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Since the last national nursing education study almost forty years ago, profound changes in science, technology, and the nature and settings of nursing practice have reshaped the field. Yet schools have lagged behind in adapting to these changes. Added to this, the profession faces a shortage of nurses and nursing faculty. To meet these challenges, the authors assert that schools, service providers, and the profession must change. They recommend four controversial yet essential changes that are needed to transform nursing education. 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