Inside Syllabus: Five Years of the Essentials: From Framework to Transformation

Inside this Syllabus Edition:

• Must See! Nurses Week Supplement: Highlights from our Member Schools and Partner Organizations
• AACN Annual Survey Data Released
• Five Years of the Essentials
• Highlights from the Deans Annual Meeting
• Register Now for the Graduate Nursing Student Academy Conference
• Apply Now for an AACN Faculty Scholars Grant
• Advancing Academic Leadership for Deans and ELAN Graduates

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Five years ago, the release of AACN’s Essentials, core competencies for professional nursing education, set in motion a new era of transformation in academic nursing. Schools nationwide began the journey to adapt their curriculum to prepare the next generation of nurses through competency-based education (CBE). The Essentials served as a catalyst to fundamentally shift how educators prepare practice-ready nurses.

Today, as we mark this milestone anniversary, schools of nursing are reflecting on their implementation efforts and sharing stories of the evolution and impact of Essentials. From reimagined curricula to shifts in culture and assessment, deans and leaders offer a window into how the Essentials have taken root and where the journey is headed.

Challenges and Adaptation

The path to implementation has not been without challenges. Schools navigated questions around assessment, faculty development, and infrastructure. But these moments of uncertainty also became opportunities for innovation, collaboration, and shared learning across institutions.

Supporting this transformation to CBE has been a network of national leaders or “champions,” Essentials coaches, and AACN volunteers and staff working alongside schools to translate vision into practice. With a view across institutions, they have identified both common hurdles and emerging successes that continue to shape the implementation landscape.

That reality is reflected in the experiences of early adopters. Five years into implementation of AACN’s Essentials, Dr. Dawn Mueller-Burke emphasizes that most schools – including her own at the University of Maryland – are still actively “on the trajectory” toward adoption rather than fully complete. As an early mover, her institution undertook the significant task of mapping and gap-analyzing more than 150 courses, but real momentum began when faculty shifed  from mapping to truly embracing CBE.

Dr. Mueller-Burke describes this transformation as a large-scale cultural shift – "like turning a massive vessel" – requiring continuous iteration, flexibility, and a willingness to "embrace the gray".

That experience extends beyond a single institution. Through her work as an Essentials coach, Dr. Mueller-Burke sees similar patterns nationwide. Schools that succeed tend to have strong leadership support, structured implementation teams, cross-functional collaboration, and active engagement with practice partners. Faculty development has emerged as a critical component, as many educators are learning new pedagogical approaches alongside the transition.

Deans’ Perspectives

For many deans, implementation was not a single initiative, but a multiyear transformation – one that is ongoing and requires aligning faculty, redesigning systems, and, in many cases, rethinking long-standing approaches to nursing education. Within that complexity, many describe a moment when the work began to resonate more deeply across their institutions.

"The Essentials gives us a chance to reach the goal we’ve always wanted in a way that is consistent."
– Dr. Jacqui McMillian-Bohler

Despite differing perspectives, faculty share a common goal: graduating knowledgeable, enthusiastic, and practiceready nurses. While some faculty may have initially resisted efforts to implement the Essentials, this shared vision pulled them into the CBE shift. 

"The dissenters had a really important voice… they allowed us to get clarity," says Dr. Mueller-Burke.

As an Essentials coach, Dr. Jacqui McMillian-Bohler, Associate Dean for Academic Innovation and Evaluation, and Director for Educational Excellence at Duke University School of Nursing, has observed that while the shift can be challenging – especially in a post-pandemic environment – faculty are generally willing to engage when they see the potential benefits for student outcomes.

Faculty must continuously resist reverting to traditional teaching models and remain committed to the Essentials’ competency-focused approach. Ongoing support from AACN, including tools like progression indicators and expanded guidance on simulation, is helping programs refine their efforts. 

A key area where this alignment is tested is assessment. "We have learned that faculty calibration is essential. One of the greatest challenges in assessment is not the absence of tools, but variation in how faculty interpret and apply them. Schools that are making the most progress are investing in faculty development focused on shared expectations. In competency-based education, assessment quality depends heavily on whether faculty have a common understanding of performance standards. Without that, even well-designed frameworks can produce inconsistent results," said Dr. Bimbola Akintade, dean and professor at East Carolina University College of Nursing.

