1. Nursing Graduates: Competency Differences
Kattie Payne, RN, MSN, PhD
Nursing Graduates: Competency Differences 

2. Objectives
Compare the competencies of graduates from Licensed Practical Nurse, Associate Degree, Bachelors, and Masters nursing programs. 
 Identify teaching strategies that are appropriate for each type of student. 
Identify clinical behaviors that illustrate the competencies of each type of graduate. 

3. Viewpoints National League for Nursing
American Association of Colleges of Nursing
IOM, Future of Nursing
Other References
Personal experience

4. National League of Nursing
First nursing organization in the United States
“…promotes excellence in nursing education to build a strong and diverse nursing workforce.”
“…championing the pursuit of quality nursing education for all types of nursing education programs.”
The NLN advances the science of nursing education, promoting evidence-based nursing education and the scholarship of teaching.
About the NLN retrieved March 6, 2013 from

5. American Association of Colleges of Nursing
“…the national voice for baccalaureate and graduate nursing education.
“… work to establish quality standards for nursing education; assist deans and directors to implement those standards;
“…influence the nursing profession to improve health care; and promote public support for professional nursing education, research, and practice.”
By 2020, highly educated and diverse nursing professionals will lead the delivery of quality health care and the generation of new knowledge to improve health and the delivery of care services.
About AACN retrieved March 6, 2013 from

6. IOM: Future of Nursing Report
, RWJF and IOM initiative to “respond to the need to assess and transform the nursing profession.”
“…nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.”
The Future of Nursing: Focus on Education. (2010). Institute of Medicine of the National Academies: Advising the nation/improving health. Retrieved March 6, 2013 from

7. Personal Experience Teaching ADN—basic and self-paced learning
BSN—generic
BSN---RN-BSN
Bachelors to BSN
Masters

8. Objective 1: Compare the competencies of graduates from Licensed Practical Nurse, Associate Degree, Bachelors, and Masters nursing programs. 
NLN competencies of graduates of nursing programs.
AACN competencies of graduates of BSN and Masters programs. 
Examine the differences in competencies between the two accrediting bodies. 

9. NLN Model for Nursing Education
All programs competency in 4 areas; Human Flourishing
Nursing Judgment
Professional Identity
Spirit of Inquiry

10. NLN Competencies Competency Associate Degree Baccalaureate Degree
Master’s
Human flourishing
Advocate for patients and families in ways that promote their self-determination, integrity, and ongoing growth as human beings.
Incorporate the knowledge and skills learned in didactic and clinical courses to help patients, families, and communities continually progress toward fulfillment of human capabilities.
Function as a leader and change agent in one’s specialty area of practice to create systems that promote human flourishing.
Nursing judgment
Make judgments in practice, substantiated with evidence, that integrate nursing science in the provision of safe, quality care and promote health of patients within a family and community context.
Make judgments in practice substantiated with evidence, that synthesize nursing science and knowledge from other disciplines in the provision of safe, quality care and promote the health of patients, families, and communities.
Make judgments in one’s specialty area of practice that reflect a scholarly critique of current evidence from nursing and other disciplines and the capacity to identify gaps in knowledge and formulate research questions.
Professional identity
Implement one’s role as a nurse in ways that reflect integrity, responsibility, ethical practices, and an evolving identity as a nurse committed to evidence based practice, caring, advocacy, and safe, quality care for diverse patients within a family and community context.
Express one’s identity as a nurse through actions that reflect integrity; a commitment to evidence based practice, caring, advocacy, and safe, quality care for diverse patients, families, and communities; and a willingness to provide leadership in improving care.
Implement one’s advanced practice role in ways that foster best practices, promote the personal and professional growth of oneself and others, demonstrate leadership, promote positive change in people and systems, and advance the profession.
Spirit of inquiry
Examine the evidence that underlies clinical nursing practice to challenge the status quo, question underlying assumptions, and offer new insights to improve the quality of care for patients, families, and communities,
Act as an evolving scholar who contributes to the development of the science of nursing practice by identifying question in need of study, critiquing published research, and using available evidence as a foundation to propose creative, innovative, or evidence based solutions to clinical practice problems.
Contribute to the science of nursing in one’s specialty area of practice by analyzing underlying disparities in knowledge or evidence; formulating research questions; and systematically evaluating the impact on quality when evidence-based solutions to nursing problems are implemented.

