I attend many interdisciplinary meetings where nursing is considered essential for these new practice futures, albeit needing new knowledge in new dimensions of tomorrow's care systems. Such areas for role expansion include genetics counseling, grade school health curriculum modules, more ethics in response to more technology, financial outcome analysis and information management, just to name a few. However, these changes are slow in coming as faculties are not engaged in these practice demands nor are they "prepared" in these areas. The resulting burden is a faculty being pushed to add yet more to the curriculum in areas their own practice does not use or understand. Accreditation, consequently, becomes the peer review gatekeeper or scapegoat against such pressure.

How can we mobilize healthy change among our faculties and use the licensure, accreditation and credentialing processes to help in these expanding knowledge areas and new roles for the profession? Must faculty have formal expertise before offering expert content? Are there other ways of making these areas available to students? With Internet potential, for example, do all schools need localized expertise?