Most nursing programs support the current shift to competency-based education (CBE), driven in part by American Association of Colleges of Nursing (AACN) Essentials. A Wolters Kluwer New Nurse Readiness Survey revealed that half of entry-level nurses are involved in practice errors, and 65% of those errors are related to poor clinical decision-making. However, the AACN Essentials approach, with its 45 competencies and more than 250+ subcompetencies, can feel overwhelming as guidance and expectations continue to evolve. Many nursing leaders feel constrained by limited time, knowledge, and budget.
Transitioning your program to CBE reframes the shift as an iterative, staged process rather than a onetime curriculum redesign. This approach can make the process feel more manageable while creating the foundation for a program that intentionally develops, measures, and demonstrates students’ growing clinical competence. In addition, the shift can help ensure that graduates are prepared to confidently practice in real-world clinical settings.
Why an AACN Essentials gap analysis is just the starting point
Many programs begin their CBE journey by conducting a gap analysis to compare their existing curriculum against the AACN Essentials competencies. The gap analysis step serves to surface misalignment, and it pinpoints areas that require focused efforts. However, gap analyses show only where a program stands — not what to do next.
Some programs assign performance of the gap analysis to a single faculty member or a small committee often lacking the governance or decision-making authority to move any further. Without clear academic leadership buy-in or direction, many programs stall there — especially when faculty are already stretched too thin. In fact, 83% of programs cite lack of faculty time or commitment as the top barrier to AACN Essentials implementation.
Moving ahead with purpose requires structure and shared purpose, and investment of up-front time in building the framework helps programs advance from concept to growth by means of iterative improvement. This is precisely what accreditors want to see: evidence of a well-thought-out program whereby progress can be measured through the course of time. Accreditors do not expect perfection; rather, they want to see measurable progress.
Why implement a staged approach to AACN Essentials for nursing practice readiness?
Many successful programs sequence their CBE in three distinct stages: diagnose, architect, and operationalize. The diagnostic stage helps leaders learn what must happen; the architectural stage builds the structure, or scaffolding, for the curriculum to evolve, and the final operationalization stage clears a path for long-term improvement and scaling throughout the program.
Stage 1: Diagnosis — mapping and aligning awareness
During stage 1, programs align expectations across the department and establish shared direction. But significant learning is required — especially clarifications of confusions about competencies, subcompetencies, and progression indicators. As of late 2025, 88% of programs reported that faculty had attended at least one CBE workshop, and 68% said the materials were significantly useful for implementing the subcompetencies.
Before moving to stage 2, programs should complete the initial gap analysis and map all 45 competencies against the current curriculum. Just as important, they must ensure a shared understanding of why the shift matters, how it relates to their work, and what comes next. They must identify a clear champion who has strong working relationships with senior leadership and practice partners. And that champion must have budgetary and decision-making authority to maintain momentum.
Stage 2: Architecture — aligning and redesigning
Next, programs should begin to design and build the architecture that will support aligned outcomes, assessments, and learning experiences. Scaffolding provides essential structure throughout the program by helping students develop clinical judgment and autonomy through three phases:
- Introduce each competency and subcompetency.
- Reinforce the knowledge and its application through repeated exposure.
- Master each competency across contexts by demonstrating clinical judgment.
Scaffolding makes curriculum design more manageable — especially when programs bundle competencies and subcompetencies together in logical groupings. Because competencies rarely exist in isolation in clinical practice, bundling helps faculty teach and assess clusters of skills.
Next, programs should define observable behaviors. AACN calls these progression indicators, which establish the things students should be able to demonstrate at various points in the curriculum. Once defined, these behaviors or indicators should be integrated into rubrics. However, the integration often requires a step back to align disparate clinical evaluation tools and to ensure faculty are consistently observing, measuring, and documenting behaviors.
Stage 3: Operationalization — embedding and scaling
With the infrastructure in place, programs can begin to operationalize CBE and embed it throughout students’ educational journeys. However, this stage is not the end of a program’s CBE implementation. Instead, it is actually the beginning of ongoing iteration that will continue gathering and incorporating feedback to further improve the curriculum.
During this stage, formalized feedback loops provide essential input. Progression indicators embedded into the curriculum provide information about how well students are performing, but that alone is insufficient. Programs should educate their practice partners on the progression indicators and then build in feedback mechanisms for stakeholders. Ongoing faculty development is also essential to further elevate the program.
At this stage, everything should be standardized and well documented. Doing so provides consistency as the program scales while also giving the faculty certain guardrails within which to experiment and innovate. Consistency also ensures that CBE survives even if program champions leave or new faculty join.
What accreditors are looking for: Progress, not perfection
Accreditors don’t expect to see a fully formed curriculum with perfectly mapped competencies and progression indicators. At this point, they are looking only for evidence that a program is building a coherent system that will intentionally develop competence, measure progression, and improve iteratively. Accreditors want to see both progress and the thought process behind the changes.
Accreditors want to see three things:
- Demonstrable student progression. Accreditors want to see how a student’s clinical judgment skills grow over time with trends across classrooms and clinical settings.
- Coherent, aligned measurement. Observable, measurable behaviors should be used in rubrics and assessments with consistent definitions and documentation across settings.
- Evidence of iterative improvement. Programs must track outcomes through time with clearly documented feedback loops and examples of curriculum adjustments after feedback.
This will look different for every program, but when each of them gets demonstrated, accreditors will see how a program is improving iteratively. Accreditors want to see that program leaders are learning from their early efforts and making changes that bring them closer to true CBE. Overall, accreditors want to see clear direction, documented improvement, and growing alignment.
The goal: Nursing practice readiness
CBE represents a shift in the way nursing programs prepare the next generation of nurses. Complying with AACN Essentials is not just a compliance exercise, nor should it be a short-term project. Instead, programs should see AACN Essentials compliance as a nudge to strengthen student confidence, reinforce faculty cohesion, and amplify a program’s reputation.
CBE has no finish line, and programs don’t have to do everything at once. They should instead focus on determining where they are and then take the next step and then another — taking a paced and measured approach that keeps teams aligned. Getting an outside perspective from professional organizations and peer networks can also help a program overcome barriers and prepare for accreditation review. Experienced nurse educators who specialize in competency-based curriculum design and accreditation alignment, such as those with Lippincott®, can help identify blind spots, sequence the work realistically, and distinguish required elements from recommendations.
Download the white paper titled Progress, not perfection: Transitioning your program to competency-based education to see the full framework, and then explore Lippincott® Nursing Education solutions for your program.