In this column, leaders from ALSN discuss the issues presented by a lack of differentiation in functional nursing leadership competencies between Masters of Science in Nursing (MSN) and Doctorate of Nursing Practice (DNP) prepared graduates. An ad hoc committee of members of ALSN) was convened to conduct a comprehensive review of the existing literature and develop an initial set of nursing leadership competency and sub-competency statements that align with the AACN's Essentials 10 Domains of competency for nursing education.

Sustaining quality and patient safety (QPS) is a global priority due to risks such as patient harm, poor experiences, inequity, and resource waste. Training and education in key competency areas can support continuous improvement and enhance workforce performance. Clearly defining core QPS competencies for healthcare staff is essential to ensure preparedness to provide quality, safe care. Competency frameworks provide structured support for training and curriculum development, with many developed globally as strategic initiatives, some using evidence-based approaches. However, there is no consensus on core competencies to promote quality and patient safety, definitions of relevant terms can vary, and evidence on framework effectiveness is mixed. To address this research gap, the objective of this review was to systematically explore and collate evidence to provide insight into the current landscape of QPS competencies and frameworks. Additionally, this review sought to identify how competencies and competency frameworks have been designed, developed, implemented and evaluated. We searched for studies on QPS competencies and frameworks in PubMed, CINAHL, Web of Science, PsycINFO, and Cochrane Library from Jan 2010 to April 2023. We also conducted grey literature searches on Google Scholar, Opengrey, and the National Institute for Health and Clinical Excellence (NICE). All studies that described QPS competencies and/or frameworks were included. Since the studies varied in type, a narrative approach was adopted to synthesise the included studies. Out of the initial 14,144 studies found, 118 were deemed relevant after thoroughly reviewing abstracts and full texts. Of these, 36 studies outlined specific QPS competency frameworks, while the remaining 82 studies assessed various QPS competencies across diverse contexts. Upon analysing data from all 118 studies, we identified 37 QPS topic areas and a variety of competency statements encompassing skills, knowledge, and behaviours deemed relevant for promoting QPS. The most frequent QPS topic areas included communication, patient safety culture, teamwork and collaboration, risk monitoring and management and patient-centred care. The review has highlighted key insights into education and training related to QPS competencies. Core competency topic areas have been identified that are essential for workforce development and the promotion of quality and patient safety in healthcare settings. However, there is a gap in research on strategies to effectively implement and integrate QPS frameworks into practice, leading to insufficient evidence on translating these competencies into real-world application.

Identification of required competencies for specialist nurses in infectious disease care: A modified Delphi study

The 2008 core competencies for the public health in Canada were used extensively however were outdated. Our objective was to determine and conduct a consultation and engagement process to update the core competencies. This study describes the approach and methods used. Feminist community-based research informed the multiple methods used to gather explicit and tacit expertise on essential knowledge, skills, and attitudes for the updated competencies. Recommendations from published literature were adapted for project governance, literature reviews, engagement, and integration of feedback on competency statements based on principles of reflection, reflexivity, equity, and transparency. More than 2300 members of the public health community contributed to updating the core competencies via in-person and virtual engagement sessions. Participants were from every province and territory and a range of public health disciplines, roles, and system levels, with a focus on integrating Indigenous and Black Health Leaders' perspectives. Over 2200 comments and edits received informed successive competency drafts. The updated core competencies incorporate timely issues, such as climate change and planetary health, for evidence-informed public health practice and policy. They emphasize the importance of First Nations, Inuit, and Métis approaches and ways of knowing, of integrating Black Health and anti-Black racism, as well as grounding values of health equity, social justice, and accountability in public health practice and policy. This manuscript adds to the international body of knowledge on methods for modernizing core competencies for public health workforce development and training.

