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Journal
© 2013
SELF-ASSESSMENT OF NURSING
INFORMATICS COMPETENCIES
FOR DOCTOR OF NURSING

PRACTICE STUDENTS

JEUNGOK CHOI, RN, PHD⁎ AND DONNA M. ZUCKER, RN, PHD†
ant Pro
st, MA.
iate Pro
st, MA.
ress cor
husetts
st, MA
223/12

of Pro
Elsevie
This study examined the informatics competencies of doctor of nursing practice (DNP) students
and whether these competencies differed between DNP students in the post-baccalaureate (BS)
and post-master’s (MS) tracks. Self-reported informatics competencies were collected from 132
DNP students (68 post-BS and 64 post-MS students) in their first year in the program (2007 to
2010). Students were assessed in 18 areas of 3 competency categories: computer skills,
informatics knowledge, and informatics skills. Post-BS students were competent in 4 areas
(computer skills in communication, systems, documentation, and informatics knowledge about
impact of information management), whereas post-MS students were competent in only 1 area
(computer skills in communication). Students in both tracks reported computer skills in decision
support as their least competent area. Overall, post-BS students reported slightly higher than or
similar competency scores as post-MS students, but scores were statistically significant in only
3 of 18 areas. The assessment indicated that knowledge and skills on informatics competencies
need to be improved, especially in computer skills for data access and use of decision support
systems. Strategies are suggested to integrate competencies into existing informatics course and
DNP curricula. Further studies are recommended using an objective measure of informatics
competencies. (Index words: Informatics competencies; Nursing informatics; Doctor of nursing
practice; DNP; Self report) J Prof Nurs 29:381–387, 2013. © 2013 Elsevier Inc. All rights reserved.
HE DOCTOR OF Nursing Practice (DNP) was Practitioner Faculties (NONPF, 2011). Incorporating
Tannounced in 2006 as a new kind of doctoral degree
for nurses by the American Association of Colleges of
Nursing (AACN, 2006). For new DNP programs, the
curriculum should contain eight essential areas of
curricular content, one of which is “information sys-
tems/technology and patient care technology for the
improvement and transformation of health care” (AACN,
2006). Integrating informatics into the DNP curriculum
requires, as a first step, accurately assessing current level
of informatics competencies in DNP students outlined by
the AACN and the National Organization of Nurse
fessor, School of Nursing, University of Massachusetts,

fessor, School of Nursing, University of Massachusetts,

respondence to Dr. Choi: School of Nursing, University of
, Amherst, 120 Skinner Hall, 651 North Pleasant Street,
01003. E-mail: [email protected]
/$ – see front matter

fessional Nursing, Vol 29, No. 6 (November/December), 201
r Inc. All rights reserved.
assessment of informatics competency into the curricu-
lum is essential for adjusting the teaching method or
content of the informatics curriculum to the students’
various needs (Jenkins, Wilson, & Ozbolt, 2007).

Despite the importance of assessing informatics compe-
tencies in the DNP curriculum, no study to date has
reported informatics competencies of DNP students. A
review of the literature revealed that a few studies
addressed informatics in advanced practice programs
including the DNP, and most of these studies defined
areas of competency (Cronenwett et al., 2009; Curran,
2003) or the extent to which graduate program has
incorporated information technology skills and knowledge
into nursing curricula (McNeil et al., 2003). Several
reported strategies to integrate informatics competencies
in a DNP or master’s (MS) curricula (Grant & Brettle, 2006;
Jenkins et al., 2007; Manning & Frisby, 2011). The purpose
of this article is to report the informatics competencies of
DNP students from 2007 through 2010 and to suggest
competency areas that will strengthen the informatics
3: pp 381–387 381
http://dx.doi.org/10.1016/j.profnurs.2012.05.014

mailto:[email protected]

http://dx.doi.org/10.1016/j.profnurs.2012.05.014

382 CHOI AND ZUCKER
curriculum. Strategies are also suggested for integrating
competencies into existing DNP curricula, with a specific
example of how competency findings were integrated into
a nursing informatics course. Because DNP students in the
post-baccalaureate (BS) and post-MS tracks have different
educational backgrounds and might have different prepa-
ration levels in informatics, we also examined whether
informatics competencies differed between DNP students
in these two tracks.
Informatics Competencies in BS Nursing
Education

