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The Value of Critical Thinking in Nursing

• How Nurses Use Critical Thinking
• How to Improve Critical Thinking
• Common Mistakes

Some experts describe a person’s ability to question belief systems, test previously held assumptions, and recognize ambiguity as evidence of critical thinking. Others identify specific skills that demonstrate critical thinking, such as the ability to identify problems and biases, infer and draw conclusions, and determine the relevance of information to a situation.

Nicholas McGowan, BSN, RN, CCRN, has been a critical care nurse for 10 years in neurological trauma nursing and cardiovascular and surgical intensive care. He defines critical thinking as “necessary for problem-solving and decision-making by healthcare providers. It is a process where people use a logical process to gather information and take purposeful action based on their evaluation.”

“This cognitive process is vital for excellent patient outcomes because it requires that nurses make clinical decisions utilizing a variety of different lenses, such as fairness, ethics, and evidence-based practice,” he says.

How Do Nurses Use Critical Thinking?

Successful nurses think beyond their assigned tasks to deliver excellent care for their patients. For example, a nurse might be tasked with changing a wound dressing, delivering medications, and monitoring vital signs during a shift. However, it requires critical thinking skills to understand how a difference in the wound may affect blood pressure and temperature and when those changes may require immediate medical intervention.

Nurses care for many patients during their shifts. Strong critical thinking skills are crucial when juggling various tasks so patient safety and care are not compromised.

Jenna Liphart Rhoads, Ph.D., RN, is a nurse educator with a clinical background in surgical-trauma adult critical care, where critical thinking and action were essential to the safety of her patients. She talks about examples of critical thinking in a healthcare environment, saying:

“Nurses must also critically think to determine which patient to see first, which medications to pass first, and the order in which to organize their day caring for patients. Patient conditions and environments are continually in flux, therefore nurses must constantly be evaluating and re-evaluating information they gather (assess) to keep their patients safe.”

The COVID-19 pandemic created hospital care situations where critical thinking was essential. It was expected of the nurses on the general floor and in intensive care units. Crystal Slaughter is an advanced practice nurse in the intensive care unit (ICU) and a nurse educator. She observed critical thinking throughout the pandemic as she watched intensive care nurses test the boundaries of previously held beliefs and master providing excellent care while preserving resources.

“Nurses are at the patient’s bedside and are often the first ones to detect issues. Then, the nurse needs to gather the appropriate subjective and objective data from the patient in order to frame a concise problem statement or question for the physician or advanced practice provider,” she explains.

Top 5 Ways Nurses Can Improve Critical Thinking Skills

We asked our experts for the top five strategies nurses can use to purposefully improve their critical thinking skills.

Case-Based Approach

Slaughter is a fan of the case-based approach to learning critical thinking skills.

In much the same way a detective would approach a mystery, she mentors her students to ask questions about the situation that help determine the information they have and the information they need. “What is going on? What information am I missing? Can I get that information? What does that information mean for the patient? How quickly do I need to act?”

Consider forming a group and working with a mentor who can guide you through case studies. This provides you with a learner-centered environment in which you can analyze data to reach conclusions and develop communication, analytical, and collaborative skills with your colleagues.

Practice Self-Reflection

Rhoads is an advocate for self-reflection. “Nurses should reflect upon what went well or did not go well in their workday and identify areas of improvement or situations in which they should have reached out for help.” Self-reflection is a form of personal analysis to observe and evaluate situations and how you responded.

This gives you the opportunity to discover mistakes you may have made and to establish new behavior patterns that may help you make better decisions. You likely already do this. For example, after a disagreement or contentious meeting, you may go over the conversation in your head and think about ways you could have responded.

It’s important to go through the decisions you made during your day and determine if you should have gotten more information before acting or if you could have asked better questions.

During self-reflection, you may try thinking about the problem in reverse. This may not give you an immediate answer, but can help you see the situation with fresh eyes and a new perspective. How would the outcome of the day be different if you planned the dressing change in reverse with the assumption you would find a wound infection? How does this information change your plan for the next dressing change?

Develop a Questioning Mind

McGowan has learned that “critical thinking is a self-driven process. It isn’t something that can simply be taught. Rather, it is something that you practice and cultivate with experience. To develop critical thinking skills, you have to be curious and inquisitive.”

To gain critical thinking skills, you must undergo a purposeful process of learning strategies and using them consistently so they become a habit. One of those strategies is developing a questioning mind. Meaningful questions lead to useful answers and are at the core of critical thinking .

However, learning to ask insightful questions is a skill you must develop. Faced with staff and nursing shortages , declining patient conditions, and a rising number of tasks to be completed, it may be difficult to do more than finish the task in front of you. Yet, questions drive active learning and train your brain to see the world differently and take nothing for granted.

It is easier to practice questioning in a non-stressful, quiet environment until it becomes a habit. Then, in the moment when your patient’s care depends on your ability to ask the right questions, you can be ready to rise to the occasion.

Practice Self-Awareness in the Moment

Critical thinking in nursing requires self-awareness and being present in the moment. During a hectic shift, it is easy to lose focus as you struggle to finish every task needed for your patients. Passing medication, changing dressings, and hanging intravenous lines all while trying to assess your patient’s mental and emotional status can affect your focus and how you manage stress as a nurse .

Staying present helps you to be proactive in your thinking and anticipate what might happen, such as bringing extra lubricant for a catheterization or extra gloves for a dressing change.

By staying present, you are also better able to practice active listening. This raises your assessment skills and gives you more information as a basis for your interventions and decisions.

Use a Process

As you are developing critical thinking skills, it can be helpful to use a process. For example:

• Ask questions.
• Gather information.
• Implement a strategy.
• Evaluate the results.
• Consider another point of view.

These are the fundamental steps of the nursing process (assess, diagnose, plan, implement, evaluate). The last step will help you overcome one of the common problems of critical thinking in nursing — personal bias.

Common Critical Thinking Pitfalls in Nursing

Your brain uses a set of processes to make inferences about what’s happening around you. In some cases, your unreliable biases can lead you down the wrong path. McGowan places personal biases at the top of his list of common pitfalls to critical thinking in nursing.