Background: The expansion of online and hybrid graduate education has shifted the central quality question from delivery feasibility to whether institutions can credibly demonstrate advanced, assessable graduate capability in digitally mediated environments. Competency-based education offers a promising framework for this challenge, but its conceptual foundations and implementation logics remain uneven across higher education. Objective: This scoping review aimed to map how competency-based curriculum design is conceptualised and operationalised in online graduate education and to identify curriculum, assessment, platform, faculty-development, and governance implications for emerging African universities. Methods: Guided by Joanna Briggs Institute scoping review methodology and a Population-Concept-Context framework, the review mapped peer-reviewed studies together with selected policy and quality assurance documents retrieved through structured searching and targeted source identification relevant to online graduate education, competency-based design, and digital higher education governance. Results: The evidence converged around six interdependent domains: competency specification, curriculum architecture, assessment evidence chains, online interaction design, learning management system configuration, and faculty and governance capability. The review found that the central problem is not merely definitional ambiguity, but the failure to sustain alignment from competency statements to valid assessment, platform workflows, and institutional quality assurance. It also found that much of the available evidence comes from higher-capacity systems and professionally regulated disciplines, limiting direct transferability to emerging African universities. Conclusion: Competency-based online graduate curricula are most defensible when treated as institution-wide design architectures rather than course-level innovations. For emerging African universities, credible implementation depends on coherent alignment among curriculum, pedagogy, assessment, platform design, faculty development, and quality management. The review therefore argues for selective translation rather than uncritical borrowing of dominant models.

The process of updating the Core Competencies for Public Health in Canada, Release 1.0, was initiated in 2023 using a multi-method approach. This included evidence syntheses, an extensive engagement process to ensure relevance to current public health challenges and a Delphi survey. The objective of this study was to assess agreement on the updated competency statements among a diverse range of public health professionals, educators, policymakers, and community representatives across Canada. A modified Delphi survey was conducted in English and French to assess agreement with 68 draft competency statements across 10 categories. Eligible participants were members of the Canadian public health community who were 18years of age or older and able to participate in either official language. Participants rated their agreement with each statement using a 6-point Likert scale, with an a priori agreement threshold set at 70%. Agreement was defined as the number of participants who responded with 'agree' or 'strongly agree' to a statement, with a predefined threshold set at 70%. Open-ended text boxes allowed for qualitative feedback, which was analyzed thematically. High agreement was achieved across all competency categories and statements, with a mean agreement level of 86.1% and an average of 551 responses per statement. The highest agreement was found in the Communication category (mean agreement of 91.5%), while the Public Health Advocacy category had the lowest agreement (79.5%). Participants expressed strong support for the inclusion of new categories and updated statements not present in Release 1.0, particularly those emphasizing social justice, technology, and advocacy. Thematic analysis revealed widespread appreciation for the update and its enhanced focus on social justice, health equity, and Indigenous inclusion, alongside concerns about tailoring expectations based on professional roles and experience. The high agreement obtained from a diverse cross-section of stakeholders affirms the relevance of the revised categories and statements to contemporary and future public health practice. These findings supported the finalization of the Core Competencies for Public Health in Canada, Release 2.0. Ongoing efforts will focus on engaging knowledge user groups and embedding the competencies into workforce planning, development, education, and training.

Systems-based practice is crucial for health professionals. Our study aimed to explore systems-based practice within health professions competency standards in Australia, Canada and the United Kingdom. We employed conceptual content analysis to review the extent to which systems-based practice is articulated within competency standards documents across 14 different health professions. Systems-based practice key word searches were undertaken across 38 documents, with frequency of terms counted and compared across professions and countries. The text surrounding the key word was analysed and categorised based on a systems-based practice framework into either knowledge (structural competencies), skills (structural action) or attitudes (social responsibility). Categories across professions were summarised and synthesised across professions for each of knowledge, skills and attitudes. The most common terms used across the professions and countries were 'quality' and 'system' with most phrases surrounding quality related to safe and effective patient care with only some references to improving care or quality improvement. Text surrounding the term 'system' mainly referred to health professions being able to navigate the systems in which they interact to provide care, with some standards describing competencies to affect systems that affect health, including bias, determinants of health, and access to care. The competency statements mostly focused on knowledge and skills with only some attitudinal capabilities described across the standards. All professions included systems-based practice competencies with some emphasising health system practice (paramedicine, midwifery, medicine, paramedicine, pharmacy, podiatry, radiography) and others including broader social systems (dietetics, nursing, physiotherapy, psychology, sonography, speech pathology, social work). Systems-based practice is as a key competency for health professionals across Australia, Canada and the United Kingdom with a focus on health care systems and limited focus on competencies that challenge broader systems and prepare graduates to address the determinants of health.