BS nursing students’ information technology abilities
have been well studied, along with recommended
interventions to improve these competencies. In general,
BS nursing students have been evaluated as having
competent (Desjardins, Cook, Jenkins, & Bakken, 2005)
or moderate informatics and technology knowledge,
attitudes, and skills (Fetter, 2009; McDowell & Ma,
2007). Desjardins et al. examined the effect of infor-
matics for evidence-based practice courses on nursing
informatics competencies in students at the end of the
BS year of a combined BS/MS program. They found that
students were competent in four areas: computer skills:
communication; computer skills: basic desktop soft-
ware; computer skills: systems; and informatics knowl-
edge: impact (Desjardins et al., 2005). More recently,
graduating BS nurses were found to have moderate
information technology skills (Fetter, 2009). These
students were most confident in their Internet, word
processing, and systems operations skills and rated
themselves lowest on care documentation and planning,
valuing informatics knowledge, skills development, and
data entry competencies (Fetter, 2009). Following
formal training and hardware provision, modest im-
provements were found in basic informatics knowledge
and skills but fewer gains in advanced skills and
information literacy for nurses at the BS (McDowell &
Ma, 2007) and post-BS (Cole & Kelsey, 2004) levels.
Improved skills have been associated with specific
educational approaches, such as distance learning
(Cole & Kelsey, 2004; Kenny, 2002), the Nightingale
Tracker system and personal digital assistants (Miller
et al., 2005; Ndiwane, 2005), and clinical simulation
methods (Rhodes & Curran, 2005).

The informatics content of curricula for BS nursing
students was found to be limited, largely because of
nursing faculty’s lack of familiarity with computerized
systems and knowledge of informatics competencies
(Ornes & Gassert, 2007). To address informatics
shortcomings in a BS nursing curriculum, the authors
designed five assignments to incrementally increase
students’ abilities to recognize the need for information
(i.e., knowledge); advance their abilities to locate,
evaluate, and use information (i.e., skills); and foster a
positive appreciation for information literacy (i.e., atti-
tudes) when planning safe and effective patient care
(Flood, Gasiewicz, & Delpier, 2010).
The informatics and technology competencies of BS
nursing graduates were issues of concern in two surveys
of nurse executives and deans and directors of under-
graduate and graduate programs (McCannon & O’Neal,
2003; McNeil et al., 2003). The nursing executives
reported that new graduate nurses needed to be familiar
with nursing-specific software such as computerized
medication administration systems (McCannon &
O’Neal, 2003). The executives recommended improving
incorporation of these skills into nursing curricula, but
the deans and directors of nursing programs reported
no formal evaluation of student informatics competen-
cies and rated faculty who were teaching informatics
content at the “novice” or “advanced beginner” level
(McNeil et al., 2003).

Informatics Competencies in Graduate
Education, Including DNP Education

The few studies that have addressed informatics compe-
tencies in graduate students have defined the areas of
competency for nurse practitioners (Cronenwett et al.,
2009; Curran, 2003), or the extent to which graduate
programs have incorporated information technology
skills and knowledge into MS nursing curricula (McNeil
et al., 2003), or suggested strategies to integrate
informatics competencies in a DNP or a MS curriculum
(Grant & Brettle, 2006; Jenkins et al., 2007; Manning &
Frisby, 2011). For example, the deans and directors of
nursing programs in one study reported that the lowest
informatics technology content areas taught in the
graduate program were standard languages or terminol-
ogies or data standards for information systems (McNeil
et al., 2003). In addition, a foundational course was
proposed for all DNP students with strategies for
integrating informatics throughout the curriculum, for
example, requiring students to use informatics tools to
search for and evaluate population-based health knowl-
edge in epidemiology, research, and statistics courses
(Jenkins et al., 2007). Informatics competencies were one
of several competencies, along with their related knowl-
edge, skills, and attitudes, integrated into an existing on-
line DNP patient safety course (Manning & Frisby,
2011). The students formed teams to produce educa-
tional videos on hand hygiene, which provided the
vehicle for experiential learning, interpretative thinking,
reflective practice, and peer review to facilitate DNP
student achievement of advanced competencies in
teamwork and collaboration, evidence-based practice,
and informatics into their existing course (Manning &
Frisby, 2011). The literature searching skills of MS- and
doctoral-level students (n = 13) improved after taking a
Web-based tutorial developed as part of a 12-week
evidence-based practice module on health and social
care (Grant & Brettle, 2006).

