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;
QSEN leaders easily adopted DSS values and methods for generating ideas and making decisions. As a result, people from multiple professional organizations were able to take QSEN work, yet unpublished, into organizational deliberations regarding standards for licensure, accreditation, and certification. They invited QSEN faculty to provide special sessions at annual meetings to build will for proposed changes. They provided in‐kind support for announcements of QSEN activities and products. They envisioned the parts of the work that could best be done by their own organizations. Beyond anyone’s hopes or expectations, the work was spread, as it was envisioned, as a product of the profession itself.
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.
Generating and Sharing Ideas: Phase II (April 2007–October 2008)
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).
Table 3.2 Participants in April 2007 Workshop to Generate Graduate‐Level QSEN Competencies and Associated Knowledge, Skills, and Attitude Learning Objectives
| 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 |
| Council on Accreditation of Certified | 1 |
| Registered Nurse Anesthetists | |
| Commission on Collegiate Nursing Education | 2 |
| National Association of Clinical Nurse Specialists | 2 |
| National League for Nursing1 | 1 |
| National Organization of Nurse Practitioner Faculties | 2 |
| Oncology Nursing Certification Corporation | 1 |
| Pediatric Nursing Certification Board |
2
|