DigComp 3.0, released in November 2025, introduces systematic AI competence labelling across all 21 digital competences - the first European framework to do so. This paper analyses the AI-labelled competence statements and learning outcomes in the DigComp 3.0 Data Supplement through the lens of design activity, arguing that the framework positions design competence as a universal digital skill. A quantitative content analysis of 362 competence statements and 523 learning outcomes shows that 82% carry some AI relevance (14% AI-Explicit, 68% AI-Implicit), with Area 3 (Content Creation) concentrating 45% of all AI-Explicit statements. Five competences - 3.1, 3.2, 3.3, 3.4, and 5.3 – form a "design competence cluster" characterised by high AI density and direct connection to content creation, evaluation, or creative problem-solving. A comparison of DigComp 2.2 and 3.0 shows that competence renames (e.g., "Programming" → "Computational thinking and programming"; "Creatively using digital technologies" → "Identifying creative solutions using digital technologies") signal a shift toward design-aware digital literacy. Three dimensions of citizen design competence are identified - AI-assisted creation, critical evaluation, and ethical and responsible use - with implications for curriculum design in pedagogical and higher education.

Clinical competency guidelines promote optimal, safe standard of care. While nationally established clinical competencies exist for burn occupational therapists and physiotherapists, no equivalent frameworks exist for burn speech-language pathologists (SLPs). To address this gap, we developed a burn-specific SLP competency tool. Led by the American Burn Association (ABA) Rehabilitation Committee, an expert panel of burn SLPs, Burn Therapists-Certified (BT-C) clinicians, and a physiatrist implemented a staged process. Current national and international practice guidelines were synthesized through modified Delphi methodology, with expert consensus meetings to create and refine a burn SLP competency tool. The ABA Burn Rehabilitation Therapists Competency Tool served as the model framework. Eighteen multidisciplinary burn clinicians representing 14 burn centers, across 3 countries, refined the burn SLP competency tool. A steering group (5 SLPs, 1 burn physiatrist) identified 103 competency statements spanning 15 core clinical domains. These were presented across 2 rounds of Delphi survey and consensus meetings. The tool was refined with each survey resulting in a final tool comprising 81 knowledge and application competency statements covering 17 domains, tailored to the burn SLP across the continuum of care for adult and pediatric populations. The tool is structured into 2 tiered levels of expertise: level 1: minimum level of specialist skill required to manage a patient with burn injury; level 2: expert level of specialist skill and recognized resource to other SLPs. This initiative has produced the first internationally developed and consensus-based competency tool for burn SLPs. It establishes a standardized reference for SLPs to deliver specialized burn care throughout the acute and rehabilitative continuum.

To establish a national consensus on the minimum expected competencies that orthopaedic surgery residents in Chile should achieve by the end of training, providing a foundation for competency-based curriculum development in comparable training contexts. A multicentre modified Delphi study was conducted involving academic leaders from orthopaedic residency programmes across Chile. An initial round of open-ended questions among programme directors generated draft competency statements, which were refined through two subsequent rounds using a 5-point Likert scale. Consensus was predefined as ≥ 80% agreement (ratings of 4 or 5) with an interquartile range ≤ 1. Competencies were organised into six ACGME core competencies and one CanMEDS role. Twenty-eight experts completed the final rounds. Consensus was achieved on 32 competency statements spanning patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, system-based practice, and scholar-research. Agreement was observed for non-procedural competencies and foundational surgical skills. In contrast, consensus was not reached regarding autonomy, even under supervision, for advanced surgical procedures, particularly arthroplasty and selected soft-tissue procedures. Qualitative feedback attributed disagreement to patient-safety considerations, procedural complexity, and differing views on the boundary between residency and fellowship-level competence. This national Delphi study establishes the first consensus-based definition of minimum expected competencies for orthopaedic surgery residency training in Chile. The resulting framework provides a shared reference aligned with international competency-based principles while remaining responsive to local training contexts, and is intended to inform educational development and accreditation discussions in similar training settings rather than mandate a uniform training model.

