Background
Quality assurance and quality enhancement processes in nursing education are vital to the establishment of a strong program. Existing quality assurance methods in nursing education such as professional self-regulation and external examination rely on provincial and national nursing associations for evaluation, putting minimal responsibility and accountability on internal program examiners. Threshold concepts and troublesome knowledge provide a framework as outlined by Land that utilizes internal examiners from both student and faculty groups and represents an alternative to traditional quality assurance in nursing education.

Purpose
To identify troublesome mental health nursing content in a nursing curriculum by exploring students and faculty perspectives.

Method
A sequential mixed methods design that utilized surveys and focus groups to explore student and faculty perspectives on troublesome mental health nursing content.

Results
The project data were able to be organized into five main content themes that were identified as being troublesome: the spectrum of mental illness, therapeutic relationships and boundaries, praxis, professionalism in nursing, and brain chemistry and its management.

Conclusion
The findings from this project are unique to the program of review but show the potential of this new approach to quality assurance and program enhancement initiatives in nursing education.

Donald M. Leidl
Canadian Journal of Nursing Research, January 24, 2018
http://journals.sagepub.com/doi/abs/10.1177/0844562117753856