Research highlights

-

Enrolled Nurse (EN) and Registered Nurse (RN) Standards for practice review

Professor Julia Morphet

nurse in uniformThe Registered Nurse (RN) standards for practice and the Enrolled Nurse (EN) standards for practice set out the expectations of an RN or EN’s practice. The Nursing and Midwifery Board of Australia (NMBA) engaged a team from Monash Nursing and Midwifery to conduct a comprehensive review of the RN standards for practice (Nursing and Midwifery Board of Australia, 2016) concurrently with review of the EN standards for practice (Nursing and Midwifery Board of Australia, 2016b). Conducting the two separate reviews concurrently provided a unique opportunity to ensure the RN and EN standards for practice were aligned, complementary, and differentiated between the RN and EN roles within the nursing profession.

A sequential four-stage mixed methods research design was adopted incorporating a comprehensive review of national and international developments in nursing standards and practice and consultation with key stakeholders, the broader profession and community. Major stakeholders in RN and EN nursing policies, accreditation, education and employers were engaged nationwide, providing their insights and perspectives that shaped the content of the revised standards.

The sequential mixed methods research design used multiple sources of data (documents, literature, participant perspectives), data collection methods (database/website searches, interviews (n=77 participants), Delphi consultation), and analytical methods (gap analysis, descriptive statistics, content analysis, item-level content validity index). This approach ensured each stage of the project built upon the previous findings.

Major changes were made to the current EN standards for practice and current RN standards for practice, reflecting contemporary and future practice through inclusion of concepts such as planetary health and health-related technology, collaborative practice and cultural safety. Patient safety remains a priority, and leadership has been emphasised. The revised standards emphasise the complementarity and differences between the EN and RN roles.

The draft EN and RN standards for practice will undergo review by the NMBA, prior to being disseminated for public national and international consultation in early 2026.

The revised standards for practice will have nationally transformative impacts on the education, practice and professional development of more than 490,000 currently practicing nurses, as well as students, new graduates, overseas trained nurses, and those returning to work across Australia. The standards will also be used to inform course accreditation authorities, education providers and employers. Shaping nursing practice that is culturally safe and evidence-informed will enhance quality of care to all recipients of care, families, and communities across Australia.


-

Providing specialist cancer nurses with a tool to measure skills and evaluate learning – the development, psychometric testing and implementation of the Cancer Nurses Self-Assessment Tool (CaN-SAT)

Associate Professor Olivia Cook

 Despite advances in screening and treatment, cancer incidence and prevalence is rising in Australia - nearly 1 in 2 Australians will be diagnosed with cancer by the age of 85.1

In response, cancer nursing continues to develop with recent recognition of it as a nursing speciality by AHPRA in 2023 and unprecedented government and non-government investment in specialist cancer nursing roles. With this investment comes a need to further grow and develop a skilled and responsive cancer nursing workforce. Beyond registration and post-graduate qualification, specialist cancer nurses are responsible for their own continuing professional development. Whilst competence must be demonstrated in the attainment of post-graduate qualifications, there was no tool available for nurses working in specialist cancer nursing roles to measure their advancement or expertise in the various aspects of cancer nursing.

Building on previous tools developed for breast cancer nurses2, the Cancer Nurse Self-Assessment Tool (CaN-SAT)3 is a nurse and consumer-designed tool for the self-measurement of 93 skills across 15 elements of practice related to specialist cancer nursing. In a collaboration between Monash Nursing and Midwifery, McGrath Foundation, Cancer Nurses Society of Australia and people with lived experience  of cancer, the tool was designed, validated, psychometrically tested, published and implemented in 2025. Designed for Clinical Nurse Specialist to Clinical Nurse Consultant level roles, the CaN-SAT allows nurses to rate their skills on Benner’s novice to expert scale with guidance statements on the skills that should be demonstrated at each level.

This practical tool takes nurses approximately 30 minutes to complete and allows them to identify their own individual learning needs and plan their education and professional development to meet those needs. It is recommended that cancer nurses complete the tool annually in conjunction with their performance appraisal. The tool can also be used to evaluate education interventions or for ongoing program evaluation.

Implementation of the tool is currently underway and to date McGrath Foundation have embedded the tool into their Cancer Care Nurse Education Program where McGrath Cancer Care nurses complete the tool as part of their onboarding program, and annually in February thereafter. Cancer Nurses Society of Australia (CNSA) will also make the tool freely available to all cancer nurses in Australia and internationally via their website in 2026. Health services and organisations are also able to use their own survey platforms to host the tool and distribute to their nursing teams. The CaN-SAT purposefully aligns with other current projects being led by CNSA – the Cancer Nursing Education Portal and the Comprehensive Cancer Nursing Framework and cancer nurses will be able to directly access education to meet their learning needs through the CNSA Cancer Nursing Education Portal.

A new project is being conducted in 2026 to develop supplementary elements of practice for breast, lung and haematological cancers and work is also being undertaken in China and Iran to translate the tool into Mandarin and Persian language. This multi-faceted approach to implementation will promote broad adoption of the CaN-SAT and foster a culture of continuous learning and development among cancer nurses in Australia and globally.

References:

1.Cancer Council Australia. Facts and figures: Cancer statistics in Australia [Internet]. Sydney: Cancer Council Australia; 2024 [cited 2026 Jan 7]. Available from: https://www.cancer.org.au/cancer-information/what-is-cancer/facts-and-figures

2. Kruss G, Dinh TTH, Van Huizen P, et al. Development and Pilot Psychometric Testing of the Cancer Nurse Self‐Assessment Tools for Early and Metastatic Breast Cancer. Journal of clinical nursing. 2025;34(9):3920-3932. doi:10.1111/jocn.17609

3. Dinh TTH, Crawford‐Williams F, Kruss G, et al. Development and Psychometric Testing of a Comprehensive Cancer Nurse Self‐Assessment Tool (CaN‐SAT) for Identifying Cancer Nursing Skills. Journal of clinical nursing. Published online 2025. doi:10.1111/jocn.70093

-


-