Using Competency Testing to Close the Practice Gap With Undergraduate Baccalaureate Nursing Students

2.50
Hdl Handle:
http://hdl.handle.net/10755/621436
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Using Competency Testing to Close the Practice Gap With Undergraduate Baccalaureate Nursing Students
Other Titles:
Closing the Theory-Practice Gap
Author(s):
Sharpnack, Patricia A.; Dillon-Bleich, Kimberly; Patton, Lauren
Lead Author STTI Affiliation:
Iota Psi
Author Details:
Patricia A. Sharpnack, DNP, RN, CNE, NEA-BC, ANEF, Professional Experience: Over 40 years of experience as an educator and administrator in nursing. Dr. Sharpnack is the Dean of the Breen School of Nursing at Ursuline College, Pepper Pike Ohio, and teaches in the baccalaureate and doctoral programs. She has been a hospital executive and consultant, most recently a Chief Nursing Officer with University Hospitals Health Systems. Her clinical specialty is critical care. She has published several articles about the Amish culture, spirituality and use of complementary and alternative practices, use of simulation in nursing education and developing leadership competencies in students. Dr. Sharpnack has presented at numerous national,regional and statewide professional conferences about nursing education, integration of quality and safety competencies, curricular development and cultural issues related to healthcare delivery. She is the President of the Ohio Board of Nursing, Chair of NEONI, a member of NCSBN IRE Committee, and a member of the QSEN National Steering Committee. Author Summary: Dr. Patricia Sharpnack is Dean and Strawbridge Professor at The Breen School of Nursing of Ursuline College. She is a member of the Board of the Ohio Board of Nursing and UHHS Board of Trustees. She received the MNRS Nursing Education Advancement of the Science Award, is a Fellow in the Academy of Nurse Educators, and received the 2015 NEONI Legacy Award. She serves on the CNEA accreditation board and is a CCNE Reviewer.
Abstract:

Background: Nurse educators are continually exploring innovative methods to evaluate transfer of course content to clinical application and competence. Assessment of clinical competence is a critical requisite of nursing professional education, yet research has shown that new graduates are not prepared for transition to practice. Systematic use of competency testing throughout the curriculum can facilitate clinical decision making skill development in undergraduate BSN students (Salem, Ramadan, El-Guenidy & Gaifer, 2012). Attempts to unify the definition of competency and link competency testing to safe practice have been initiated in Canada, the United Kingdom, and Australia; however, evidence of this work has not been broadly presented in the United States McWilliam & Botwinski, 2012). The OSCE is defined as “an approach to the assessment of clinical competence in which the components of competence are assessed in a well-planned or structured way with attention being paid to objectivity” (Najja, Docherty & Miehl, 2016). An OSCE requires that each student demonstrate particular skills and behaviors in a simulated situation or with standardized patients.

Purpose: To explore the use of competency testing through objective structured clinical examinations (OSCE) in facilitating the transition to professional nursing practice.

Conceptual Framework: Ericsson’s Theory of Deliberate Practice was used to frame the study. The design demonstrates alignment with the statewide nurse competency model (USA).

Method: Exploratory study. Nurse educators designed a series of OSCE’s as a final semester summative assessment for students in a baccalaureate nursing program. Clinical practice partners provided input and guidance on station design and evaluated testing criteria and processes. Station design was aligned with the state action coalition's nurse competency model designed by nurse leaders in education and practice. Clinical scenarios that provided students an opportunity to demonstrate competency at patient management skills and identification of quality and safety concerns were included. Students were required to make clinical judgments based on assessments, initiate interventions, and demonstrate a professional, therapeutic relationship with the patient and/or family. Faculty evaluated each student on achievement of competencies using an objective evaluation tool; inter-rater reliability was maintained through consistent trained evaluators and the use of Panopto technology to record all stations. Student demographics and data from competency scores, participant feedback and NCLEX –RN results from more than 65 students was obtained.

Results: A chi-square test was performed to assess the relationship between competency testing stations, the ATI Pharmacology standardized assessment and NCLEX passage. The results for the ATI standardized assessment (1, N=65, = 6.08, p<.05), the clinical decision making competency station (1, N=65, = 4.4, p<.05), and the quality and safety station (1, N=65, = 4.69, p<.05), were significant. No significance was found with the delegation, patient assessment, or medication administration stations. Student and faculty feedback indicate that the OSCE effectively and fairly evaluated clinical competencies and judgement skills. Students suggested that the use of OSCE’s be integrated early in the curriculum to reduce stress level and promote improved accountability for best practice and maintenance of clinical competency. The lack of a reliable and valid tool for competency assessment was a limitation of the project.

Conclusion:  The association between preparedness for practice and competency development has implications for nursing. Including competency testing throughout the curriculum, specifically testing that requires clinical decision-making is vital for safe transition to practice. The use of OSCE’s at key points in the educational process can assist in evaluating student performance, identifying the need for remediation opportunities prior to graduation, and preparing students for the transition to practice. The use of Panopto video recordings of student testing provided opportunity for student reflection and self-assessment. Evidenced-based strategies that promote the use of competency testing and the integration of technology are essential for transference of knowledge into professional practice. Further research to evaluate student outcomes and develop a valid and reliable tool is essential in this process.

