AACN
PUBLISHES CORE CURRICULUM FOR
MASTER'S-DEGREE NURSING EDUCATION
Long-Awaited
Model Sets Out to Standardize Widely Divergent Requirements
for Clinical Experience and Coursework
WASHINGTON,
D.C., May 8, 1996 -- Registered
nurses who graduate from master's-degree programs should
understand the "totality" of managed care and
other health care systems, be able to analyze the cost-effectiveness
of clinical decisions, have the skills to assume leadership
roles across a variety of settings, and be adept at interpreting
health care research for consumers and policymakers, says
a landmark model curriculum issued by the American Association
of Colleges of Nursing (AACN).
Moreover,
educational programs for nurse practitioners, clinical nurse
specialists, and other RNs with advanced practice skills
(APNs) should provide a minimum of 500 hours of direct clinical
experience, the AACN curriculum says.
Developed
across 18 months of regional, consensus-building conferences
and broad professional input, the AACN model, The
Essentials of Master's Education for Advanced Practice Nursing,
outlines a standardized core curriculum for APNs and all
other registered nurses who are prepared at the master's-degree
level. With participation by nurse educators, clinicians,
administrators, and researchers from a broad array of specialties,
states, and organizations, AACN's five regional conferences
were an outgrowth of the Association's 1993 position statement,
Nursing Education's Agenda for the 21st Century,
which called for a "common educational core" to
ensure that America's master's-educated RNs are sufficiently
prepared to practice in a health system marked by "rapidly
changing technologies and dramatically expanding knowledge."
AACN
members approved the master's Essentials at their spring
semiannual meeting in Washington, DC.
"It
is at the graduate level where nursing education is experiencing
not only its greatest growth, but also --- many observers
say -- its greatest lack of consistency," says AACN
President Carole A. Anderson, PhD, RN, FAAN. Indeed, a comprehensive
survey by AACN in 1990 found that master's-degree programs
in nursing had a host of divergent requirements for clinical
practice and coursework.
"At
the same time," Dr. Anderson adds, "the health
system's greater acceptance of the roles of advanced practice
nurses has placed greater scrutiny on their skills and educational
preparation." Prepared typically in master's-degree
programs, APNs are advanced registered nurses with skills
in a particular specialty area and who practice with greater
clinical independence than do RNs.
APNs
include four categories of providers: 1) nurse practitioners,
who deliver front-line primary and acute care in community
clinics, schools, hospitals, and other settings, and perform
such services as diagnosing and treating common acute illnesses
and injuries, providing immunizations, conducting physical
exams, and managing high blood pressure, diabetes, and other
chronic problems; 2) certified nurse-midwives, who provide
prenatal and gynecological care to normal healthy women,
deliver babies in hospitals, private homes, and birthing
centers, and continue with follow-up postpartum care; 3)
clinical nurse specialists, who provide care in a range
of specialty areas, such as cardiac, oncology, neonatal,
pediatric, and obstetric/gynecological nursing; and 4) certified
registered nurse anesthetists, who administer more than
65 percent of all anesthetics given to patients each year
and are the sole providers of
anesthesia in approximately one-third of U.S. hospitals.
"The
sheer diversity of APNs -- particularly the expansive array
of specialties of nurse practitioners and clinical nurse
specialists -- has accelerated the need for the education
of these and other master's-prepared RNs to be grounded
in a uniform curriculum. While nursing specialty organizations
will continue to define their individual educational requirements,
there are distinct skills and knowledge that all master's
graduates in nursing must possess. It is these core elements
that AACN's master's Essentials sets forth,"
Dr. Anderson explains.
In
developing the curricula, AACN's Task Force on the Essentials
of Master's Education convened the regional conferences
to provide a national forum for developing a document that
would be backed by wide professional support. The original
intent of the project was to focus mainly on the education
of advanced practice nurses.
However,
soon after deliberations began, a consensus emerged that
two separate but related components of the Essentials
were needed -- a statement of the essential core content
for all master's-educated nurses and a statement of the
core curriculum for all APNs who work in direct care roles.
AACN's master's Essentials presents these
two elements.
Completed
in 1995, the draft document was circulated nationwide to
AACN-member schools as well as to other nursing and health
care organizations for comment. "Along with our regional
meetings, AACN sought this broad base of input to assure
that the final document would be the centerpiece of a consistent
set of standards for master's education for nursing practice,"
Dr. Anderson says.
The
model AACN curriculum has three main components: 1) a Graduate
Nursing Core, the essential foundation for all students
who pursue a master's degree in nursing, regardless of specialty.
The curricular elements in the graduate core are consistent
with standards established by the Council of Graduate Schools;
2) an Advanced Practice Nursing Core, content deemed essential
for all nurses who provide direct care at an advanced level;
3) and a Specialty Curriculum comprised of clinical and
classroom learning experiences defined by nursing organizations
that represent nurse practitioners, clinical nurse specialists,
certified nurse-midwives, and certified registered nurse
anesthetists.
The
Essentials not only calls on master's programs
to give all graduates -- regardless of specialty -- a firm
understanding of the roles and requirements of advanced
practice nursing, but also to be solidly grounded in such
areas as health care policy, organization, and financing.
Moreover, programs in nursing administration and community
health also should include AACN's core master's curriculum
in their teaching, the Essentials points out.
"Only
through such content will advanced RNs be able to provide
quality care that is also cost-effective, and have the skills
for leadership roles to manage the human, financial, and
physical resources of health care," Dr. Anderson says.
Specifically,
coursework at the master's level should provide graduates
with the knowledge and skill to analyze the results of policy
research that impact upon health care delivery; be familiar
with health services across a variety of systems, including
acute and outpatient care as well as managed care and integrated
care settings; and understand the interaction between quality
controls and regulatory controls, the Essentials
points out. Graduates also should understand the economic
implications of health planning, the organization of personnel
and resources, and the design of payment systems.
In
addition, the Essentials stresses the need
for graduates to work both in collaborative and interdependent
relationships with other health professionals, design and
deliver health care that is culturally relevant, and develop
holistic plans of care that address the health promotion
and disease prevention needs of clients.
Finally,
as health care technology expands and the demands for cost-containment
increase, ethical decisionmaking must be a core component
of all master's-degree nursing education, the Essentials
urges. This not only includes the ability to counsel patients
as ethical issues arise, but for nurses to participate in
discussions of health care ethics as they affect one's community,
society, and the health professions overall.
While
AACN views the master's Essentials as the
foundation of all master's-degree preparation for nursing,
it is expected that educators will individualize the model
to their schools' own missions and to the needs of their
regions and student populations.
The American Association of Colleges
of Nursing is the national voice for university and four-year-college
education programs in nursing. Representing more than 580
member schools of nursing at public and private institutions
nationwide, AACN's educational, research, governmental advocacy,
data collection, publications, and other programs work to
establish quality standards for bachelor's- and graduate-degree
nursing education, assist deans and directors to implement
those standards, influence the nursing profession to improve
health care, and promote public support of baccalaureate
and graduate nursing education, research, and practice.
###
CONTACT: Robert Rosseter
(202) 463-6930, x231
rrosseter@aacn.nche.edu
