Am I my students' nurse? Reflections on the nursing ethics of nursing education.

Despite having worked in higher education for over twenty years, I am still, first and foremost, a practicing nurse. My employer requires me to be a nurse and my regulator regards what I do as nursing. My practice is regulated by the Code and informed by nursing ethics. If I am nurse, practicing nursing, does that mean that my students are my patients? This paper considers how the relationship that I have with my students can be informed by the ethics of the nurse/patient relationship. After some initial theoretical preparation concerning argument from analogy, the paper identifies some areas for comparison between the two relationships. Areas of similarity and difference identify two areas of concern: Nurse education and educators regularly engage in coercion and surveillance in an attempt to increase student success, both of which would be considered outside nursing ethics. It is concluded that these coercive practices are not conducive to an environment where character is cultivated. Despite current financial and workforce pressures, nurse lecturers and more especially their managers would do well to return to the professional ethics of nursing to question and guide their practice.

Effect of empathy competence on moral sensitivity in Chinese student nurses: the mediating role of emotional intelligence.

BACKGROUND: Ethical issues may pose challenges to nursing students entering clinical practice. Moral sensitivity can assist them in recognising existing moral situations and then taking adequate action. Identifying the variables associated with moral sensitivity may be useful in preparing to improve nursing students' moral sensitivity. OBJECTIVES: This study investigated empathy, emotional intelligence, and moral sensitivity in Chinese student nurses to explore the association among these three factors and to verify the mediating function of emotional intelligence in determining the connection between empathy and moral sensitivity. DESIGN: This study used a cross-sectional correlational design. SETTING AND PARTICIPANTS: Through convenience sampling, 239 fourth-year nursing undergraduates at a university in Western China were enrolled in this study. METHODS: Nursing students who volunteered to participate in the study completed self-reported scales on empathy, emotional intelligence, and moral sensitivity between September and October 2022. The potential mediating effect was explored using the Process Macro and bootstrap method. RESULTS: The nursing students' average scores were 39.62 ± 5.27 on moral sensitivity, 108.21 ± 15.49 on empathy, and 124.41 ± 13.66 on EI. Moral sensitivity was positively correlated with emotional intelligence (r = 0.454, p < 0.001) and empathy (r = 0.545, p < 0.001). Furthermore, empathy exerted a substantial direct effect on nursing students' moral sensitivity (B = 0.1424, p < 0.001). Emotional intelligence could mediate the indirect path from empathy to moral sensitivity. (B = 0.0372, p < 0.001). CONCLUSION: Emotional intelligence mediated the association between empathy and moral sensitivity. Thus, educational activities and programmes placing an emphasis on empathy and emotional intelligence may offer an alternative way to promote moral sensitivity in Chinese student nurses. IMPLICATIONS: Nursing educators can organise programmes to improve nursing students' emotional competence and professional values. Early exposure to clinical practice benefits nursing students a lot in terms of building interactions with patients and increasing emotional resonance. In addition, nursing educators should develop situational teaching in nursing ethics courses to help students cope with ethical issues.

Student nurses as a future general practice nursing workforce. Implementing collaborative learning in practice: implications for placement learning and patient access. A mixed methods study.

BACKGROUND: There is a global shortage of nurses, with particularly acute shortfall in General Practice Nursing in the United Kingdom estimated at as high as 50% vacancy rate by 2031 by some sources. There has previously been reluctance for General Practices to host student nurses on placement, but it has become imperative to increase placement capacity if practices are to be able to recruit a future workforce. Collaborative Learning in Practice is a means of organising placement learning for student nurses using a coaching model, that allows for leadership development, peer support and earlier engagement in patient care, and increases placement capacity. METHODS: This was a mixed methods study using qualitative data from focus groups to evaluate the implementation of Collaborative Learning in Practice, and routinely collected audit data on numbers of clinic appointments to investigate the potential impact an increased capacity of student nurses might have on patient access to services. The aims of this study were: to implement and evaluate Collaborative Learning in Practice in General Practice Nursing settings; to explore issues of interprofessional learning; to explore patient access to services related to increased student nurse capacity. RESULTS: Our qualitative data indicated the following themes as important to students and staff: Peer Support; Interprofessional Learning; and the Importance of 'own clinics' for students to see patients. The audit data indicated that having students leading their own clinics increased the clinic numbers available by approximately 20% compared to when students were not in placement. CONCLUSIONS: This study shows that student nurses increased clinic capacity and improved access for patients. Students valued their placement, felt that they were more 'part of the team' than in other placements and consequently had a greater sense of belonging. This was multifaceted, coming in part from the welcoming practice staff, in part from the opportunities for peer support engendered by the collaborative learning in practice model, and in part from the interprofessional learning opportunities available. General Practice Nursing placements for students are important for future workforce recruitment and can help meet Quality and Outcomes Framework targets for General Practices.