India faces a growing need for Palliative Care due to its ageing population, rising cancer burden, and high prevalence of chronic illnesses. Unfortunately, less than 4% of the population has access to Palliative services, and the country ranks 59th in the 2021 Quality of Death Index. Contextually relevant and culturally sensitive nursing competencies are crucial to address this gap. However, there is no structured, evidence-based palliative nursing competency framework tailored to India's sociocultural and healthcare realities. This study explored stakeholder perspectives to identify core nursing competencies required for palliative care in the Indian context. A qualitative design was employed, comprising seven Focus Group Discussions with nurses involved in delivering care to patients with life-limiting illnesses, and thirty five In-Depth Interviews with patients and caregivers at various stages of the disease trajectory, from diagnosis to terminal illness and end-of-life. Data were analysed using Braun and Clarke's thematic analysis approach. Line-by-line coding was conducted using Open Code 4.02 version to systematically identify themes and subthemes. These were synthesized into competency domains and statements that reflect the essential skills, knowledge, and attitudes required for palliative nursing in India. To ensure the rigor and trustworthiness of the findings, measures such as member checking and peer debriefing were undertaken throughout the research process. Thematic analysis yielded seven distinct competency domains. These domains captured a wide range of nursing roles, including understanding foundations of Palliative Care, communication, ethical, legal, and professional responsibilities, symptom management and enhancing comfort, psychosocial, cultural, and spiritual aspects of care, and team collaboration. The findings emphasized the importance of culturally grounded, holistic, and compassionate care tailored to the needs of Indian patients and their families. Importantly, region-specific factors, such as Indian family dynamics, cultural attitudes towards death, and spiritual beliefs, emerged prominently during the thematic analysis. Interestingly, there was a notable convergence between the views expressed by nurses in focus group discussions and those of participants in in-depth interviews regarding essential palliative care competencies. This study presents an empirically derived set of thematic domains and insights for palliative care nursing competencies, grounded in stakeholder perspectives and tailored to the Indian context. The identified domains can inform curriculum development, training programs, and policy formulation to strengthen palliative care services across India. The study is registered in the Clinical Trials Registry of India CTRI/2023/07/055216) dated 14/07/2023.

The transition from academic study to professional practice can be challenging for newly graduated nurses who have less than 12 months of experience. Newly graduated nephrology nurses need opportunities to build competence and confidence to provide quality and safe nephrology nursing care. A team of nursing educators and instructional designers integrated competency statements from the American Nephrology Nurses Association's Nephrology Nursing Scope and Standards of Practice (9th ed.) into a nurse residency program, which positively impacted competency obtainment, role confidence, and retention data for this population of nephrology nurses.

Rapid advancements in augmented and artificial intelligence (AI) are reshaping health care, necessitating a strategic approach to integrating innovation into nursing education and practice. This article details a collaborative initiative between academic and practice partners aimed at the initial steps towards establishing the required knowledge, skills, and abilities for nurses to lead change through the creation of Nurse Innovator Competencies. After an extensive review of literature, the team identified the absence of established Nurse Innovator Competencies. Through a collaborative and iterative process involving subject matter experts (SMEs) in both innovation and academia, key domains for the competencies, including Innovative Thinking, Information Management and Technological Acumen, Iterative Development, Transformational Leadership, and Compassionate Care, were established. Utilizing the same approach, the team then crafted competency statements and solicited input from nurse innovators and health care employees. The results of this effort underscore the critical areas for enhancement and suggest methodologies for integrating these competencies into nursing curricula and nursing practice. While future analysis is needed to further test the survey tool and expand the data collection, the initial findings indicate emerging reliability. Ultimately, the Nurse Innovator Competencies are expected to serve as a guide to empower nurses to lead innovation while maintaining the core value of compassionate care in health care settings.

Competency frameworks play an important role in strengthening workforce capacity for promoting population health and wellbeing. However, competencies need to be periodically reviewed and revised to maintain their relevance to changing practice and contexts. This paper reports on the process of reviewing and updating the International Union for Health Promotion and Education (IUHPE) Core Competencies for Health Promotion. A multistage process was employed, which involved conducting a scoping review of the literature on health promotion competencies (2012-2022), based on which suggested revisions to the IUHPE Core Competency statements were made. An online consultation was then undertaken with the health promotion community, as represented by practitioners and members registered with the IUHPE Accreditation System, to consider the updated Revised Draft Framework with proposed changes. There was a high level of consensus concerning the proposed changes among respondents, based on which a revised version of the Competency Framework was produced. This was then forwarded to the IUHPE Global Accreditation System Management Committee and Executive Board for approval. The findings from this updating process are discussed and the implications for future developments are considered.

