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  1. Sayre, Michelle M. PhD, RN, NEA-BC
  2. McNeese-Smith, Donna EdD, RN, NEA-BC
  3. Leach, Linda Searle PhD, RN, NEA-BC
  4. Phillips, Linda R. PhD, RN


"Speaking up" is a critical component in improving patient safety. Studies indicate, though, that most registered nurses prefer using behaviors of avoidance or accommodation in conflict situations. The purpose of this quasi-experimental study was to determine whether an educational intervention using scenarios, personal reflection, and peer support in small groups could improve speaking-up behaviors in registered nurses. Results showed a significant difference in speaking-up behaviors and scores in the intervention group (P < .001).