The development of in-house programs typically involves several steps: 1. Needs Assessment: Identifying the gaps in knowledge or skills among the nursing staff. 2. Curriculum Design: Creating content that addresses these gaps, often in collaboration with clinical educators and subject matter experts. 3. Implementation: Rolling out the program through workshops, online courses, or hands-on training sessions. 4. Evaluation: Assessing the effectiveness of the program through feedback, assessments, and performance metrics.