AONL nurse leader competencies, mapped to the exams

In October 2022 the organization replaced its five role-specific competency sets with one set for every nurse leader. The March 2026 refresh keeps that single set and adds a sixth domain, Leader Within, which the model places at the base of the others.

Three parts make up the framework:

• Core competency statements: what every nurse leader is expected to know and do. The full document is for members.
• Domains and subdomains: public on the framework page, listed below.
• Functional competency behaviors: role-specific, observable behaviors from supervisor and nurse manager to director and chief nurse executive. They are under revision during 2026.

Names as published on the framework page:

• Leader Within: reflective practice and foundational thinking; innovation and entrepreneurship; relationship-centered leadership; career development; professional identity; personal well-being.
• Leadership: systems and complex adaptive thinking; change management; courageous leadership; decision-making; transformation and innovation; crisis leadership and organizational resilience.
• Professionalism: professional and organizational accountability; advocacy; disparities in care; governance.
• Communication and Relational Leadership: effective communication; influencing behaviors; relationship management; psychological safety; interprofessional collaboration.
• Knowledge of the Healthcare Environment: practice oversight; evidence-based practice and innovation; organizational sustainability; quality, safety and improvement science; economics and policy; regulatory leadership; global health perspective and collaboration; community and population health; digital health, informatics and AI leadership.
• Business Skills and Principles: financial management; strategic management; workforce leadership and optimization.

The manager exam's outline uses five domains: Communication and Relationship Building, Health Care Environment and Clinical Principles, Leadership, Professionalism, and Business Skills and Principles. The executive exam uses the same five. The mapping below is ours, matched by name and subdomain, with the page on this site that owns each topic:

• Leader Within gets no separate outline domain yet; its self-reflection and career items sit inside the outline's Professionalism domain.
• Leadership matches the outline domain of the same name: change models, decisions, delegation. See leadership on the CNML and nursing leadership styles.
• Professionalism matches its namesake: the CNML professionalism page, and the ANA Code of Ethics on ethics and regulation.
• Communication and Relational Leadership is the renamed Communication and Relationship Building: communication and relationships.
• Knowledge of the Healthcare Environment corresponds to Health Care Environment and Clinical Principles, but its subdomains are spread over several exams: quality and safety at system level, EBP, QI and research, and informatics on the NI-BC.
• Business Skills and Principles keeps its name: CNML business skills, with budgets, HPPD and FTE math on business management.

The other reference framework is the American Nurses Association's Nursing Leadership: Scope and Standards of Practice, 3rd edition (2024), published in earlier editions as Nursing Administration: Scope and Standards of Practice. It is on the reference list of the unit-level leadership exam's October 2025 outline. Where the AONL framework describes competencies, the ANA book sets standards of practice and professional performance for nurses in leadership roles.