Influence of student nurses' perceived caring behavior of their instructors on their psychological well-being: a cross-sectional study.

AIM: This study aimed to understand the influence of clinical instructors' caring behavior on the psychological well-being of student nurses. DESIGN: This study survey used the quantitative cross-sectional research design. METHOD: The sample comprised 405 Saudi nursing students studying at Shaqra University. The study used two instruments: the "Nursing Students' Perceptions of Instructor Caring" and the "Student Well-being Process Questionnaire." Convenience sampling was used to collect data from November 2021 to February 2022. RESULT: The students' perceived Instructor caring was high. The psychological well-being of students was high. There were significant variations in the students' perceived Instructor's caring in terms of year level. A very weak positive correlation existed between the student nurses' rank in their families and their perceived Instructor's caring. Furthermore, gender, year level, family structure, and the Instructor's caring subscales "supportive learning climate," "appreciation of life's meaning," and "control versus flexibility" were significant predictors of the student's psychological well-being. CONCLUSION: The study's results support studies that nursing students' psychological well-being is influenced by their gender, family structure, year level, and perceived Instructor's caring behavior.

Enhancing student nurses' clinical education in aged care homes: a qualitative study of challenges perceived by faculty staff.

BACKGROUND: Ageing populations are increasing the demand for geriatric care services. As nursing schools respond to this demand, more high-quality clinical placements are required, and aged care homes offer suitable placement sites. Although an aged care experience for students is beneficial, the basis for effective implementation of these placements is yet to be fully established. The aim of this study was to explore faculty staff perspectives on the challenges associated with providing effective clinical education in aged care homes for first-year student nurses. METHODS: An exploratory qualitative study was performed. Fifteen in-depth interviews were conducted with program leaders of nursing degree programs (n = 4), course leaders (n = 6) and practice coordinators (n = 5) in three Norwegian universities. Data were analysed using thematic analysis. The findings were reported using the Standards for Reporting Qualitative Research (SRQR). RESULTS: Five themes were identified regarding the perceived challenges to implementing effective clinical education in aged care homes: (1) low staffing levels of registered nurses limit the capacity to effectively host students; (2) prevalence of part-time teachers can compromise the quality of students' learning experiences; (3) tensions about the required qualifications and competencies of nurse teachers; (4) variation in learning assessments; and (5) lack of quality assurance. CONCLUSIONS: These challenges signal key areas to be addressed in quality assurance for effective aged care placements. Further research into the minimum staffing levels required to support student learning in the aged care setting is required. Methods for developing shared practices to facilitate learning in aged care homes need to address the prevalence of part-time teaching appointments. Further research into the levels of qualification and competence required to support student learning in aged care facilities can assist with setting standards for this sector. Finally, academic-practice institutions must engage with government officials and national nursing bodies to develop national standards for clinical education in aged care homes.

Testing and e-learning activity designed to enhance student nurses understanding of continence and mobility.

OBJECTIVES: The aim of this study was to test if the e-learning activity that we developed could improve student nurses' knowledge of continence and mobility and whether or not students would find the style of learning beneficial. METHODS: A quasi-experimental pre-post-test design was used to test if the continence and mobility e-learning activity could improve student nurses' knowledge about assessing and managing the needs of continence and mobility. An 18-item true/false knowledge of continence quiz was completed by 116 student nurses and a Likert style feedback learning survey was completed by 135 nursing students. RESULTS: There was a statistically significant increase in students' knowledge about continence and its relationship to mobility following the e-learning activity. The e-learning activity also enhanced students' knowledge, confidence and perceptions about older people. CONCLUSIONS: The e-learning activity we developed has the potential to improve nursing students' knowledge about continence and mobility in an enjoyable manner.

"We'll check vital signs only till we finish the school": experiences of student nurses regarding intra-semester clinical placement in Ghana.

