As the US health care system undergoes its biggest transformation in a generation, nurses must take on new leadership roles to ensure the success of collaborative, outcome-driven patient care.

Significant barriers still stand in the way to advancing nurses into leadership roles, however. Established hierarchies are slow to disappear. The traditional nursing curricula has little leadership training built in. And many veteran nurses are particularly frustrated with their careers.

Leadership training built around the concept of efficacy, or the power to produce a desired effect, can give nurses the skill sets needed to overcome these barriers. Efficacy principles allow nurses to embrace new challenges, practice new leadership skills, build confidence, and seek feedback. Over time, this allows nurses to "show up" at work in a new way that gets their voices heard and acknowledged so they can contribute fully to the future success of managing optimal patient care.

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