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Care: A focused attention on, and when possible, engagement with a patient to determine a
person’s particular needs and the use of clinical judgment to meet those needs (Grace, 2018).
Care outcomes: Harris (1991) defined outcomes as the end points of care, substantial changes
in the health condition of a patient, and changes in patient behavior caused by medical
interventions. Given these definitions, outcomes related to clinical practice are any change that
resulted from health care.
Caring relationship: Caring constitutes the essence of what it is to be human, having a profound
effect on well‐being and recovery, being at ease, and being healed. When hospitality is received,
patients feel a connection, they begin to trust, and their healing begins.
Clinical immersion: A brief, structured, intense nursing practicum where the entire focus is in a
particular clinical setting without the distraction of other academic classes (Tratnack, et al., 2011).
Clinical judgment: The skill of recognizing cues regarding a clinical situation, generating and
weighing hypotheses, taking action, and evaluating outcomes for the purpose of arriving at a
satisfactory clinical outcome. Clinical judgment is the observed outcome of two unobserved
underlying mental processes, critical thinking and decision making (NCSBN, 2018).
Clinical reasoning: Thought processes that allow healthcare providers to arrive at a conclusion.
Cognitive flexibility: A critical executive function involving the ability to adapt behaviors in
response to changes in the environment. Cognitive flexibility generally refers to the ability to
adapt flexibly to a constantly changing environment.
Complex systems: Systems whose behavior is intrinsically difficult to model due to the
dependencies, competitions, relationships, or other types of interactions between their parts
or between a given system and its environment. Complex systems have distinct properties that
arise from these relationships, such as nonlinearity, emergence, spontaneous order, adaptation,
and feedback loops, among others.
Competence: The array of abilities (knowledge, skills, and attitudes) across multiple domains
or aspects of performance in a certain context. Competence is multi-dimensional and dynamic
(Frank, Snell, Cate, et al., 2010).
Competency: An observable ability of a health professional, integrating multiple components
such as knowledge, skills, values, and attitudes. Since competencies are observable, they can be
measured and assessed to ensure their acquisition (Frank, Snell, Cate, et al., 2010).
Competency framework: An organized and structured representation of a set of interrelated
and purposeful competencies (Englander et al., 2013, p. 1089).
Competency list: The delineation of the specific competencies within a competency framework
(Englander, et al., 2013, p.1089).
Concepts: A concept is an organizing idea or mental construct represented by common
attributes. Rodgers (1989, p. 332) describes concepts as “an abstraction that is expressed in
some form.”

56 THE ESSENTIALS: CORE COMPETENCIES FOR PROFESSIONAL NURSING EDUCATION