“We all form biases based on our own experiences. However, nurses have to learn to separate their own biases from each patient encounter to avoid making false assumptions that may interfere with their care,” he says. Successful critical thinkers accept they have personal biases and learn to look out for them. Awareness of your biases is the first step to understanding if your personal bias is contributing to the wrong decision.

New nurses may be overwhelmed by the transition from academics to clinical practice, leading to a task-oriented mindset and a common new nurse mistake ; this conflicts with critical thinking skills.

“Consider a patient whose blood pressure is low but who also needs to take a blood pressure medication at a scheduled time. A task-oriented nurse may provide the medication without regard for the patient’s blood pressure because medication administration is a task that must be completed,” Slaughter says. “A nurse employing critical thinking skills would address the low blood pressure, review the patient’s blood pressure history and trends, and potentially call the physician to discuss whether medication should be withheld.”

Fear and pride may also stand in the way of developing critical thinking skills. Your belief system and worldview provide comfort and guidance, but this can impede your judgment when you are faced with an individual whose belief system or cultural practices are not the same as yours. Fear or pride may prevent you from pursuing a line of questioning that would benefit the patient. Nurses with strong critical thinking skills exhibit:

• Learn from their mistakes and the mistakes of other nurses
• Look forward to integrating changes that improve patient care
• Treat each patient interaction as a part of a whole
• Evaluate new events based on past knowledge and adjust decision-making as needed
• Solve problems with their colleagues
• Are self-confident
• Acknowledge biases and seek to ensure these do not impact patient care

An Essential Skill for All Nurses

Critical thinking in nursing protects patient health and contributes to professional development and career advancement. Administrative and clinical nursing leaders are required to have strong critical thinking skills to be successful in their positions.

By using the strategies in this guide during your daily life and in your nursing role, you can intentionally improve your critical thinking abilities and be rewarded with better patient outcomes and potential career advancement.

Frequently Asked Questions About Critical Thinking in Nursing

How are critical thinking skills utilized in nursing practice.

Nursing practice utilizes critical thinking skills to provide the best care for patients. Often, the patient’s cause of pain or health issue is not immediately clear. Nursing professionals need to use their knowledge to determine what might be causing distress, collect vital information, and make quick decisions on how best to handle the situation.

How does nursing school develop critical thinking skills?

Nursing school gives students the knowledge professional nurses use to make important healthcare decisions for their patients. Students learn about diseases, anatomy, and physiology, and how to improve the patient’s overall well-being. Learners also participate in supervised clinical experiences, where they practice using their critical thinking skills to make decisions in professional settings.

Do only nurse managers use critical thinking?

Nurse managers certainly use critical thinking skills in their daily duties. But when working in a health setting, anyone giving care to patients uses their critical thinking skills. Everyone — including licensed practical nurses, registered nurses, and advanced nurse practitioners —needs to flex their critical thinking skills to make potentially life-saving decisions.

Meet Our Contributors

Crystal Slaughter, DNP, APRN, ACNS-BC, CNE

Crystal Slaughter is a core faculty member in Walden University’s RN-to-BSN program. She has worked as an advanced practice registered nurse with an intensivist/pulmonary service to provide care to hospitalized ICU patients and in inpatient palliative care. Slaughter’s clinical interests lie in nursing education and evidence-based practice initiatives to promote improving patient care.

Jenna Liphart Rhoads, Ph.D., RN

Jenna Liphart Rhoads is a nurse educator and freelance author and editor. She earned a BSN from Saint Francis Medical Center College of Nursing and an MS in nursing education from Northern Illinois University. Rhoads earned a Ph.D. in education with a concentration in nursing education from Capella University where she researched the moderation effects of emotional intelligence on the relationship of stress and GPA in military veteran nursing students. Her clinical background includes surgical-trauma adult critical care, interventional radiology procedures, and conscious sedation in adult and pediatric populations.

Nicholas McGowan, BSN, RN, CCRN

Nicholas McGowan is a critical care nurse with 10 years of experience in cardiovascular, surgical intensive care, and neurological trauma nursing. McGowan also has a background in education, leadership, and public speaking. He is an online learner who builds on his foundation of critical care nursing, which he uses directly at the bedside where he still practices. In addition, McGowan hosts an online course at Critical Care Academy where he helps nurses achieve critical care (CCRN) certification.

What is Critical Thinking in Nursing? (With Examples, Importance, & How to Improve)

Successful nursing requires learning several skills used to communicate with patients, families, and healthcare teams. One of the most essential skills nurses must develop is the ability to demonstrate critical thinking. If you are a nurse, perhaps you have asked if there is a way to know how to improve critical thinking in nursing? As you read this article, you will learn what critical thinking in nursing is and why it is important. You will also find 18 simple tips to improve critical thinking in nursing and sample scenarios about how to apply critical thinking in your nursing career.

What Is Critical Thinking In Nursing?

4 reasons why critical thinking is so important in nursing, 1. critical thinking skills will help you anticipate and understand changes in your patient’s condition., 2. with strong critical thinking skills, you can make decisions about patient care that is most favorable for the patient and intended outcomes., 3. strong critical thinking skills in nursing can contribute to innovative improvements and professional development., 4. critical thinking skills in nursing contribute to rational decision-making, which improves patient outcomes., what are the 8 important attributes of excellent critical thinking in nursing, 1. the ability to interpret information:, 2. independent thought:, 3. impartiality:, 4. intuition:, 5. problem solving:, 6. flexibility:, 7. perseverance:, 8. integrity:, examples of poor critical thinking vs excellent critical thinking in nursing, 1. scenario: patient/caregiver interactions, poor critical thinking:, excellent critical thinking:, 2. scenario: improving patient care quality, 3. scenario: interdisciplinary collaboration, 4. scenario: precepting nursing students and other nurses, how to improve critical thinking in nursing, 1. demonstrate open-mindedness., 2. practice self-awareness., 3. avoid judgment., 4. eliminate personal biases., 5. do not be afraid to ask questions., 6. find an experienced mentor., 7. join professional nursing organizations., 8. establish a routine of self-reflection., 9. utilize the chain of command., 10. determine the significance of data and decide if it is sufficient for decision-making., 11. volunteer for leadership positions or opportunities., 12. use previous facts and experiences to help develop stronger critical thinking skills in nursing., 13. establish priorities., 14. trust your knowledge and be confident in your abilities., 15. be curious about everything., 16. practice fair-mindedness., 17. learn the value of intellectual humility., 18. never stop learning., 4 consequences of poor critical thinking in nursing, 1. the most significant risk associated with poor critical thinking in nursing is inadequate patient care., 2. failure to recognize changes in patient status:, 3. lack of effective critical thinking in nursing can impact the cost of healthcare., 4. lack of critical thinking skills in nursing can cause a breakdown in communication within the interdisciplinary team., useful resources to improve critical thinking in nursing, youtube videos, my final thoughts, frequently asked questions answered by our expert, 1. will lack of critical thinking impact my nursing career, 2. usually, how long does it take for a nurse to improve their critical thinking skills, 3. do all types of nurses require excellent critical thinking skills, 4. how can i assess my critical thinking skills in nursing.