In summary, this review of the literature reveals a lack
of studies on informatics competency assessment of DNP
students. Existing literature has focused solely on
defining the areas of competency (Cronenwett et al.,
2009; Curran, 2003; McNeil et al., 2003) or strategies to

383SELF-ASSESSMENT OF NURSING INFORMATICS COMPETENCIES
integrate informatics competencies into DNP or MS
curricula (Grant & Brettle, 2006; Jenkins et al., 2007;
Manning & Frisby, 2011). Measuring DNP students’
perceived informatics competencies is one of the
elements for successfully designing informatics curricula
and in meeting the DNP informatics competencies
outlined by the AACN (2006) and the NONPF (2011)
by identifying areas of deficits and strengthening those
areas. Thus, this study was undertaken to assess
perceived informatics competencies of DNP students.

Methods
Our school of nursing began offering the DNP for both
post-BS and poststudents in 2006 using on-line distance
education. This program was accredited in 2010 by the
Commission on Collegiate Nursing Education. Since
2007, the informatics for nursing practice course is
offered in the first semester of the program. The
informatics course and informatics concepts threaded
through courses in our DNP program have been designed
and implemented according to the AACN DNP Essentials
IV: Information Systems/Technology and Patient Care
Technology for the Improvement and Transformation of
Health Care and the NONPF’s Technology and Informa-
tion Literacy Competencies.

During the first week of the course, students were asked
to take an informatics competency assessment embedded
in the Blackboard Vista learning management system.
Students were told that the information was being
collected for course evaluation and improvement pur-
poses, and responses to the survey would have no effect on
their current or future success in the course or program.

Competency Assessment Tool
The 86-item informatics competency assessment was
based on a published set of 43 informatics competency
statements for beginning and experienced nurses (Stag-
gers, Gassert, & Curran, 2001; Staggers, Gassert, &
Table 1. Examples of Informatics Competency Statements

Informatics competency category

Computer skills: documentation • Use applications for
• Use application to d

Computer skills: decision support • Uses decision suppo
or differential diagnos

Computer skills: communication • Use telecommunicat
with other systems (e
• Use e-mail
• Use interactive com

• Informatics knowledge: privacy/security • Discuss the principle
for patient confidentia
• Describe patients’ ri

• Informatics knowledge: impact of
computerized information management

• Explain use of netwo
• Identify the basic co
computer and workst
• Discuss the impact o
of the nurse

Informatics skills: data • Convert information
• Evaluate health infor
Curran, 2002), with additional items related specifically
to evidence-based practice and information literacy
(Bakken et al., 2004; Curran, 2003). Each item is rated
on a 5-point Likert scale (1 = not competent to 5 = expert).
Items are arranged using the 18 competency areas in three
competency categories: computer skills, informatics
knowledge, and informatics skills. Means were calculated
for each of the 18 competency areas. Table 1 shows sample
competency statements.

These 86 competency statements measure skills and
knowledge of 18 competency areas, which are decision
support system, basic desktop software, health care
information system, data access and monitoring, comput-
erized information management system, ethical and legal
issues related to use of health care information system, and
consumer health information resources. These areas are
consistent with the informatics competencies outlined
by AACN DNP Essentials IV and NONPF’s Technology
and Information Literacy Competencies.

This assessment measures students’ perceived compe-
tencies by self-report. Measuring students’ perceptions of
informatics skills and knowledge is an important step in
assessing informatics competencies because direct mea-
sures of competencies are time consuming and may
not be feasible with large numbers of students. Students’
self-report of perceived competencies has been used by
many researchers as a measure of informatics competen-
cies (Desjardins et al., 2005; Fetter, 2009; Garde,
Harrison, & Hovenga, 2005; Hwang & Park, 2011;
McDowell & Ma, 2007; Ornes & Gassert, 2007; Yoon,
Yen, & Bakken, 2009).

