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Developing an Evaluation Framework Based on Entrustable Professional Activities for Advanced Practice Nurses in

Shifan Han1,2, Wenjing Dong3, Xuan Duan1

  • 1School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, China.

International Nursing Review
|January 21, 2026
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Summary

This study developed an evaluation framework for advanced practice nurses (APNs) in China, using entrustable professional activities to define roles and guide implementation. The framework supports competency-based education and policy development for safe, effective APN practice.

Keywords:
advanced practice nurseentrustable professional activitiesevaluation frameworkprescriptive authorityrole qualificationscope of practice

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Area of Science:

  • Nursing Science
  • Healthcare Policy
  • Professional Development

Background:

  • Advanced practice nurses (APNs) globally provide high-quality, cost-effective care.
  • China lacks defined APN roles and national evaluation standards, hindering integration.
  • Conceptual ambiguity and regulatory gaps impede APN role implementation in China.

Purpose of the Study:

  • To develop an evaluation framework for APN roles in China.
  • To address ambiguity, scope, and regulatory gaps in APN implementation.
  • To guide policy, education, and credentialing for APNs.

Main Methods:

  • Scoping review of international APN evaluation frameworks.
  • Two-round Delphi study with 27 experts to establish entrustable professional activities (EPAs).
  • Structured consensus meetings to refine the evaluation framework.

Main Results:

  • Developed an EPA framework with 20 indicators across five domains.
  • Domains include clinical assessment, advanced practice, communication, education/research, and chronic disease management.
  • Final framework established after expert panel consultations.

Conclusions:

  • The framework clarifies APN roles, linking education, competencies, and practice.
  • Provides an organized approach to evaluating APN competencies and role readiness.
  • Supports competency-based education, assessment, and policy development for APNs in China.