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APRN LACE dialogue for CNSs
Blog is about the changes and updates related to the implementation of the Advanced Practice Registered Nurse Consensus Model for Regulation and the Licensure, Accreditation, Certification and Education changes that will need to take place over the next few years.
Tuesday, February 15, 2011
Let's talk about the Education aspect...where it truly all begins
The acronym for the implementation of the APRN Consensus Model is actually LACE...that stands for Licensure, Acrreditation, Certification and Education...but really the whole thing needs to start with the education of future CNSs.
Education has been varied in the CNS world. The wonderful thing called academic freedom has made it so that there are almost as many variations on CNS education as there are programs to educate CNSs. That is a good thing from the perspective of the consumer as the market clearly has driven the education...what society needs in that area is what is educated. What is not good is when there is a comparison of the curriculum and standards for CNS education and there is little to compare.
Back in 1995 the National Association of Clinical Nurse Specialists was created. The dynamic and passionate leaders who created the association also identified the need for educational standards and competency statements. They worked on them and they were released in 1998 for the first time. These competencies were wondeful and described CNS practice in a whole new way...three spheres of influence...rather than subroles and roles that were innumerable and unmanageable. They were not widely adopted however and were not widely accepted.
The competencies were revised in 2004 and ran into the same difficulties...poor acceptance due to a perceived lack of collaboration. I said perceived...these competencies were widely vetted and validated through studies but for some reason did not meet the needs of the national groups that would approve them and move them forward for use within all CNS education.
Finally in 2008-2010 the competencies were yet again revised using the format for competency development that is now broadly accepted and have now gained acceptance from national nursing organizations. It is hoped that these newly revised competencies will be incorporated into the educational programs nation-wide for some standardization of educational expectations.
Additionally, there have been competencies defined for education of Masters and Doctoral level CNS programs. These will be released for general use very soon if they have not already been released.
All of these competencies define the role and how to educate for the role...another other piece needed were the competencies for the adult/gero population and those have been completed as well and are available on the NACNS and the AACN websites as it was an NACNS and AACN co-chair team that facilitated their creation. These competencies and educational strategies to instruct them will be presented at the NACNS conference in March.
These pieces all fit together to make the picture complete for at least one of the do we get the word out for all of them...and how do we get the work done in the educational programs to have them address the integration of the competencies so that CNS education is well situated for the new model by 2015?
Your thoughts??
Dr. Kelly A. Goudreau said:
Diana, I will be sharing the survey with the legislative/regulatory committee of NACNS and will be encouraging the use of it with many more states. It would be good to get a nation-wide perspective with the same survey content. If you are looking to survey in your state please contact Diana...
Ms. Diana Wortham said:
The newly formed NCBON APRN Advisory Committee is charged to explore compare and contrast the APRN Regulatory Model and implications for APRN practice in NC. Interested CNS have developed a state wide CNS environmental assessment that would yield pertinent and invaluable insight to the NC APRN Advisory committee’s efforts.Utilizing the LACE framework, a draft survey was circulated to evaluate tool integrity and question clarity on practice sensitive elements. Methodological and content expertise has been offered by Dr. Jan Fulton. The project is heading to a state stakeholder’s conference call early March and final survey revisions forthcoming. It is my hope that bloggers would be willing to share knowledge of their state’s inventories that parallel this effort in an attempt to ensure content and context inclusiveness as well as seek CNSs to beta test our survey to further ascertain content validity. For feedback or networking contact me at
About the Author

Kelly A Goudreau DSN, RN, ACNS-BC
Kelly A Goudreau DSN, RN, ACNS-BC is an Associate Editor for the Clinical Nurse Specialist Journal and has been a participant on behalf of NACNS in the development of the APRN Consensus Model and subsequent discussions about implementation of the LACE entity.

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