AACN is committed to sharing information and resources to assist with the implementation of the AACN Essentials. The Frequently Asked Questions (FAQs) below addresses common areas of concern, including implementation expectations, the new model for nursing education, CCNE accreditation, and clinical hours and curriculum expectations. Questions related to Nursing Education as a concentration in graduate programs are also addressed.
Please send requests for answers to additional FAQs to email@example.com.
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How does AACN define 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 assesses student achievement of those competencies. AACN is not requiring schools to move to time-variable education or organize academic content according to competencies instead of by course. In fact, 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 in order to implement the Essentials framework, depending on the extent and nature of the proposed changes.
How is the re-envisioned Essentials document organized?
What are the featured domains and concepts found within the Essentials?
Within the Essentials, there are 10 domains that were adapted from the interprofessional work initiated by Englander (2013) and tailored to reflect the discipline of nursing. Domains are broad areas of competence that, when considered in the aggregate, constitute a descriptive framework for the practice of nursing. The domains include:
In addition, eight featured concepts associated with professional nursing practice are integrated within the Essentials. A concept is an organizing idea or a mental abstraction that represents important areas of knowledge. A common understanding of each concept is achieved through characteristics and attributes. Concepts are equally as important as domains. Although not every concept is found within every domain, each concept is represented in most domains – and all domains have multiple concepts represented.
Do I need permission to use content contained in the Essentials for scholarly or commercial purposes?
Yes. AACN holds the copyright on the Essentials (all rights reserved). AACN member institutions and their faculty may download and save one copy of this document solely in order to implement its contents. No other uses of the Essentials document, in whole or in part, are allowed by any other person or entity, including, but not limited to, no commercial use, reproduction, retransmission, sharing, editing, or creating of derivative works, without the prior written permission of AACN. Permission may be requested by contacting AACN’s Editorial Director Bill O’Connor at firstname.lastname@example.org.
When does AACN expect implementation of the 2021 Essentials to be completed?
The AACN Board of Directors recognizes that the Essentials provides a new model for professional nursing education, which includes a transition to competency-based education. They also recognize the enormity and breadth of challenges this transition presents for many schools. Therefore, the transition to the Essentials will be an extended process that may take three years or longer for schools to fully implement. See AACN's Statement on the Timeline for Essentials Implementation issued on May 23, 2023.
How will AACN facilitate the transition?
AACN is committed to facilitating this transition and providing support and resources to make the implementation a reality. The association will:
What can schools/programs begin doing now to begin this transition?
The transition to competency-based education and this new model for nursing education will be a gradual process, possibly taking three years or longer to fully implement. However, there are some steps schools can begin doing now to begin this process. Recommended early steps include:
Why two levels of competencies/sub-competencies for professional nursing education?
How does this new model differentiate between master’s and DNP programs?
What about an advanced generalist master’s degree or the Clinical Nurse Leader (CNL) program?
How does this new model differentiate between BSN and entry-level (or generic) master’s degree programs?
How do associate degree nursing (ADN) programs fit in to this new model for nursing education?
Are there required number of practice or clinical hours for entry-level programs?
Are clinical experiences in entry-level programs expected across the spheres of care?
Are there required number of practice or clinical hours for advanced-level nursing education programs?
How many practice hours are required for advanced-level programs? Is it 500 or 1000 practice hours?
How do the 500 practice hours in the Essentials relate to the 750 direct patient care hours in the National Task Force’s 2022 Standards for Quality Nurse Practitioner Education?
Does a program need to perform an assessment of the Level 1 competencies when students enter an MSN or DNP program?
Does a program need to demonstrate achievement of each competency and sub-competency with individual student evaluation measure?
What will be the biggest change or impact that the 2021 Essentials will have on our nursing curricula?
Will competencies or content in physiology/pathophysiology, health assessment, and pharmacology (commonly referred to as the 3 Ps) be required for all advanced nursing education?
Can an advanced nursing program focus on nursing education as a specialty?
Will the Commission on Collegiate Nursing Education (CCNE) require AACN’s 2021 Essentials and, if so, when? (Response From CCNE)
Posted February 27, 2023
If you have a stand-alone, post master’s DNP program (i.e., leadership) does this program require 500 hours or 1000 practice hours? Would one assume that applicants to this DNP program with an MSN would have 500 practice hours associated with their prior master’s degree? Ultimately resulting in 1000 practice hours?
Completion of a minimum of 500 practice hours (direct and indirect) in the discipline of nursing, post entry-level education, and attainment of Level-1 sub-competencies are required for demonstration of the advanced-level sub-competencies. The number of practice hours in a post-MSN program will vary based on the area of advanced nursing practice, the student’s previous master’s or graduate program, as well as the number of hours needed for the student to integrate all the advanced-level competencies into his/her practice. Please see pages 7-8 of the Frequently Asked Questions document for additional clarification regarding clinical hours.
