Children's Hospital of Philadelphia (CHOP) holds nursing practice to the highest standards, supporting the achievement of high quality patient care and professional nursing advancement. Professional practice is the core of nursing and each nurse is expected to assume professional autonomy. The Professional Advancement Program at Children’s Hospital of Philadelphia is based on the seminal work of Dr. Patricia Benner (1982) From Novice to Expert: Excellence and Power in Clinical Nursing Practice.

CHOP's Professional Advancement Program recognizes that all nurses practice on a continuum of proficiency from novice to expert depending on experience, complexity of the patient, and the environment in which they work. The determination of proficiency, according to the Dreyfus Model of Skill Acquisition, described by Dr. Benner, uses a holistic approach to provide a foundation for clinical knowledge development and career progression.

All nurses at CHOP are participants in the Professional Advancement Program. The expectation of the Department of Nursing is that all new to practice Registered Nurses are hired into a position as a Nurse Resident, and are required to demonstrate clinical competency within 12 months of hire.

• Clinical competency is defined as satisfactory completion of hospital, Department of Nursing, and unit-based orientation as well as performing job responsibilities with a score of fully achieves expectations or better on their annual evaluation.
• After completion of Residency, the nurse advances to the Clinical Nurse position.

Experienced Registered Nurses are hired into the Clinical Nurse role and associated job description. The performance of Clinical Nurses is evaluated annually. All Clinical Nurses are expected to demonstrate core competencies and perform job responsibilities with a score of fully achieving expectations or better on their annual performance review.

Clinical Nurses can be promoted to a Clinical Nurse Expert position based on their annual evaluation, demonstration of core competencies and leadership potential, and successful submission and approval of their PEAK II application.

Professional Excellence & Advancing Knowledge (PEAK) is a development opportunity within the Professional Advancement Program. PEAK I and PEAK II represent the choices available for individual advancement. All Clinical Nurses are eligible for participation in PEAK as long as they meet the basic criteria identified in the Letter of Intent. Participation in PEAK is voluntary for a Clinical Nurse and represents a nurse’s choice to advance personally and professionally. PEAK nurses will be recognized in multiple ways for their participation in the program. Maintenance of PEAK I or PEAK II status requires annual revalidation at their annual performance review.