QSEN Task Force

Just Culture Assessment Tool-Nursing Education (JCAT-NE)

Members of the QSEN Academic Task Force recently undertook work to assess just culture in nursing education. The taskforce developed, analyzed, and published the Just Culture Assessment Tool-Nursing Education (JCAT-NE), an instrument designed to assess just culture in Academia (Walker et al., 2019a). Using the JCAT-NE a team of over twenty taskforce members developed and conducted a multi-site research study to assess nursing students’ perceptions of just culture in undergraduate nursing programs. Study findings demonstrate the need to incorporate just culture principles into nursing education (Walker et al., 2019b). 

A fair and just culture is one in which students learn and improve by openly identifying and assessing their weaknesses, and feel supported in reporting errors. Emphasis is not placed on blaming the individual but rather examines personal and system processes that can best support safety. While this concept has been adopted in the healthcare setting, blame and discipline are still the primary method nursing education uses to manage safety concerns with students. To best prepare our students for practice, nursing education must begin to operate as a just culture.

Within QSEN, just culture has been acknowledged as central to safety competence. As part of the safety competency we expect students to describe factors that create a culture of safety, utilize organizational error reporting systems and value their own role in preventing errors. These knowledge, skills and attitudes describe important components of just culture. Disch and Barnsteiner (2017) created additional awareness about just culture by publishing a national study of how nursing programs handle error reporting. Their work found more than half of nursing programs report no error reporting system. Their national survey identified key areas of opportunity for the incorporation of just culture in nursing education. Subsequently, Barnsteiner and Disch (2017) developed a framework for creating  just culture in nursing programs. The first step is assessment of the current program culture as perceived by students and faculty. The JCAT-NE is a valid and reliable tool that was developed to measure just culture with nursing academia and can provide program level assessment date. To learn more about nursing students perceptions of just culture in nursing education or the JCAT-NE instrument please read the article published in Nurse Educator. https://journals.lww.com/nurseeducatoronline/Abstract/publishahead/Nursing_Students__Perceptions_of_Just_Culture_in.99435.aspx 


Barnsteiner, J., & Disch, J. (2017). Creating a fair and just culture in schools of nursing. The American Journal of Nursing, 117(11), 42-48. https://doi.org/10.1097/01.Naj.0000526747.84173.97  https://www.ncsbn.org/Barnsteiner_Creating_a_fair_and_just_culture_in_schools_of_nursing.pdf 

Disch, J. & Barnsteiner, J. (2017). Exploring how nursing schools handle student errors and near misses. The American Journal of Nursing, 117(10) 24-31. https://doi.org/10.1097/01.NAJ.0000525849.35536.74 https://www.ncsbn.org/Disch_Exploring_how_nsg_schools_handle_student_errors.pdf 

Walker, D., Altmiller, G., Barkell, N., Hromadik, L., Toothaker, R. (2019a). Development and validation of the just culture assessment tool for nursing education (JCAT-NE). Nurse Educator, 24(5) https://doi.org /10.1097/NNE.0000000000000705

Walker, D., Altmiller, G., Hromadik, l., Barkell, N., Barker, N., Boyd, T, Compton, M., Cook, P., Curia, M., Hays, D., Flexner, F., Jordan, J., Jowell, V., Kaulback, M., Magpantay-Monroe, E., Rudolph, B., Toothaker, R., Vottero, B., Wallace, S. (2019b). Nursing students’ perception of just culture within nursing programs: A multisite study. Nurse Educator Advance Online Publication. https://doi.org/10.1097/NNE.0000000000000739