Nurses International

About the
NI Clinical

The Nurses International Clinical Alliance is a membership program established to ensure collaboration, sharing, ongoing development, and evaluation of the Clinical Transition Framework (CTF).  The CTF model was established over two decades of multi-agency resource development, implementation, and research by Vermont Nurses in Partnership which is now a part of Nurses International and known as The NI Clinical Alliance.  Nurses International manages current resource development and distribution to safeguard ongoing updates, research and synergy with NI BSN online course curriculum.

The Clinical Transition Framework (CTF) was initially created as a statewide standardized orientation and clinical competency development and validation process for on-boarding students and new staff members and is now used across the United States of America and globally.

The CTF is a patient safety initiative delivered within a workplace culture of nurture and support. The framework includes resources, forms, instructional materials and process for competency development and validation for direct care providers in the clinical setting.

Resources include specialty specific tools for competency development and validation of capability. The CTF addresses competency assessment and validation for acute, chronic, clinic and home care settings.

The NI Clinical Alliance takes a ‘share and share back’ approach to nurse professional development, thus our pool of resources experiences ongoing growth and updates.


The Clinical Transition Framework (CTF) is a clinical pathway for professional nurse orientation, development, and competency validation that serves as an international model for nurse professional development. The CTF includes standards that deliver both preceptor and clinical competency development, as well as leadership and educator development tools. The CTF develops care providers within a nurturing, collaborative, safe, & productive clinical environment.

The model supports effective orientation, internships, &/or residency programs for newly hired nurses. The competency tools and process fit for new graduate nurse residency programs or on-boarding proficient nurses. The framework provides tools for competency-based development and data collection for each new direct care provider. Research shows that the CTF brings return on investment through decreased turnover, improved safety, lowered costs, and higher satisfaction of staff, preceptors, and managers.

Alfaro-LeFevre, R. (2019). Critical Thinking, Clinical Reasoning, and Clinical Judgment: A Practical Approach ( 7th ed.). Philidelphia: Elsevier.

Alfaro-LeFevre, R. & Boyer, S. (2019) What Are Our Opportunities in Preparing the Next Generation of Nurses and Where Are We Going Wrong? The Journal of Nursing Administration. 49(11):515-516. doi: 10.1097/NNA.0000000000000804

Barba, M., Valdez-Delgado, K., VanFosson, C., Caldwell, N., Boyer, S., Robbins, J., & Mann-Salinas, E. (2019). An Evidence-Based Approach to Precepting New Nurses. American Journal of Nursing, Special Feature – 119(3), 46-51.

Boyer, S. (2017). Clinical Transition Framework: Efficient solutions for transitional support systems. Nurse Leader , Doi: 10.1016/j.mnl.2017.o3.013. .

Boyer, S. (2019). Clinical Transition Framework User Manual. Ascutney, VT: VT Nurses in Partnership, Inc.

Boyer, S., Mann-Salinas, E., & Valdez-Delgado, K. (2018). Clinical Transition Framework: Integrating accountability, sampling, and coaching plans in professional practice development. Journal for Nurses in Professional Development, 34(2):84-91. doi: 10.1097/NND.0000000000000435.

Boyer, S., Mann-Salinas, E., Valdez-Delgado, K., & VanFosson, C. (2019). Using the Delphi technique to determine core components of a Nurse Competency Program. Journal for Nurses in Professional Development, JNPD-19-017R2. DOI: 10.1097/NND.0000000000000569 , Accessed at: on 8/8/2019.

Boyer, S., Valdes-Delgado, K., Huss, J., Barker, A., & Mann-Salinas, E. (2017). Impact of a Nurse Residency Program on Transition to Specialty Practice – Editor’s Pick . Journal for Nurses in Professional Development, 33 (5), 220–227. doi. 10.1097/NND.0000000000000384.

Hawkins, P., & Exstrom, S. (2014, 7 29). Adaptation of a Transition to Practice Program for New Graduates in Acute and Long-term Care Facilities in Urban and Rural Nebraska: A Pilot Study. Retrieved from National Council of State Boards of Nursing (NCSBN):

Lenburg, C. (2009). The COPA Model: A Comprehensive Framework Designed To Promote. Nursing Education Perspectives, 30, 312 – 317.

Lenburg, C. (2010). Competency Outcomes and Performance Assessment for contemporary nursing education. In L. Caputi, Teaching nursing: The art and Science, Volume 2, (2nd ed.) (pp. 175-215). Glen Ellyn, IL: College of DuPage Press.

Lenburg, C., Abdur-Rahman, V., Spencer, T., Boyer, S., & Klein, C. (2011). Implementing the COPA model in nursing education and practice settings: Promoting competence, quality care, and patient safety. Nursing Education Perspectives,, 32 (5), 290-296.

Mann-Salinas, E., Hayes, E., Robbins, J., Sabido, J., Feider, L., Allen, D., & Yoder, L. (2014). A systematic review of the literature to support an evidence-based Precepting Program. Burns, 40(3), 374-387. DOI:

Omer, T. A., Suliman, W. A., & Moola, S. (2016). Roles and responsibilities of nurse preceptors: Perception of preceptors and preceptees. Nurse education in practice, 16(1), 54-59.

Robbins, J. R., Valdez-Delgado, K. K., Caldwell, N. W., Yoder, L. H., Hayes, E. J., Barba, M. G., . . . Mann-Salinas, E. A. (2017). Implementation and outcomes of an evidence-based precepting program for burn nurses. Burns,



The Clinical Alliance ensures

Collaboration Sharing Ongoing Development