AACN sub-competency2.2dP4 · Integration

Demonstrate the ability to conduct sensitive or difficult conversations.

AACN domain
2.Person-Centered Care

Genuinely cross-Practice. Procedural assessment in Hands; clinical reasoning in Head; therapeutic communication in Integration.

Competency
2.2Communicate effectively with individuals.
Five Practices mapping
P4 · IntegrationThe Big Picture

"How do you bring it together?"

Progression Indicators

The three-bucket rubric for this sub-competency. Behavioral anchors are shown when available.

Not Demonstrated

No evidence yet. Either the behavior has not been performed in a captured context, or the captured evidence does not yet meet the rubric.

Novice anchor: Avoids difficult conversations; redirects emotional content; defers to physician for bad news delivery.
Developing

Matches the AACN Developing descriptor for this sub-competency. Caps at Developing in solo activation mode for P3 (Hands) sub-comps without preceptor observation.

Advanced beginner anchor: Conducts sensitive or difficult conversations (bad news, goals of care) using appropriate framework (SPIKES, NURSE); maintains presence; allows silence.
Developed

Matches the AACN Developed descriptor. For P3 sub-comps this requires a preceptor or peer observation to triangulate the self-report.

Competent anchor: Conducts complex difficult conversations including end-of-life; supports peers after hard conversations; teaches communication skills.

Deeper analysis coming. All 434 sub-competency pages are scaffolded against the AACN definition, the Five Practices mapping, and the Progression Indicator rubric. 5 carry the full narrative this version (listed on the framework index). The remaining long-form copy is being authored alongside the behavioral anchors and will land in the next framework version.

Currently writing the long-form for: 2.8c, 2.8d, 2.8b, 3.1c, 10.2a.

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