Public health practice necessitates effective health communication. Now, more than ever, public health practitioners must possess the competencies - the skills, knowledge, and attitudes - to communicate effectively. Using a robust, multi-step, multi-method research process, we sought to develop a set of communication competency statements for public health professionals in Canada, in communication-focused roles. Following earlier research steps that included scoping reviews, environmental scans, a national survey (n = 378), and key informant interviews (n = 12), which established an initial set of competency statements, a modified Delphi technique was conducted with a panel of public health communication experts which included two online survey rounds (n = 19, n = 18) with one virtual meeting (n = 7) in between to develop consensus on the initial competency statements. An a priori threshold for consensus of 75% agreement was set. After the second Delphi survey, participants reached consensus on all competency statements with 96% of participants agreeing with each statement on average, an increase from the first Delphi survey. Between the two Delphi surveys, revisions were made to the statements based on quantitative and qualitative participant feedback. The research has resulted in 18 communication competency statements comprising the Public Health Communication Competency Framework, which are intended to serve as a roadmap for public health professionals whose roles encompass communication, guide curricula development in public health programs, catalyze professional development in communication, and support public health systems to achieve the essential public health functions.

ABSTRACTAimTo validate a Competency Framework for Genomics Nurse Educators, strengthening the genomics‐informed nursing workforce.Background/IntroductionA pressing global need for nurse educators equipped to build genomic literacy within the profession prompted the International Society of Nurses in Genetics to develop the Competency Framework for Genomic Nurse Educators.MethodsA draft framework was refined using literature and stakeholder input guided by an evidence‐based model for competency framework development. A modified Delphi study with an international panel of genomics nurse experts completed a three‐round Delphi study. Methodology and reporting adhere to EQUATOR guidelines using the CONFERD‐HP and CREDES checklists.ResultsA 24‐member panel—with genomic nursing expertise spanning 13 countries—validated a set of competency statements organized into three domains covering foundational knowledge, genomics‐specific teaching approaches, and contribution to the discipline through leadership and academic–practice partnerships.DiscussionThese competencies address essential aspects of genomics nursing education and respond to increasing demand for specialization within academic nursing education.ConclusionThe validated framework addresses gaps in global genomic nursing education. This framework supports a focused approach to genomics education, preparing a new generation of nurse educators to meet the challenges of precision health.Implications for NursingImplementing this framework can standardize genomics education, strengthen faculty development, and ensure nurses are prepared to practice genomics‐informed nursing.Implications for Nursing and Health PolicyCompletion of the framework affirms genomics nursing education as a distinct specialty, laying groundwork for formal credentialing and shaping education priorities. Increasing the number of nurse educators with genomic expertise can strengthen academic–practice partnerships and foster global collaboration, ultimately supporting the equitable integration of precision health in nursing worldwide.

Dementia care requires a wide range of knowledge and skills delivered by both unpaid care partners and health and social care providers. In Ontario, Canada, no systematic framework currently aligns educational content with dementia care competencies. This gap risks the effectiveness of dementia-related education and care delivery. Therefore, this study protocol describes our approach to achieve consensus on the behavioural statements that describe the core competencies required of care partners, health and social care providers involved in dementia care. We will use a two-round modified Delphi method with expert panellists from two groups: (1) care partners with experience caring for someone living with dementia and (2) interprofessional health and social care providers working with people living with dementia. We will purposively recruit up to 80 panellists (40 per group). Panellists will assess standardized behavioural competency statements derived from earlier study phases, rating them on importance and measurability using a nine-point Likert scale. Round 1 will include opportunities for panellists to suggest new statements. Statements reaching ≥70% agreement (rated 7–9 on a 9-point Likert scale) and demonstrating a narrow interquartile range (IQR ≤ 2) will advance to Round 2. In the second round, a higher consensus threshold (≥80%) and stability in ratings (median shift ≤1 point) will determine final inclusion. Qualitative feedback through open-ended questions will be analyzed alongside quantitative results to refine the statements. Findings will support the development of a consensus-based Dementia Care Competency Framework to guide evidence-based educational initiatives and care delivery across settings. This inclusive approach will provide a model for ensuring both lived experience and clinical expertise shape the future of dementia care education in Canada and beyond.

