BREATHE: A Longitudinal Competency Framework for AGACNP Professional Formation

BACKGROUND: Competency-based graduate nursing education expects learners to develop clinical judgment, systems thinking, and professional identity, yet few longitudinal frameworks make this progression visible in Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) education. BREATHE addresses this gap. METHOD: BREATHE was developed through iterative conceptual design grounded in the AACN Synergy Model for Patient Care, deliberate practice, and situated learning, informed by national competency and certification standards. It is implemented through an existing learning management system across three clinical semesters; formal outcomes evaluation is planned in a subsequent cohort. RESULTS: BREATHE comprises seven longitudinal components: Build the Story, Recognize Priorities, Evaluate Evidence, Act Thoughtfully, Team and Transition, Humanize Care, and Evolve Practice, each engaged with increasing developmental depth across three clinical semesters. CONCLUSION: BREATHE positions advanced practice readiness as visible, coached, and cumulative professional formation, extending beyond documentation of clinical exposure toward intentional developmental growth.