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making an action out of knowledge—using knowledge to reflect, analyze, judge, resolve,
discover, interact, and create. Active learning requires clear information regarding what is to
be learned, including guided practice in using that information to achieve a competency. It
also requires regular assessment of progress towards mastery of the competency and frequent
feedback on successes and areas needing development. Additionally, students must learn
how to assess their own performances to develop the skill of continual self-reflection in their
own practice.
Stakeholders (employers, students, and the public) expect all nursing graduates to exit their
education programs with defined and observable skills and knowledge. Employers desire
assurance that graduates have expected competencies—the ability “to know” and also “to do”
based on current knowledge. Moving to a competency-based model fosters intentionality of
learning by defining domains, associated competencies, and performance indicators for those
competencies. Currently, there is wide variability in graduate capabilities. Therefore, there is a
need for consistency enabled by a competency-based approach to nursing education.
A standard set of definitions frame competency-based education in the health professions and
was adopted for these Essentials. Adoption of common definitions allows multiple stakeholders
involved in health education and practice to share much of the same language. These
definitions are included in the glossary (p. 59).

Nursing Education for the 21st Century
In addition to the foundational elements on which the Essentials has been developed, other
factors have served as design influencers. What does the nursing workforce need to look like
for the future, and how do nursing education programs prepare graduates to be “work ready”?
Nursing education for the 21st century ought to reflect a number of contemporary trends and
values and address several issues to shape the future workforce, including diversity, equity, and
inclusion; four spheres of care (including an enhanced focus on primary care); systems-based
practice; informatics and technology; academic-practice partnerships; and career-long learning.
Diversity, Equity, and Inclusion
Shifting U.S. population demographics, health workforce shortages, and persistent health
inequities necessitate the preparation of nurses able to address systemic racism and pervasive
inequities in health care. The existing inequitable distribution of the nursing workforce
across the United States, particularly in underserved urban and rural areas, impacts access
to healthcare services across the continuum from health promotion and disease prevention,
to chronic disease management, to restorative and supportive care. Diversity, equity, and
inclusion—as a value—supports nursing workforce development to prepare graduates who
contribute to the improvement of access and care quality for underrepresented and medically
underserved populations (AACN, 2019). Diversity, equity, and inclusion require intentionality,
an institutional structure of social justice, and individually concerted efforts. The integration
of diversity, equity, and inclusion in this Essentials document moves away from an isolated
focus on these critical concepts. Instead, these concepts, defined in competencies, are
fully represented and deeply integrated throughout the domains and expected in learning
experiences across curricula.

THE ESSENTIALS: CORE COMPETENCIES FOR PROFESSIONAL NURSING EDUCATION

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