• Ask relevant questions • Justify opinions • Address and evaluate multiple points of view • Explain assumptions and reasons related to your choice of patient care options

5. Can I Be a Nurse If I Cannot Think Critically?

Brain, Decision Making and Mental Health pp 179–189 Cite as

Critical Thinking in Nursing

• Şefika Dilek Güven 3  
• First Online: 02 January 2023

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Part of the book series: Integrated Science ((IS,volume 12))

Critical thinking is an integral part of nursing, especially in terms of professionalization and independent clinical decision-making. It is necessary to think critically to provide adequate, creative, and effective nursing care when making the right decisions for practices and care in the clinical setting and solving various ethical issues encountered. Nurses should develop their critical thinking skills so that they can analyze the problems of the current century, keep up with new developments and changes, cope with nursing problems they encounter, identify more complex patient care needs, provide more systematic care, give the most appropriate patient care in line with the education they have received, and make clinical decisions. The present chapter briefly examines critical thinking, how it relates to nursing, and which skills nurses need to develop as critical thinkers.

Graphical Abstract/Art Performance

Critical thinking in nursing.

This painting shows a nurse and how she is thinking critically. On the right side are the stages of critical thinking and on the left side, there are challenges that a nurse might face. The entire background is also painted in several colors to represent a kind of intellectual puzzle. It is made using colored pencils and markers.

(Adapted with permission from the Association of Science and Art (ASA), Universal Scientific Education and Research Network (USERN); Painting by Mahshad Naserpour).

Unless the individuals of a nation thinkers, the masses can be drawn in any direction. Mustafa Kemal Atatürk

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Nevşehir Hacı Bektaş Veli University, Semra ve Vefa Küçük, Faculty of Health Sciences, Nursing Department, 2000 Evler Mah. Damat İbrahim Paşa Yerleşkesi, Nevşehir, Turkey

Şefika Dilek Güven

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Güven, Ş.D. (2023). Critical Thinking in Nursing. In: Rezaei, N. (eds) Brain, Decision Making and Mental Health. Integrated Science, vol 12. Springer, Cham. https://doi.org/10.1007/978-3-031-15959-6_10

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Critical thinking in nursing clinical practice, education and research: From attitudes to virtue

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• 1 Department of Fundamental Care and Medical Surgital Nursing, Faculty of Medicine and Health Sciences, School of Nursing, Consolidated Research Group Quantitative Psychology (2017-SGR-269), University of Barcelona, Barcelona, Spain.
• 2 Department of Fundamental Care and Medical Surgital Nursing, Faculty of Medicine and Health Sciences, School of Nursing, Consolidated Research Group on Gender, Identity and Diversity (2017-SGR-1091), University of Barcelona, Barcelona, Spain.
• 3 Department of Fundamental Care and Medical Surgital Nursing, Faculty of Medicine and Health Sciences, School of Nursing, University of Barcelona, Barcelona, Spain.
• 4 Multidisciplinary Nursing Research Group, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Hospital, Barcelona, Spain.
• PMID: 33029860
• DOI: 10.1111/nup.12332

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science.

Keywords: critical thinking; critical thinking attitudes; nurse education; nursing care; nursing research.

© 2020 John Wiley & Sons Ltd.

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The Importance of Critical Thinking in Nursing

An American Association of Nurse Practitioners (AANP) survey found that a majority of nurse practitioners saw three or more patients per hour. Nurse practitioners see patients of all ages with a broad spectrum of potential ailments. Critical thinking skills in nursing improve patient outcomes by enabling evidence-based decision-making. 

Nurse practitioners gather considerable amounts of patient data through evaluations, tests and conversations. Each patient’s information can be interpreted and analyzed to determine the best courses of action for their health. A growing emphasis on critical thinking in nursing stems from the increasing importance of nurse practitioners in primary care.

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Growing need for critical thinking in nursing.

There is a significant shortage of primary care services throughout the United States. GoodRx identified 80% of counties as “health care deserts” or locations without easy access to necessary services. This data includes the following categories relevant to family nurse practitioners:

• 9% of counties lack enough primary care providers to serve the local population
• Residents in 20% of counties are at least 30 minutes away from hospitals
• Residents in 45% of counties are at least 20 minutes away from community health centers

“Health care deserts” are worsening because of a shortage of primary care physicians. The Association of American Medical Colleges ( AAMC ) estimates up to 48,000 more primary care providers are needed to meet patient care needs by 2034. This shortfall translates to a lack of preventive care and increased reliance on emergency care facilities.

The U.S. Bureau of Labor Statistics ( BLS ) projects a 52% growth in nurse practitioner roles by 2030. This growth is fueled not only by “health care deserts” but an aging population and public health threats like COVID-19. Critical thinking by nurse practitioners can overcome these challenges even with limited resources and stressful situations.

The Critical Thinking Process

The first step in incorporating critical thinking into patient care is understanding the critical thinking process. The National League for Nursing Accreditation Commission ( NLNAC ) defines critical thinking as:

“the deliberate nonlinear process of collecting, interpreting, analyzing, drawing conclusions about, presenting, and evaluating information that is both factually and belief based.”

Critical thinking in nursing does not move in a straight line because each patient is unique. There isn’t a one-size-fits-all diagnosis for patients because there isn’t a single type of patient. Nurse practitioners can apply the following steps in the Clinical Reasoning Cycle as they evaluate patient care decisions.

