Frequently Asked Questions
1. Where are the competencies for each master’s focus area (e.g. education, informatics, administration, leadership, etc.)?
A table is included in the tool kit listing the various competencies that are currently available for advanced role preparation. The table includes links to relevant professional groups that have developed and published competencies for these areas. Linking the Master’s Essentials (AACN, 2011) with these competencies provides an important source of information that faculty can use in curricular design.
2. Given that students with an education focus are advancing their clinical education, will they be required to complete clinical experiences in education and the “clinical practice area” they are developing?
The Master’s Essentials (AACN, 2011) specify that all students in MSN programs complete advanced clinical educational activities that include supervised clinical experience. Students in tracks that prepare them for the clinical educator role need clinical experiences that provide them the opportunity to integrate new learning and expand one’s own area of nursing practice. In addition to these clinical or practice experiences, the student may have opportunities within the program to supervise students in the clinical area or teach in the practice or academic environment. Curricular design is the purview of faculty at each school and reflects numerous variables, including philosophy, local considerations, decisions about role preparation, and others. Faculty preparing students for roles as educators should determine the types of experiential learning they think are most appropriate to meet program outcomes in addition to advanced clinical experiences.
3. What types of clinical experiences are necessary to meet the expectations in the Master’s Essentials (2011)? How many clinical hours are required for the MSN degree?
Clinical experiences should include those learning experiences that advance students’ understanding of clinical phenomena, whether at the individual or aggregate level. Because the definition of advanced nursing practice that is included in the 2011 Master’s Essentials (AACN, 2011) emphasizes those interventions that influence health outcomes, clinical experiences should relate to health outcomes. Faculty have the responsibility for designing learning experiences that help students achieve program outcomes and meet the essentials of MSN education. Therefore, the exact types of clinical learning experiences cannot be prescribed, but should result from faculty analyses of learning needs and expected program outcomes.
The Master’s Essentials does not specify the number of clinical hours required for a master’s degree. Rather, the document indicates that sufficient clinical immersion should be included to allow students to achieve the master’s-level competencies and those required by various professional organizations for specific roles. Master’s degree programs that have not transitioned their advanced practice tracks to the DNP level should adhere to the requirements of the APRN Consensus Document (2008) and the NTF Criteria for Quality Nurse Practitioner Programs (2008). In addition, programs preparing graduates for one of the four APRN roles must ensure that graduates are eligible to sit for national certification in the role and population. The national certification organizations set specific eligibility criteria for certification. Because this tool kit provides strategies for operationalizing the Master’s Essentials, it is not a standard-setting document and does not specify a required number of clinical hours.
Faculty might use innovative strategies to assess student achievement of clinical competencies. Examples might include portfolios; advanced simulations including human actors, virtual simulation, and use of high fidelity mannequins; and telemonitoring with students in distant sites, to name a few.
4. How are the APRN roles (NP, CRNA, CNS, CNM ) integrated with the Master’s Essentials?
While the target date for transitioning advanced practice education to the Doctor of Nursing Practice level is 2015, not all schools will have completed the transition by this time. Therefore, the Master’s Essentials indicates that just as with other role preparation, specialty role preparation can be added to master’s education. The diagram on page 8 of the Master’s Essentials shows that master’s programs include the graduate core competencies that are delineated in the Master’s Essentials, an APRN core, and role/population specific courses. The APRN core includes three separate, comprehensive advanced courses in pathophysiology, pharmacology, and health assessment as specified in the APRN Consensus Model (2008), and advanced clinical courses that contain both role and population preparation also delineated in the APRN Consensus Model.
5. How does the public health nurse fit with the Master’s Essentials conceptual model (page 8)?
Community health nursing can contain either or both an indirect (aggregate or population) focus and a direct focus (e.g., in community clinics or home care where care is provided to individuals as well as populations). If a program is preparing students for an indirect care focus, content in the 3 Ps is not required. Programs that are preparing students for direct care roles must include content in the 3 Ps (advanced pathophysiology, advanced pharmacology, and advanced health assessment). The APRN Consensus Model recognizes that public health nursing is an advanced area of nursing practice but does not meet the criteria for and cannot use the term APRN. A nurse prepared in community health cannot be called an APRN unless he/she is prepared as a nurse practitioner or clinical nurse specialist in adult/gerontology or across the lifespan and then has the specialty content in community health added to the program.
6. How does the entry-level generalist master’s program fit with the Master’s Essentials? Can some Baccalaureate Essentials being met through the Master’s Essentials avoid unnecessarily lengthy program requirements?
Schools that offer generalist Master’s degree programs that prepare pre-licensure students should ensure that students meet both the Baccalaureate Essentials and the Master’s Essentials. Because master’s education builds upon baccalaureate preparation, achievement of the Master’s Essentials in many cases will also mean that graduates have achieved the Baccalaureate Essentials. Faculty should evaluate both sets of Essentials in light of their curricula to ensure that graduates meet both sets of competencies.
