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level sub-competencies. Some students may require more. These practice hours also provide
a foundation for the additional time-based requirements set by specialty organizations or
external licensing/certifying bodies, which will require additional practice time for preparation
in advanced nursing specialties or advanced nursing practice roles. Hours of practice do not
necessarily need to be delineated by competency type (Essentials or specialty/role). Some, but
not all, Level 2 sub-competencies and/or specialty/role competencies may be demonstrated and
assessed concurrently. It is expected that faculty create clinical/practice learning experiences
that provide for active learning, repetition, interprofessional engagement, and successive levels
of difficulty. As the strength of evidence to support valid and reliable assessment techniques
builds, the role of practice experiences and number of hours (e.g., time-based requirements)
may evolve in the future.
Immersion Practicum Experiences
Development of competency attainment is facilitated through use of focused and sustained
practice experiences. Immersion experiences, expected in advanced nursing education
programs, provide the learner with the opportunity to integrate the advanced level subcompetencies and applicable specialty competencies. An immersion also provides an
opportunity for the learner to focus on a population of interest, an advanced nursing role, or
specialty area of study. Placement of integrated or immersion experiences may vary and depend
upon the program’s design, curriculum, and specialty requirements.
Simulation
Simulation experiences represent an important component of clinical/practice education,
serving as a valuable augmentation to direct clinical care or practice within healthcare settings.
Laboratory and simulation experiences provide an effective, safe environment for learning and
demonstrating competencies, particularly high-risk and low-frequency experiences. However,
practice experiences in actual practice settings continue to represent the most important
component of nursing practice education and are required in advanced nursing programs for
the learning and demonstration of the Level 2 sub-competencies and integration of specialty
competencies. Simulation learning experiences align with best practice standards such as those
developed by the International Nursing Association for Clinical Simulation and Learning (INACSL)
or the Society for Simulation in Healthcare (SSH). The use of simulation in the curriculum as
a replacement of direct patient clinical/practice hours or experiences is also determined by
requirements of national specialty education, certification entities, and regulatory entities.
Practice experiences may include simulated experiences for the attainment of a portion of the
Level 2 sub-competencies, particularly for experiences that are high risk and low frequency or
may not be available to all students, and in accordance with requirements set forth by specialty
organizations and/or licensing/certifying bodies. Regardless of the design of the experiences,
programs are expected to document attainment of these sub-competencies through varied and
comprehensive assessment methods across the curriculum.
DNP Scholarly Project/Product
There are many past, present, and projected healthcare dilemmas that call for healthcare
transformation. Nurses, as members of the healthcare team, are expected to assume a
prominent role in addressing these dilemmas. Nurses cannot be expected to significantly
24 THE ESSENTIALS: CORE COMPETENCIES FOR PROFESSIONAL NURSING EDUCATION