1,721,031 research outputs found
Navigating the Future with Nursing Foresight NCSBN Keynote Presentation
No full textAn introduction to the concept of nursing foresight and a discussion related to nine principles that activate and support the development of a futures thinking mindset.Keynote presentation for the National Council of State Boards of Nursing 2018 Institute of Regulatory Excellence ConferenceNational Council State Boards of Nursing ( NCSBN)Pesut, Daniel. (2018). Navigating the Future with Nursing Foresight NCSBN Keynote Presentation. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/192543
Conscious Elderhood: An Integrated Framework for Nurse Leaders in the Wisdom Years
Full text linkThis integrated framework offers nurse leaders practical tools for transforming retirement from passive withdrawal into active wisdom contribution. By addressing all three dimensions simultaneously, nurses can leverage decades of clinical and leadership experience to mentor emerging professionals, advance the discipline, and model healthy aging while maintaining purpose and vitality.Background: With 10,000 Baby Boomers retiring daily, the nursing profession faces a critical leadership transition as experienced nurses enter elderhood. Despite living 20-30 years post-retirement, most lack a roadmap for this developmental stage, resulting in loss of valuable wisdom and mentorship capacity. Purpose: This article presents an integrated framework synthesizing eight evidence-based systems for conscious elderhood, offering nurse leaders a comprehensive approach to navigating the wisdom years with purpose, continued contribution, and legacy planning. Methods: A confirmatory integration methodology examined eight complementary frameworks: Zweig’s inner work of aging, Conley’s Modern Elder Academy, Schuster’s narrative reclamation, Bateson’s compositional life design, life review and legacy planning, the conscious aging movement, the Hindu Ashrama system, and Erikson’s developmental stages. Areas of convergence across all eight systems were identified as validated pathways for conscious elderhood. Results: The integration revealed three essential dimensions requiring simultaneous attention: personal development (shadow work, life review, mortality awareness), professional development (mentorship, wisdom transmission, encore purpose), and spiritual development (contemplative practice, legacy creation, conscious preparation). A three-phase roadmap emerged: Awakening (ages 55-65), Integration (65-75), and Liberation (75+).Pesut, Daniel. (2025). Conscious Elderhood: An Integrated Framework for Nurse Leaders in the Wisdom Years. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/277276
Chapter 12: Transformed and in Service: Creating the Future Through Renewal
Full text linkThe book "Visionary Leadership: A Guidebook for 21st Century Managers and Leaders" by Billy Rosa, published by Springer Publishers, provides a comprehensive framework for understanding and developing visionary leadership. It guides managers and leaders through four phases of the vision development and realization cycle, emphasizing the importance of seeing the company and its role through new lenses. The book also teaches leaders to embrace employees as visionary partners in the journey to build a better organization. It features real-world case examples and chapter summaries with key takeaways, allowing business leaders to walk through the visioning process with their teams from start to finish. This book is particularly beneficial for consultants and coaches who want to support visionaries at any level of an organization.A reflection on becoming a nurse and the importance of renewal in professional life. " Personally, and professionally, I believe reflection is a means of renewal. My logic goes something like this: as self is renewed, commitments to service come forward more easily. Renewed commitments to service require attention to mindfulness and reflective practice. Mindful reflective practice begets questions that support inquiry. Such inquiry guides knowledge work and evidence-based care giving. Care giving supports society as knowledge, values, and service intersect. Knowledgeable people and especially knowledgeable nurses provide care that society needs. Creating a caring society is the spirit work of nursing. Creating a caring society starts with nurses caring for themselves and becoming, through reflection, more conscious and intentional in their being, thinking, feeling, doing, and acting. Reflection is a form of “inner work” that results in the energy for engaging in “outer service.” Reflection in-and-on action supports meaning-making and purpose management in one’s professional life."Pesut, Daniel. (2016). Chapter 12: Transformed and in Service: Creating the Future Through Renewal. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/277130
Love, Courage, Honor: Twenty Years of Renewal Leadership in Nursing The Legacy of the Daniel J. Pesut Spirit of Renewal Award
Full text linkIn November 2003, Daniel Pesut—the first male president of Sigma Theta Tau International—delivered a presidential address that would shape the society's direction for decades. Titled "Create the Future through Renewal," his call invited nurses worldwide to embrace renewal across six vital domains: self, service, scholarship, science, society, and spirit. He described creative thinking as an essential source of professional renewal and urged nurses to transform discontent into hope through imagination, reflection, and visionary leadership (Pesut, 2003). Over the past two decades, twelve distinguished nurse leaders have received the Spirit of Renewal Award. Recipients hail from different generations, geographic regions, and specialties, yet they share a common capacity for transformative influence. Together, their contributions chronicle not only personal achievement but the evolving consciousness of the nursing profession. Through these twelve remarkable nurse leaders, we see renewal as ethical practice, as creative expression, as social advocacy, and as generous mentorship. We see it as both personal journey and professional obligation. We see it as grounded in nursing's heritage while oriented toward emerging futures. Most importantly, we see it as fundamentally human—an expression of nursing's enduring commitment to care, to justice, to wisdom, and to hope.