To help, Dr. Julie Zerwic, dean and professor at the University of Iowa, has supported faculty as and co-chair of AACN’s Essentials Implementation Steering Committee through feedback and the development of surveys to identify curriculum gaps and next steps for nursing schools in the implementation phase. The committee has organized educational sessions, including one-day intensive programs and Q&A sessions at AACN conferences, to deeply engage faculty in this process. Dr. Zerwic noted that the evaluation of the Essentials initiative will be complex due to schools’ varying accreditation timelines; the committee is discussing ways to identify best practices from early adopters to share with other schools.

Student Impact and Assessment

As programs evolve, so too does the student experience. The move to CBE has shifted not only how students are assessed, but how they develop as practice-ready professionals, bringing new clarity and intention to their educational journeys.

Although implementation is ongoing, early feedback from students is encouraging, with learners reporting greater engagement, clearer connections between coursework and practice, and increased confidence in clinical settings.

According to Dr. McMillian-Bohler, early indicators suggest positive student impact. Learners appear to be progressing more quickly in their clinical development, demonstrating stronger critical thinking and greater ability to articulate their practice.

Among the most complex and critical areas has been assessment. Five years after the official endorsement of the Essentials, many programs are at various stages of implementation along the continuum of full adoption. Although this phase will be ongoing and iterative, programs must work next to measure competency in meaningful ways. Emerging models and best practices help create clearer pathways for evaluating student progress and program outcomes.

"Give your learners every opportunity to demonstrate what they can do with what they know."
– Dr. Dawn Mueller-Burke

According to Dr. Akintade, one best practice that schools should pay close attention to is the shift toward formative assessments. Rather than relying on summative evaluations, formative assessment uses multiple low- and medium-stakes data points collected across courses, clinical experiences, simulations, and practice settings to build a more complete picture of learner development. 

He also highlights the use of developmental milestones and leveled expectations. "Over time, we have become better at acknowledging that competency is not a single event but a trajectory. Students should not be expected to demonstrate entry-to-practice competence at the beginning of a program. Instead, assessment systems should reflect progressive growth, with benchmarks appropriate to the learner’s place in the curriculum. This has helped schools create more realistic, transparent, and supportive assessment models," says Dr. Akintade.

Some information has been gathered regarding what worked well and challenges faced, but a more comprehensive programmatic evaluation is needed. Dr. Zerwic sees the recently released progression indicators and a scenario framework as transformative in assessing the impact of the Essentials in competency-based nursing curricula.

Building on this, Dr. Akintade emphasizes one of the most valuable lessons from the past five years is that assessment must be accompanied by rich feedback and opportunities for coaching. He says that CBE is most effective when assessment is used not just to judge performance, but to advance learning. Students benefit when they understand where they are, what evidence supports that judgment, and what specific steps will help them progress.

What’s Next?

At the five-year mark, the Essentials are no longer just a framework, but a lived experience across schools of nursing. While implementation continues to evolve, one theme is clear: this work is not simply about meeting new standards, but about better preparing graduates for the realities of modern healthcare.

"The biggest breakthrough has been the shift from viewing assessment as episodic and transactional to seeing it as continuous, evidence-based, performancefocused, and developmental. Schools that embrace that mindset and build systems that support it will be far better positioned to prepare graduates who are truly practice-ready," says Dr. Akintade.

Looking ahead, Dr. McMillian-Bohler expects continued evolution of the Essentials, including refinements, expanded case examples, and clearer implementation strategies. She underscores the importance of ongoing collaboration among educators, accreditors, and practice partners to fully realize the vision. 

Dr. Mueller-Burke echoes the need for closer academic-practice partnerships to evaluate how well graduates are prepared and whether CBE improves retention, readiness, and satisfaction in the workforce. She also expects continued refinement of implementation strategies, broader integration of tools like progression indicators, and a stronger emphasis on data collection to assess outcomes.

Ultimately, success will be measured by better-prepared graduates, stronger academic-practice partnerships, and narrowing the gap between education and clinical practice.

As these voices reflect on progress and possibility, they underscore a shared commitment to advancing nursing education – and a collective confidence in what comes next.