Keywords:
Competency Testing; OSCE; Transition to Practice
Repository Posting Date:
6-Jun-2017
Date of Publication:
6-Jun-2017
Other Identifiers:
INRC17I04
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleUsing Competency Testing to Close the Practice Gap With Undergraduate Baccalaureate Nursing Studentsen_US
dc.title.alternativeClosing the Theory-Practice Gapen
dc.contributor.authorSharpnack, Patricia A.en
dc.contributor.authorDillon-Bleich, Kimberlyen
dc.contributor.authorPatton, Laurenen
dc.contributor.departmentIota Psien
dc.author.detailsPatricia A. Sharpnack, DNP, RN, CNE, NEA-BC, ANEF, Professional Experience: Over 40 years of experience as an educator and administrator in nursing. Dr. Sharpnack is the Dean of the Breen School of Nursing at Ursuline College, Pepper Pike Ohio, and teaches in the baccalaureate and doctoral programs. She has been a hospital executive and consultant, most recently a Chief Nursing Officer with University Hospitals Health Systems. Her clinical specialty is critical care. She has published several articles about the Amish culture, spirituality and use of complementary and alternative practices, use of simulation in nursing education and developing leadership competencies in students. Dr. Sharpnack has presented at numerous national,regional and statewide professional conferences about nursing education, integration of quality and safety competencies, curricular development and cultural issues related to healthcare delivery. She is the President of the Ohio Board of Nursing, Chair of NEONI, a member of NCSBN IRE Committee, and a member of the QSEN National Steering Committee. Author Summary: Dr. Patricia Sharpnack is Dean and Strawbridge Professor at The Breen School of Nursing of Ursuline College. She is a member of the Board of the Ohio Board of Nursing and UHHS Board of Trustees. She received the MNRS Nursing Education Advancement of the Science Award, is a Fellow in the Academy of Nurse Educators, and received the 2015 NEONI Legacy Award. She serves on the CNEA accreditation board and is a CCNE Reviewer.en
dc.identifier.urihttp://hdl.handle.net/10755/621436-
dc.description.abstract<p><strong>Background: </strong><span>Nurse educators are continually exploring innovative methods to evaluate transfer of course content to clinical application and competence. Assessment of clinical competence is a critical requisite of nursing professional education, yet research has shown that new graduates are not prepared for transition to practice. Systematic use of competency testing throughout the curriculum can facilitate clinical decision making skill development in undergraduate BSN students (Salem, Ramadan, El-Guenidy & Gaifer, 2012). Attempts to unify the definition of competency and link competency testing to safe practice have been initiated in Canada, the United Kingdom, and Australia; however, evidence of this work has not been broadly presented in the United States McWilliam & Botwinski, 2012). The OSCE is defined as “an approach to the assessment of clinical competence in which the components of competence are assessed in a well-planned or structured way with attention being paid to objectivity” (Najja, Docherty & Miehl, 2016). An OSCE requires that each student demonstrate particular skills and behaviors in a simulated situation or with standardized patients.</span></p> <p><strong>Purpose: </strong>To explore the use of competency testing through objective structured clinical examinations (OSCE) in facilitating the transition to professional nursing practice.</p> <p><strong>Conceptual Framework</strong>: Ericsson’s Theory of Deliberate Practice was used to frame the study. The design demonstrates alignment with the statewide nurse competency model (USA).</p> <p><strong>Method</strong>: Exploratory study. Nurse educators designed a series of OSCE’s as a final semester summative assessment for students in a baccalaureate nursing program. Clinical practice partners provided input and guidance on station design and evaluated testing criteria and processes. Station design was aligned with the state action coalition's nurse competency model designed by nurse leaders in education and practice. Clinical scenarios that provided students an opportunity to demonstrate competency at patient management skills and identification of quality and safety concerns were included. Students were required to make clinical judgments based on assessments, initiate interventions, and demonstrate a professional, therapeutic relationship with the patient and/or family. Faculty evaluated each student on achievement of competencies using an objective evaluation tool; inter-rater reliability was maintained through consistent trained evaluators and the use of Panopto technology to record all stations. Student demographics and data from competency scores, participant feedback and NCLEX –RN results from more than 65 students was obtained.</p> <p><strong>Results: </strong>A chi-square test was performed to assess the relationship between competency testing stations, the ATI Pharmacology standardized assessment and NCLEX passage. The results for the ATI standardized assessment (1, N=65, = 6.08, p<.05), the clinical decision making competency station (1, N=65, = 4.4, p<.05), and the quality and safety station (1, N=65, = 4.69, p<.05), were significant. No significance was found with the delegation, patient assessment, or medication administration stations. Student and faculty feedback indicate that the OSCE effectively and fairly evaluated clinical competencies and judgement skills. Students suggested that the use of OSCE’s be integrated early in the curriculum to reduce stress level and promote improved accountability for best practice and maintenance of clinical competency. The lack of a reliable and valid tool for competency assessment was a limitation of the project.</p> <p><strong>Conclusion: </strong> The association between preparedness for practice and competency development has implications for nursing. Including competency testing throughout the curriculum, specifically testing that requires clinical decision-making is vital for safe transition to practice. The use of OSCE’s at key points in the educational process can assist in evaluating student performance, identifying the need for remediation opportunities prior to graduation, and preparing students for the transition to practice. The use of Panopto video recordings of student testing provided opportunity for student reflection and self-assessment. Evidenced-based strategies that promote the use of competency testing and the integration of technology are essential for transference of knowledge into professional practice. Further research to evaluate student outcomes and develop a valid and reliable tool is essential in this process.</p>en
dc.subjectCompetency Testingen
dc.subjectOSCEen
dc.subjectTransition to Practiceen
dc.date.available2017-06-06T19:38:16Z-
dc.date.issued2017-06-06-
dc.date.accessioned2017-06-06T19:38:16Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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