Nurses at the University of Alabama at Birmingham have published a detailed 
competency-based curriculum to assess nurse practitioner’s transition into the critical care practice role. Unfortunately, the authors note that often, there is little to no time set aside for the transition from critical care bedside nurse to advanced practitioner; this curriculum was developed to address that need.
Elements of Competence
The authors identify the 3 key elements of competence (the KSA Model)
- Knowledge
- Skills
- Attitudes
Remember, competence is knowing what to do, how to do it, and performing in the environment of practice. A checklist outlining equipment set-up is only one element of competence in caring for patients requiring chest drainage, for example.
APRN Critical Care Practice
The topics included in this curriculum are:
- Professional development
- Scientific foundation of practice
- Procedural skills
- Diagnostic studies
- Mechanical ventilation
- Management of complex diseases
- End-of-life care
- Patient safety
- Pharmacology
The nurse researchers who developed this curriculum tested it by sending it to 109 faculty and practitioners who had graduated within the past two years within the U.S. They were asked to score the parts of the curriculum on a 1-4 Likert scale, based on relevance to practice.
What is Most Relevant?
The highest mean ratings, meaning those most relevant to APRN practice:
- Management of complex diseases (3.92)
- Diagnostic studies (3.89)
- Pharmacology (3.89)
These are consistent with the Accreditation Council for Graduate Medical Education’s requirements for medical residents.
The lowest mean ratings:
- Scientific foundation of practice (3.61)
- Professional development (3.63)
While the focus on clinical practice without the underlying nonclinical science may be troubling, the authors believe that some of the details for these competencies were thought to be doctoral level practice, not Master’s level.
