defining moment nursing

Nurse leader resilience: career defining moments

Affiliation.

• 1 Cultures of Excellence, Creative Health Care Management, Minneapolis, MN.
• PMID: 25714948
• DOI: 10.1097/NAQ.0000000000000087

Resilience is an essential component of effective nursing leadership. It is defined as the ability to survive and thrive in the face of adversity. Resilience can be developed and internalized as a measure to improve retention and reduce burnout. Nurse leaders at all levels should develop these competencies to survive and thrive in an increasingly complex health care environment. Building positive relationships, maintaining positivity, developing emotional insight, creating work-life balance, and reflecting on successes and challenges are effective strategies for resilience building. Nurse leaders have a professional obligation to develop resilience in themselves, the teams they supervise, and the organization as a whole. Additional benefits include reduced turnover, reduced cost, and improved quality outcomes through organizational mindfulness.

• Attitude of Health Personnel
• Career Choice*
• Leadership*
• Nurse Administrators / psychology*
• Resilience, Psychological*
• Self Care / psychology*
• Workplace / psychology

What is Competency-Based Education?

AACN defines competency-based education as “a system of instruction, assessment, feedback, self-reflection, and academic reporting that is based on students demonstrating that they have learned the knowledge, attitudes, motivations, self-perceptions, and skills expected of them as they progress through their education.” 

Other organizations define competency-based education differently, including the U.S. Department of Education, which more narrowly defines this term as education “that organizes academic content according to competencies—what a student knows and can do—rather than following a more traditional scheme, such as by course.” Nursing programs are encouraged to institute a process to ensure curricula address the competencies delineated in the Essentials and assess student achievement of those competencies. 

Note: AACN does not require schools to move to time-variable education or organize academic content according to competencies instead of by course. We anticipate most programs will continue to organize academic content by course. Even so, AACN reminds nursing programs that accrediting agencies and state boards of nursing may require notification or approval of substantive changes proposed to implement the Essentials framework, depending on the extent and nature of the proposed changes. 

What CBE is not

• A checklist of tasks
• A one-and-done experience or demonstration
• Isolated in one sphere of care or context
• Demonstrated solely on an objective test

Basic principles of CBE

• Shifts the primary focus of education to the desired outcomes for learners rather than the structure and process of the educational system (Backward design).
• A set of expectations that, when taken collectively, demonstrate what learners can do with what they know.
• Demonstrated across all spheres of care and in multiple contexts.
• Clear expectations are made explicit to learners, employers, and the public.
• A result of determined (planned and repeated) practice.
• Visibly demonstrated and assessed over time by multiple methods and multiple assessors.  

What are the benefits of CBE?

• Makes the student the center of learning and responsible for their learning
• Improves equity by serving diverse learners
• Mitigates bias using formative and focused feedback from multiple assessors using multiple methods Helps the student relate specific courses and learning experiences to the development of overall competencies
• Clarifies faculty expectations regarding student development/performance and allows the faculty to hold students accountable for prior learning
• Relates curriculum and course work to life and professional expectations
• Establishes in an objective way the rigor of the curriculum
• Promotes faculty development about teaching effectiveness – faculty move to the role of coach
• Creates a community of faculty with common goals and expectations for student development
• Provides an overall cohesive framework for course and program design and development
• Improves the quality of nursing education to meet the demands, challenges and opportunities of the future.
• Requires internal motivation, a collaborative culture, and the continuous cycle of using assessment data and our collective wisdom to improve teaching and learning and to assure the competence of our graduates 

Featured Videos

The dean's role in competency-based education.

What is Competency Based Education?

Additional Videos

Dr. Jean Bartels’ Video on Competency-Based Education December 2020 [Video Length - 63 minutes]

Dr. Jean Bartels’ Video on Competency-Based Education November 2019 [Video Length - 23 minutes]

CBE Q&A with Dr. Robert Englander

Dr. Robert Englander is a member of AACN’s Assessment Expert Working Group, which is helping to identify the role AACN should take in addressing competency assessment as well as possible strategies for competency assessment. Read Dr. Englanders recent interview in AACN's Syllabus for more insight on CBE and assessment.

Read the Q&A

CBE Resources

Guiding Principles for Competency-Based Education and Assessment

Webinars & Programs

Giddens, J. (2020). Demystifying concept-based and competency-based approaches.  Journal of Nursing Education , 59(3):123-124.

Kavanagh, J. & Sharpnack, P. (2021) Crisis in competency: A defining moment in nursing education.  OJIN: The Online Journal of Issues in Nursing , 26(1), Manuscript 2. Accessible online at  https://www.doi.org/10.3912/OJIN.Vol26No01Man02

Moreau, K.A (2021). Exploring the connection between programmatic assessment and program evaluation within competency-based medical education programs.  Medical Teacher , 43(3):250-252.

