Development of a nursing practice based competency model for the Flemish master of nursing and obstetrics degree Gerlinde De Clercq a, ⁎, Guido Goelen b , Dirk Danschutter a,b , Joeri Vermeulen a , Luc Huyghens b a Master of Nursing and Obstetrics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium b Critical Care Department, Vrije Universiteit Brussel, Brussels, Belgium summary article info Article history: Accepted 10 March 2010 Keywords: Nursing Nurse's role Competency-based education Delphi technique The aim was to identify a set of competences for the Flemish academic Master of Nursing and Obstetrics degree that answer perceived needs in health care. The competency model was to demonstrate a degree of consensus among key nurses. The study was conducted in all Flemish hospitals registered to have 400 beds or more. Head nurses of surgery, geriatrics and intensive care units were eligible to participate, as well as one nurse from administration per hospital. A two round Delphi process allowed participants to comment on items identified in an analysis of existing international competency profiles of master level nurses and adapted to the Flemish context. Competences agreed to by 90% of the respondents were considered to have consensus. Fifteen out of 19 eligible hospitals were recruited in the study, 45 nurses participated in the Delphi panel. Consensus was reached on 31 competences that can be assigned to 5 nurse's roles: nursing expert, innovator, researcher, educator and manager. The resulting competency profile is in accordance with published profiles for similar programs. The reported study demonstrates a practical method to develop a consensus competency model for an academic master program based on the input of key individuals in mainstream nursing. © 2010 Elsevier Ltd. All rights reserved. Introduction Current developments in health care often entail high demands on nursing. Therefore continuing to provide high quality nursing in a rapidly evolving care environment can be challenging (Forker, 1996). Some of the current developments require exceedingly complex nursing by highly trained and specialist nurses. A number of levels of practice and autonomy of such highly trained and specialist nurses can be categorized as Advanced Practice Nursing (APN), i.e. “The application of an expanded range of practical, theoretical, and research-based therapeutics to phenomena experi- enced by patients within a clinical area of the larger discipline of nursing.” (Hamric, 2005, p. 89). One way to define APN is by 7 essential competences: a. direct care, b. expert guidance and coaching of patients, families, and care providers, c. consultation, d. research skills, use and implementation of evidence-based practice, evaluation and conduct, e. clinical and professional leadership, change agent, f. collaboration, and g. ethical decision-making (Hamric, 2005, p.96 ). Different APN specialties, such as Nurse Practitioner, Clinical Nurse Specialist, Certified Nurse-Midwife, and Certified Registered Nurse Anaesthetist, require specific additional competences. Training requirements for APN differ across countries, as does the identification of the specialties. A 2008 United States proposal requires a nurse to complete an accredited graduate-level education program in preparation of one of four specialties to become an Advanced Practice Registered Nurse (APRN Joint Dialogue Group, 2008). The four specialties that qualify are Nurse Anaesthetist, Nurse- Midwife, Clinical Nurse Specialist, and Nurse Practitioner. All of these substantially focus on the direct care of individuals. The Canadian Nurses Association defines APN as “... an umbrella term describing an advanced level of clinical nursing practice that maximizes the use of graduate educational preparation, in-depth nursing knowledge and expertise in meeting the health needs of individuals, families, groups, communities and populations” (Canadi- an Nurses Association, 2008, p. 9). The required training comprises a graduate degree in nursing and sufficient clinical experience for the necessary competencies to have developed. Competences are assigned to one of four categories: a. clinical, b. research, c. leadership and d. consultation and collaboration. The Clinical Nurse Specialist and Nurse Practitioner are commonly recognized as APN (Macdonald et al., 2006). The United Kingdom Royal College of Nursing uses the term Nurse Practitioner (NP) for nurses that have undertaken a specific course of study of at least Honours level and that perform specific duties. These duties include assessing a patient's health care needs, an assessment that may comprise a physical examination, and screening patients for Nurse Education Today 31 (2011) 48–53 ⁎ Corresponding author. Laarbeeklaan 121, 1090 Brussels, Belgium. Tel.: +32 24791890, + 32 474836809; fax: + 32 24797102. E-mail address: gerlinde.de.clercq@gmail.com (G. De Clercq). 0260-6917/$ – see front matter © 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.nedt.2010.03.013 Contents lists available at ScienceDirect Nurse Education Today journal homepage: www.elsevier.com/nedt