As Sigma Theta Tau International looks toward the next two decades, the Spirit of Renewal Award continues to serve as both compass and mirror—pointing toward nursing's highest aspirations while reflecting the profession's evolving understanding of what renewal requires. The award's legacy reveals that renewal is not episodic but continuous, not individual but relational, not purely aspirational but urgently necessary.In every profession, there are moments and movements that call people to think differently, act courageously, and reimagine what is possible. In nursing, renewal is not merely an inward process—it is the capacity to influence systems, restore purpose, and cultivate innovation in others. For twenty years, the Daniel J. Pesut Spirit of Renewal Award has recognized nurse leaders who embody this transformative ethos—those who nurture hope, spark imagination, and reawaken meaning in individuals, institutions, and communities. Named for Dr. Daniel J. Pesut—an internationally recognized scholar of reflective practice, creativity, and clinical reasoning—the award celebrates nurses whose work exemplifies the renewal principles he championed as President of Sigma Theta Tau International from 2003 to 2005. This article explores the award's origins, honors its twelve distinguished recipients, and reflects on the evolving nature of renewal in professional nursing (Pesut, 2025).Pesut, Daniel. (2025). Love, Courage, Honor: Twenty Years of Renewal Leadership in Nursing The Legacy of the Daniel J. Pesut Spirit of Renewal Award. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/277248
The Outcome-Present State-Test (OPT) Model of Clinical Reasoning: A Framework for Advanced Practice Nursing
Full text link- Describe the structure, process, and elements of the OPT Model of Reflective Clinical Reasoning to illustrate the complex dynamics between and among patient care problems and nursing care interventions, outcomes, and judgments.
- Appreciate the development of knowledge representation and levels of practice data to filter, frame and focus clinical reasoning for clinical nurse specialist practice.
- Gain insight into the cognitive, metacognitive, and self-regulatory thinking processes to support application, use, and evaluation of the OPT model in clinical specialist practice.
- Consider use of the OPT Model of Reflective Clinical Reasoning to manage the complexities of care coordination and care planning in clinical nurse specialist practice.The purpose of this article is to introduce the Outcome Present State Test (OPT) Model of Reflective Clinical Reasoning and discuss the value and importance of nursing knowledge work to support the clinical reasoning skill set of clinical nurse specialists. Knowledge representation and levels of practice data are critical to methods clinical nurse specialists use to filter, frame, and focus nursing care associated with individual, family, community, and health system care challenges. Nursing process is the foundation for patient problem management. The OPT model is an innovation in clinical reasoning that enhances clinical nurse specialist education, practice, competencies, and research efforts. In this chapter changes to the nursing process through time are described and discussed. The Outcome Present State Test (OPT) Model of Reflective Clinical Reasoning is explained. The cognitive and metacognitive thinking strategies that support use of the OPT model are identified and defined. Strategies to support the complexity of thinking involved in clinical reasoning are outlined. The process has evolved through time with attention to the
ontology, epistemology, and evolving nature of professional nursing and developments in knowledge representation. These developments have influenced clinical reasoning perspectives and the critical, creative, systems, and complex thinking skills that support clinical reasoning (Nursology, n.d., Kuiper, Pesut, Arms, 2016).Pesut, Daniel. (2025). The Outcome-Present State-Test (OPT) Model of Clinical Reasoning: A Framework for Advanced Practice Nursing. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/277124
Minnesota Nursing Informatics Leadership Inventory (MNILI) Self-Assessment and Leadership Development Resource
No full textThe Minnesota Nursing Informatics Leadership Inventory (MNILI) is a self-assessment tool designed to help nursing informatics leaders evaluate their leadership skills across diverse organizational cultures and scenarios. Developed at the University of Minnesota School of Nursing, the MNILI is grounded in the Competing Values Framework (CVF), one of the most widely validated models for understanding organizational culture and leadership effectiveness in healthcare settings. Nursing informatics leaders operate at the intersection of clinical practice, technology, and organizational change. They must navigate complex human and technological systems while managing competing values and priorities. The MNILI was created to address a gap in assessment options: while informatics competency tools existed, there was no instrument specifically designed to assess the requisite variety of leadership skills needed by nursing informatics leaders to succeed across different organizational cultures. This resource is designed for nursing informatics professionals at all