BACKGROUND: Clinical practicum is an integral part of nursing education because it provides students with opportunities to perform nursing care and practice specific nursing tasks. In Ghana, little is known about the experiences of baccalaureate student nurses with regard to intra-semester clinical practicum. This study therefore, explored perceptions, challenges, and how the intra-semester clinical practicum affects the learning process of student nurses in a private university in Ghana. METHODS: Exploratory descriptive phenomenological design was used. Nine in-depth interviews and three focus group discussions were conducted for baccalaureate student nurses in their second, third and fourth years of study. Only those who have attended intra-semester clinical practicum for at least two semesters in the course of their study were recruited. Purposive sampling technique was used to select the participants. The sample size was based on data saturation, however, a total of 33 participants were recruited. Data was analysed using content analysis technique. RESULTS: The findings show that baccalaureate student nurses perceive the intra-semester clinical practicum as beneficial. It affords the opportunity to translate theoretical knowledge into practice concurrently. However, students recounted their stressful experiences during the clinical period which negatively affected their academic work. Additionally, staff nurses assigned the students to do menial jobs instead of appropriate nursing tasks. CONCLUSIONS: A review of the "block" method in which students will go to clinicals for a stipulated number of consecutive days in a month and then resume lectures, is worth considering.

Swedish student nurses' perception of peer learning as an educational model during clinical practice in a hospital setting-an evaluation study.

BACKGROUND: Peer learning, a collaborative learning model has no tradition in clinical education for undergraduate student nurses in Sweden, and little is reported of the student experience. An increasing number of students have led to a pressing need for preceptors and clinical placements thus, highlighting the need for a supportive educational model. The objectives for the current study were to explore how student nurses' evaluated peer learning as an educational model during clinical practice in a hospital setting, and to compare perceptions among student nurses from year one and three. METHODS: A questionnaire developed for the purpose of this study was developed and responded to by 62 (year one) and 73 (year three) student nurses. Data were collected between 2011 and 2013. The questionnaire contained six open- ended and eight closed questions on a four point Likert-scale. Written responses were analysed by content analysis and the closed questions by using descriptive statistics. Mann-Whitney U-test was used to examine differences in relation to students from year one and three. RESULTS: The peer learning experience was evaluated in a positive way. Statistical significance differences were shown for two out of eight closed questions. The peer learning activities were evaluated as supportive and relevant for learning. Three categories emerged from the content analysis: "a feeling of safety", "a sense of competition" and "the learning experience". CONCLUSION: A feeling of safety seems to be connected to students' perception of increased learning and independence. However, the sense of negative competition needs to be addressed when students are prepared for the teaching and learning activities in the peer learning model. Finally, what needs to be further investigated is what challenges and opportunities the peer learning model presents to preceptors.

Ubuntu as an Instrument to Foster Holistic Nursing: The Views of South African Student Nurses.

Introduction: Ubuntu is an African philosophy that reflects holistic and comprehensive care among people in the community. Holistic nursing is a philosophy of caring that focuses on holistic healing and humanism. The purpose of the study was to explore the views of the South African final-year student nurses on the ability of Ubuntu to foster holistic nursing. Methods: An exploratory descriptive qualitative method was used. Eight focus group interviews were conducted with final-year student nurses at selected universities. Colaizzi seven steps process of data analysis was utilized. Results: One of the themes that emerged was that Ubuntu can be an instrument to foster holistic nursing Ubuntu and holistic nursing share many common attributes, hence, the teaching and learning of Ubuntu could foster the type of caring embodied by holistic nursing. Discussion: Ubuntu represents an important care philosophy that can foster holistic nursing, especially when the inner driving force of the nurses is primarily to care for patients.

A Model to Prevent Substance Use/Abuse by Student Nurses at Limpopo College of Nursing, South Africa.

BACKGROUND: Substance use/abuse is a global challenge that has detrimental effects on nations' health, wealth, and security. Substance users in Africa make up roughly 17% to 21% of global illicit drug users in Africa and cannabis abuse (63%) (UNODC, 2010). PURPOSE: We aimed to develop, describe, and evaluate a model that could be used as a framework of reference to prevent substance use/abuse by student nurses at Limpopo College of Nursing, South Africa. METHOD: A mixed-method study approach was used following a qualitative exploratory, descriptive, and contextual design to explore factors contributing to substance use/abuse by student nurses and quantitatively examine the impact of substance use/abuse on students' academic achievements in Limpopo Province. FINDINGS: The results of the first empirical phase reveal two themes and seven subthemes from the semi-structured interviews with lecturers, students, and support staff. The literature supported the results. In phase 2, we analyzed the concept of the "prevention" of substance use/abuse by student nurses following the process of a concept analysis by Walker and Avant (2016). The results were conceptualized within the six elements of practice theory: context, agent, recipient, dynamic, process and procedure, and outcome. CONCLUSIONS: The relational statements provided the basis for the model description. A reliable method was used to describe and evaluate the model.

