Background The Fuld Fellows Program provides selected pre-licensure nursing students with a foundation in the science of patient safety, quality improvement and leadership through coursework and a mentored experience working on a quality improvement project. We evaluated this program’s impact on Fellows’ patient safety competence and systems thinking. Methods Cohorts I-VI ( n = 116) completed pre-post program evaluation that included measurement of patient safety competence through the Health Professional Education in Patient Safety Survey (H-PEPSS) and systems thinking using the Systems Thinking Scale. Pre- and post-program H-PEPSS and Systems Thinking Scale scores were compared using the Wilcoxon Signed-Rank Test. The Fellows were compared to non-Fellows on patient safety competence and systems thinking using t-tests. Results Patient safety competence on all H-PEPSS scales improved from baseline to end of program: teamwork (2.6 to 3.1), communication (2.1 to 3.2), managing risk (2.2 to 3.3), human environment (2.8 to 3.7), recognize and respond to risk (2.7 to 3.6), and culture (2.9 to 3.8) ( p < 0.05). The Fellows, in comparison to the non-Fellows, reported a significantly higher ( p < 0.05) mean change score in five of the six H-PEPSS subscales. Fellows’ mean systems thinking score increased from 66 ± 7 at baseline to 70 ± 6 at program completion ( p < 0.05), this mean post completion score was significantly higher than the non-Fellows reported mean STS score of 62 ± 7. Conclusion The Fuld Fellows Program effectively facilitated patient safety and quality improvement and systems thinking learning among pre-licensure nursing students. This program can serve as a model for integrating quality and safety concepts into health professionals’ curricula.

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