career stages, including current and aspiring chief nursing informatics officers, informatics team leaders, educators, consultants, data analysts, quality improvement specialists, EHR trainers and builders, researchers, policy analysts, and graduate students in nursing informatics programs. It is equally valuable for experienced leaders seeking to refine their approach and for emerging leaders building foundational awareness of their leadership strengths. This is a standalone resource that does not require internet access or a website. It includes everything one needs to complete the MNILI, score results, interpret a leadership profile, and create a professional leadership development plan. Work through the sections in order: first complete the demographics section, then respond to all four scenarios, score results using the worksheet provided, interpret the profile using the guidance in Section 5, and finally use Section 6 to create a personalized leadership development plan.The Minnesota Nursing Informatics Leadership Inventory (MNILI) is a free, theory-based self-assessment instrument grounded in the Competing Values Framework (CVF) that measures leadership skill preferences across four organizational culture types and four nursing informatics scenarios. Since its pilot validation in 2020, the instrument has been completed by 508 nursing informatics leaders and students across 59 countries. The MNILI was designed from the outset as both a research instrument and a professional development tool. Its four-scenario structure mirrors the case-based pedagogies that nursing educators already use effectively. Its Likert rating format (0 = not like me to 4 = very much like me) generates a quantitative profile that students can track over time, making it suitable for both formative and summative assessment. Its theoretical grounding in the CVF connects individual self-assessment to broader organizational and leadership theory, facilitating deep learning rather than superficial competency-checking. The MNILI demonstrates strong psychometric properties — excellent overall internal consistency, adequate item discrimination, theoretically consistent intercorrelation structure, moderate cross-scenario stability, and expected null known-groups findings — that support its use as a validated instrument for nursing informatics leadership assessment across diverse global populations. The scale's CVF-based four-culture structure is supported empirically by the pattern of inter-scale correlations, consistent with both the instrument's theoretical foundations and prior organizational culture research. The MNILI has been validated for use in nursing informatics education (pre-post assessment of leadership development), research (cross-national comparison of leadership profiles), and professional practice (individual self-assessment and organizational leadership planning). Future investment in formal measurement invariance testing, test-retest reliability, and criterion validity will further consolidate its position as the leading theory-grounded leadership assessment instrument for the nursing informatics field.Monsen, Karen; Pesut, Daniel. (2026). Minnesota Nursing Informatics Leadership Inventory (MNILI) Self-Assessment and Leadership Development Resource. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/278943
The Minnesota Nursing Informatics Leadership Inventory (MNILI)
No full textThe Minnesota Nursing Informatics Leadership Inventory (MNILI) is a self-assessment tool designed to help nursing informatics leaders evaluate their leadership skills across diverse organizational cultures and scenarios. Developed at the University of Minnesota School of Nursing, the MNILI is grounded in the Competing Values Framework (CVF), one of the most widely validated models for understanding organizational culture and leadership effectiveness in healthcare settings. Nursing informatics leaders operate at the intersection of clinical practice, technology, and organizational change. They must navigate complex human and technological systems while managing competing values and priorities. The MNILI was created to address a gap in assessment options: while informatics competency tools existed, there was no instrument specifically designed to assess the requisite variety of leadership skills needed by nursing informatics leaders to succeed across different organizational cultures. This resource is designed for nursing informatics professionals at all career stages, including current and aspiring chief nursing informatics officers, informatics team leaders, educators, consultants, data analysts, quality improvement specialists, EHR trainers and builders, researchers, policy analysts, and graduate students in nursing informatics programs. It is equally valuable for experienced leaders seeking to refine their approach and for emerging leaders building foundational awareness of their leadership strengths. This is a standalone resource that does not require internet access or a website. It includes everything you need to complete the MNILI, score your results, interpret your leadership profile, and create a development plan. Work through the sections in order: first complete the demographics section, then respond to all four scenarios, score your results using the worksheet