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Development and Validation of the Nurse Practitioner Clinical Competency Progression Rubric
Jeanne Moore1, Tracey Chan, Julianne Doucette
1Author Affiliations: Johns Hopkins School of Nursing, Baltimore, Maryland (Dr. Moore); Oakland University School of Nursing, Rochester, Michigan (Dr. Chan); Rush University College of Nursing, Chicago, Illinois (Dr. Doucette); and Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, Michigan (Dr. Slager).
Background:
As nurse practitioner (NP) education adopts competency-based education, programs lack workplace-based, behaviorally anchored tools to track longitudinal competency progression and assess practice readiness.
Purpose:
The purpose was to develop and validate the Nurse Practitioner Clinical Competency Progression Rubric (NP-Clin-CPR), a rubric aligning Dreyfus novice-to-expert stages with entrustable professional activity entrustment levels to monitor competency progression across core NP clinical activities.
Methods:
The NP-Clin-CPR defines 5 Dreyfus-aligned levels across autonomy, knowledge, standard of work, and contextual understanding; encounter complexity is recorded separately. Behavioral descriptors were drafted using structured large language model prompts informed by the American Association of Colleges of Nursing and National Organization of Nurse Practitioner Faculty indicators and refined to consensus. Eight NP experts rated relevance and clarity on a 4-point scale; item-level content validity indices (I-CVI) ≥ 0.78 and scale-level CVI/Ave ≥ 0.90 were targeted.
Results:
After 2 rounds, all 40 descriptors met I-CVI and scale-level CVI/Ave thresholds for relevance and clarity.
Conclusions:
The NP-Clin-CPR is a valid, behaviorally anchored, complexity-stratified rubric integrating Dreyfus and entrustable professional activity frameworks.
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