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Core Competencies in Nursing Credentialing and Certification

Core Competencies in Nursing Credentialing and Certification. Future Directions of Credentialing Research in Nursing: A Workshop. Disclosures. Laurie M. Lauzon Clabo, PhD, RN Dean, School of Nursing MGH Institute of Health Professions

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Core Competencies in Nursing Credentialing and Certification

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  1. Core Competencies in Nursing Credentialing and Certification Future Directions of Credentialing Research in Nursing: A Workshop

  2. Disclosures Laurie M. Lauzon Clabo, PhD, RN • Dean, School of Nursing MGH Institute of Health Professions • Chair, American Association of Colleges of Nursing (AACN) Task Force on Advanced Practice Registered Nurses (APRN) Clinical Education • Work-in-progress; not yet finalized or approved by AACN Board

  3. “The AACN Board of Directors charges the task force with the development of a white paper that re-envisions clinical training for advanced practice registered nurses (APRNs).” To meet the charge the task force should: • Describe the current state of APRN clinical training, challenges, and regulatory requirements. • Describe the current state of APRN clinical training, challenges, and regulatory requirements. • Consider competency assessment as an emerging and potential element of a re-envisioned approach to APRN clinical training.

  4. To meet the charge the task force should: • Develop a set of recommendations for restructured or re-envisioned clinical training, including alternative models for APRN clinical training that: • maximize clinical resources; • consider current and potential financial implications; • provide opportunities to prepare APRNs with the full graduate, role and population-focused competencies; and • highlight opportunities and innovations for interprofessional learning and practice.

  5. Current Challenges in APRN Clinical Training • Increased demand for APRN services • Many programs report being at capacity, with clinical training (along with faculty shortages) cited as a major constriction in the pipeline • > 14,600 qualified applications not accepted for graduate programs in 2012 (AACN, 2013) • Competition and scarce resources for clinical training sites and preceptors

  6. Current State of APRN Clinical Training • Mounting regulatory issues for in-state and distance-learning students • None, inadequate or unstandardized preceptor training • Pressure to compensate preceptors • Variable student competence when entering clinical training • Productivity impact on preceptors • Competition for APRN learning experiences, particularly in some areas of practice and geographic regions

  7. Core Competencies as a Foundation for APRN Education and Practice:A three decade journey • Core Competencies for Nurse Midwifery (1978, 2011) • Domains and Core Competencies for Nurse Practitioner Practice (1990, 2011) • Statement on Clinical Nurse Specialist Practice and Education (1998, 2004) • Scope of Nurse Anesthesia Practice (1980, 2013)

  8. Competencies, Licensure and Certification

  9. One Model: Nurse Practitioner Redesign Giddens, J., Lauzon Clabo, L. M., Gonce-Morton, P. Jeffries, P., McQuade-Jones, B., & Ryan, S. (2014)

  10. Current State: • No finite set of nationally recognized, consensus-based common/core competencies for APRNs • Emerging national discussion regarding the reliance on “clinical hours” requirements • No evidence that clinical hour requirements serve as an effective proxy for NONPF core competencies (Halas et al., 2012) • While a competency framework for APRN practice is described as desirable, APRN professional organizations are moving in unique trajectories that are exclusive and unique to each particular role

  11. Core and Role-Specific Competencies: A Milestones Approach Core/Common Preclinical Clinical Graduation Continuing Experiences Education Professional Development

  12. Recommendations in Consideration by APRN Task Force • Identify common APRN core competencies across role and population focus • Identify milestones for the APRN core competencies from pre-clinical experience to graduation • Develop standardized assessment tool to be used by preceptors and/or faculty based on the common core APRN competencies.

  13. Recommendations for Study • Identification of essential competencies along multiple dimensions (educational preparation, role, population focus, continuing professional development) • Development of robust/efficient strategies for assessment • Explore the relationship between competencies and patient outcomes especially in light of the unit-based nature of nursing practice in many settings • What, if any, relationships exist between individual achievement of competence and group/team/interprofessional performance?

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