provided, interpret your profile using the guidance in Section 5, and finally use Section 6 to create your personalized development plan.The Minnesota Nursing Informatics Leadership Inventory (MNILI) was developed to expand assessment options and tools in the area of nursing informatics leadership. This article describes the result of the pilot test of the instrument. Using an ordinal Likert scale (0 = not like me to 4 = very much like me), respond ents rated 12 leadership skills associated with four types of cultures across four scenarios. Respondents preferred collaborative culture leadership skills across all scenarios and differentially preferred culture-specific skills by scenario. Overall, older and more experienced respondents were more satisfied as leaders (p = 0.003) and more often used a democratic leadership approach (empower and care about all voices; p = 0.012). In three of the four cultures, nursing informatics leaders reported preferred and collaborative leadership skills that matched the scenario. This study provides preliminary evidence for using the MNILI to assess the requisite variety of nursing informatics leadership skills. Further research is needed to understand the dynamic interactions between organizational culture and nursing informatics leadership that are informed by conscious leadership and attention to the requisite variety of leadership skills. In addition to the original published pilot study, this resource is designed for nursing informatics professionals at all career stages, including current and aspiring chief nursing informatics officers, informatics team leaders, educators, consultants, data analysts, quality improvement specialists, EHR trainers and builders, researchers, policy analysts, and graduate students in nursing informatics programs. It is equally valuable for experienced leaders seeking to refine their approach and for emerging leaders building foundational awareness of their leadership strengths.Monsen, Karen; Pesut, Daniel. (2020). The Minnesota Nursing Informatics Leadership Inventory (MNILI). Retrieved from the University Digital Conservancy, 100-111.doi:10.12927/cjnl.2020.26188
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
The Care Coordination Clinical Reasoning Systems Model: Advancing the OPT Model for Advanced Practice Nursing Education and Practice
Full text linkDespite the recognized importance of care coordination competencies, nursing education has lacked comprehensive frameworks to systematically develop the complex clinical reasoning skills required for this multifaceted role. Traditional clinical reasoning models, while valuable for individual patient care, do not adequately address the systems-level thinking, interprofessional collaboration, and organizational dynamics inherent in care coordination activities. This gap in educational frameworks limits the preparation of nursing students and the ongoing professional development of practicing nurses for the demands of contemporary healthcare delivery.
Background: The Outcome-Present-State-Test (OPT) Model of Clinical Reasoning the Outcome-Present-State-Test (OPT) Model of Clinical Reasoning, developed by Pesut and Herman (1999), has been extensively utilized in nursing education to structure and support clinical reasoning development Pesut, 2025a; 2025b; 2025c; 2025d). The model has garnered over 3,680 citations in the scholarly literature, demonstrating its widespread adoption and impact on nursing education and practice. The OPT model provides a visual representation of the concurrent consideration of multiple patient problems and issues, supporting the development of critical, creative, and reflective thinking skills essential for professional nursing practice.The changing landscape of healthcare delivery demands that advanced practice nurses possess sophisticated clinical reasoning skills that extend beyond individual patient care to encompass systems-level thinking and interprofessional team coordination. This article introduces the Care Coordination Clinical Reasoning (CCCR) Systems Model, an innovative framework that builds upon the established Outcome-Present-State-Test (OPT) Model of Clinical Reasoning. The CCCR model integrates patient-centered, team-centered, and organizational-centered systems thinking to support the complex clinical reasoning required for effective care coordination in contemporary healthcare contexts. By incorporating the Competing Values Framework and Value Network Analysis, the model provides nursing educators, students, and practitioners with structured tools and strategies to navigate the multifaceted challenges of coordinating care across settings, disciplines, and healthcare delivery systems. This article explicates the theoretical foundations, practical applications, and educational implications of the CCCR model, demonstrating its utility as both a teaching-learning strategy and a framework for advancing nursing practice in accountable care organizations and interprofessional team environments.Kuiper, Ruth Anne; Pesut, Daniel; Arms, Tamatha. (2025). The Care Coordination Clinical Reasoning Systems Model: Advancing the OPT Model for Advanced Practice Nursing Education and Practice. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/277243
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