Blog 002: A Review of the 2018 QSEN International Forum: Lessons Learned Integrating QSEN Competencies into Nursing Curricula

Nurse educators are well aware that the delivery of patient-centered, safe, and evidence-based nursing care has become increasingly complex, requiring more sophisticated clinical reasoning and nursing judgement of nurses. Barkell and Snyder (QSEN, 2018) advocated incorporating evidence-based practice and these higher-level thinking skills into clinical and classroom activities across the curriculum. Jowell, et. al. (QSEN, 2018) described the results of a multi-site study on the use of constructive feedback as a teaching strategy to strengthen students’ decision making and clinical reasoning skills.    

Melnyk’s (QSEN, 2018) keynote address focused entirely on evidence-based practice and included the central theme of improving the preparation of health care professionals for this challenging environment through embedding an evidence base into all classroom and clinical learning experiences and interactions. Melnyk further discussed the integration of the quadruple aims into the preparation of nurses at all levels of education. The quadruple aims includes:

• improving the quality of patient experiences
• improving population health
• improving the work life of healthcare professionals
• limiting or decreasing the cost of healthcare

Meeting these expectations demands that even new graduate nurses demonstrate high caliber clinical judgment and reasoning. An increasingly diverse student population and the variable quality of clinical placement sites challenge nursing faculty to adapt teaching styles and curricular offerings. Developing new ways to consider, implement, and evaluate teaching and learning is critical to a comprehensive, cohesive response to these challenges. Focusing on the quadruple aims provides guidelines for faculty in designing and implementing course and clinical activities.

The QSEN Competencies conform perfectly to the expectations of the 21st century nurse. Integrating the QSEN Competencies into the academic preparation of nurses maintains the focus on patient outcomes and the provision of safe, effective care, resulting in a positive change in patient experiences. Several speakers at the conference highlighted the need for integrating the QSEN Competencies into nursing curriculum through “a quality and safety education… journal club” (Scherzer), “the clinical practice orientation of new nurses”, (Vorachek & Linsmeyer) and “measuring KSAs for the QSEN Competencies with newly licensed registered nurses in the hospital setting” (Letourneau & McCurry). Implementing these strategies requires some curricular revision and faculty development.

The QSEN Competencies, which are based on improving the patient experience, can impact the preparation of nurses and other healthcare professionals and ultimately change the culture of healthcare. The challenge for faculty, clinical leaders and administrators at all levels is how can the QSEN Competencies be integrated into nursing education and how will the impact of this change be measured?

"How can the QSEN Competencies be integrated in nursing education?"

The answer to the first question, distilled from the QSEN Conference, is engaging in continuous academic quality improvement. Changing the culture is critical to improving the education of nurses and, through them, the patient experience. After all, culture eats strategy!!!

"How will the impact of this change be measured?"

The answer to the second question is more elusive. Measuring the knowledge, skills, and attitudes (KSAs) of nursing students in patient centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics is a step to understanding the impact of integrating the QSEN Competencies into a program. Roseann Colosimo and I (QSEN, 2018) found that some sections of the NCLEX^® Program Reports provide useful measures of student KSAs in some of the QSEN Competencies. This is a start. It is hoped that the NCLEX Program Reports will one day provide measures of QSEN Competencies to educators.

The entire conference was uplifting and challenging for the attendees. I could not possibly mention all of the great ideas that were sparked through attendance at this conference. For me, some of the greatest insights came from endnote speaker, John Baumann, whose motivational presentation on living with Parkinson’s Disease was simultaneously inspiring and humbling. Mr. Baumann is an inspirational speaker, a best-selling author and a well-respected workshop facilitator. His descriptions brought to life the need for nurse educators and clinical practice partners to maintain the focus on the patient experience. We frequently get “lost” in providing care and fail to maintain our focus on the recipient of that care. Nursing care is about the patient’s response to illness and is predicated on improving the patient experience. We can never lose sight of that. The 2018 QSEN International Forum did a fantastic job of providing information to educators on how to help their students keep their focus on the patients that they serve.

References

Altmiller, G. (2018). Report of the 2017 National QSEN Faculty Survey: Where do we go from here?  Special Session at the 2018 QSEN International Forum.

Barkell, N. & Snyder, S. (2018). Strengthening the use of evidence-based practice among students and faculty. Presentation at 2018 QSEN International Forum.

Baumann, J. (2018). Motivational speaker living with Parkinson’s Disease. Endnote Speaker at the 2018 QSEN International Forum.

Colosimo, R. & Dearman, C. (2018). Mapping the QSEN Competencies to the NCLEX^® Examination. Presentation at the 2018 QSEN International Forum.

Jowell, V., Altmiller, G., Deal, B., Ebersole, N., Flexner, R., Jordan, J., Norris, T., Risetter, M.J., Schuler, M. Szymanski, K., Vottero, B., & Walker, D. (2018). The constructive feedback teaching strategy: A multi-site study of its effect. Presentation at the 2018 QSEN International Forum.

Letourneau, R. & McCurry, M. (2018) Measuring KSAs for the QSEN competencies with newly licensed registered nurses in the hospital setting. Presentation at the 2018 QSEN International Forum.

Melnyk, B. (2018). Evidence Based Practice. Keynote presentation at 2018 QSEN International Forum.

Scherzer, R. (2018). A quality and safety education for nurses journal club project (QSEN-JCP). Presentation at the 2018 QSEN International Forum.

Vorachek, E. & Linsmeyer, J. (2018). Incorporating QSEN competencies into clinical practice orientation. Presentation at the 2018 QSEN International Forum.