AACN Essentials

The Essentials

What is Competency-Based Education?

What is Competency-Based Education?

AACN defines competency-based education as “a system of instruction, assessment, feedback, self-reflection, and academic reporting that is based on students demonstrating that they have learned the knowledge, attitudes, motivations, self-perceptions, and skills expected of them as they progress through their education.” 

Other organizations define competency-based education differently, including the U.S. Department of Education, which more narrowly defines this term as education “that organizes academic content according to competencies—what a student knows and can do—rather than following a more traditional scheme, such as by course.” Nursing programs are encouraged to institute a process to ensure curricula address the competencies delineated in the Essentials and assess student achievement of those competencies. 

Note: AACN does not require schools to move to time-variable education or organize academic content according to competencies instead of by course. We anticipate most programs will continue to organize academic content by course. Even so, AACN reminds nursing programs that accrediting agencies and state boards of nursing may require notification or approval of substantive changes proposed to implement the Essentials framework, depending on the extent and nature of the proposed changes. 

What CBE is not

  • A checklist of tasks
  • A one-and-done experience or demonstration
  • Isolated in one sphere of care or context
  • Demonstrated solely on an objective test

Basic principles of CBE

  • Shifts the primary focus of education to the desired outcomes for learners rather than the structure and process of the educational system (Backward design).
  • A set of expectations that, when taken collectively, demonstrate what learners can do with what they know.
  • Demonstrated across all spheres of care and in multiple contexts.
  • Clear expectations are made explicit to learners, employers, and the public.
  • A result of determined (planned and repeated) practice.
  • Visibly demonstrated and assessed over time by multiple methods and multiple assessors.  

What are the benefits of CBE?

  • Makes the student the center of learning and responsible for their learning
  • Improves equity by serving diverse learners
  • Mitigates bias using formative and focused feedback from multiple assessors using multiple methods Helps the student relate specific courses and learning experiences to the development of overall competencies
  • Clarifies faculty expectations regarding student development/performance and allows the faculty to hold students accountable for prior learning
  • Relates curriculum and course work to life and professional expectations
  • Establishes in an objective way the rigor of the curriculum
  • Promotes faculty development about teaching effectiveness – faculty move to the role of coach
  • Creates a community of faculty with common goals and expectations for student development
  • Provides an overall cohesive framework for course and program design and development
  • Improves the quality of nursing education to meet the demands, challenges and opportunities of the future.
  • Requires internal motivation, a collaborative culture, and the continuous cycle of using assessment data and our collective wisdom to improve teaching and learning and to assure the competence of our graduates 

Featured Videos

The Dean's Role in Competency-Based Education

What is Competency Based Education?

Additional Videos

Dr. Jean Bartels’ Video on Competency-Based Education
December 2020 [Video Length - 63 minutes]

Dr. Jean Bartels’ Video on Competency-Based Education
November 2019 [Video Length - 23 minutes]

CBE Q&A with Dr. Robert Englander

Dr. Robert Englander is a member of AACN’s Assessment Expert Working Group, which is helping to identify the role AACN should take in addressing competency assessment as well as possible strategies for competency assessment. Read Dr. Englanders recent interview in AACN's Syllabus for more insight on CBE and assessment.

Read the Q&A


Giddens, J. (2020). Demystifying concept-based and competency-based approaches. Journal of Nursing Education, 59(3):123-124.

Kavanagh, J. & Sharpnack, P. (2021) Crisis in competency: A defining moment in nursing education. OJIN: The Online Journal of Issues in Nursing, 26(1), Manuscript 2. Accessible online at https://www.doi.org/10.3912/OJIN.Vol26No01Man02

Moreau, K.A (2021). Exploring the connection between programmatic assessment and program evaluation within competency-based medical education programs. Medical Teacher, 43(3):250-252.

Carol Carraccio, MD, MA, Robert Englander, MD, MPH, Elaine Van Melle, PhD, Olle ten Cate, PhD, Jocelyn Lockyer, PhD, Ming-Ka Chan, MD, MHPE, Jason R. Frank, MD, MA(Ed), and Linda S. Snell, MD, on behalf of the International Competency-Based Medical Education Collaborators   Advancing Competency-Based Medical Education: A Charter for Clinician–Educators.  Academic Medicine, Vol. 91, No. 5 / May 2016