Data Analysis
Data were analyzed using SPSS, Version 19 (Chicago, IL).
Students’ informatics competencies were summarized
using descriptive statistics (frequencies, percentages,
means, and standard deviations). Differences in infor-
matics competencies by student track (post-BS vs. post-
Competency statement

structured data entry
ocument patient care
rt systems, expert systems, and aids for clinical decision making
is
ion devices (e.g., modems or other devices) to communicate
.g., access data, upload, and download)

munication devices with patients and other health care providers
s of data integrity, professional ethics, and legal requirements
lity and data security
ghts as they pertain to computerized information management
rks for electronic communication (e.g., Internet)
mponents of the computer system (e.g., features of a personal
ation)
f computerized information management systems on the role

needs into answerable questions
mation on the Internet using a structured critique format

384 CHOI AND ZUCKER
MS) in the DNP program were analyzed using indepen-
dent t tests. The internal consistencies of the entire
instrument and for each of three competency categories
were assessed using Cronbach’s alpha.

Results
Demographics of Student Sample

Informatics competency scores were based on 132 DNP
students in the post-BS or post-MS track in 2007 (n = 31),
2008 (n = 18), 2009 (n = 44), and 2010 (n = 39). The
sample was predominantly female (76.8%), with slightly
more in the post-BS track (54.6%, n = 72) than in the
post-MS track (45.4%, n = 60).

Informatics Competencies
Informatics competency scores in computer skills,
informatics knowledge, and informatics skills did not
differ significantly across years in the post-BS and post-
MS tracks, F(3, 64) = .93 to 1.22, P = .31 to 0.43 in the
post-BS track; F(3, 60) = 1.85 to 2.09, P = .11 to .15 in the
post-MS track. Therefore, the data from 2007 through
2010 were aggregated for analysis.

The internal consistency reliabilities of the instrument
were high; Cronbach’s alpha for all items was .98, for
computer skills was .97, for informatics knowledge was
.95, and for informatics skills was .93.

Competency scores are summarized by track in
Table 2. With competence indicated by a minimum
score of 3, overall post-BS and post-MS students were not
competent in any of the three categories of informatics
competencies. Post-BS students’ mean (SD) competency
Table 2. Summary of Competency Scores

Competency scale No. of items

Post-BS
(n = 72

M

Computer skills
Decision support 1 1.62
Communication 5 3.33
Basic desktop software 8 2.67
Systems 7 3.14
Documentation 4 3.10
Data access 6 1.98
Monitoring 2 2.69
Education 8 2.07
Administration 3 2.35
Informatics knowledge
Impact 9 3.15
Privacy–Security 4 2.47
Systems 5 2.56
Data 8 2.26
Informatics skills
Data 8 2.04
Systems 1 2.54
Clinical 1 2.63
Administration 5 2.34
Privacy–Security 1 2.72

⁎ Post-BS: post-BS track.
† Post-MS: post-MS track.
scores in computer skills, informatics knowledge, and
informatics skills were 2.55 (.64), 2.61 (.64), and 2.46
(.77), respectively. Post-MS students’ mean (SD) compe-
tency scores in computer skills, informatics knowledge,
and informatics skills were 2.39 (.67), 2.42 (.68), and
2.36 (.78), respectively.

More specifically, post-BS students were competent in
four areas: computer skills: communication (M = 3.33,
SD = .61); computer skills: systems (M = 3.14, SD = .83);
computer skills: documentation (M = 3.10, SD = .91);
and informatics knowledge: impact of computerized
information management (M = 3.15, SD = .69). Post-BS
students reported their least competent informatics
area as computer skills: decision support (M = 1.62,
SD = .86) followed by computer skills: data access (M =
1.98, SD = .63).

In contrast, post-MS students were competent in only
one area, computer skills: communication (M = 3.15,
SD = .68), and did not achieve competence in the other
informatics areas. However, post-MS students reported
their least competent area as computer skills: decision
support (M = 1.78, SD = .98), followed by computer
skills: data access (M = 1.91, SD = .66), the same as the
post-BS students.

