It is the position of AMSN that:

• Medical-surgical nursing is the largest specialty of professional nursing, with its own skill sets in several domains definable from novice to expert.
• A wide range of complex patients and multiple diagnoses demand advanced critical thinking and skill on multiple levels from the medical-surgical nurse.
• As part of the medical-surgical nursing practice, patient education is fundamental to patient care.
• Skilled transitions of care are a hallmark of medical-surgical nursing practice and patient outcomes.
• Evidence-based practice competencies in medical-surgical nursing help to standardize professional development, assessment and nursing practice to their highest possible capacity, to the benefit of patients, the public, the health care industry sector, and the nursing profession.

Overview

Beyond licensure and professional certification, neither the health care industry sector nor individual nurses possess sufficient validated guidance necessary to assess and then improve competency in a standardized, evidence-based manner.

The recent COVID-19 pandemic has driven a sustained period of accelerated practice and practice development, requiring rapid and expert adaptation on the part of medical-surgical nurses and all categories of health care industry sector stakeholders.

Employers characteristically assess nursing skills via review of curriculum vitae and professional experience, and by non-standardized clinical practice skills assessment checklists unique to each facility and unit. Checklist results may map to supervised practice mentoring and assessment, which is also neither standardized nor based in evidence.

An evidence-based, standardized approach to defining medical-surgical nursing practice competencies provides the profession and the industry the tools it needs to apply these nursing professionals to their highest and greatest capacity, to the benefit of patients, the health care sector, the public and the profession.

Rationale

Standardizing the definition of evidence-based competencies in medical-surgical nursing affords both nurses and employers robust assessment of well-defined practice characteristics and the capacity to map further acquisition of skills and experiences intended to improve care delivery for patients’ benefit.

Following an extensive needs assessment, development, evaluation, validation and implementation process, AMSN has published a medical-surgical nursing competency framework, organizing the profession’s practice into two domains of practice and patient management, professional concepts, spanning 28 defined competencies, plus individual attributes.

Medical-surgical nurses use all of their assessment and practice skills, communication skills, time-management skills for several patients concurrently, impacting patients well-being and health outcomes.  Because competencies are an essential foundation of professionalism in the interest of patient safety and outstanding health care delivery and support of patient health, a systematic characterization of practice competencies promotes the professionalism of medical-surgical nurses.

Standardized competencies support the profession attracting and retaining outstanding professionals into medical-surgical nursing practice in the interest of patient safety and continuous health care improvement. Medical-surgical nursing is a nursing specialty, and professional competencies demonstrate the depth and breadth of expertise required of medical-surgical nurses, thus validating the significant value these nurses bring to the healthcare system, to patients and their families. The rapidly evolving and complex care environment demands more expertise than ever from highly skilled medical-surgical nursing specialists.

Definitions

• Competency represents the behavioral characteristics supporting competence, an ability acquired through experience and learning.
• Nursing competency means the ability of a nurse to effectively demonstrate a set of attributes, such as personal characteristics, values, attitudes, knowledge and skills, which are required to fulfill his or her professional responsibility.  
• Nursing specialty encompasses a specified area of discrete study, research, and practice as defined and recognized by the profession.

• Academy of Medical-Surgical Nurses. (2018). Scope and standards of medical-surgical nursing practice (6th ed.). Academy of Medical-Surgical Nurses.

• Academy of Medical-Surgical Nurses (2021). AMSN competency framework for medical-surgical nurses (1st ed, prepublication). Academy of Medical-Surgical Nurses. (https://www.amsn.org/learning-development/amsn-medical-surgical-nursing…)

• Fukada M. (2018). Nursing competency: definition, structure and development. Jrnl Med Sci 2018 Mar; (61)1, 1-7, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871720/.

• Grindel, C. (2005). Medical-surgical nursing: A specialty or not? MEDSURG Nursing, 14, 5-6.