7. How might faculty move students from the Master’s to DNP and demonstrate competence at the doctoral level? How is practice content different for the Master’s and DNP students?
Curriculum development takes into account the highest level of outcome expectations for graduates and builds toward those ends. The Master’s Essentials and DNP Essentials Crosswalk Table (p. 55) show how the two levels compare, making it possible to design curricula that meet either or both. Practice content at the DNP level is specialized and highly sophisticated, requiring an in-depth understanding, analysis, synthesis, and comfort with ambiguity and uncertainty. The DNP Essentials delineate these outcome competencies.
8. Could students meet the Master’s Essentials without a specific project course?
A project course is not required by the Master’s Essentials. The Essentials are specifications of outcome competencies, rather than curricular design requirements. Faculty have the responsibility and authority to design curricula that prepare students for these competencies and any others that are specific for role preparation as required by relevant professional organizations.
9. How are schools determining which programs are needed in their community?
Schools of nursing might consider a variety of approaches to continually updating program offerings to be responsive to their communities of interest. Deans and directors might engage external stakeholders on a regular basis in talking about trends in practice changes and the types of needs these trends suggest to nurse executives and other health, business, and community leaders. This could be done through external advisory groups, regular breakfast or lunch meetings, participating in local groups of deans and directors with chief nursing officers, and a wide range of other meetings with leaders in other sectors such as business. Faculty and academic administrators might use what they know about national trends as well as local needs to conduct market analyses to determine the potential demand and viability for new programs. These are just a few ideas about ways academic nursing leaders try to determine which programs will be most needed in their communities and which they might launch that will stimulate changes in practice. Examples of areas that schools might include in Master’s programs are nursing management, informatics, clinical education, clinical nurse leader, or public health nursing to name a few.
10. Where can I find guidelines for schools that are trying to decide whether they have the infrastructure and resources to move their specialty tracks to the Doctor of Nursing Practice level?
The Essentials of Doctoral Education for Advanced Nursing Practice (AACN, 2006) includes a section on “Indicators of Quality in Doctor of Nursing Practice Programs” that addresses this question. Key resources include faculty with relevant expertise and doctoral preparation, sufficient financial resources, space, and equipment, access to advanced clinical practice settings particularly those with active faculty practices, a vibrant practice scholarship environment, and access to expert clinicians from other disciplines and professionals from other areas with whom students can work.
11. How might schools that determine that their mission or other factors will preclude adding a DNP program work with other schools to make seamless progression from a Master’s to DNP possible for advanced practice students?
Articulated models of graduate education in nursing are being developed and build on earlier models of undergraduate and graduate articulations. Generally these involve one or more Master’s degree-granting institutions collaborating with a doctoral degree-granting institution to design curricula that are integrated at the point where students move into doctoral studies. It may be possible for schools to agree that the Master’s degree-granting institution will accept selected courses from the doctoral degree-granting institution as part of the Master’s program or that the doctoral degree-granting institution will accept courses from the master’s degree program, thereby streamlining the students’ experiences and generating efficiencies. Such arrangements have the advantage of making doctoral education more accessible to students in a local area without the infrastructure costs of opening a new doctoral program. These arrangements also help institutions whose missions or charters might not include doctoral education.
12. How might the Master’s Essentials serve as a core for graduate education, with role preparation following the core or doctoral preparation following the core?
Faculty may decide to approach curricular design by thinking of graduate education as a seamless progression all the way through to doctoral education, with or without awarding a Master’s degree. Such models have been in place for some years in Baccalaureate-PhD programs. With Baccalaureate-DNP programs now opening, the concept is expanding. Now that the new Master’s Essentials are available, faculty groups have the opportunity to reconceptualize graduate education. Curricula may be designed so that a student graduates from the master’s degree program perhaps eligible to sit for CNL certification, or in nursing management, but able to transition into a DNP program without repeating the graduate core courses. A second option may be to design the curriculum so that the student has the option to graduate with a master’s degree or continue directly into the DNP program to attain preparation in an advanced area of nursing specialization. The table in the Master’s tool kit that compares Baccalaureate, Master’s, and DNP Essentials (p. 55) provides initial guidance on the differences at each level. Some have commented that little difference seems to exist across various Essentials. This can be an advantage that makes conceptualizing movement from the BSN to MSN and to the DNP or PhD a new opportunity for rethinking graduate education.
13. Where can one find core competencies for interprofessional collaboration?
The IOM report on Health Professions Education: A Bridge to Quality (2003) created the framework for the development of core competencies for interprofessional collaboration. These competencies are described and analyzed in a 2011 report, Core competencies for Interprofessional Collaborative Practice, published by the Interprofessional Education Collaborative. Additionally, the Quality and Safety Education for Nurses (QSEN) competencies serve as a resource for faculty in developing interprofessional content and learning strategies (See http://www.qsen.org/).
