Model for Nursing Education and Essentials

Nursing Education and Essentials and Models

Model for Nursing Education and Essentials

A New Model for Nursing Education

    These Essentials represent a new direction for nursing education, influenced by AACN's Vision for Academic Nursing (AACN, 2019), setting in place a new model for preparing professional nurses, which includes a transition to competency based education. This model provides the structure across education programs and provides a mechanism to adapt to future changes within nursing education.

    Currently, multiple educational programs and degree pathways exist that prepare nurses for similar roles. As an example, there are several types of programs and degrees that prepare students to become a registered nurse, and there are multiple education programs and paths to prepare a nurse practitioner (NP) and multiple types of NP certification. 

    These multiple program options confuse external stakeholders as well as those within our own discipline regarding differences between an academic degree and a role as if the academic degree means a specific nursing role. The new model is an intentional departure from the previous versions of the Essentials that were aligned to an academic degree. 

    Thus, a primary intent of the Essentials is to create more consistency in graduate outcomes, influenced by the robustness of the learning experiences and demonstration of competencies. By emphasizing the attainment of competencies within an academic program, employers will have a clear expectation of knowledge and skill sets of nursing graduates.

    Two levels of sub competencies reflect the educational stages of nurses as they enter professional practice and as they return to school to advance their education.The first level sub-competencies set the foundation for nurses entering professional practice. 

    These level one (entry-level) competencies are used within curricula for prelicensure preparation as well as professional nursing degree completion pathways for nurses with initial preparation at the associate degree or diploma level. Although learning experiences may vary across individual programs, they provide an opportunity for learners to demonstrate attainment of competencies in multiple and authentic contexts over time (not a “one and done”/checklist approach).

    The second level sub-competencies build and expand the competence of the nurse seeking advanced education in nursing and broadens the breadth of experiences in context and complexity as compared to graduates of entry level programs. Advanced nursing education affords the student the opportunity to focus on an advanced nursing practice or specialty advanced nursing practice role. 

    Level 2 sub-competencies form the foundation for all advanced education, and as conceptualized, apply to all advanced nursing practice specialties and advanced nursing practice roles. Referencing Thorne's use of “nursing's angle of vision” reinforces the importance of nurses using the unique knowledge and insight of the profession to inform any practice role and to impact the challenges in health care. 

    Competencies designated for an advanced nursing practice specialty (informatics, administration/practice leadership, public health/population health, health policy) or an advanced practice nursing role (certified nurse practitioner, certified nurse midwife, certified clinical nurse specialist, certified registered nurse anesthetist ) are integrated with and complement the Essentials competencies. 

    These Essentials represent an opportunity for a future characterized by greater clarity as it relates to expectations of graduates and a more disciplined approach to nursing education. Competencies are used within the academic program as core expectations, thus setting a common standard. 

    Additional elements within a degree plan will allow schools to differentiate degree paths using the same sub competencies and to distinguish themselves in alignment with various institutional missions. This model adapts to the current state of nursing education, and perhaps more importantly, provides a path for an evolving trajectory for nursing education. 

    Over time, higher education, stakeholder demands, nursing regulatory standards, and economics are among the many forces that will drive the direction and pace of change for nursing education in the future. This model has been designed to adapt to such future changes, not only for the degrees offered, but also for recognized areas of emphasis at the advanced education level by coupling with specialty competencies and/or certification standards.

    The Essentials do not apply directly to the preparation of nurse researchers in a PhD (or other nursing research-focused) program. However, the second-level sub competencies could be used by PhD programs to guide core courses for doctoral nursing, particularly for programs offering baccalaureate to PhD degrees. 

    Additionally, for nursing programs offering both DNP and PhD degrees and/or PhD to DNP or DNP to PhD options, the second-level core sub-competencies could form the basis for shared core courses between the two doctoral degree programs representing efficiencies in program delivery as well as for more seamless pathways from one degree to the other.