Reforms in nursing education across Western Europe: from agenda to practice.

The overall goal of this research was to analyze implementation processes translating the nursing education reform agenda into practice across 20 Western European countries. The analysis centered on the substantial changes in structure and ethos created in nursing programs and the adjustments required from nursing faculty members as part of their integration into higher education institutions. Based on the model of implementing organizational change by Pettigrew, Ferlie, and McKee, three major implementation domains were analyzed: (1) the adjustment of nursing faculty members into higher education settings and toward their new roles; (2) the applicability of the graduate profile; and (3) the adequacy of the nursing curriculum for higher education institution and the reformed health care systems. A critical analysis of the scientific literature and policy documents revealed a striking similarity with regard to the difficulties and concerns appearing in the various Western European countries implementing nursing education reforms. Three sorts of difficulties emerge repeatedly in the reforming nursing education programs. These difficulties are related to (1) the adjustment of nursing faculty members into higher education settings and toward their new roles, (2) the competencies held by graduates of preregistration programs, and (3) the content and structure of the nursing curriculum. Future questions, lessons, and potential directions are discussed in this article.