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demonstrate competencies in multiple contexts and settings. Demonstration of the Level 1 subcompetencies by the end of the program will enable the new professional nurse to practice as a
generalist in any setting with diverse populations and with all ages.
Although all students will have learning experiences across all four spheres of care, entry-level
professional programs could create opportunities for students to gain additional education
(through immersion experiences, electives, badges, or certificates) in any of the four spheres.
Such a path would allow a graduate to have a defined area of emphasis (if desired) upon
graduation, and/or to attain a documented area of emphasis in a post-entry level program
certificate option.
Clinical Expectations
Entry-level professional nursing education programs provide rich and varied opportunities for
practice experiences (both direct and indirect care experiences) across the four spheres of
care, designed to assist the graduate to achieve Level 1 sub-competencies upon completion
of the program. Theoretical learning becomes a reality as students are coached to make
cognitive connections between the cases or situations presented in the classroom, simulation,
or laboratory and in actual practice settings. Clinical experiences also assist the graduate to
develop proficiency in cognitive, psychomotor, and affective learning. Clinical experiences are
essential for students to care for a variety of individuals, families, groups, and populations
across the lifespan and across the four spheres of care. Clinical learning provides opportunities
for a student to enhance the provision of care and gain the skills needed to be an effective
member of an interprofessional team; thus, interprofessional experiences in a variety of
practice settings are essential.
Graduates of all types of entry-level professional nursing education programs need sufficient
practice experiences (both direct and indirect care experiences) to demonstrate end-ofprogram learning outcomes inclusive of all Level 1 sub-competencies. All learners in entry-level
professional nursing education programs (pre-licensure and post-licensure [degree-completion]
programs) will engage in direct patient care learning activities in all four spheres of care and
across the life span and provide clear evidence of student (Level 1) competency achievement.
Clinical Sites
Nursing programs are responsible for ensuring clinical placements are safe, supportive, and
conducive for learning by individual students or groups of students. The program is responsible
for providing sufficient and appropriate clinical sites/placements for students to demonstrate
attainment of Level 1 sub-competencies. The program faculty assesses clinical sites to
determine that, on the aggregate, clinical experiences provide students learning opportunities
to foster interprofessional team practice and to provide care within the four spheres of care
and with care recipients from diverse backgrounds and cultures, from different genders and
age groups and with different religious and spiritual practices, including those who may be
considered most vulnerable. Programs are responsible for informing clinical educators or
preceptors about the specific learning that is expected and occurring in didactic and laboratory
settings and provide appropriate learning opportunities across settings to reinforce learning as
well as demonstrate achievement of competencies (Level 1 sub-competencies) across the 10
Essentials domains.

20 THE ESSENTIALS: CORE COMPETENCIES FOR PROFESSIONAL NURSING EDUCATION