(a) For purposes of this section, the following terms have the following meanings:
  (1) 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.
  (2) 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.
  (3) Advanced Physiology and Pathophysiology Course- 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) Role preparation--formal didactic and clinical experiences/content that prepares nurses to function in an APRN role.
  (5) Clinical major courses--courses that include didactic content and offer clinical experiences in a specific population focus area.
  (6) Practicum/Preceptorship/Internship/Residency/Fellowship--a designated portion of a formal APRN education program that is offered in a health care setting and affords students the opportunity to integrate theory and role in both the APRN role and population focus area through direct patient care/client management. Practicums/Preceptorships/Internships/Residencies/Fellowships are planned and monitored by either a designated faculty member or qualified preceptor.
(b) In order to be eligible to apply for licensure as an APRN, the registered nurse must have completed a post-basic advanced educational program of study appropriate for practice in an APRN role and population focus area recognized by the Board. RN to BSN programs shall not be considered post-basic programs for the purpose of this rule.
(c) Individuals prepared in more than one APRN role and/or population focus area (including blended role or dual specialty programs) shall be considered to have completed separate APRN education programs of study for each role and/or population focus area.
(d) Applicants for licensure in an APRN role and population focus area recognized by the Board must submit verification of completion of all requirements of an advanced educational program that meets the following criteria:
  (1) Graduation from an APRN graduate or post-graduate program as evidenced by official documentation received directly from an APRN education program accredited by a nursing accrediting body that is recognized by the Board and the U.S. Secretary of Education and/or the Council for Higher Education Accreditation (CHEA), or its successor organization, as recognized by the Board. Programs may be approved by the appropriate licensing body in the state in which the program is located. A state licensing body's accreditation process must meet or exceed the requirements of accrediting bodies specified in Board policy.
  (2) Programs of study shall be at least one academic year in length and shall include a formal preceptorship. One academic year in length shall be evaluated based on the equivalent of a full time academic load.
  (3) Graduates of APRN education programs who were prepared for two population foci or two different APRN roles shall demonstrate that they have completed didactic content and clinical experience in both functional roles and population foci.
(e) Applicants for licensure as clinical nurse specialists must submit verification of the following requirements, in addition to meeting other APRN requirements for licensure:
  (1) completion of a minimum of a master's degree in the discipline of nursing, and
  (2) completion of a minimum of nine semester credit hours or the equivalent in a specific clinical major. Clinical major courses must include didactic content and clinical experiences in the clinical nurse specialist role in a specific population focus area. Courses in advanced health assessment, advanced physiology and pathophysiology, and advanced pharmacotherapeutics cannot be counted toward meeting the nine semester credit hour requirement.
(f) Applicants for APRN licensure shall provide evidence of completion of an APRN education program that prepared the graduate to practice in one of the four APRN roles and at least one of the population foci recognized by the Board. The curriculum shall include:
  (1) Three separate, dedicated graduate level courses in:
    (A) Advanced health assessment that includes assessment of all human systems, advanced assessment techniques, concepts and approaches;
    (B) Advanced pharmacology that includes pharmacodynamics, pharmacokinetics, and pharmacotherapeutics of all broad categories of agents; and
    (C) Advanced physiology and pathophysiology, including general principles that apply across the lifespan;
  (2) Diagnosis and management of diseases and conditions across practice settings, including diseases representative of all systems appropriate to the role and population focus area of licensure;
  (3) Preparation that provides a basic understanding of the principles for decision making in the identified role;
  (4) Preparation in the core competencies for the identified APRN role;
  (5) Role preparation in one identified population focus area of practice; and
  (6) APRN core content including legal, ethical, and professional responsibilities of the APRN.
(g) The curriculum shall be consistent with competencies of the specific areas of practice.
(h) Graduates of APRN education programs who were prepared for two population foci or completed APRN role preparation in more than one role within the same program shall provide such evidence as is required for Board staff to verify that the program included sufficient content and clinical experience to practice the full scope of practice of both functional roles and population foci.
(i) Each instructional track/major shall have a minimum of 500 supervised clinical hours as defined by the Board. The supervised experience shall have been directly related to the role and population focus area of licensure and include pharmacotherapeutic management of patients.
(j) Evidence of recognition of prior learning and advanced placements in the curriculum for individuals who hold a master's degree in nursing and are seeking preparation in a different role and/or population focus area through post-graduate preparation must be provided to the Board for review. Evidence shall be provided demonstrating that the post-master's nursing student completed the requirements of the master's APRN program through a formal graduate level certificate in the desired role and population focus area. Post-master students must demonstrate they have met the same APRN outcome competencies as master level students in the full scope of the role and population focus area.

Source Note: The provisions of this §221.3 adopted to be effective February 25, 2001, 26 TexReg 1509; amended to be effective January 2, 2006, 30 TexReg 8881; amended to be effective June 29, 2010, 35 TexReg 5561; amended to be effective February 27, 2019, 44 TexReg 833