Differences in Competency Scores Between Post-BS
and Post-MS DNP Students

Post-BS students reported slightly higher than or similar
competency scores as post-MS students in most areas
except two (computer skills: decision support and
informatics skills: data). However, these differences
⁎,
)

Post-MS †,
(n = 60)

Post-BS vs.
post-MS

PSD M SD Independent t

0.86 1.78 0.98 −1.02 .31
0.61 3.15 0.68 1.66 .01
0.80 2.60 0.75 0.51 .61
0.83 2.98 0.72 1.18 .24
0.91 2.63 0.91 3.01 .003
0.63 1.91 0.66 0.54 .59
0.95 2.28 0.93 2.51 .01
0.75 1.94 0.78 0.99 .33
0.72 2.22 0.81 0.97 .33

0.69 2.91 0.69 1.95 .05
0.80 2.44 0.81 0.21 .84
0.69 2.28 0.73 2.24 .03
0.64 2.06 0.74 1.66 .01

0.67 2.09 0.63 −0.39 .70
1.06 2.22 0.95 1.86 .07
0.98 2.58 0.92 0.33 .74
0.84 2.24 0.76 0.74 .46
1.16 2.69 1.01 0.18 .86

385SELF-ASSESSMENT OF NURSING INFORMATICS COMPETENCIES
were statistically significant in only three areas: computer
skills: documentation (t = 3.01, P = .003), computer
skills: monitoring (t = 2.51, P = .01), and informatics
knowledge: systems (t = 2.24, P = .03). For the other
areas, no significant differences were identified (Table 2).

Discussion
Low Competence Across Informatics

Competency Areas
Overall, DNP students in the post-BS and post-MS tracks
at the beginning of their first semester were not competent
in any of the three categories of informatics competency:
computer skills, informatics knowledge, and informatics
skills. This assessment indicates that DNP students’
knowledge and skills on overall informatics competencies
need to be improved through the informatics curriculum.
In particular, students in both tracks scored the lowest
(from not competent to somewhat competent) on
computer skills: decision support, followed by computer
skills: data access. These results show that students
perceived that they were not competent in using decision
support systems, aids for clinical decision making or
differential diagnosis, accessing or extracting information
from clinical data sets (e.g., minimum data set), searching
for and retrieving literature resources and integrating
them into a personally usable file (e.g., RefWorks, an on-
line tool for managing references and citations), using
data and statistical analyses to describe and evaluate
practice, and using computer applications for statistical
analysis (e.g., SPSS) and nursing research. Our findings
indicate that these areas need to be prioritized when
designing an informatics course in DNP curricula.

Integrating Competencies Into Existing
DNP Curricula

The results of this study reveal ample room for
improvement across almost all surveyed informatics
competencies, except three competency areas for post-
BS students and one for post-MS students. To efficiently
and effectively address the deficiencies in informatics
curricula, we recommend that educators prioritize
students’ most pressing improvement needs and then
strategize how to include content in the informatics
curriculum leading to informatics competencies.

However, preparing DNP students to be competent in
all the areas of informatics competencies during one
informatics course does not seem practical or efficient.
Instead, informatics competencies need to be incorporat-
ed into the DNP curriculum in collaboration with other
DNP instructors (Flood et al., 2010; Jenkins et al., 2007).
For example, activities or exercises using spreadsheets,
databases, and statistical software could be included in
DNP courses such as nursing research or intermediate
biostatistics, leadership, or health quality.

Familiarizing students with statistical software for
quality improvement projects can be incorporated into
leadership or health quality courses. Another example
would be to use informatics tools such as retrieving data,
information, and knowledge to investigate population
health (in an epidemiology course) and to evaluate
knowledge for evidence-based practice (in a research
methods course). Informatics skills could be incorporat-
ed into clinical practicum courses in the DNP curriculum
by applying point-of-care technologies for decision
support and documentation. Administrative, clinical,
and educational databases could be utilized in the
planning and execution of the capstone project (Jenkins
et al., 2007).

