Nursing programs and pre-medical courses increasingly assign The Immortal Life of Henrietta Lacks in first year ethics or professional foundations courses, aiming to build a habit of ethical reflection before students begin clinical work where the stakes of consent and patient trust become immediate rather than theoretical. The writing assigned around this book in a nursing context often blends personal reflection with professional analysis in a way that other disciplines' assignments do not, since nursing programs are simultaneously trying to shape professional identity and teach analytical reasoning. Grading this hybrid writing requires a rubric that respects both dimensions without letting either one crowd out the other.

A common assignment format asks students to write from the perspective of a nurse at the bedside in 1951, describing what they would have needed to know or say to ensure genuine informed consent given what nursing ethics require today. This perspective taking exercise works well because it puts students directly into the caregiving role they are training for, rather than leaving them as distant historical judges of a decision made by physicians decades ago. Grading this kind of assignment requires checking whether the student's imagined nursing intervention is realistic given the historical context, since an anachronistic response, imagining a level of nurse autonomy that did not exist in a 1950s segregated hospital, misses the point of the exercise even if the ethical instinct behind it is sound.

A rubric for this assignment should include a category for historical realism alongside the more standard categories for ethical reasoning and writing clarity, since students sometimes solve the ethical problem too easily by imagining themselves with more power or authority than a nurse would actually have held in that specific hospital at that specific time. The strongest essays acknowledge this tension explicitly, showing awareness that a 1951 nurse advocating strongly for a Black patient's consent rights would have faced real professional and social barriers, while still articulating what small, realistic steps that nurse could have taken within those constraints. This nuance is exactly what separates a genuinely thoughtful response from a well intentioned but historically naive one.

Balancing Personal Reflection and Professional Analysis

Because nursing education places real value on reflective practice as a professional skill, instructors often want some personal voice in these essays, students connecting the Lacks case to their own developing sense of what kind of nurse they want to be, without letting the assignment drift entirely into memoir disconnected from the ethical content of the book. A rubric that allocates a modest but real portion of the grade to personal reflection, separate from and in addition to ethical analysis, signals that both matter without letting reflection substitute for the harder analytical work the assignment is also meant to build. Essays that are purely reflective, full of personal aspiration but light on specific engagement with the book's ethical content, should not score as highly as essays that integrate both dimensions.

• Score historical realism separately from the ethical instinct behind a student's response
• Allocate a defined but limited portion of the grade to personal professional reflection
• Require specific reference to nursing ethics codes alongside the historical scenario
• Flag responses that imagine unrealistic levels of authority for a 1950s nurse
• Reward essays that propose realistic, constrained actions rather than idealized solutions

Connecting to Current Nursing Codes of Ethics

Tying the assignment explicitly to a current professional code of ethics, such as the American Nurses Association's code, gives students a concrete modern reference point to contrast against the 1951 scenario, and it makes the assignment feel directly relevant to the licensure and professional standards they will be held to after graduation. Essays that cite specific provisions of a current ethics code and explain how those provisions would have changed the Lacks case, had they existed and been followed at the time, demonstrate a level of professional literacy that generic ethical reasoning alone does not capture. A rubric that explicitly rewards this citation, rather than treating it as optional flourish, pushes students toward the kind of specific, code grounded reasoning that will serve them well in future clinical ethics situations.

Instructors should be careful that this requirement does not turn into a rote citation exercise where students simply quote a provision without connecting it meaningfully to the Lacks scenario, since that produces technically compliant but analytically shallow writing. Feedback should distinguish clearly between a citation that is merely present and one that is genuinely integrated into the argument, with the rubric language spelling out that distinction so students understand what level of integration earns full credit versus partial credit on this particular criterion.

Managing Grading Volume in Cohort-Based Programs

Nursing programs often move students through coursework in cohorts, meaning an entire class year submits the same assignment within the same narrow window, which creates a grading volume challenge similar to what other large courses face but with the added complexity of this hybrid reflective and analytical format. Because personal reflection genuinely varies in ways that resist a purely mechanical rubric, instructors often find that reading these essays in shorter, more frequent sessions rather than one long grading marathon preserves the attention needed to fairly evaluate the personal dimension of each response. Rushing through reflective writing tends to produce feedback that feels generic even when the underlying grading criteria were sound, which undercuts the professional formation goal the assignment is meant to serve in the first place.

Some programs address the volume challenge by having a teaching assistant or clinical instructor do a first pass focused purely on the analytical and historical accuracy criteria, flagging any factual errors or gaps in ethical reasoning, before the lead instructor does a second pass focused specifically on the reflective and professional identity dimension of each essay. This division of labor keeps each reader's attention focused on a narrower set of criteria per pass, which tends to produce more consistent and higher quality feedback overall than asking a single reader to evaluate every dimension of a complex hybrid assignment in one continuous read.