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Visual representation of the relationships among concepts and ideas

Competencies for Professional Nursing Practice

Chapter 4

Overview Competencies

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American Association of Colleges of Nursing (AACN) Essentials

Quality and Safety Education for Nurses (QSEN)

Technology Informatics Guiding Education Reform (TIGER) Initiative

Nurse of the Future (NOF): Nursing Core Competencies

Figure 4-1 The Nurse of the Future: Nursing Core Competencies graphic.

Reproduced from Massachusetts Department of Higher Education. (2016). Nurse of the future: Nursing core competencies:

Registered nurse. Retrieved from

Nurse of the Future: Nursing Core Competency Graphic

Illustrates, through use of broken lines, the reciprocal and continuous relationship between each competency and nursing knowledge, that the competencies may overlap and are not mutually exclusive, and that all competencies are of equal importance.

Nursing knowledge is placed as the core in the graphic to illustrate that nursing knowledge reflects the overarching art and science of professional nursing practice.

NOF Core Competency Model (1 of 3)

Essential knowledge, attitudes, and skills (KAS), reflecting cognitive, affective, and psychomotor learning domains, are specified for each competency.

The KAS identified in the model reflect the expectations for initial nursing practice following the completion of a prelicensure professional nursing education program.

NOF Core Competency Model (2 of 3)

Human beings/patients: Recipients of nursing care or services; may be individuals, families, groups, communities, or populations

Environment: The atmosphere, milieu, or conditions in which one lives, works, or plays

Health: Experience, often expressed in terms of wellness and illness, that may occur in the presence or absence of disease or injury

NOF Core Competency Model (3 of 3)

Nursing: The protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human response; and advocacy in the care of individuals, families, groups, communities, and populations

The NOF Core Competencies

Patient-centered care



Systems-based practice

Informatics and technology


Teamwork and collaboration


Quality improvement

Evidence-based practice

Why Is Critical Thinking Important in Nursing Practice?

Essential to providing safe, competent, and skillful nursing care.

The inability of a nurse to set priorities and work safely, effectively, and efficiently may delay patient treatment in a critical situation and result in serious life-threatening consequences.



Thinking Like a Nurse

Clinical judgment

Clinical reasoning




Clinical Judgment (1 of 2)

Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand.

Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as engagement with the patient and his or her concerns.

Clinical Judgment (2 of 2)

Clinical judgments are influenced by the context in which the situation occurs and the culture of the nursing unit.

Nurses use a variety of reasoning patterns alone or in combination.

Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the development of clinical knowledge and improvement in clinical reasoning.

Critical Thinking and Clinical Judgment in Nursing

Purposeful, informed, outcome-focused thinking

Carefully identifies key problems, issues, and risks

Based on principles of the nursing process, problem solving, and the scientific method

Applies logic, intuition, and creativity

Driven by patient, family, and community needs

Calls for strategies that make the most of human potential

Requires constant reevaluating

Characteristics of Critical Thinking

Rational and reasonable

Involves conceptualization

Requires reflection

Includes cognitive skills and attitudes

Involves creative thinking

Requires knowledge



Characteristics of a Critical Thinker (1 of 2)


Bases judgments on facts and reasoning

Doesn’t oversimplify

Examines available evidence before drawing conclusions

Thinks for themselves

Remains open to the need for adjustment and adaptation throughout the inquiry



Characteristics of a Critical Thinker (2 of 2)

Accepts change


Welcomes different views and values examining issues from every angle

Knows that it is important to explore and understand positions with which they disagree

Discovers and applies meaning to what they see, hear, and read



Approaches to Developing Critical Thinking Skills

Nursing process

Concept mapping


Group discussions



Nursing Process



Outcome identification






Concept Mapping

Visual representation of the relationships among concepts and ideas

Useful for summarizing information, consolidating information from different sources, thinking through complex problems, and presenting information in a format that shows an overall structure of the subject




Allows you to view your own thinking, reasoning, and actions.

Helps create and clarify meaning and new understandings of experiences.

When you encounter a similar situation, you should be able to recall what you did or would do differently and your reasoning.



Journaling Suggestions

What happened?

What are the facts?

What feelings and senses surrounded the event?

What did I do?

How and what did I feel about what I did?

What was the setting?

What were the important elements of the event?

What preceded the event, and what followed it?

What should I be aware of if the event recurs?



Group Discussions

Cooperative learning occurs when groups work together to maximize learning.

Explore alternatives.

Different scenarios of “What if?”, “What else?”, and “What then?”

Arrive at conclusions.

Connect clinical events or decisions with information obtained in the classroom.


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