Consider the Situation

First impressions of new patients can distract from effective evaluations. Personal experiences and assumptions may lead to hasty conclusions about patient needs. The first step to critical thinking in nursing involves a dispassionate consideration of the facts.

Nurse practitioners often have the basic facts about their patients’ conditions before stepping into exam rooms. A simple repetition of the patient’s age and reported illness counters assumptions that can negatively impact patient care.

Collect Information

Critical thinking requires the synthesis of existing and new information for effective analysis. Nurse practitioners can pull useful details from patient charts and histories when they are available. An evaluation of visual appearance, speech, blood pressure and other metrics builds on this previous work.

Skilled practitioners automatically apply their knowledge of physiology, pharmacology and other areas during the collection process. They also keep best practices, cultural competence and ethics in mind while working with patients. This recall makes it easier to process information during diagnosis.

Process Information

There is a multi-step process for turning raw information into useful insights for patient care. Nurse practitioners effectively process patient data by:

• Analyzing information within the context of normal and abnormal ranges
• Separating relevant and irrelevant data while finding information gaps
• Focus on relationships between symptoms and cues
• Deduce potential causes of health problems
• Compare similar situations between current and past patients
• Predict potential outcomes and complications from treatment

Nurse practitioners are ready to diagnose patient conditions following this process. Depending on symptoms, they’ll have considered and eliminated multiple diagnoses based on careful consideration of the facts. This step also takes into consideration risks for other health issues without treatment.

Set Goals and Act

A patient’s course of treatment should follow the SMART model for goal-setting. The best treatment plans are Specific, Measurable, Achievable, Realistic and Timely to support the measurement of their efficacy. This model creates a repeatable process that is effective across patient demographics and conditions.

Critical thinking in nursing produces clear goals that are essential to patient adherence to treatment. Treatment plans may include prescribed medications, therapies and visits with specialists. Nurse practitioners collaborate with their patients and colleagues on supportive frameworks for effective treatment.

Evaluate and Reflect

Follow-up appointments provide opportunities for evaluation of treatment plans. Nurse practitioners compare past and present metrics when determining improvements in patient conditions. A useful method for evaluating success is whether the following rights of clinical reasoning were applied:

• Right cues 
• Right patient
• Right action
• Right reason

Frequent reflection on this process is essential for improvement as a nurse practitioner. Self-directed explorations of what should have been done and what could have happened in each case sharpen critical thinking skills. An understanding of what was learned in each case creates points of comparison for future patients.

Improving Your Critical Thinking

Critical thinking in nursing improves through thoughtful deliberation and frequent use. Nurse practitioners should speak with their colleagues and mentors about their applications of critical thinking. Frequent collaboration on patient care also places the focus on evidence-based care rather than personal assumptions.

Updated knowledge of nursing resources and tools makes it easier to implement critical thinking in nursing. Medical journals and continuing education courses reinforce what nurse practitioners have learned throughout their careers. Carson-Newman University provides a strong foundation for improved critical thinking through its Online MSN-FNP.

Preparing for Clinical Decisions at Carson-Newman

Carson-Newman’s innovative program prepares BSN & MSN-educated nurses for future roles as family nurse practitioners (FNPs). The in-person requirements for this 100% online degree are clinical placements and a three-day campus residency. Students can complete the Online MSN-FNP in as little as 32 months.

Every course in the program is taught by an experienced nurse educator who also practices in their community. Carson-Newman reinforces the importance of critical thinking in nursing with courses on topics including:

• Advanced Health Assessment
• Advanced Pathophysiology
• Advanced Primary Care Nursing for Adults

FNP students receive full support from Carson-Newman to identify clinical placements in their communities. They also receive one-on-one guidance from Student Success Advisors throughout their time at the University. This commitment to nursing education helped Carson-Newman reach the top third of graduate nursing programs in U.S. News & World Report's rankings.

Contact an enrollment advisor today to learn how Carson-Newman can prepare you for a role as an FNP.

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About carson-newman’s online fnp programs.

Founded in 1851, Carson-Newman is a nationally ranked Christian liberal arts university. An online, yet personal, learning environment connects you with fellow students, faculty, and staff. Faith and learning are combined to create evidence-based online graduate nursing programs designed to transform you into a more autonomous caregiver.

Through its online program and student-centric curriculum, Carson-Newman provides a life-changing education where students come first. Designed for working nurses, Carson-Newman’s affordable FNP programs feature 100% online coursework with no mandatory log-in times, clinical placement service, and exceptional individualized support that prepare graduates to pass the FNP licensure exam.

If you’re ready for the next step in your nursing career, consider the online Master of Science in Nursing – Family Nurse Practitioner offered by Carson-Newman University and accredited by the CCNE.

For those who already hold an MSN degree, consider pursuing a Post-Master’s FNP Certificate to enjoy all the leadership opportunities, job satisfaction and autonomy of a family primary care provider. For more information, visit onlinenursing.cn.edu.

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Effectiveness of SBAR-based simulation programs for nursing students: a systematic review

College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, 50612 Republic of Korea

Kyoungrim Kang

Jongmin park, associated data.

All data generated during this study are included in this published article.

Situation, background, assessment, and recommendation (SBAR) has been extensively used in clinical and nursing education. A structured communication program increases effective communication, positivity, and education satisfaction during inter-professional collaboration among nursing students. This systematic review aimed to identify and synthesize evidence on the effectiveness of SBAR-based simulation training for nursing students.

A research protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The protocol for this study was registered in PROSPERO (CRD42021234068). Eight bibliographical databases were searched for studies published between 2001 and 2021, using relevant search terms. Searches were conducted in PubMed, Embase, Cumulative Index to Nursing and Allied Health, and Cochrane Central Register of Controlled Trials for literature in English, and DBpia, Research Information Sharing Service, Korean Studies Information Service System, and Korea Institute of Science and Technology Information for literature in Korean. After screening titles, abstracts, and full-text papers, pertinent data were extracted, and critical appraisals of the retrieved studies were performed. Data were analyzed using the framework approach, and the findings were presented in a narrative summary. The Effective Public Health Practice Project “Quality Assessment Tool for Quantitative Studies” was used to assess the quality of the included studies.

