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Assistant: C. Meyers Pamela Mitchell1 , 3 University of Washington Leslie Hall1 RWJF ACT Initiative; IHI Health Professions Education Collaborative Denise Hirst4 Assistant: D. O’Neal Web Manager Dori Taylor Sullivan Steve Segedy4 Sacred Heart University, Fairfield, CT, and Duke University Mary (Polly) Johnson NCSBN Vice President Deborah Ward4 University of Washington and UC‐Davis MaryJoan Ladden Director, RWJF ACT Initiative Judith Warren University of Kansas Audrey Nelson PI, ANA Safe Patient Handling Initiative Joanne Pohl4 NONPF President Elaine Tagliareni NLN President Elect

      1 Dartmouth Summer Symposium community.

      2 IHI board members.

      3 Phase I only.

      4 Phase II only.

      AACN, American Association of Colleges of Nursing; ACGME, Accreditation Council for Graduate Medical Education; ACT, Achieving Competence Today; ANA, American Nurses Association; AONE, Association of Nurse Executives; IHI, Institute for Health Care Improvement; NCSBN, National Council of State Boards of Nursing; NLN, National League for Nursing; NONPF, National Organization of Nurse Practitioner Faculties; PI, principal investigator; RWJF, Robert Wood Johnson Foundation; UC, University of California; UNC, University of North Carolina;

      Another impact factor was the QSEN decision to forge a path slightly different from medicine’s response to the IOM (2003) report. Physician leaders who had worked to create alignment on descriptions of system‐level competencies for undergraduate, graduate, and continuing medical education chose not to outline learning objectives for the competencies, believing that being overly prescriptive would lessen their ability to attract faculty to the goal of improving quality and safety education. With hundreds of community college, diploma, and university‐based nursing education programs, and with the need to develop thousands of nursing faculty who taught in classroom, clinical, and simulation/skills laboratory teaching roles, QSEN leaders decided we could not assume everyone would be attracted, willing, and able to independently invent their own objectives and teaching strategies. In fact, QSEN’s explicit goal was to make it as easy as possible for nursing faculty to envision their roles in supporting quality and safety education.

      As we embarked on the iterative work to outline knowledge, skills, and attitudes (KSA) objectives for each of the six QSEN competencies, we completed an initial assessment of undergraduate program leader views of how well nursing was doing currently in each domain. As reported by Smith et al. (2007), when QSEN competency definitions were the sole reference point, survey respondents from 195 schools reported that they were already teaching to these competencies, albeit with room for some improvement, and that students were generally leaving their programs having developed competencies in patient‐centered care, teamwork and collaboration, evidence‐based practice, quality improvement, safety, and informatics.

      QSEN leaders clearly needed to outline the gap in professional development they knew existed. Collectively, the KSAs provided a template against which schools could identify gaps between current curricular content and the desired future. The intensive group work to define learning objectives, therefore, turned out to be an essential element in the process of building the will to change.

      Phase I ended with a burst of national presentations, the publication of a special issue of Nursing Outlook (2007), and the launch of the QSEN website, each activity aimed at stimulating the will to change through sharing of initial ideas about competency definitions, learning objectives, and annotated bibliographies. The QSEN faculty/advisory board debated logical next steps and decided the field was not ready for a widespread faculty development initiative. We needed a robust package of teaching ideas to move to a train‐the‐trainer initiative comparable to the End‐of‐Life Nursing Education Consortium (Malloy et al., 2008). Phase II objectives, therefore, were to develop, seek feedback, and build consensus for KSAs applicable to graduate education, and widen the network of QSEN experts and advocates by attracting prelicensure faculty innovators to develop, test, and disseminate teaching strategies for QSEN competency development (see Figure 3.1).

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Professional Organizations Number of Representatives
American Association of Colleges of Nursing1 1
American Association of Critical Care 1
Nurses Certification Board
American College of Nurse Midwives 1
American Nurses Association 2
American Nurses Credentialing Center 2
American Psychiatric Nurses Association 1