Diane C. Viens, DNSc, CFNP


Topics in Advanced Practice Nursing eJournal. 2003;3(3) 

In This Article

Educational Guidelines and Competencies

Since its inception in 1980, NONPF has continued to develop and maintain educational guidelines and program standards. The curricular framework presented by NONPF through domains and competencies serves as a generic guide for persons involved in curricula development for NP education. Documents prepared by educational task forces within NONPF in 1990, 1994, and 1995 delineated this curricular framework as well as the program standards. By 2000, NONPF had increased the number of NP practice domains to 7:

  1. Management of patient health/illness status

  2. The NP-patient relationship

  3. The teaching-coaching function

  4. Professional role

  5. Managing and negotiating healthcare delivery systems

  6. Monitoring and ensuring the quality of healthcare practice

  7. Cultural competence

Each domain has specific core competencies required for all NPs to enter practice, regardless of their specialty. These core competencies for NP graduates build on nursing knowledge, graduate nursing core content, and advanced nursing practice content. In the 1995 updating of the core competencies, NONPF obtained input from a coalition of 14 nursing organizations and significant input from NP faculty. The latest edition of the competencies in 2002 incorporates further recommendations from NP education, practice, and certification. The core competencies are the gold standard for maintaining and shaping quality NP educational programs, serving as the guide for national curriculum and policy development and as a model for international nursing organizations.

To further promote quality NP educational programs, NONPF also facilitated the development of competencies in specialty areas. Specialty areas reflect the role of the practitioner in clinical practice and the population served. As of fall 2002, at least 80% of all NP graduates were prepared in a primary care specialty area (eg, family, adult, or pediatric medicine; gerontology; or women's health). The Division of Nursing (Bureau of Health Professions, Health Resources and Services Administration, United States Department of Health and Human Services) supplied funding for a collaborative project to develop national, consensus-based competencies for these primary care specialty areas. A national panel of representatives from stakeholder nursing organizations and a broader, external validation panel participated in the process leading to the completion of the competencies, which received endorsement by 19 national nursing organizations. (The full report and competencies are available to download from the NONPF Web site.)

This established process for obtaining broad input from NP and nursing organizations to achieve national consensus is providing a model for other competency projects. NONPF is currently facilitating the work of a national panel in completing the consensus-based competencies for the psychiatric-mental health NP and is beginning a similar process for acute care NP competencies.

The process can also serve as a guide for other areas of advanced practice nursing and other health care disciplines to respond to the national emphasis on building curriculum around competencies. The recommendations of the recent Institute of Medicine's report, Health Professions Education: A Bridge to Quality , highlight the need for an outcome-based education system and for foundational, shared competencies across disciplines.

The present efforts of NONPF focus on maintaining the currency of the domains and competencies and promoting effective assessment and evaluation tools. The challenge across healthcare disciplines is to show that graduates have the knowledge and skills necessary to function in their roles. As with the development of monographs highlighting curriculum topics and other publications to assist faculty, NONPF is expanding current work and undertaking new initiatives to provide resources to faculty and programs in measuring the competency level of NP students.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.