Twelve studies were included: 3 randomized controlled trials and 9 quasi-experimental studies. Two overarching themes were noted, namely communication clarity and critical thinking. The results of six out of 12 studies produced significant results in favor of SBAR-based simulation in terms of communication clarity. Divergent results were obtained regarding communication ability, critical thinking, confidence, learning self-efficacy, and attitude toward patient safety. The results of these studies highlight that communication clarity ultimately leads to positive results in terms of nursing students’ behaviors related to patient safety.

Conclusions

This review provides a comprehensive update of the literature on the effectiveness of SBAR-based nursing simulation programs for nursing students. These programs were found to have positive learning outcomes because of clear and concise communication. Further studies on the effectiveness of various learning outcomes derived from SBAR-based programs are required.

Accurate communication skills among healthcare professionals are very important in the current healthcare environment, where multidisciplinary care and collaborative practice are recommended. A nurse’s ability to communicate is one of the most important competencies for efficiently providing information necessary to report a patient’s condition. A nurse’s clear communication ability contributes to improving the quality of nursing and minimizing accidents that may occur in clinical settings [ 1 , 2 ].

Situation, background, assessment, and recommendation (SBAR) has been extensively used in clinical and healthcare educational settings [ 3 ]. The SBAR includes the communication of the patient’s current situation, the background and causes of the situation, the assessment of the current condition, and the reporter’s recommendations for further treatment [ 3 ]. SBAR is a reliable and validated communication tool that can be easily implemented in hospital-based practices for sharing information among healthcare providers [ 4 ] and is a structured communication tool that enables clear communication in a short time [ 5 ].

Nursing students are expected to develop practical nursing competencies and communication skills through theoretical learning and clinical practice [ 6 ]. Still, many nursing college students merely observe in their clinical training. That is, their attitudes are pretty passive, which makes it challenging to achieve these educational goals. Simulation-based education may be a helpful supplement in clinical practice for nursing students to address this issue. This can improve nursing competencies by enabling iterative and direct learning using virtual scenarios [ 7 ].

A structured communication program increases effective communication, positivity, and education satisfaction during inter-professional collaboration among nursing students [ 3 ]. In previous studies, incorporating SBAR techniques into simulation-based education positively affected communication skills, clarity, and confidence [ 8 – 10 ]. Using SBAR, nurses can more accurately recognize patient condition changes, enabling precise, effective, enhanced communication and cooperation among healthcare staff [ 11 , 12 ]. Research on the effectiveness of SBAR in nursing education is still ongoing, and it is necessary to promote its implementation in the curriculum sufficiently.

As a result of reviewing research on structured communication programs in Korea, studies such as the SBAR program have been conducted using a combination of theory lectures, role-play, discussion, debriefing, team activity, case-based, and simulation methods [ 1 , 13 ]. Many overseas studies have applied a communication promotion program to nursing education using theoretical lectures, role-play, theater therapy techniques, online media use, simulations, pamphlets, reflection, feedback and discussion, and DVD viewing [ 14 – 17 ].

Most communication programs implemented for nurses or nursing students had statistically significant effects. Still, the concept and evidence of the program were not uniform, and the tools used by each researcher, research participants, and measurement period varied. Although simulation education is becoming more important in clinical practice when a simulation program using SBAR is applied, contradictory results (effective/ineffective) have been reported as research results, and the lack of high-quality literature (low-modest) was confirmed. Each program has a different composition, contents, and results; therefore, it is necessary to systematically examine the contents and effects of various simulation programs using SBAR [ 18 ]. Accordingly, the contents, effects, and trends of the SBAR-based programs were comprehensively reviewed and integrated to provide the best basis for future communication program development for nursing students. This systematic review aimed to identify and synthesize evidence on the effectiveness of SBAR-based simulation programs for nursing students.

This systematic review aimed to integrate and analyze the effects of SBAR-based nursing simulation programs for nursing students. The primary research question guiding this systematic review is: What is the impact of the SBAR-based simulation program on nursing students? To address this question, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and meta-analyses [ 19 ]. The study protocol was registered on the PROSPERO website (CRD42021234068; https://www.crd.york.ac.uk/PROSPERO/ ).

Eligibility criteria

This study applied the PICO-SD (participants, intervention, comparison, outcomes, study design) tool as follows: (1) participants (P): nursing students; (2) intervention (I): nursing simulation programs that utilized SBAR-centered scenarios or activities; (3) comparison (C): different simulation programs or other educational interventions; (4) outcome (O): significant effects of the intervention; and (5) study design (SD): randomized controlled trial (RCT), or quasi-experimental design. Studies with nursing students as participants, either exclusively or as part of a sample including other healthcare students/professionals, are eligible for inclusion. The following studies were excluded: (1) single-arm studies, (2) observational studies, qualitative studies, mixed method studies, review articles, editorials, case studies, and proceedings, and (3) pilot studies. The publication year of the articles was limited from January 1, 2001, to June 30, 2021.

Search strategies and study selection

A systematic literature review was conducted for articles published from January 1, 2001, to June 30, 2021. We searched international studies in the following databases: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health (CINAHL). Domestic studies were searched in DBpia, Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), and Korea Institute of Science and Technology Information (Kisti). The keyword selection and search included Medical Subject Headings (MeSH) and Emtree for thesaurus in biomedical and life sciences. The keywords included “nursing,” “SBAR,” “ISBAR,” “SBAR-R,” “simulation,” “program*,” and “intervention*.” The search was limited to articles written in Korean or English.

In title screening, two independent reviewers (J.Y. and J.P.) examined the identified records’ titles to exclude irrelevant studies. Any discrepancies were resolved through discussion or consultation with a third reviewer (K.K.), if necessary. Next, the two reviewers examined the abstracts and keywords of the remaining records to refine the list of potentially relevant studies further. Any disagreements at this stage were also addressed through discussion or consultation with the third reviewer. Finally, the two reviewers independently assessed the full-text articles of the remaining studies for eligibility according to the pre-specified inclusion and exclusion criteria. Disagreements at this stage were also resolved through discussion or consultation with a third reviewer. We also manually screened the reference lists of the included studies and relevant reviews to ensure that all pertinent studies were identified.