Carol Carraccio, MD, MA, Robert Englander, MD, MPH, Elaine Van Melle, PhD, Olle ten Cate, PhD, Jocelyn Lockyer, PhD, Ming-Ka Chan, MD, MHPE, Jason R. Frank, MD, MA(Ed), and Linda S. Snell, MD, on behalf of the International Competency-Based Medical Education Collaborators   Advancing Competency-Based Medical Education: A Charter for Clinician–Educators.   Academic Medicine , Vol. 91, No. 5 / May 2016

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Crisis in Competency: A Defining Moment in Nursing Education

2021, OJIN: The Online Journal of Issues in Nursing

Advancing the mission of nursing education for a future we cannot yet fully conceive is a daunting task. The rapidly changing healthcare landscape is an exciting world of innovation, digital transformation, and accelerated knowledge creation that offers hopeful, and infinite possibilities to improve patient care, safety, and outcomes. New data suggest a continuing decline in the initial preparedness of new nurses at a time when preparation is most needed. We must adapt and embrace pedagogies relevant to a new generation of learners. In this article, we first describe the digital disruption informed by innovation moving at warp speed, catalyzing necessary and long overdue change not only in healthcare, but in how education is conceptualized and delivered. Leading and promoting the paradigm shift needed for this change is not discretionary as nurse educators strive to enhance the competency of new registered nurses. Leaders in nursing education have initiated efforts to appraise the s...

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In the wake of the global COVID-19 pandemic, nursing education emerged as a frontrunner in the race to adapt and innovate. This article embarks on an exploration of the dynamic evolution that nursing education underwent in response to the crisis. From harnessing technology's power to reshaping clinical training, the nursing education arena witnessed a remarkable metamorphosis. Our journey through these changes' sheds light on their profound implications, shaping the future of nursing education worldwide.

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When the COVID-19 pandemic started to spread around the world, the situation became difficult for many educational institutions. The objective of this study was to discover the learning experiences and the expectations about the changes in education, in light of the abrupt change from face-to-face to e-learning education, of nursing students enrolled in Bachelor's degree of governmental universities, This study aimed to examine nursing students attitude toward e-learning. This study utilized a descriptive cross-sectional design with 50 nursing students as study participants. Data were collected via an online survey tool. The imposition of e-learning sets limitations for older students, Students expressed concern about what an interruption in their nursing education would mean for their future careers as Registered Nurses. Many students in clinical placements were in their final focus clinical practicum, and thus close to successfully completing their program. Some learners were only one or two courses away from completion of their Bachelor of Nursing degree. In addition to canceling their current clinical placement, they had concerns about progressing in the rest of their program. Digital Health Insights provide healthcare leaders and experts with the latest artificial intelligence and digital transformation news, trends, and strategies in healthcare today. Our goal is to empower you with innovative ways to collect, pool, and analyze high-quality data from which you can extract actionable insights. Through artificial intelligence and digital trends in healthcare, we can use these insights to create efficiencies that improve patient care while reducing or streamlining healthcare costs. I.

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A defining moment for nursing

RCN Chief Nurse Nicola Ranger discusses our new definition of nursing and how the RCN is seeking to influence governments and policymakers on issues around safe staffing and effective care.

Earlier this year, nursing was confirmed to be the most trusted profession  amongst the British public.   Despite this, the image that exists in the public consciousness of nurses, health care assistants and other nursing professionals bears little resemblance to the realities of modern nursing.  As a College, we are incredibly proud of our 107-year history and of all of the inspiring nursing pioneers who came before us. But as many of you who are reading this will know, the nursing profession has changed significantly over the years - it is vital that this is recognised.  During my own 34 years as a registered nurse, the role has evolved, developed and become increasingly complex. Nursing staff now take on more responsibilities than at any point in the profession’s history.   In spite of this, nursing remains a chronically undervalued profession.   One can’t help but wonder if the fact that we are a female-dominated profession is the reason that nursing pay consistently falls behind not only other health professionals, but public sector workers more broadly.  It has been over twenty years since the RCN last published a definition of nursing, so the time has come to revise this with one which encompasses the many facets of nursing today and raises the profile and value of the work that we do.  Our new definition  was developed by the RCN Professional Nursing Committee in collaboration with RCN members, fellows and professional forums to encompass all aspects of modern nursing and the work that we do.  You can use the definition to help patients, families and colleagues understand what they can expect from nursing professionals and identify areas within your organisation where you think that this is not being recognised.  As well as highly skilled clinical practitioners, registered nurses are dynamic leaders and strategic decision makers. We use clinical judgement and problem-solving skills to manage and co-ordinate the complexity of health and social care.  These are the messages that we must make clear, not only to the public, but in the halls of government too. We’ve been taking action across the UK this week to ensure that elected officials are listening.  On Wednesday, the RCN submitted evidence  in a preliminary hearing for Module 3 of the COVID-19 Inquiry. This module examines the impact of the pandemic on health care systems in the four nations of the UK. We’re asking for long COVID to be recognised in disability law and for health care workers with ongoing health issues to be properly compensated.

