Competency based clinical education for advanced practice registered nurses: raising the bar

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Competency Based Assessment , APRN education , Clinical Competence
Ainslie, Marcy M.
Advanced Practice Registered Nurses (APRNs), Midwives, Nurse Anesthetists, Nurse Practitioners, and Clinical Nurse Specialists, are playing a more significant role in today's delivery of healthcare. The advanced practice nursing apprenticeship clinical training model, established by Loretta Ford over 50 years ago, was designed for a small number of trainees(Stewart, 2015); itis not scalable to meet the current increased marketplace demand for APRNs. This research looks at the clinical preparation and education of APRNs. In it, existing competency frameworks of other health professions are considered for applicability to the APRN roles along with perspectives of APRN program coordinators, who would be charged with implementing curricular changes. The broader perspective of the nursing leadership and its readiness to implement competency-based assessment is also explored. To accomplish this, current guidelines, competencies, recommendations, and accreditation standards are cross-mapped to the Englander et al. (2013) competency framework. The American Association of Colleges of Nursing (AACN) selected this framework as the scaffolding for which APRN competencies will be established. Themes deemed significant to advanced practice nursing in the original nursing documents that are not represented in Englander et al.'s (2013) work are also identified. APRN program coordinators around the country, from all size institutions and programs were surveyed on their perspective of competency based assessment and readiness for educational reform. Nursing leaders from APRN professional organizations, licensure organizations, and certification organizations were interviewed to obtain feedback to the cross mapping data and program coordinator survey data results. From this triangulation of data sources across stakeholders in APRN education, evidenced based recommendations are presented to build momentum for educational reform.