0. Veteran Competencies for Undergraduate Nursing Education
Jacqueline Moss, PhD, RN, FAAN; Randy Moore, DNP, RN; & Cynthia Selleck PhD, RN, FAAN

1. Veteran Competencies for Undergraduate Nursing Education¹
There are over 23 million military Veterans living in the United States
Over 16% of these Veterans have service connected disabilities
Only around 38% of Veterans receive any portion of their healthcare in a Veterans Health Administration (VHA) facility ²
Veterans are seen across all healthcare settings and it is imperative that nursing students become adequately prepared to care for Veterans and their families

2. Veterans Affairs Nursing Academic Partnership (VANAP)
The Birmingham VA Medical Center entered an academic partnership with the University of Alabama at Birmingham (UAB) School of Nursing (SON) in 2009
One of our objectives was to create a “Veterans Health elective”
Over 200 students have successfully completed this elective course
Through this experience the VANAP faculty realized that all nursing students would benefit from incorporating key elements of Veteran centric health issues across the curriculum

3. Military & Veteran Culture
Military service men and women are indoctrinated into the culture of the military during their period of service.
This begins in recruit training (boot camp) or Officer Candidate School
This then frequently permeates their life and sometimes can lead to difficult interactions with people who have not had the same indoctrination, training, & experiences.
Equipping undergraduate nursing students with a minimum level of understanding of what issues Veterans face along with some basic knowledge on how to best interact with them became our goal

4. Competency Framework
The American Nurses Association defines a competency as “an expected level of performance that integrates knowledge, skills, abilities, & judgment.”³
The National Council of State Boards of Nursing defines competence as “the application of knowledge and the interpersonal, decision-making, and psychomotor skills expected for the practice role, within the context of public health, safety, & welfare.” ⁴
Each of these definitions emphasizes psychomotor, effective, and affective components necessary for explicating nursing competencies.

5. Competency Development
An initial set of competencies and related knowledge, skills, and attitudes (KSAs) were developed after an extensive literature review including a collection of VHA policies and procedures related to Veteran care
Through this process an initial set of ten competency areas were identified
Military/Veteran culture Military Sexual Trauma (MST)
Veterans Healthcare Administration - Traumatic Brain Injury (TBI)
Amputation and Assistive devices - Post Traumatic Stress Disorder (PTSD)
Environmental/Chemical exposures - Suicide
Substance Use Disorders (SUD) - Homelessness

6. Validation of Competencies
After obtaining Institutional Review Board (IRB) approval content experts from around the country were recruited to review and rate these competencies and associated KSAs
These reviewers were selected because of their expertise in developing and implementing educational programs for undergraduate students regarding care of Veterans
Content experts were asked to rate the competency topic and associated KSAs on a 4-point Likert-type scale
Content experts were also asked to suggest any additions or suggestions for changes

7. Competency Titles

8. 1. Military & Veteran Culture 2. Post-traumatic Stress Disorder

9. 3. Amputation & Assistive Devices 4. Environmental/Chemical Exposures

10. 5. Substance Use Disorder 6. Military Sexual Trauma

11. 7. Traumatic Brain Injury 8. Suicide

12. 9. Homelessness 10. Serious Illness Esp. at End-of-Life

13. References
¹Moss, J., Moore, R., & Selleck, C. (2015). Veteran Competencies for Undergraduate Nursing Education. Advances in Nursing Science. 38(4), pp doi: /ANS
²US Department of Veterans Affairs. Trends in the utilization of VA programs and services: FY2009 to FY Facts/Utilization_quickfacts_FY2014.pdf. Accessed February 4, 2015.
³American Nurses Association. Nursing: Scope and Standards of Practice. 2nd ed. Silver Spring, MD: American Nurses Association; 2010.
⁴National Council of State Boards of Nursing. Assuring Competence: A Regulatory Responsibility. Chicago, IL: National Council of State Boards of Nursing; 1996.