Data extraction

To ensure the objectivity of data extraction, two reviewers (K.K. and Y.L.) independently extracted data from the included studies. We collected data regarding the authors, year of publication, country, study design, subjects, sample size, intervention characteristics, control groups, and outcome measurements. In case of disagreement between researchers, a consensus was reached by discussion with a third reviewer (J.Y.).

Quality assessment

We used the Effective Public Health Practice Project (EPHPP) “Quality Assessment Tool for Quantitative Studies” [ 20 ] to assess the quality of the included studies. Reviewers provided strong, moderate, or weak ratings for the following domains: selection bias, design, confounders, blinding, data collection methods, and withdrawals and dropouts. Strong, moderate, and weak global ratings were determined according to the number of weak ratings received [ 20 ]. The EPHPP tool was used to assess the quality of both RCT and quasi-experimental studies included in our systematic review. While the tool is applicable to both study designs, slight modifications were made as needed to accommodate the differences between RCTs and quasi-experimental studies. Two independent authors (J.Y. and J.P.) assessed the quality of the included studies, and any disagreements were resolved through discussion or consultation with a third reviewer (K.K.), if necessary.

Search results

Figure  1 shows the flow of the study selection process for this review. After searching eight databases, 453 studies were found. A total of 170 studies were removed as duplicates and the titles and abstracts of 283 studies were screened. Due to irrelevancy, 257 studies were excluded, the full texts of 26 studies were reviewed, and two additional articles were searched and reviewed from other sources. Ultimately, 12 studies were included in the narrative analysis.

PRISMA flow diagram of the study selection process

Description of the included studies

Table  1 presents the characteristics of the studies included in the narrative analysis. Of the 12 included studies, most were conducted in Korea [ 3 , 21 – 28 ] and one each in Ireland [ 29 ], Spain [ 30 ], and the USA [ 31 ]. A quasi-experimental design was used in nine studies [ 3 , 21 , 23 – 28 , 31 ] and a RCT was adopted in the remaining three studies [ 22 , 29 , 30 ]. In two studies [ 24 , 29 ], more than one experimental group was designated. The total sample size was 886 participants (503 in the intervention group and 383 in the control group). The individual sample size of each group— the experimental and control groups of the included studies—was mostly under 50, and the average of both experimental and control groups was approximately 34.7.

Characteristics of Included Studies

Abbreviations: C, control group; CI, confidence interval; CP, clinical practicum; N, nursing students; M, medical students; Q&A, questions and answers; SBAR, situation-background-assessment-recommendation; RCT, randomized controlled trial; E, experimental group.

Interventions of the included studies

The interventions in the included studies varied in detail, including orientation, pre-briefing, and role-play. The duration of the programs also varied between one and six hours. Except for one study [ 3 ], that applied a four-phase clinical practicum (CP) with SBAR training, the other eight studies in Korea included orientation, lecture, or educational sessions for more than 60 min before the simulation scenario performance with role-play. A recent study [ 24 ] applied for a three-session program. Each session consisted of education with orientation for 20 min, assertiveness skills or role-play for 15–20 min, and group discussion for 10 min. Other studies mostly ran a program comprising education with 60–120 min of orientation, role-play for 60–120 min, and debriefing/discussion for about 30 min. One study [ 29 ] adopted e-learning with simulations for a two-session program. Compared to the experimental groups, programs applied to the control groups included a diverse range of program in nursing education studies. These included e-learning programs, self-learning, group discussions, simulation programs, regular clinical practice, pre-briefing and debriefing sessions, conventional learning methods, and a focus on nursing processes and therapeutic communication. The variety of programs provided a comprehensive understanding of different approaches in nursing education and allowed for thorough evaluation of the experimental group interventions.

Outcomes of the included studies

Six studies measured “communication clarity” using communication clarity scale (CCS) by Marshall et al. [ 32 ], and one study [ 22 ] used a structured communication tool [ 33 ]. The “communication ability” was evaluated using the 15-item general interpersonal communication competence scale (GICC) [ 34 ] in three studies [ 22 – 24 ]. Other communication-related variables were “report clarity”, measured by two items each for SBAR [ 25 ], “capacities to identify roles and to communicate”, measured by KidSIM team performance (KidSIM-TPS) [ 30 ], “SBAR communication accuracy”, using the tool developed by Yu & Kang [ 3 ], and “SBAR communication” itself by checklist [ 27 ]. The other outcomes for examining the effects of the interventions included “confidence”, scored on visual analogue scale (VAS) in four studies [ 3 , 25 , 27 , 31 ], “clinical competence”, scored by the clinical competence instrument by Lee in one study [ 24 ], “self-efficacy” by general self-efficacy scale [ 28 ] and learning self-efficacy scale [ 3 ], and “critical thinking”, rated with the critical thinking instrument by Yoon in three studies [ 23 , 26 , 28 ].

Quality of included studies

An overview of the quality of the included studies is shown in Table  2 and the global ratings are presented in Table  1 . Of the 12 studies included in the present systematic review, nine studies were classified as weak, three as moderate [ 22 , 24 , 30 ], and none were classified as strong. Most of the studies were appraised as weak at the “selection bias” (11 out of 12 studies) and “blinding” (nine studies), whereas 11 studies were rated as strong at “confounders” and “withdrawals and dropouts”. Eight studies were evaluated as strong in the “data collection method” category. In the “study design” section, 10 studies were classified as moderate in consideration of randomization.

Quality Assessment of Included Studies Using the EPHPP Tool

Abbreviations: EPHPP, Effective Public Health Practice Project; S, strong; M, moderate; W, weak

Overview of findings

The objective of this systematic review is to examine and synthesize the available evidence regarding the effectiveness of SBAR-based simulation training for nursing students. In this discussion, we will address two main themes: communication clarity and beyond communication, which encompasses communication ability, critical thinking, self-leadership, patient safety, confidence, and self-efficacy. Our findings suggest that SBAR-based simulation programs have the potential to enhance nursing students’ communication clarity, thereby contributing to improved communication in clinical settings.

