1. Gustin, Tammy J. MS, RN, CNS
  2. Semler, Janice E. MS, RNC, CNS
  3. Holcomb, Marjorie W. MS, RNC
  4. Gmeiner, Jayne L. MS, CNS
  5. Brumberg, Annette E. BSN, CRRN
  6. Martin, Patricia A. PhD, RN
  7. Lupo, Therese C. MS, RN, CNA


Clinical ladders help maintain expert, motivated, and effective nurses in direct patient care roles. While many institutions were phasing out clinical ladders for registered nurses, Miami Valley Hospital was proactively evaluating the original version. The authors describe their clinical advancement program, based on Benner's model, with program evaluation results. The program participation rate has increased overall. Participants perceive their work and environment more positively than nonparticipants.