In relation to the 500 clinical practice hours to demonstrate the Level 2 competencies for all graduate degrees, can you give an idea of how these hours are being envisioned in non-APRN tracks, such as leadership?
Students in non-APRN tracks need practice experiences in healthcare settings where they can engage with patients, families, populations, and other health professionals. Non-APRN students engaged in these experiences will not be providing direct care the same as an APRN. Examples might be engaging with the quality/safety committee to assess outcomes in a unit or the system; designing and implementing new policies; rounding and speaking with patients, families, and nurses regarding care, processes, etc.; meeting with the head of pharmacology regarding their decisions to change the formulary and how it will impact care; or meeting with the Nursing Practice Council to understand the issues, such as workforce shortages or how technologies might improve patient outcomes.
You indicated that curricular changes due to 2021 Essentials implementation does require substantive change notification?
Yes, CCNE has said that if transitioning to CBE, you do need to notify them of a substantive change.
Are direct care experiences in all 4 spheres of care expected for direct entry programs?
Yes, however, clinical learning experiences related to each sphere of care do not necessarily require four different settings. Rather they refer to the patient’s needs and type of care being provided.
For clarification, does a BSN-DNP program require at least 500 hours?
Yes, 500 hours are expected the student to attain and demonstrate the Level 2 competencies. Participation in a minimum of 500 practice hours (direct and indirect) in the discipline of nursing, post entry-level education, and attainment of Level-1 sub-competencies, are required for demonstration of the advanced level sub-competencies. The number of practice hours in a post-BSN DNP program will vary based on the area of advanced nursing practice the student is pursuing and the number of hours needed for the student to integrate all the advanced-level competencies into his/her practice.
What level of competency is expected of graduates of direct-entry, MSN generalist degrees?
If it is an entry-level generalist master’s program, it is recognized in the Essentials as a Level 1 program.
Posted November 22, 2022
The National RN to BS Faculty Forum has recently posted a position statement identifying the Essentials Domains and Competencies that are met, partially met, and not met through NCLEX-RN examination. Has AACN given any consideration to this position statement in terms of guidance for RN-BSN programs on implementing the Essentials?
AACN met with several key leaders working on this position paper in the summer, 2022 and provided comments and suggested edits. AACN has posted this new resource on our website and believes it will be a helpful guide for post-licensure BSN or MSN programs.
What types of direct or indirect experiences may contribute to the minimum 500 practice hours in various non-clinical activities of learning such as leading, data managing, or educating nurses/students?
For non-direct care advanced-level specialties - informatics, administration/practice leadership, public health/population health, health policy, both direct and indirect experiences are needed to demonstrate the Essentials Level 2 sub-competencies. However, the types of direct and indirect experiences are informed/determined by the Essentials level 2 sub-competencies and the specialty competencies. Many of the experiences that prepare a student with the Level 2 sub-competencies and the specialty competencies may be done together. Development and demonstration of the specialty competencies should complement and build on the Level 2 sub-competencies.
Are DNP Leadership program tracks expected to achieve all the same Level 2 competencies as the DNP NP program tracks?
Yes. All DNP programs (post-baccalaureate and post-master’s) demonstrate that graduates attain and integrate all Level 2 sub-competencies and competencies for at least one advanced nursing specialty or role. All students in Level 2 programs must demonstrate the Level 2 sub-competencies, which is the foundation for advanced-level nursing.
Can you clarify whether the requirements for the Immersion Practicum Experiences are limited to direct patient care experiences?
Immersion experiences in advanced nursing education programs will likely be a combination of direct and indirect care and are meant to provide the learner with the opportunity to integrate the advanced-level sub-competencies and applicable specialty/role competencies into their practice. Immersion experiences allow the learner to focus on their population of interest, advanced nursing role, or specialty area of study. For students in entry-level professional nursing programs, immersion experiences will likely be a combination of direct and indirect care. Immersion experiences provide the learner with the opportunity to integrate the Level 1 sub-competencies into their practice which will, in general, require a greater focus on direct care. Programs should develop immersion or synthesis experiences that allow students to integrate learning and gain experience that facilitates transition into practice.
Why was only one Champion selected for each school of nursing?
AACN intentionally asked each member school to identify one Essentials Champion for several reasons. The role of the designated Champion is to ensure that all faculty within your school are receiving Essentials and Competency-Based Education (CBE) educational resources from AACN, to bring questions from all faculty back to AACN, and to increase communication across all programs within your school, both entry and advanced level programs. It is important that the Essentials implementation and transition to CBE is not done in siloes. Second, we have heard from schools who are moving along successfully with their implementation efforts that identifying one faculty member to take the lead in their communication has been critical to their success. For AACN member deans, who have not yet assigned a champion, please contact email@example.com.