Professional Nurses' Experiences of Student Nurses' Absenteeism during Psychiatric Clinical Placement in Limpopo Province, South Africa: A Qualitative Study.

Psychiatric clinical placement is as essential as other placements in any discipline in nursing education as it allows student nurses to correlate theory to practice. Several research studies have been conducted on nurses' experiences of the clinical supervision of students, but absenteeism is still a challenge globally. In this study, professional nurses' experiences of student nurses' absenteeism from psychiatric clinical placements in Limpopo Province, South Africa, were examined. Three designated specialty mental institutions in Limpopo Province were the sites of the study. Explorative, descriptive, and contextual designs were used in a qualitative approach. A qualitative approach was used because the study sought professional nurses to narrate their experiences through in-depth, semi-structured interviews, which could only be achieved through a qualitative approach. A total of eleven professional nurses, four from two specialized psychiatric hospitals and three from one specialized psychiatric hospital, were purposively sampled and interviewed. These nurses participated in in-depth interviews that were used to gather data, which were then thematically analyzed. One theme and three sub-themes on professional nurses' experiences of the absenteeism of student nurses during psychiatric clinical placement were revealed. The theme was student factors leading to absenteeism, while the sub-themes were fear of mental health care users, negative attitudes towards psychiatric nursing science, and students' lifestyles. Based on the findings, student nurses' absenteeism can be caused by many factors. A qualitative study should be conducted to seek strategies to mitigate the absenteeism of student nurses during clinical placement in the psychiatric hospitals of Limpopo Province.

Do professional nurses practice what they preach? A qualitative study on professional socialisation of student nurses in the clinical learning environment.

While working alongside professional nurses, student nurses develop professional identity and learn the professional nursing role, a process known as professional socialisation. Professional nurses should model professional behaviour to be emulated by student nurses. We used a qualitative exploratory design to explore if professional nurses behave in a manner that supports professional socialisation of student nurses in a clinical learning environment. According to our observations, two main categories emerged regarding professional nurses' behaviour. The first category was unprofessional conduct with sub-categories that included disrespect, infringed patient privacy, breached confidentiality, inappropriate dress code and lack of punctuality. The second category was ward disorganisation which was related to delegating duties and structured orientation programmes for student nurses. In this study, professional nurses did not behave in a manner consistent with professional socialisation in the clinical learning environment. Student nurses may struggle to develop professional identity, leading to reduced confidence and poor patient quality care. Student nurses need to be professionally socialised in a clinical learning environment and professional nurses need to be empowered on how to carry out this process.

Challenges Regarding Transition from Case-Based Learning to Problem-Based Learning: A Qualitative Study with Student Nurses.

BACKGROUND: The transition from case-based learning to problem-based learning can be challenging and may have negative effects on the academic, psychological, emotional, or social well-being of student nurses. As a result, this exposes student nurses to high failure rates, anxiety disorders, a loss of uniqueness, and fear of the unknown. However, student nurses employ different strategies aimed at overcoming challenges faced during this transition period. METHODS: An exploratory, and descriptive research approach was used. A purposive non-probability sampling technique was used to select participants. Focus group discussions via Zoom video communication were used to collect data, which were analysed using Braun and Clarke's six steps of thematic analysis. RESULTS: The following three themes emerged: challenges regarding facilitation, challenges regarding assessment, and strategies to overcome challenges. CONCLUSIONS: The study established that student nurses are faced with different challenges during the transition from one teaching strategy to another. Student nurses suggested strategies that could be used to overcome these challenges. However, these strategies are not enough and therefore more needs to be done to support and empower student nurses.

Achievements and challenges in baccalaureate student nurses' preparation for evidence-based nursing practice: A mixed methods study.

