(a) The program of study shall be:
  (1) At least the equivalent of one (1) academic year;
  (2) Planned, implemented, and evaluated by the faculty;
  (3) Based on the philosophy/mission and objectives/outcomes;
  (4) Organized logically and sequenced appropriately;
  (5) Based on educational principles acceptable to the Board; and
  (6) At or beyond the master's degree level.
(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.
(c) The curriculum content shall include:
  (1) Didactic and clinical learning experiences necessary to meet the objectives/outcomes;
  (2) Concepts and principles critical to advanced practice registered nursing;
  (3) Professional and legal implications of the nurse in the advanced role;
  (4) Knowledge and skills relevant to practice in the area of role and population focus; and
  (5) Evidence of inclusion of the following curricular requirements:
    (A) Separate courses in advanced pharmacotherapeutics, advanced health assessment, and advanced physiology and pathophysiology. These courses must be graduate level academic courses;
    (B) Evidence of theoretical and clinical role preparation;
    (C) Evidence of clinical major courses in the population focus area;
    (D) Evidence of a practicum/preceptorship/internship to integrate clinical experiences as reflected in essential content and the clinical major courses.
    (E) In this subsection, the following terms have the following definitions:
      (i) Advanced Health Assessment Course--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. Content must include assessment of all human systems, advanced assessment techniques, concepts, and approaches.
      (ii) Advanced Pharmacotherapeutics Course--a course that offers content in pharmacokinetics and pharmacodynamics, pharmacotherapeutics of all broad categories of agents, and the application of drug therapy to the treatment of disease and/or the promotion of health.
      (iii) Advanced Physiology and Pathophysiology Course--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.
      (iv) Role preparation--formal didactic and clinical experiences/content that prepare nurses to function in an advanced practice registered nurse role.
      (v) Clinical major courses--courses that include didactic content and offer clinical experiences in a specific population focus area.
      (vi) Essential content--didactic and clinical content essential for the educational preparation of individuals to function within the scope of advanced practice registered 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.
      (vii) Practicum/Preceptorship/Internship--a designated portion of a formal advanced practice registered nurse education program that is offered in a health care setting and affords students the opportunity to integrate theory and clinical practice in both the advanced practice registered nurse role and population focus area through direct patient care/client management. Practicums/Preceptorships/Internships are planned and monitored by either a designated faculty member or qualified preceptor.
(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.
(e) A clinical nurse specialist program must 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.
(f) Individuals prepared in more than one (1) advanced practice registered nurse role and/or population focus (including blended role or dual specialty programs) shall be considered to have completed separate advanced practice registered nursing education programs of study for each role and/or specialty area.
(g) The program of study shall include a minimum of 500 separate, non-duplicated clinical hours for each advanced role and population focus within the advanced practice registered nursing education program.
(h) Post-master's preparation may be offered as graduate level course work through master's or higher level advanced practice registered nursing education programs that include the desired role and population focus and otherwise meet the standards in this chapter.
  (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) Only registered nurses who hold master's degrees in nursing shall be eligible for post-master's preparation as clinical nurse specialists.
(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) Changes in program philosophy/mission and objectives/outcomes that result in a reorganization or reconceptualization of the entire curriculum, and/or
  (2) An increase or decrease in program length by more than nine (9) 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; amended to be effective December 9, 2018, 43 TexReg 7894