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Dr. Fater is Professor and Dr. Weatherford is Assistant Professor, College of Nursing, University of Massachusetts-Dartmouth, North Dartmouth; Mr. Ready is Senior Director, Patient Services and Professional Practice, Saint Vincent Hospital, Tenet Healthcare Corporation, Worcester; Dr. Finn is Director of Professional Practice, Research, and Development, Saint Anne's Hospital, Fall River; and Ms. Tangney is Faculty, Blue Hills Practical Nurse Program, Canton, Massachusetts.
This project was funded by a grant from the Massachusetts Department of Higher Education Nursing Education Redesign Grant Program.
The authors have disclosed no potential conflicts of interest, financial or otherwise.
With greater access to health care for those underinsured or without insurance due to the implementation of the Affordable Care Act in 2014 and the looming retirements of a large number of nurses, the need for nurses in all practice specialties and settings is expected to rise. Not all nurses entering the work-force transition to practice successfully. Of particular concern is the loss of newly licensed nurses within the first year of practice. Winfield, Melo, and Myrick (2009) reported up to 50% of nurses leave their first position within 1 year due to stressors in the work-place. Stressors include feelings of lack of confidence and competence in their work; risk of making errors; exposure to new situations (Oermann & Gavin, 2002); role overload and role ambiguity (Chang & Hancock, 2003); skill, knowledge, and performance deficits; and concerns about relationships with peers and coworkers (Casey, Fink, Krugman, & Propst, 2004). How can nurses, including the most vulnerable newly licensed nurses, become better prepared to function effectively in acute care?
One approach is competency-based education. Clinical competency is important to nurses, nurse educators, and nurse administrators. Nurse educators are responsible to ensure that graduates are competent practitioners. Although competency is the responsibility of the individual nurse, health care organizations must guarantee that their practitioners are competent and that timely training is available. The organization also must be designed to support competent practice. Sportsman (2010) argued that seamless competency education is critical over the practice career of nurses.
One framework to accomplish this is the Massachusetts model for competency development. The Massachusetts Department of Higher Education (MDHE) Nurse of the Future Nursing Core Competencies (NOFNCC) Committee identified 10 core competency domains essential to nursing in