Integrating Competencies Into an Informatics Course
After the final survey of students’ perceived informatics
competencies in 2010, the findings were incorporated
into our school of nursing’s current informatics course.
This 14-week on-line informatics course provides an
overview of current information systems/technology-
enabled health care environment, functions of the
informatics nurse specialist, and cutting-edge issues in
health care informatics that impact the role of the DNP-
prepared nurse in various health care settings. The course
content emphasized decision support systems and
information access and retrieval from large data sets.
These two content areas were also strengthened using
course assignments. Throughout the semester, students
participated in three projects: two individual projects
(e.g., health literacy assessment of health-related Web
pages and a literature review on the impact of decision
support systems on health care practice) and one group
project (e.g., development of a proposal to design a
computerized evidence-based clinical practice guideline
system). For a health literacy assessment project,
students evaluated the readability of Web pages using
three readability assessment tools—Fry, Simplified Mea-
sure of Gobbledygook, and Flesch–Kincaid. For a review
paper, students searched research databases, Current
Index to Nursing and Allied Health Literature and
PubMed, retrieved full-text articles from electronic
journals, wrote a paper, and formatted it according to
the American Psychological Association Manual using
Refworks, an on-line citation and reference management
software. For a group project, students developed a
proposal for a computerized decision support system to
implement evidence-based practice guidelines into clin-
ical practice. The project consisted of an on-line
presentation and an accompanying written report. To
facilitate group work, students were given three commu-
nication boards: (a) chat/Whiteboard, (b) discussion
board, and (c) Wimba Voice discussion board (Wimba,
2012). The chat/Whiteboard is a synchronous system in
which students communicate by typing comments and
getting responses immediately from other group mem-
bers. The second discussion board is an asynchronous
system in which activities are self-directed and students
have greater freedom to process information and pace
their learning/understanding. The third Wimba Voice
discussion board is a synchronous system to record, post,
and share audio messages with others.

To examine student improvement in perceived infor-
matics competencies after taking the revised informatics

386 CHOI AND ZUCKER
course, we selected and surveyed in the first and last weeks
of the semester 31 DNP students registered in the nursing
informatics course. The findings show a significant
improvement in perceived informatics competencies in
all three categories; students’ mean competency scores
improved from “not competent” to “competent”: 2.60 to
3.75 in computer skills, paired t test(30) = 12.04, P b .05;
2.64 to 3.87 in informatics knowledge, paired t test(30) =
10.94, P b .05; and 2.55 to 3.83 in informatics skills, paired
t test(30) = 9.74, P b .05, respectively. Specifically,
students in both the post-BS and post-MS tracks improved
in the two areas of lowest perceived competencies;
computer skills: decision support and computer skills:
data access improved from a mean score of 1.97 (pre) to
3.52 (post), and 2.03 (pre) to 3.47 (post), respectively.
These differences are significant; paired t(30) = 1.55, P b
.05 for computer skills: decision support and paired t(30)
= 1.43, P b .05 for computer skills: data access. These
findings indicate the revised course improved students’
perceived informatics competencies.

Differences in Competency Scores of Post-BS Versus
Post-MS Tracks

One interesting finding of this assessment is that post-BS
students reported higher competency scores than post-
MS students in 16 of 18 competency areas. This finding
cannot be compared with the literature because no study
was found to compare competencies between two tracks
of DNP students. However, our findings may reflect the
higher number of post-BS students who were recent
graduates (within the last 3 to 5 years) and who had been
more exposed to informatics in their undergraduate
programs compared with post-MS students. Similarly,
Maag (2006) reported that graduate nursing students
were found to have less exposure than undergraduate
students to formal information technology education
during nursing school. However, the differences between
post-BS and post-MS track DNP students in this study
were statistically significant in only 3 of 18 competency
areas; thus, further studies are needed to explore
differences in competency scores in the two tracks.

Limitations and Future Research
Informatics competencies were measured using students’
self-report, not their actual performance on informatics
knowledge and skills. Therefore, students could under-
estimate or overestimate their competence (Elder &
Koehn, 2009). However, the informatics competency
assessment was not considered in academic performance,
providing little motivation for students to overestimate.

Nevertheless, this limitation could be addressed in
further studies by combining students’ self-report with
direct measures of informatics competencies. Because
most of the DNP programs are currently offered in on-line
format, an efficient method may be to use computer-
generated, computer-graded assessment tools already
embedded in on-line learning systems, thus allowing
immediate feedback upon completing the assessments.
With these on-line assessment tools, questionnaires
assessing actual performance on computer skills can be
developed in a multiple-choice or true/false format. For
example, a multiple-choice format question could be
“What is the correct sequence of steps when you insert
citations from Refworks?,” and a true/false format
question could be “To save a voice recording file in
Wimba voice discussion board, the first step is to click on
the ‘new’ icon in the title bar.”

Conclusion
Establishing a baseline of informatics competencies in
DNP students is vital to planning an informatics
curriculum and adequately preparing students to use
information technologies to promote safe and evidence-
based nursing care. Students’ perceived informatics
competencies need to be taken into consideration as
part of competency assessments when developing the
DNP curriculum.

Our study findings indicate that students …