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The National Association of Clinical Nurse Specialists (NACNS) hosted the fourth invitational Summit for the CNS Community on July 21-22 at Sigma Theta Tau headquarters in Indianapolis, Ind. The focus of the 2006 Summit was doctoral education for clinical nurse specialists (CNS) and practice competencies of the doctorally prepared CNS.


A total of 35 individuals attended, representing NACNS and the following organizations:


American Association of Critical Care Nurses, American Association of Critical Care Nurses Certification Corp, American Nurses Association; American Nurses Credentialing Center; and the ANCC Commission on Certification; American Psychiatric Nurses Association; American Society of PeriAnesthesia Nurses; Association of periOperative Registered Nurses; Association of Rehabilitation Nurses; Board of Certification for Emergency Nursing; Commission on Collegiate Nursing Education and the CCNE Board of Commissioners; Emergency Nurses Association; National League of Nursing-AC; Oncology Nursing Society; and the Quad Council/Association of Community Health Nursing Educators.


Kelly Goudreau, President of NACNS, opened the meeting and provided background on the CNS competencies and educational guidelines contained in the NACNS Statement on CNS Practice and Education (2004). She then presented an update on the CNS Competency Validation survey currently in process and outlined the goals for the Summit. Participants recommended that NACNS collaborate with other nursing specialty organizations to increase the response rate to the CNS competency validation survey. Representatives from several specialty organizations offered to support the NACNS competency validation survey by notifying and encouraging their CNS members to complete the survey.


Sally Tibbals and Nancey France facilitated a panel presentation and discussion on Doctor of Nursing Practice (DNP) programs for clinical nurse specialists. Invited panelists were as follows: Dr Carolyn Williams, Professor and Dean, University of Kentucky, College of Nursing; Dr Carol Thompson, University of Tennessee Health Science; Dr Robin Dennison, Assistant Professor, University of Cincinnati College of Nursing; and LaRae Huycke, DNP Student at the University of Tennessee. Participants asked questions about how the program of study would differ for nurses entering with bachelor's or master's degrees and whether the DNP would become the required degree for all advanced practice roles. Dr Williams provided an overview of the proposed DNP Essentials and indicated that Essential 8 addresses the foundation practice competencies seen as necessary for all DNP practice. However, competencies related to specialty role also should be developed. All organizational representatives indicated that NACNS should take a lead role in defining the competencies for clinical nurse specialists.


Phyllis Gaspar and Ann Jacobson, members of the NACNS Education Committee, provided an overview of their work comparing the competencies identified in the DNP Essentials document with the competencies listed in the NACNS Statement on Clinical Nurse Specialist Practice and Education (2004) for the 3 spheres of influence. Drs Gaspar and Jacobson will continue to refine this comparison document with input from the other members of the Education Committee and the NACNS Board.



On the second day of the Summit, participants were divided into 4 groups. Each of the first 3 groups addressed 1 of the 3 Spheres of Influence and was asked to review current CNS competencies (NACNS Statement, 2004) and identify gaps, compare the CNS competencies to DNP essentials and make recommendations for additional competencies needed for CNS practice at the doctoral level, and identify educational implications of recommendations. A fourth group was asked to discuss issues related to doctoral education for clinical nurse specialists. Results of the discussions indicated that the CNS competencies and education recommendations contained in the NACNS Statement on Clinical Nurse Specialist Practice and Education (2004) are still important and relevant, although some updating and revision is needed.



Judy Spross, cochair of the Education Committee and Peggy Gerard, Treasurer, led a group discussion and summation of major issues/recommendations. Consensus was achieved around the following:


* Specialty organizations are willing to partner with NACNS to increase response rate to the NACNS Competency Survey.


* The NACNS Statement provides an excellent foundation for identifying CNS competencies and education but needs some revision and updating, particularly in the areas related to collaborating with other disciplines, evidence-based practice, translating evidence into practice, safety and quality, and information technology.


* Many changes have occurred since the NACNS white paper on the DNP was published. NACNS should review the white paper on the DNP and update.


* DNP programs are developing, and there is a need to define Essential 8 for CNS education and practice. NACNS should take the lead in developing Essential 8 for CNSs.


* Most specialty organizations represented had not discussed future education for CNS practice. Each organization should discuss: "What is the appropriate level of education for entry into CNS practice in the future?"





* NACNS will work with specialty organizations to improve response rate to the NACNS Competency Survey.


* NACNS will create a Taskforce to develop educational guidelines and objectives for CNSs prepared in a DNP program. Taskforce will have representatives from specialty organizations.


* President Kelly Goudreau will share comments and recommendations regarding the NACNS white paper on the DNP with Board members. Results of the Board review will be disseminated.


* The specialty organizations agreed to ask their respective Boards to discuss what education requirements for CNSs should look like in the future. Recommendations from each organization should be sent to NACNS.