Impacts of interventions

Six of the included studies measured the clarity of communication. A previous study showed that teaching SBAR techniques to healthcare providers can improve communication clarity in both classroom and clinical settings [ 35 ]. Adaptation to clinical practice is significant for novice nurses entering the clinical environment after graduation [ 27 ]. As an approach to address the communication difficulties of new nurses in the early stages of adjustment, offering a program including SBAR before graduation improved communication and information organization skills and increased the reliability of information transmission [ 36 ]. Previous studies have measured fidelity to SBAR by determining the extent to which users perform SBAR as intended (e.g., measures of adherence to the mnemonic during communication). Classroom-based studies achieved levels of fidelity to SBAR ranging from 71–87% and reported moderate to considerable improvements in the clarity of communication [ 3 , 32 , 37 ].

On the other hand, studies conducted in clinical settings have shown no or only moderate improvements in clarity, with fidelity ranging from 53–83% [ 38 – 40 ]. The lesser improvements in communication clarity seen in studies from clinical settings suggest the need to establish higher fidelity to SBAR as intended [ 35 ]. In other words, implementing without confirming adherence or exposing nursing students to SBAR only in classroom settings does not lead to the planned improvement in communication. Therefore, preparing a method to check and monitor fidelity to SBAR in a simulation program that reproduces the clinical situation is necessary.

In addition to communication ability, critical thinking, self-leadership, patient safety, confidence, and self-efficacy were also reported to achieve effectiveness as a result of the SBAR-based simulation program. SBAR-based education can improve critical thinking in the process of presenting various clinical judgment grounds to students and finding the best decision and evidence to confirm the decision [ 41 ]. In addition, it can be expected to improve self-leadership by giving individuals the spontaneity and self-direction necessary to judge, act, and perform work in a desirable way [ 21 ]. Furthermore, positive self-leadership can lead to self-confidence and self-efficacy in clinical performance. In previous studies, SBAR education and implementation positively improved patient safety competencies [ 21 , 22 ]. Repeated use of SBAR helps to structure what to observe, what information to collect, and in what order to deliver content to alert the doctor; such structured information can enable nurses to make quick judgments and actions in urgent situations [ 22 ]. Therefore, the use of standardized communication tools facilitates proficient performance of nursing students and ultimately improves patient safety competency [ 22 ].

The interventions included in the analysis consisted of orientation, pre-briefing, role-play simulation, debriefing, or discussion. In 8 studies, pre-briefing was performed for more than 60 min. Pre-briefing may comprise several activities that include planning, using facilitation strategies, and transferring information. For novice nursing students who do not have experience or practice in thinking like a nurse or with the processes of reflection [ 42 ], a structured pre-briefing activity could support metacognition or critical thinking [ 43 ]. Indeed, theory-based, structured pre-briefing can impact nursing students’ clinical judgment, perceptions of pre-briefing, and competency performance and may enhance meaningful simulation learning [ 43 ]. Simulations consisted of role-playing or self-assertive training. Role performance simulation, including SBAR before graduation, helps new nurses improve their communication and information organization skills and the reliability of information delivery. In addition, assertive training has a positive effect on enhancing communication confidence and interpersonal relationships. When providing debriefing and discussion, it is adequate to avoid lecture-type methods and to receive feedback after directly observing one’s performance [ 44 ]. It is necessary to strengthen communication skills based on self-reflection and group reflection.

Limitations

The program implemented in the literature included in this study confirmed the effectiveness of simulation education using SBAR. However, because there were differences in the intervention period, measurement methods, and intervention components of the programs, it was difficult to compare and analyze the effects in an integrated manner. In addition, programs implemented in the literature do not incorporate surveillance or other monitoring of fidelity to SBAR. This could potentially limit the effectiveness of simulation training using SBAR. Another limitation is the presence of additional interventions alongside SBAR in some included studies, which may have influenced the observed outcomes and made it difficult to isolate the specific impact of SBAR-based simulation training. Finally, additional studies reporting low fidelity or no improvement in communication clarity may not have been published; therefore, there is also a limitation due to publication bias.

Implications for practice and future research

Simulation approaches in nursing education are now being proposed as a new pedagogical method to complement or replace clinical practice. The findings of the current study suggest that SBAR-based simulation programs have positive effects on nursing students’ capabilities for practice, with satisfaction and intense concentration in the provided situation. In future research, standardized and validated interventions for SBAR training should be researched for effectiveness during nursing education. Another potential research study would be to identify the effects of different simulation methodologies, such as web-based, high fidelity, and virtual simulations.

This review provides a comprehensive update of the literature on the effectiveness of SBAR-based nursing simulation programs for nursing students. Our findings indicate that such programs lead to enhanced communication clarity and other positive learning outcomes among nursing students. However, given the variability in program components and measurement methods, it is essential to continue exploring the specific effects of SBAR-based simulation programs on various learning outcomes. This will enable a deeper understanding of the most effective strategies for optimizing communication and other crucial skills in nursing education.

Acknowledgements

Not applicable.

Abbreviations

Authors’ contributions.

All authors contributed to the design of the systematic review. J.Y. and J.P. constructed the search strategy. J.Y. performed the search. J.Y. and J.P. reviewed citations for inclusion in the review based on abstract and full-text review. K.K. and Y.L. performed the data extraction. J.Y. and J.P. assessed the quality of included studies. All authors contributed to the writing and critical revision of the manuscript. All authors have approved the final version of the manuscript.

This research was supported by PNU-RENovation (2020–2022).

Data availability

Declarations.

The authors declare no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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CNO of the Future: The Transformation of Nursing Leadership

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Why Nursing Leadership Skills Are in High Demand

The changing role of cnos: strategies for nursing leadership, the nursing leadership skills in highest demand, leading by listening, training for the future of nursing leadership, building a career roadmap to nursing leadership.

In post-pandemic times, burnout is a prevalent issue among nurses – and one that’s prompting many of them to search for work in different industries . These higher turnover rates are leading to strained budgets for health care executives as they fill staffing gaps with more costly temporary workers. 

That’s one example of why nursing leaders equipped with the right skills to lead in difficult times are in high demand – and the role of the Chief Nursing Officer is changing along with the entire health care system. 

Emeritus Healthcare brought together a panel of noted nursing experts for a fireside chat on the right training and skills for the next generation of nursing leadership and management to address the challenges the industry now faces. With the high retirement rates of senior nursing leaders, there’s a lot of opportunity for nurses to prepare themselves to take on leadership roles. And organizations can invest in upskilling current workers to help minimize turnover.

