Changes in nursing education in the European Union.

PURPOSE To provide an overview of changes in nursing education in the European Union (EU) within the framework of the Bologna Declaration, signed in 1999 by the European ministers of education, and to describe specific efforts and changes in Spain. ORGANIZING CONSTRUCTS (a) the Bologna Declaration process, its recent reforms in all disciplines including nursing, and perspectives on future developments; (b) the Tuning Project, designed and carried out by a group of European universities to meet the challenges posed by the Bologna Declaration; and (c) efforts in a group of Spanish universities to promote higher education in nursing. FINDINGS AND CONCLUSIONS These changes promote enhanced academic recognition, professionalism in nursing education, and graduates' competencies in practice in most European countries by specifying the undergraduate nursing degree as the minimal entrance level for practice and master's and doctoral programs for further career development.