Rethinking Quality in Nursing Education Repenser la qualité en formation infirmière

Keywords:

• nursing education,
• quality nursing education,
• accreditation,
• nursing leadership

At the inception of the nursing education accreditation program in Canada were concerns for the protection of the public’s interests and the establishment of a commission on accreditation for the health professions. The Association of Universities and Colleges of Canada (AUCC)—now called Universities Canada—represented the health professions at this commission. With the conviction that “nursing as a profession is accountable to the public and has a responsibility to ensure the quality of the education preparation of its members” (Thomas & Arseneault, 1993, p. 82), the Canadian Association of University Schools of Nursing (CAUSN)—now the Canadian Association of Schools of Nursing (CASN)—composed then of about 20 members schools, became the accrediting agency in 1972, alongside the accrediting bodies of other health professions, such as medicine and dentistry (Kirkwood & Bouchard, 1992). CAUSN had, since 1957, established standards for its members schools and recognized the value of a national accreditation process (Thomas et al., 1992). This process required vision and commitment. Today, we ask: How was quality conceptualized then, and what are current views in higher education? Why is it so crucial to maintain an open dialogue on this issue of quality in nursing education? Defining quality remains a challenge, even for contributors to Quality in Higher Education, a social sciences and humanities journal intended to further this endeavour (Harvey, 2023, 2024; Williams, 2025). Nonetheless, the nursing deans and directors of CAUSN member schools delineated four quality dimensions for their educational programs: relevance as the response to major societal trends that affect the health needs of the community; accountability as teaching that the primary responsibility of nursing is to the person, family, group, or community; relatedness as the interconnectedness of each part of the educational program in moving towards its goals; and uniqueness as the leveraging of the available resources in the educational program’s setting (Thomas & Arseneault, 1993). These dimensions, still pertinent today, have gradually been refined and edited in the revised versions of the accreditation program (CASN, 2020). Thomas and Arseneault (1993) reported three important features of the early accreditation program that complement this conceptualization of quality. First, teaching and students’ learning was “the critical point in its design and was identified as the primary source of data for the accountability criterion” (p. 83). Second, the process invited schools to demonstrate how the program is contributing “to current and future societal needs” (p. 83). Third, the fundamental principle of fostering continuous quality improvement of the educational program distinguished it from “the traditional accreditation that may have a static quality” (p. 83). These characteristics of the accreditation program were recently echoed and supported by the results of a survey reported by Harvey (2023, 2024) in response to three questions on quality in higher education. Among these was the following: “To what extent have quality assurance processes affected the quality of higher education?” (Harvey, 2023, p. 154). Most respondents—contributors to the journal for which Harvey was the editor—from 50 countries thought that the quality of higher education had been affected positively, mainly by having fostered the development of a culture of quality. In their responses, the participants defined quality in education in various ways—as excellence, consistency, fitness for purpose, or transformation. Yet, Harvey (2023, 2024) found a consensus regarding the loss of centrality on quality teaching and mainly students’ learning within quality assurance programs, one of the features of the early nursing education accreditation program. This search for quality has prompted the surge in research and scholarship on teaching and learning in health professional education in recent decades. Fostering quality enhancement was another feature discussed in the survey and reported as …