The knowledge and skills needed by critical care nurses and the content and strategies of England's existing critical care nursing education programs were examined to identify core competencies that could provide a central foundation for and promote national comparability of critical care nursing programs throughout England. The study included a comprehensive literature review, an analysis of curriculum documents from 105 English National Board-approved critical care nursing courses offered at 30 institutions, telephone interviews with 84 program leaders, and a telephone survey of 81 clinical managers. The analysis was complicated by the fact that each curriculum document was written differently. Neither was any consistent pattern in the configuration and weighting of core, specialist, or cluster modules identifiable. A general drift away from formal curriculum models to modular frameworks was observed. Two distinct approaches to the generation of practice outcomes were evident, predetermined outcomes set by the curriculum development team and student-determined outcomes. Ensuring that programs are responsive to local needs emerged as a key factor in the changing provision of critical care courses; however, a tension between being responsive to local needs and trying to establishing a "gold standard" or comparability of courses was sometimes evident. (Contains 46 tables/figures and 313 references.) (MN)