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Historically, graduate education in nursing has been primarily concerned with the clinical role. In recent years it has been suggested that graduate education needs to consider alternate programs of study that prepare nurses for clinical leadership that are distinct from management and advanced practice roles. Graduate education is needed that focuses on the skills required to coordinate care and implement outcome-based practice and quality improvement strategies. Two models are currently being proposed that meet these objectives. The first is the population health nurse expert that functions on the macrosystems approach and the second is the clinical nurse leader which is based on a microsystems framework. The two models are compared and a combined model where the clinical nurse leader is based on the population health framework is proposed.