“The entire landscape of our profession has changed over the last couple of years,” said Dr. Jerry E. Spicer, Regional Chief Nurse Executive (CNE) at Kaiser Permanente. “And it really is demanding that, as nursing leaders, we recognize the fact that this landscape has changed and how do we best react to it?.”

More than ever, nurses want to work closer to home, making it more challenging for management to attract and retain the necessary workforce. Plus, pressures from pandemic nursing have caused more experienced nurses to consider leaving the profession. 

During 2021 alone, the RN workforce shrank by 100,000 nurses, which is hard to absorb when the need for nurses is only rising. The turnover rate has also increased by 8.4% in 2021, bringing the national average for nurse turnover to 27.1% . The financial implications add up quickly, as the average cost of turnover for a single staff nurse is $46,100. These days, recent graduates also have fewer on-the-job mentors to consult for guidance.  

Nursing leadership needs to complement the clinical competencies from their frontline care experience with added business training. This ensures they can effectively lead change, advocate for their workforce, and manage health care systems’ financial priorities. Clinical knowledge is the foundation of a strong nursing leadership style. But the skills and tools of an executive must come into play to meet these challenges.

Understanding the challenges nurses face allows nursing leadership to think differently and respond to those changes accordingly. 

We must “[rise] to the occasion as leaders to find out what brings a sense of belonging,” said Dr. Brooke Baldwin, CNE at the University of California, Irvine (UCI) Health. “How do we build that reconnection to what many of us came into health care to do—which is to care for people, to provide the best quality patient care?”

For nurses to thrive, managers must practice active listening and learn from frontline staff. Listening to the concerns of nurses in these positions allows managers to advocate to the C-suite for the tools and practices their staff needs to do their best work. Better supporting frontline employees can help nursing leadership develop structures and processes that set up their workforce for success.

“We have to think constantly as nurse execs [about] what we’ re going to do. Are there new nursing models that we can put in place?’” said Pat Patton, System CNE at the University of California, San Francisco. “Virtual nursing has taken off now across the organization. How do we retain some of our senior nurses who could do that and work remotely, and take care of our patients because of their expertise and skills and knowledge? We don’t want that going out the door because it’s invaluable to those people.”

For other frontline nurses, allowing for greater flexibility in scheduling can bolster employee retention by creating an environment that’s responsive to all team members.

Nursing management must combine analytical and creative thinking with soft skills like empathy to engage nurses and interact with the C-suite effectively. Clinical competencies are part of the decision-making involved, but the abilities to build an argument and negotiate are critical skills that are heightened within the CNO role today as they navigate new challenges and demands.

When you are the CNO, you represent nursing in the C-suite, said host Ranil Herath, President of Emeritus Healthcare . Alongside other functional and operational executives in the C-suite, you have to frame nursing challenges and opportunities from the business, finance, and operational lenses – a critical skill. When you are a nurse manager, director, or team leader, you are making the case to other nurses, but this changes when you become the CNO.

It’s the CNO’s core duty to serve as the “voice of nurses” to other senior executives, with their clinical knowledge of nursing to back up any business case they make. Rather than seeing nursing as an expense, nursing leadership needs to understand – and be able to articulate – the revenue-generating aspects of nursing to other C-suite executives.

In today’s world, nursing administrators will lead a diverse workforce and must be adept at understanding and working with people from all demographics and nursing contexts, including nurses who work in widely varied healthcare settings.

People skills are core skills within nursing – and even more so for nursing leadership. During the recent fireside chat, the panel stressed the need for nursing leadership to use active listening and be nimble and agile. This is in part a response to changing needs and conditions within the nursing workforce during unusual periods like the pandemic and whatever future changes occur in health care. 

As a nursing leader, you should quickly learn about each nursing team’s diverse responsibilities and perspectives. CNOs need to understand all the roles of their nursing staff—ER, OR, PICU, ambulatory, outpatient, inpatient, pediatric, adult, and psychiatric—and be open to learning from each specialty within the workforce. 

The role of the CNO also requires merging relational competencies with a broad knowledge of the healthcare landscape. Nursing leadership is in an ideal position to listen to frontline nurses and C-suite concerns, helping both sides understand the other group’s issues and priorities. This is especially important as hospital beds fill up and challenges in all parts of the healthcare system persist.  

As health care systems continue to face heightened challenges, nursing leadership becomes ever more essential. Leaders are a bridge between the care provided by nurses and the decisions that shape care delivery. One way to fast-track our next generation of nurse leaders is with flexible, team-based learning , where learners aren’t constrained by the limitations of geography and can still collaborate in real-time.

For example, the Chief Nursing Officer Program from the UCI Leadership Development Institute operates on a cohort-based learning model , with students working together in courses and eventually becoming part of a larger alumni network of peer support.

  “We are providing an extremely unique form of education that takes the business acumen and makes it immediately applicable to people who need it now,” said Dr. Maritza Salazar Campo, faculty director for the UCI Leadership Development Institute’s CNO Program.

“If you want to be a cutting-edge executive in nursing, we’re going to help you do that fast—we’re going to fast-track you to that endpoint,” she adds. There are live remote experiences that happen in real-time as well as on-campus components to promote community and knowledge sharing. At the core of the program is applying business acumen to nursing leadership.

It’s these types of programs that offer a fast-track education for aspiring nursing leaders to upskill and move confidently toward the highest levels of management.

For many reasons – especially the high retirement rates of senior nursing executives – opportunities are plentiful in nursing leadership. Nurses considering moving into a management or C-suite role should consider their personal and professional goals to build a roadmap for their individual journey toward a career that will allow them to grow and develop their talents. At the same time, organizations might weigh enrolling existing staff in a nursing leadership program to boost employee retention by focusing on continuous learning and career pathing .

With the right mindset, a background in clinical skills, and a passion for nursing, aspiring leaders can acquire the training to move into positions where they can impact the future of the profession.

Learn more about the UCI Leadership Development Institute’s CNO program – a nine-month, immersive learning journey – or explore ways Emeritus Healthcare can upskill your team or organization through our learning solutions.

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