• Nursing education;
  • professional identity;
  • patient safety;
  • quality and safety education for nurses



The purpose of this study was to identify patterns of professional identity arising from the Quality and Safety Education for Nurses (QSEN) attitudes among students completing their prelicensure education.


This mixed-method study used a modified Q-methodology design with a purposeful sample of 36 baccalaureate students graduating from three campuses of a large Midwestern university. Data were collected near the end of the spring semester of 2013.


Participants rank-ordered their agreement or disagreement with a set of subjective statements reflecting the 46 QSEN attitudes. Data were analyzed using a standard three-step approach that included generating a correlation matrix, completing factor analysis followed by varimax rotation, and calculating the factor scores.


Twenty statements represented consensus among the participants, and there was strong agreement that patient safety was both an individual and a team effort. Three professional identity typologies emerged: champions, collaborators, and individualists.


Evidence was found that these students internalized the QSEN attitudes to varying degrees, but more work may be needed to internalize all attitudes, especially those related to patient-centered care. Future research is needed to evaluate how students with different perspectives transition to practice and to explore other factors that comprise professional identity.

Clinical Relevance

This study expands on what is known about patterns of professional identity among nurses and helps provide a beginning framework for understanding the values new graduates bring to practice.