In Scotland, members working in community nursing and care homes met with Maree Todd MSP, Minister for Social Care, Mental Wellbeing and Sport, to discuss the Scottish government’s plans for a National Care Service. During the roundtable, members emphasised the key role of nursing staff in meeting increasingly complex health care needs within care homes and the community. They also discussed the impact of recruitment and retention challenges and the urgent need for safe staffing within care homes and the community.  In Northern Ireland, we’ve launched a public action to encourage people to email their MLAs to demand pay parity for nursing staff with the rest of the UK and highlight the impact that the absence of the Northern Ireland Executive is having on health and social care.   This week in Wales we released a new workforce  report which highlights the 2,727 registered nurse vacancies currently in the country and the increased cost in agency nursing fees. The report shows nursing staff are working 69,877 additional hours every week which is the equivalent of an extra 1,863 full-time posts.    This week I’ve been speaking to both the Institute of International and European Affairs and the European Forum of National Nursing and Midwifery Associations. I used these platforms as an opportunity to highlight the current issues facing our profession around workforce planning, safe staffing and international recruitment, and to ensure that these matters are kept high on the political agenda.  Speaking of which, party conference season is now upon us, and I am delighted that the RCN will be attending all three of the main political parties’ conferences. While there, we will inform the parties of the RCN’s policy priorities. With a general election likely in the next 12 months, they are a key influencing opportunity for the College.  At the weekend I will be travelling to Manchester, alongside RCN Deputy President, Tracey Budding, to attend the Conservative Party conference. I’ll be representing the RCN at a joint panel event with the thinktank Demos, on the future of the health and care workforce and I look forward to meeting with other health and care stakeholders.   You too can join in these important conversations by actively participating in RCN Congress 2024 . Applications are now open to become a voting member and represent your peers, and you can also shape the agenda itself by submitting an item for debate.   Rest assured, we will be taking every opportunity at all these events over the next few weeks and months to stress the urgent need for action on pay and safe staffing.   We will ensure that politicians from across the political spectrum understand what nursing is, the vital role that nursing staff play and the direct consequences for the future of health and care in the UK if nursing fails to get the recognition required to recruit and retain nursing staff to the profession. 

Professor Nicola Ranger

General Secretary and Chief Executive

Professor Nicola Ranger joined the RCN in December 2022. She was previously Chief Nurse and Executive Director of Midwifery at King’s College Hospital NHS Foundation Trust in London. Before that, she held Chief Nurse posts at both Brighton and Sussex University Hospitals NHS Trust and Frimley Health NHS Foundation Trust.

She has also held a number of senior nursing roles at University College London Hospitals NHS Foundation Trust and Surrey and Sussex Healthcare NHS Trust. Earlier in her career, she worked at America’s George Washington University Hospital in Washington and at Mount Sinai Medical Centre in New York.

Page last updated - 02/10/2023

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Caring Mentorship in Nursing Leadership

• First Online: 16 July 2023

Cite this chapter

• Janette V. Moreno 3 , 4 &
• Jennifer Rangel 5 , 6  

121 Accesses

This chapter details the experience of how a mentoring relationship became a defining moment in an emerging nurse leader’s life’s journey. A defining moment is a “short experience that is both memorable and meaningful” (Heath and Heath, The power of moments, Simon and Schuster, Inc., New York, 2017, p. 12). Defining moments are built around any of these four elements: elevation, insights, pride, and connection. The element of “elevation” is a phenomenon or event that is literally extraordinary and unforgetable. That moment of elevation starts to open up the individual to develop “insights” that would change or influence their life’s decisions moving forward. There is a sense of “pride” in these defining moments that gives the individual courage and strength. And finally, these defining moments are solidified when shared with others. Not all defining moments have the four elements, but if they do, which was what the mentee experienced in this situation, it is very powerful and life-changing. In this reflection, the mentee’s defining moment is the discovery of authenticity, showing up with 100% of oneself. The mentor, being a Caritas Coach, integrated the Theory of Caring Science on the practice of loving kindness for self and others. The mentor introduced how mindful meditation using a simple quick coherence technique with heart-focused breathing can easily transform an individual’s state in less than a minute by releasing stress and diminish draining emotions such as fear, frustrations, or anxiety. The practice of loving kindness for self through mindful meditation allows for authentic, caring, and trusting relationships that transform the person’s life journey at a given moment in time.

Authenticity is a collection of choices that we have to make everyday. It’s about the choice to show up and be real. The choice to be honest. The choice to let our true selves be seen. —Brené Brown

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Nursing Professional Development, Geri and Richard Brawerman Nursing Institute, Cedars-Sinai, Los Angeles, CA, USA

Janette V. Moreno

Beverly Hills, CA, USA

Maternal Child Health Services Regional Patient Care Services Kaiser Permanente Northern California, Oakland, CA, USA

Jennifer Rangel

Ripon, CA, USA

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Correspondence to Janette V. Moreno .

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CEO, CAPPS International, Portland, OR, USA

Nancy Rollins Gantz

Nursing Science Department, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

Thóra B. Hafsteinsdóttir

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Moreno, J.V., Rangel, J. (2023). Caring Mentorship in Nursing Leadership. In: Rollins Gantz, N., Hafsteinsdóttir, T.B. (eds) Mentoring in Nursing through Narrative Stories Across the World . Springer, Cham. https://doi.org/10.1007/978-3-031-25204-4_2

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