14. What types and/or levels of interprofessional collaboration competencies are expected in the New MSN Essentials?
The Master’s Essentials identify interprofessional collaboration as a key strategy for improving patient and population health outcomes as one of its key Essentials Specific content is focused on informatics, quality and safety, evidence-based practice, informatics, and patient-centered care. All graduates of a master’s degree nursing program are expected to attain the outcome competencies delineated in Essential VII. Interprofessional collaboration competencies do overlap between baccalaureate, master’s, and doctoral level education; however, the crosswalk included in this tool kit does differentiate the three levels of professional development expected in this essential content area.
Within the master’s degree curriculum on interprofessional collaboration, specific content and experiences may differ depending upon the role or area of practice for which the graduate is being prepared, (e.g. clinical educator, CNL, administrator/manager, public health nurse, or other advanced roles).
15. Why is interprofessional education a necessary component of the new Master’s Essentials?
Interprofessional education engages students of different professions in interactive learning with each other. Being able to work effectively as members of clinical teams within and across disciplines as students is a fundamental part of that learning. Interprofessional learning is necessary to enhance the learner outcomes and promote collaborative interprofessional practice to enhance patient care outcomes. The new Master’s Essentials builds this essential component into the learning of all master’s programs with the ultimate goal of increasing inter-professional collaboration in education and practice to impact patient and population outcomes and to prepare graduates to assume leadership roles on healthcare teams.
16. What interprofessional collaborative practice learning experiences are needed for the new Master’s Essentials?
Interprofessional collaborative practice learning experiences and activities should expand student awareness within nursing and vis-à-vis other health professions. Distinct clinical practice learning experiences can be designed using the content areas of informatics, quality and safety, patient- and family- centered care, and evidenced-based practice.
As an example, for a master’s program focused on nursing informatics, students might work in interdisciplinary teams of either students or professionals that include computer science, informatics, nursing, medicine, health administration, and others. Learning activities could be designed to ensure that students in each profession are required to interact with each discipline and patients and families to understand the impact of their performance on each other and the patient. Interprofessional collaborative learning is particularly suited to simulation activities, service learning experiences, as well as clinical practice experiences. The design, implementation, and evaluation of interprofessional collaborative practice learning activities must be evaluated in terms of patient and population outcomes to determine efficacy and long-term implications for building teamwork knowledge and competencies.
17. Which scholarship outcomes are anticipated with the new Master’s Essentials?
Scholarly outcomes originate from the focus areas and/or roles. Scholarly writing and critical thinking is essential for all master’s graduates. For example, the clinical nurse leader (CNL) must conceptualize problems, analyze relevant research, and determine the best evidence to implement and evaluate change strategy to improve microsystems clinical and cost outcomes for patients and/or populations. The new Master’s Essentials address the scholarship outcomes specifically in Essential IV: Translating and Integrating Scholarship into Practice and include the ability to write in a variety of formats, and present and share information with diverse audiences across venues. Likewise, Essential I: Background for Practice from Science and Humanities and Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Scholarship necessitate knowledge, skills, and competencies in scholarship and outcomes to design, implement, and evaluate change and impact.
Master’s level education incorporates scholarship into all aspects of the core, foundational, role competencies, and practice experiences. Implementation of the Essentials requires all master’s programs to implement the scholarly components of role competency and practice experience regardless of the type of program and academic environment. Opportunities abound for scholarly practice and collaboration across schools, professions, and clinical facilities is encouraged. Examples of collaborative opportunities include evidence-based projects in community-based practices and health centers particularly Federally Qualified Health Centers, VA hospitals, clinics, and hospitals, as well as policy and advocacy projects. The tool kit incorporates numerous examples of scholarship and scholarly activities across the focus areas and roles, particularly in the Integrative Learning Strategies section (p. 5). These activities can serve as a starting point for innovative curriculum development integrating core, foundational, role and practice knowledge, skills, and attitudes to develop master’s level competencies.
18. What substantive content areas should drive anticipated outcomes and scholarship in the area of focus and role specialization?
All master’s graduates, including those prepared in any of the four APRN roles, must attain the outcomes delineated in all nine Essential areas. These Essentials areas are considered the Graduate Core for all master’s degree programs. Substantive content should be included in each of these areas, which include evidence-based practice, informatics, organizational and systems leadership, quality and safety, policy and advocacy, interprofessional collaboration, clinical prevention/population health, and program evaluation for improving patient and population outcomes. The content may vary based on the specific area of focus or role preparation. Additional content related to these areas includes: epidemiology, statistics, research design and methodology, root cause analyses of clinical or system error, interprofessional teamwork, and policy and advocacy. Content in advanced nursing roles that tracks outcomes should be related to improving patient and population outcomes, rather than focused on nursing processes. Data that show improvement in incidence trends or patient outcomes and efficiency should drive clinical practice protocols. The viability of the advanced nursing roles as well as APRN roles is directly linked to improving patient and population outcomes associated with access, cost, and quality.
Given the complementarities of the Essentials across the Baccalaureate, Master’s, and DNP levels, outcomes across these levels will need to be analyzed to determine the quality and associated scholarship across focus areas and levels.