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What is a Concept-Based Nursing Curriculum? (And Can You Still Use It In Your Program?)
If your program spent the last decade converting to a concept-based curriculum, the current push toward competency-based education might have you asking a fair question in faculty meetings: Didn't we just do this?
You rebuilt courses around perfusion and gas exchange. You retired the body-systems lectures you inherited. Now the conversation has changed to be all about domains, sub-competencies, and crosswalks, and it's reasonable to wonder whether all that concept work is headed for the recycling bin.
It isn't. This post will break down what concept-based curriculum is, how it differs from competency-based curriculum, and why the two actually work better together.
The Short Answer
A concept-based curriculum organizes content around a defined set of core concepts instead of an exhaustive list of diseases, body systems, or populations. Students learn each concept deeply, then apply it through a number of carefully chosen exemplars.
And yes, you can still use it in the current nursing education climate. Concept-based and competency-based approaches answer two different questions:
Concept-based answers: How do we organize what students need to know?
Competency-based answers: What must graduates be able to do, and how do we know they can do it?
One is a strategy for structuring content. The other is a strategy for defining and verifying outcomes. A program can (and should) do both.
Where Concept-Based Curriculum Came From
Concept-based curriculum was nursing education's answer to content saturation. Every year brings new drugs, new guidelines, and new technology, and for decades our response was to add another slide. Nothing ever came out and everything just accumulated. Faculty felt the push to cram more in, students tried to memorize harder, and retention suffered.
A case was made in the mid-2000s that we could not keep covering everything, and that trying to do that was working against learning. The alternative was to teach fewer things at a greater depth and trust students to transfer that understanding to situations never covered in class.
The idea of covering less content can seem counterintuitive and maybe even counterproductive, especially if you’ve never experienced it as a student or attempted to teach like that as a faculty. But the truth is, that at any level of nursing education, we cannot teach our students everything about all the possible things they’ll encounter in their nursing practice. Instead, we need to focus on the skills and knowledge to approach any situation competently and safely even if they were not prepared for that exact scenario.
How It Works
A concept-based curriculum has three moving parts.
Concepts. These are big organizing ideas. Most models group them into health and illness concepts like perfusion, gas exchange, inflammation, and glucose regulation; professional nursing concepts like clinical judgment, ethics, and collaboration; and patient attribute concepts like development and culture.
Exemplars. These are the specific conditions or situations used to teach the concept. Faculty choose them based on prevalence and how well they illustrate the concept. For inflammation, a graduate pathophysiology course might use asthma, rheumatoid arthritis, and inflammatory bowel disease.
Conceptual learning. This is the teaching approach that makes the structure work. Students learn the concept first, study the exemplars, then practice recognizing the concept in unfamiliar presentations.
That last piece is cognitive load theory at work. Experts don't hold thousands of isolated facts in memory. Instead, they hold organized schemas and attach new information to them. An NP student who understands inflammation as a concept has a place to hang the next inflammatory condition they meet in the clinic, even though it never appeared on a slide.
Concept-Based vs. Competency-Based
Concept-Based | Competency-Based | |
Core question | How is content organized? | What can graduates do? |
Organizing unit | Concepts and exemplars | Competencies and sub-competencies |
Primary focus | Depth of understanding and transfer | Demonstrated performance |
What it solves | Content saturation | The practice-readiness gap |
Risk when used alone | Students explain the concept but can't act on it | Students perform tasks without understanding how to adapt |
Look at that bottom row, because it's the whole argument for keeping both. A student who can define perfusion beautifully and can't manage a patient with decompensated heart failure isn't ready. Neither is a student who can follow the heart failure checklist and is lost the moment the patient doesn't match it.
So, Can You Still Use It?
Yes, and the Essentials expect you to think conceptually.
The AACN Essentials are built on 10 domains and 8 concepts for nursing practice. In the updated 2026 edition, those concepts are clinical judgment, communication, compassionate care, access, connection, and engagement, ethics, evidence-based practice, health policy, and social determinants of health. The 2026 update kept the 10 domain titles and replaced the fourth concept with Access, Connection, and Engagement. CCNE's standards call for programs to incorporate both the domains and the concepts.
It's also worth knowing that Jean Giddens, the same scholar who championed concept-based curriculum, co-chaired the task force that wrote the 2021 Essentials. These two movements share a family tree.
Making the Two Work Together
Here's what integration looks like at the course level.
Let concepts organize the content and competencies define the outcome. Your unit is still perfusion. Your objective changes from Explain the concept of perfusion to Develop an evidence-based management plan for an adult with impaired perfusion in primary care.
Turn exemplars into assessment contexts. You already selected the conditions that best represent each concept. Those become the cases for your OSCEs, simulations, and case-based assignments.
Assess transfer on purpose. Include at least one assessment built on a condition you didn't teach. If students learned perfusion through heart failure and peripheral artery disease, give them a patient with a different perfusion problem and see what they do. That is the truest test of whether conceptual learning worked.
The Hard Parts
Choosing exemplars means choosing what to leave out, and every faculty member has a condition they can't imagine not teaching. Those conversations get personal quickly.
Students often find the approach abstract at first, especially those who expect body-systems approach to the content. They need to hear why you're teaching this way, more than once.
Most of us were taught in a systems-based model, so teaching conceptually takes deliberate practice. And in graduate programs, certification exam blueprints and clinical rotations are still organized largely by population and system. Many NP programs land on a hybrid: systems-based course structure with concepts used as a teaching strategy inside it. That counts. You don't need a fully concept-based program to teach conceptually.
Where to Start
Find out what your program already has. Pull the concept list if one exists. If your courses are systems-based, identify three or four concepts that recur across your content.
Pick one concept and audit it. Where is it introduced? What exemplars are used? Is there any assessment that asks students to do something with it?
Rewrite one objective. Move it from explaining the concept to performing with it.
Add one transfer case. Use an unfamiliar exemplar in a discussion, case study, or debrief.
Read the Essentials concepts. Note where each already lives in your course and where it's missing.
New to the competency side of this conversation? Start with Competency-Based Curriculum in Nursing Education: An Intro for Faculty.
Jacklyn DelPrete, EdD, CRNP, FNP-C, CNE is a family nurse practitioner, full-time graduate nursing faculty member, and founder of The Elevated NP. Questions or topics you'd like covered? Reach out at elevatednpteam@gmail.com.
For more information:
2026 AACN Essentials: https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2026.pdf
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