BACKGROUND: Evidence-based nursing (EBN) implementation is still limited. The effect of the incorporation of this competence into the whole nursing curricula as a cross-cutting topic has not yet been assessed. OBJECTIVE: This study aimed to explore the perceptions of final year student nurses of their preparation for EBN practice and its current implementation in the local healthcare system. DESIGN: This study followed a mixed-methods approach. The data collection methods were a self-administered online questionnaire followed by individual in-depth interviews. RESULTS: The majority of participants (93.4%) chose asking a colleague as the main source of information for decision making during their last year of clinical training. However, scientific evidence was considered the most accurate and credible source instead of colleagues. The main barriers impeding EBN practice were revealed to be: not being able to find the required information, lack of time to search, and not feeling able to interpret information found. In the qualitative analysis of the interviews, three categories were identified: 'Towards EBN at a snail's pace'; 'A huge gap between theory and practice'; and 'Where is nursing?' CONCLUSIONS: Although participants in this study consistently attributed more credibility to clinical guidelines, protocols, and scientific publications over colleagues, asking a colleague continues to be the main resource to address clinical doubts. Lack of institutional support, the unresolved theory-practice gap in nursing, and the status of nurses in relation to other healthcare providers were identified as barriers for further EBN implementation.

A Comparative Analysis of Student and Practising Nurses' Health Literacy Knowledge in Ghana.

This study examined student and practising nurses' health literacy knowledge, and its correlates in Ghana. It was underpinned by an adapted version of the Institute of Medicine's (IOM) conceptual framework of health literacy. We used convenience and snowball sampling techniques to collect data from 876 nurses (477 student nurses and 399 practising nurses) in a cross-sectional survey from February 2019 to June 2019. The respondents were drawn from all the former ten administrative regions of Ghana. Approximately 75.4% of the respondents had heard of health literacy. However, health literacy knowledge was generally low (average score of 6.6 out of 20) among both groups, with student nurses (average score of 5.8 out of 20) having significantly lower scores than practising nurses (average score of 7.4 out of 20). Factors associated with health literacy knowledge among student nurses included gender (male, B = -0.499, p < 0.01), trust in others (B = -0.874, p < 0.001), cultural values (B = 0.276, p < 0.001), year of study (B = 0.244, p < 0.05), and frequency of curative care use (B = -0.236, p < 0.05). For practising nurses, trust (B = -1.252, p < 0.01), cultural values (B = 0.357, p < 0.01), and working experience (B = 0.612, p < 0.01) were associated with their health literacy knowledge. Thus, responses targeted at gaps in health literacy knowledge of student and practising nurses must be sensitive to personal characteristics (e.g., gender), social values (e.g., issues of trust, and cultural beliefs and practices), as well as factors relating to nursing education and experience.

Student Nurses Undertaking Acute Hospital Paid Placements during COVID-19: Rationale for Opting-In? A Qualitative Inquiry.

The research aim was to evaluate the rationale of undergraduate final-year student nurses to undertake paid clinical placements during COVID-19 (Wave 1). The nursing profession reacted innovatively to meet demands placed on the National Health Service during COVID-19. Temporary changes to professional regulation enabled final-year United Kingdom nursing students to voluntarily undertake paid placements in the National Health Service. Neither full-time employees nor full-time students, volunteers undertook a unique hybrid role bolstering the front-line health workforce. Using reflective qualitative inquiry, 17 volunteers evaluated reasoning for entering practice in acute hospitals. Online surveys based around the UK Nursing and Midwifery Council Competency Framework (NMC 2012) were completed weekly for 6 weeks. Data were thematically analysed. Six themes were identified, including sense of duty, and opting-in or out. These highlighted the importance of collaboration and the tripartite relationship between University, host and student during placement, and the influence of these on the learning experience. Several significant insights emerged for nurse education and curricula during pandemics related to patient safety, safety climate and governance. The insights were used to develop a "Student Nurses Placement Framework" with recommendations for Pre-During-Post placement, offering a guide for future nursing workforce recruitment and retention.

Student nurses' experiences regarding their clinical learning opportunities in a public academic hospital in Gauteng province, South Africa.

