendix), in accordance with current guidance for reporting scoping review protocols.

The methodological process underpinning the design and planning of this scoping review is illustrated in Fig 1. This flow diagram summarizes the sequential phases, key decision points, and validation steps undertaken to ensure methodological rigor and transparency. A tentative timeline for the different phases of the scoping review is provided in Supplementary Information (S5 Appendix).

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Fig 1. Flow diagram of the scoping review process.

Sequential phases, key decision points, and validation steps.

https://doi.org/10.1371/journal.pone.0359546.g001

Search strategy

An initial limited search of MEDLINE (via PubMed), CINAHL (via EBSCO), and Web of Science informed the full search strategy, developed with a university librarian and peer-reviewed via PRESS [40]. The final search strategy combines terms related to nursing identity, organizational transformation, and strategic communication, limited to studies published between 2000 and 2025; a period reflecting the development of structured strategic communication practices and identity frameworks in healthcare. Boolean operators and MeSH terms were used to maximise sensitivity and capture both controlled vocabulary and free-text variations (S6 Appendix)

The main search will be conducted in seven bibliographic databases and be complemented by grey literature searches (see Table 2). To enhance transparency and reproducibility, database-specific adaptations of the search strategy are provided in S7 Appendix. Reference lists of included studies and relevant reviews will be screened (snowballing). No language restrictions will apply; non-English/Spanish records will be machine-translated for screening and full-text review. A preliminary search of Cochrane, JBI Evidence Synthesis, PROSPERO, and OSF found no existing or ongoing scoping reviews on this topic.

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Table 2. Information sources by type.

https://doi.org/10.1371/journal.pone.0359546.t002

Strengths and limitations

This section outlines the key methodological advantages and potential constraints of the proposed scoping review, highlighting factors that support the rigor and relevance of the findings as well as considerations that may influence their interpretation [24,36,37,42].

Strengths:

• Adherence to established methodological standards (JBI framework, PRISMA-ScR guidelines).
• Application of a robust tri-dimensional analytical framework enabling multidimensional, practice-oriented synthesis.
• Comprehensive search strategy across seven databases, grey literature inclusion, and absence of language restrictions, enhancing comprehensiveness and reducing publication bias.
• Methodological rigour is further ensured through piloting, dual independent screening/extraction, and iterative refinement of tools and criteria.
• Integration of the ISPIN-IBIN Framework adds analytical rigor and practical relevance, revealing concrete opportunities for embedding identity-focused communication in leadership, education, and policy initiatives.

Limitations:

• As a scoping review, no formal quality appraisal will be conducted, potentially limiting interpretability of findings.
• Conceptual heterogeneity across studies may reduce comparability and pose synthesis challenges.
• Inconsistent terminology or indexing may lead to the inadvertent exclusion of relevant literature, despite the comprehensive search strategies.
• The review will map and categorise communication strategies without assessing effectiveness or impact, though studies evaluating effectiveness will be included where relevant.
• Given the conceptual novelty and interdisciplinary complexity, the volume of eligible studies may be limited, potentially constraining breadth of available and transferability across diverse healthcare settings.

Potential sources of bias inherent to scoping reviews should be acknowledged. Consistent with JBI methodology, this review will not undertake a formal critical appraisal of included sources, as its primary purpose is to map the breadth and characteristics of the available literature. Nevertheless, the methodological characteristics and nature of the included sources will be considered when interpreting the mapped evidence. Publication bias, language bias, and conceptual heterogeneity may also influence the resulting evidence map despite the inclusion of grey literature and the absence of language restrictions. These potential sources of bias will be mitigated through a comprehensive peer-reviewed search strategy, independent dual screening and data extraction, calibration procedures, and predefined coding frameworks to enhance transparency, consistency, and reproducibility.

Despite these methodological limitations and potential sources of bias, the rigorous methodological approach adopted—including adherence to JBI guidance, independent dual review processes, and transparent reporting—is expected to provide a credible and comprehensive synthesis of the available evidence. The resulting evidence map is expected to provide meaningful guidance for nursing leadership and policy development, stimulate further research, and support systematic integration of strategic communication and professional identity within nursing-led organizational transformation.

Ethics and dissemination

This scoping review requires no ethical approval as it involves only publicly available documents and published literature, with no primary or personal data collection.

Results will be disseminated through:

• Publication in a peer-reviewed journal.
• Presentations at relevant academic and professional conferences.
• Stakeholder briefings for nursing leadership, organizational development, and health communication communities.

The protocol has been prospectively registered on the Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/VHC4K

Supporting information