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Healthcare organizations are challenged to provide an environment that enhances professional growth. Miami Valley Hospital responded by examining its evaluation system for clinical nurses and designing a developmental evaluation process. The result is an objective position description outlining global responsibilities of a nurse and a comprehensive, unit-specific assessment of performance. As nurses are guided and nurtured in their development, the opportunities for them to excel are unlimited.

Clinical ladders help maintain expert, motivated, and effective nurses in direct patient care roles. While many institutions were phasing out clinical ladders for registered nurses, Miami Valley Hospital was proactively evaluating the original version. The authors describe their clinical advancement program, based on Benner's model, with program evaluation results. The program participation rate has increased overall. Participants perceive their work and environment more positively than nonparticipants.