BACKGROUND: During the training of student nurses, clinical placement is a compulsory requirement, as it exposes them to learning opportunities for the acquisition of clinical skills. This prepares them to become safe and competent professional nurses. However, the increased intake of student nurses in the Gauteng nursing colleges led to overcrowding in a public academic hospital, thus negatively influencing their learning experiences and availability of clinical learning opportunities. AIM: The purpose was to explore and describe the student nurses' experiences regarding their clinical learning opportunities to make recommendations to enhance their clinical learning opportunities in order to address the optimisation of their learning experiences. METHODOLOGY: A qualitative, exploratory, descriptive and contextual research design was used. A purposive sampling method was used to select second-year student nurses registered in the Regulation (R425) programme for qualifying as a nurse (general, psychiatry and community) and midwife, as they would have acquired at least 1 year of clinical experience. Four focus groups, which comprised six to eight participants, were constituted, and research was conducted until data were saturated. Field notes were simultaneously taken to enrich the data collected. Thematic coding of qualitative data was used. Principles of trustworthiness and ethical principles were adhered to. RESULTS: The study revealed four themes. Three were negative experiences that included overcrowding, negative emotional experiences of student nurses and challenges of professional nurses. A theme concerning positive experience entailed knowledge-sharing amongst various health care disciplines. CONCLUSION: It was evident that student nurses had more negative emotional experiences than positive experiences. Therefore, the need to enhance their clinical learning opportunities in order to address the optimisation of learning experiences is eminent.

Transition into remote and rural nurse education and careers: a qualitative study of student nurses.

BACKGROUND: Global nurse shortages present a threat to the sustainability of remote and rural healthcare. Interventions have been developed to support recruitment and retention of nurses that focus on providing pre-nursing experience for school pupils who intend to pursue nursing careers. However, there is a lack of evidence around how pre-nursing experience supports transition into nurse education. AIMS: This study aims to explore the impact of a pre-nursing scholarship for school pupils in remote and rural areas of Scotland on experiences of transition into nurse education. METHODS: This was a qualitative study involving semi-structured telephone and face-to-face interviews with pre-nursing scholarship participants. RESULTS: An authentic pre-nursing experience supported school pupils' transition to nurse education. First, it increased students' self-efficacy, both in their decision to choose nursing as a career and their ability to nurse. Second, it helped students to realise that the opportunity to study closer to home was available to them. Third, it supported students' educational and social integration, helping them feel prepared for university teaching and learning approaches and the social experience of being a student. CONCLUSIONS: Pre-nursing experience can support transition into nurse education and contribute to career pathways that support recruitment and retention of nurses in remote and rural areas.

Nutritional status of the student nurses of a tertiary health-care center - A mixed-method study.

CONTEXT: Nursing students are the future role model of health; so critical evaluation of their nutritional status is imperative for effective functioning of health sector. AIMS: The aim is to assess the nutritional status of nursing students using basal metabolic index and exploring the causes of malnutrition along with uncovering the causes behind these causes of malnutrition. SETTING AND DESIGN: Nutritional status of student's nurses was assessed by mixed-method study design in tertiary care center of Mumbai, India. MATERIALS AND METHODS: The method is to use the census method for sampling 280 nursing students of a tertiary care center interviewed using a semistructured interview schedule. Focus group discussions were held with student nurses, which were selected through purposive sampling technique to interpret the instigator causes behind causes of malnutrition. STATISTICAL ANALYSIS: Descriptive statistics was applied on qualitative data. Conceptual model framed on themes and subthemes based upon the codes from qualitative data. RESULTS: Students having BMI less than 18 and more than 24.9 were 189 and 11, respectively, out of 280 students. About 64.20% had acidity and 11.07% performed regular exercises evolving major themes: challenges, stress, attitude, knowledge, social barriers, and motivators. CONCLUSION: About 67.5% of nursing students had BMI less than 18. Inappropriate dietary pattern, frequent ailments, and improper personal habits ensued their malnourished status. Lack of proper knowledge on balanced diet, work place stress, and challenges such as financial constrain, peer pressure, and health ailments along with improper perception of body image of the student nurses are major triggering factors behind the causes of malnutrition.

The visibility of QSEN competencies in clinical assessment tools in Swedish nurse education.

BACKGROUND: Prospective nurses need specific and sufficient knowledge to be able to provide quality care. The Swedish Society of Nursing has emphasized the importance of the six quality and safety competencies (QSEN), originated in the US, in Swedish nursing education. PURPOSE: To investigate the visibility of the QSEN competencies in the assessment tools used in clinical practice METHOD: A quantitative descriptive method was used to analyze assessment tools from 23 universities. RESULTS AND CONCLUSION: Teamwork and collaboration was the most visible competency. Patient-centered care was visible to a large degree but was not referred to by name. Informatics was the least visible, a notable concern since all nurses should be competent in informatics to provide quality and safety in care. These results provide guidance as academic and clinical programs around the world implement assessment of how well nurses have developed these essential quality and safety competencies.