11. American Association of Colleges of Nursing (AACN)
The American Association of Colleges of Nursing (AACN) is the national voice for baccalaureate and graduate nursing education. AACN's educational, research, federal advocacy, data collection, publications, and special programs work to establish quality standards for nursing education; assist deans and directors to implement those standards; influence the nursing profession to improve health care; and promote public support for professional nursing education, research, and practice.
Commission on Collegiate Nursing Education (CCNE) is an agency, contributing to the improvement of the publics health. CCNE ensures the quality and integrity of baccalaureate, graduate, and residency programs in nursing.
About AACN retrieved March 6, 2013 from

12. AACN Position on Nursing Education
“The preferred vision for nursing education includes generalist, advanced generalist, and advanced specialty nursing education.
Generalist nurse education occurs at a minimum in baccalaureate degree nursing programs.
Advanced generalist education occurs in master’s degree nursing programs, including the Clinical Nurse Leader (CNL®), which is an advanced generalist nursing role.
Advanced specialty education occurs at the doctoral level in Doctor of Nursing Practice (DNP) or research focused degree programs (PhD, DNS, or DNSc).
End of program outcomes for the baccalaureate, master’s, and doctoral nursing programs build on each other.
American Association of Colleges of Nurses. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author. Retrieved from

13. AACN: BSN Graduates
The baccalaureate graduate nurse is prepared to practice with patients, including individuals, families, groups, communities, and populations across the lifespan and across the continuum of healthcare environments.
The baccalaureate graduate understands and respects the variations of care, the increased complexity, and the increased use of healthcare resources inherent in caring for patients.
American Association of Colleges of Nurses. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author. Retrieved from

14. AACN: Master’s in Nursing Education
Graduates of master’s degree programs in nursing are prepared with broad knowledge and practice expertise that builds and expands on baccalaureate or entry-level nursing practice. This preparation provides graduates with a fuller understanding of the discipline of nursing in order to engage in higher level practice and leadership in a variety of settings and commit to lifelong learning.
For those nurses seeking a terminal degree, the highest level of preparation within the discipline, the new conceptualization for master’s education will allow for seamless movement into a research or practice-focused doctoral program
AACN, 2006, 2010

15. AACN: Masters Programs
Advanced practice clinician
Nurse practitioner
Nurse anesthetist
Nurse-midwife
Clinical nurse specialist
American Association of Colleges of Nursing. (2011). The essentials of master’s education in nursing.

16. AACN: Doctoral Programs
Terminal degrees
Research vs Practice Focused programs
Share “…share rigorous and demanding expectations: a scholarly approach to the discipline, and a commitment to the advancement of the profession.”
Practice: emphasis on practice and less on theory, meta-theory, research methodology, and statistics. Have a practice application-oriented project.
Research: extensive research with dissertation

17. CCNE Competencies
See handout

18. Objective 1: Compare the competencies of graduates from Licensed Practical Nurse, Associate Degree, Bachelors, and Masters nursing programs.
Bedside nurse
Leadership role
Global perspective
Research
General education, prerequisites

19. Group discussion

20. Objective 2: Identify teaching strategies that are appropriate for each type of student. 
Difference between teaching AD, BSN, RN-BSN, Masters. 
Where are the differences? Why are there differences?
Examples of teaching strategies. 

22. Curriculums LPN (Community college) Little science courses
ADN (Community college)
Basic science background
BSN (some in community colleges)
Liberal arts
Science background

23. Copyright 2010 © Mary Jo C. Stanley

24. Simple Concept Map

25. Complex Mind Map

27. Subactivities of Teaching-Learning Strategies for Use of Film in Education
Oh, J. (2013). A review of teaching-learning strategies to be used with film for prelicensure students. Journal of Nursing Education. 52(3):

28. Small Group Discussion
Examples of teaching strategies
Use of films: reflective activities, practical activities, and evaluative activities
Critical thinking: art-based, questioning, cross-cultural nursing experience, and preceptorship
Problem-based learning
Portfolio goals,etc.
Clinical judgment: Simulation and debriefing
Teach back
Cultural competency: clinical experiences, standardized patients and immersion experiences have produced the most favorable results which increase student awareness, knowledge and confidence in working with ethnically diverse patients.
Social networks?
Reflective journaling, case studies,
Critiques---literature search
Story-telling, controversial topics, application of ethical principles to situations, beliefs and practices.
Questioning status quo
Constructivists assert that knowledge and truth are based on beliefs and experience in situations (Cobb & Bowers, 1999) a product of individual cognition (simpson, 2002) and situated in contexts (Bredo, 2006).

29. Objective 3: Identify clinical behaviors that illustrate the competencies of each type of graduate. 
Translating competencies into the clinical situation.
Behavioral expectations of each type of graduate. 

30. Small Group Discussion
Behavioral expectations of each type of graduate Texas Board of Nursing Clinical Competencies Handout

31. Questions?