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Nursing education, RN-BSN program, systems, systems thinking



  1. Stalter, Ann M. PhD, MEd, RN
  2. Jauch, Amy MSN, RN, CNE


Background: Nurses need to take a lead in reducing medical errors. Formal education of systems thinking (ST) can be a catalyst for error prevention.


Problem: Integration of ST in RN-BSN education has not been studied.


Approach: A descriptive, cross-sectional design using survey methods was used.


Outcomes: Deans of accredited RN-BSN programs across the Midwest reported on ST integration across their RN-BSN programs. Gaps in ST integration were identified as (1) a lack of evaluation tools to determine mastery of systems theory, thinking and awareness, and the application of quality and safety competencies for systems-level synthesis and (2) program outcomes emphasizing autonomy of systems-level decisions.


Conclusions: Systems thinking was integrated across curricula among most accredited RN-BSN programs in the Midwest. Recommendations are to integrate systems theory into program outcomes and to develop evaluation tools that validate ST mastery.