Dementia care requires a wide range of knowledge and skills delivered by both unpaid care partners and health and social care providers. In Ontario, Canada, no systematic framework currently aligns educational content with dementia care competencies. This gap risks the effectiveness of dementia-related education and care delivery. Therefore, this study protocol describes our approach to achieve consensus on the behavioural statements that describe the core competencies required of care partners, health and social care providers involved in dementia care. We will use a two-round modified Delphi method with expert panellists from two groups: (1) care partners with experience caring for someone living with dementia and (2) interprofessional health and social care providers working with people living with dementia. We will purposively recruit up to 80 panellists (40 per group). Panellists will assess standardized behavioural competency statements derived from earlier study phases, rating them on importance and measurability using a nine-point Likert scale. Round 1 will include opportunities for panellists to suggest new statements. Statements reaching ≥70% agreement (rated 7-9 on a 9-point Likert scale) and demonstrating a narrow interquartile range (IQR ≤ 2) will advance to Round 2. In the second round, a higher consensus threshold (≥80%) and stability in ratings (median shift ≤1 point) will determine final inclusion. Qualitative feedback through open-ended questions will be analyzed alongside quantitative results to refine the statements. Findings will support the development of a consensus-based Dementia Care Competency Framework to guide evidence-based educational initiatives and care delivery across settings. This inclusive approach will provide a model for ensuring both lived experience and clinical expertise shape the future of dementia care education in Canada and beyond.

To develop precision health (PH) competencies and evaluate their comprehensiveness and fit into nursing practice. A modified e-Delphi technique was used to gather perceptions and achieve consensus on the inaugural set of PH domains, competency statements and sub-competencies developed by a workgroup formed under the aegis of the American Nurses Association (ANA). A set of PH competencies and sub-competencies was developed by the ANA workgroup, beginning with a literature review, followed by a multi-step work process of the group over 3 years (2022-2025). Then, a modified e-Delphi technique was conducted via a four-point Likert scale Qualtrics survey, using a purposive sample of PH experts. The respondents were asked to agree or disagree with each competency or sub-competency statement and suggest modifications. The threshold of concordance was set at 80%. The ANA workgroup reached consensus on six domains, six competency statements and 43 sub-competency statements to represent PH in nursing practice in its entirety. Forty experts in the field evaluated and offered revisions to the final 44 sub-competencies that represent the knowledge and skills necessary for PH in general nursing practice. A majority of the competency statements obtained favourable agreement from the expert panel, and a typical pattern of convergence was observed over two rounds of evaluation. The development of PH competencies is the essential first step in the attempt to integrate PH into nursing practice. The competency statements will inform nursing curricula, clinical practice guidelines, funding opportunities and role expectations in all healthcare settings. This work sets the stage for subsequent interprofessional practice initiatives and research exploring how these competencies influence patient outcomes, workforce readiness and the practical integration of advanced technologies into precise care.

IntroductionCyberattacks continue to intensify and are currently the top global technological risk. This global increase in cyberattacks and the growing dependence on digital platforms have also heightened the significance of cybersecurity within the accounting profession. As future custodians of sensitive financial data, accounting students must possess both the technical understanding and the practical skills to prevent such threats. Given the importance of the digital economy within the accounting profession, accounting curricula often do not include cybersecurity education, resulting in accounting students being inadequately prepared. This research aimed to fill this gap by formulating cybersecurity education guidelines through competencies for an accounting curriculum and is designed to be incorporated into various modules throughout the curriculum.MethodsContent analysis was conducted as part of the literature review to determine which competency frameworks of accounting professional bodies were relevant and which cybersecurity competency statements were to be included in the questionnaires as part of the quantitative study. While the study is predominantly quantitative in nature, the incorporation of participant comments adds a minor qualitative dimension, making the overall design descriptive with supportive qualitative elements. The questionnaire was distributed to accounting academics, and 41 responses were received.ResultsThe findings from this study indicate that accounting academics lack knowledge around cybersecurity and do not know how to incorporate the topic into the curriculum. Academics have also viewed cybersecurity as an important component of the accounting curriculum, given its emphasis within the digital economy.DiscussionThis study contributes to the development of the accounting curriculum and highlights the importance in developing cybersecurity skills in future accounting professionals which can be incorporated by making use of real-life case studies, using experts from the cybersecurity industry.