Rounds with Leadership: Joining the Conversation about Competency-Based Education

Welcome to Rounds with Leadership, a new forum for AACN's Board Chair and President/CEO to offer commentary on issues and trends impacting academic nursing.

How we educate nurses to thrive in today's healthcare system is a topic of great interest in academic nursing circles. We can no longer assume that traditional approaches to undergraduate and graduate nursing education are necessarily the most effective ways to meet the learning needs of today's students.  In fact, the American Council on Education has challenged all institutions of higher education to adapt in response to a new generation of students, faculty, and technological advances. As the science of learning evolves, so must our approach to preparing tomorrow's nursing workforce. Similarly, we must find new ways to help professionals maintain necessary competencies and acquire new competencies throughout their career.

One promising approach to re-envisioning nursing education involves competency-based, time-variable instruction. In essence, competency-based education allows students to progress through a defined program of study at their own pace with faculty offering feedback and guidance along the way. This approach offers a personalized learning experience, in which students can accelerate through content that is easily mastered and concentrate more time on subject matter requiring intense study.  It also requires faculty to reconsider assessment and develop new strategies to ensure the full assessment-feedback cycle.

To further advance the national conversation about competency-based education and its utility in health professions education, the Josiah Macy Foundation held an invitational conference in June 2017. This event brought together 39 academic leaders from medicine, nursing, and pharmacy as well as experts in educational theory and reform, medical residents (learners), and education and residency program accreditors. Dr. Juliann Sebastian from the University of Nebraska Medical Center College of Nursing was among the small handful of nurses invited to participate. Those invited gathered in Atlanta for two-and-a-half days of robust discussion and debate.  By the end of the conference, the attendees had agreed upon the following vision for transforming America's health professions education system:

With the achievement of competency-based, time-variable health professions education, we envision a healthcare system in which all learners and practitioners are actively engaged in their own education and continuing professional development to improve the health of the public. In this system, learners and faculty partner to co-produce learning, all practitioners are lifelong learners, and all healthcare environments place a high value on learning.

Next steps and recommendations identified at the Macy conference have been compiled in the recently released report titled Achieving Competency-Based, Time-Variable Health Professions Education. This report provides a blueprint for moving to a competency-based higher education system, including actionable recommendations in five areas: Systems Redesign; Creating a Continuum of Education, Training, and Practice; Implementing a Robust Program of Assessment; Enabling Technologies; and Outcomes Evaluation. These recommendations are designed to spark dialogue around key questions that must be considered as competency-based education evolves. For example, how will offering time-variable programs influence the cost of education? How can we develop individualized nursing programs that meet the needs of students and the entire academic unit? How will the faculty role change as the move to competency-based education matures?

As academic nursing leaders, I invite you to join this conversation and help us address some key questions facing our profession. AACN's annual fall meeting, which has been renamed the Academic Nursing Leadership Conference, provides an ideal forum for you and your colleagues to consider how to Harness Our Collective Strengths around issues driving change in the profession, including the push towards competency-based education. We do hope you can join us in Washington, DC on October 28-31 to help us chart the future of nursing education.