1. (a) The program of study shall be:

   1. (1) At least the equivalent of one academic year;
   2. (2) Planned, implemented, and evaluated by the faculty;
   3. (3) Based on the philosophy/mission and objectives/outcomes;
   4. (4) Organized logically and sequenced appropriately;
   5. (5) Based on educational principles acceptable to the Board; and
   6. (6) At or beyond the master's degree level.
2. (b) For clinical nurse specialist programs, the program of study must also qualify the graduate for a minimum of a master's degree in nursing.

3. (c) The curriculum content shall include:

   1. (1) Didactic and clinical learning experiences necessary to meet the objectives/outcomes;
   2. (2) Concepts and principles critical to advanced practice nursing;
   3. (3) Professional and legal implications of the nurse in the advanced role;
   4. (4) Knowledge and skills relevant to practice in the area of specialty; and

   5. (5) Evidence of inclusion of the following curricular requirements:

      1. (A) Separate courses in pharmacotherapeutics, advanced assessment and pathophysiology and/or psychopathology (psychopathology accepted for advanced practice nurses prepared in the psychiatric/mental health specialty only). These courses must be graduate level academic courses;
      2. (B) Evidence of theoretical and clinical role preparation;
      3. (C) Evidence of clinical major courses in the specialty area;
      4. (D) Evidence of a practicum/preceptorship/internship to integrate clinical experiences as reflected in essential content and the clinical major courses.

      5. (E) In this subsection, the following terms have the following definitions:

         1. (i) Advanced Assessment Course means a course that offers content supported by related clinical experience such that students gain the knowledge and skills needed to perform comprehensive assessments to acquire data, make diagnoses of health status and formulate effective clinical management plans.
         2. (ii) Pharmacotherapeutics means a course that offers content in pharmacokinetics and pharmacodynamics, pharmacology of current/commonly used medications, and the application of drug therapy to the treatment of disease and/or the promotion of health.
         3. (iii) Pathophysiology means a course that offers content that provides a comprehensive, system-focused pathology course that provides students with the knowledge and skills to analyze the relationship between normal physiology and pathological phenomena produced by altered states across the life span.
         4. (iv) Role preparation means formal didactic and clinical experiences/content that prepare nurses to function in an advanced nursing role.
         5. (v) Clinical major courses means courses that include didactic content and offer clinical experiences in a specific clinical specialty/practice area.
         6. (vi) Clinical specialty area means specialty area of clinical practice based upon formal didactic preparation and clinical experiences.
         7. (vii) Essential content means didactic and clinical content essential for the educational preparation of individuals to function within the scope of advanced nursing practice. The essential content includes but is not limited to: advanced assessment, pharmacotherapeutics, role preparation, nursing specialty practice theory, physiology/pathology, diagnosis and clinical management of health status, and research.
         8. (viii) Practicum/Preceptorship/Internship means a designated portion of a formal educational program that is offered in a health care setting and affords students the opportunity to integrate theory and role in both the clinical specialty/practice area and advanced nursing practice through direct patient care/client management. Practicums/Preceptorships/Internships are planned and monitored by either a designated faculty member or qualified preceptor.
4. (d) For clinical nurse specialist programs, the curriculum must also contain a minimum of nine (9) semester credit hours or the equivalent in a specific clinical major. Clinical major courses must include didactic content and offer clinical experiences in a specific clinical specialty/practice area recognized by the Board .
5. (e) If a clinical nurse specialist program has as a goal or outcome the preparation of graduates for approval for prescriptive authority, then the program must also include at a minimum a separate course in diagnosis and management of diseases and conditions within the clinical specialty area recognized by the Board. This course(s) must be an advanced level academic course(s) with a minimum of 45 clock hours.
6. (f) Individuals prepared in more than one advanced practice role and/or specialty (including blended role or dual specialty programs) shall be considered to have completed separate advanced practice nursing educational programs of study for each role and/or specialty area.
7. (g) The program of study shall include a minimum of 500 separate, non-duplicated clinical hours for each advanced role and specialty within the advanced practice nursing education program.

8. (h) Post-master's preparation may be offered as graduate level course work through master's or higher level advanced practice nursing educational programs that include the desired role and specialty and otherwise meet the standards in this chapter.

   1. (1) Post-master's students are required to complete a minimum of 500 clinical hours in addition to the entire role, clinical major, and curricular requirements , or the equivalent set forth in this chapter . Courses may be waived if an individual's transcript indicates that an equivalent course has been successfully completed or if the student demonstrates proficiency, validating program outcomes according to written program policies. Clinical hours shall not be waived.
   2. (2) Only registered nurses who hold master's degrees in nursing shall be eligible for post-master's preparation as clinical nurse specialists.

9. (i) Board staff approval is required prior to implementation of major curriculum changes. Proposed changes shall include information outlined in Board guidelines and shall be reviewed using Board standards. Changes that require approval include:

   1. (1) Changes in program philosophy/mission and objectives/outcomes that result in a reorganization or reconceptualization of the entire curriculum, and/or
   2. (2) An increase or decrease in program length by more than nine semester credit hours or 25%.

Source Note:The provisions of this §219.9 adopted to be effective September 13, 2001, 26 TexReg 6889; amended to be effective January 8, 2008, 33 TexReg 184.