Competencies of Staff Educators
Competencies of Staff Educators
Competencies of Staff Educators
for
Staff Educators
TOOLS TO EVALUATE AND ENHANCE NURSING PROFESSIONAL DEVELOPMENT
C ONTENTS
List of figures and exhibits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii About the authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .viii Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi Section I: Competency assessment and validation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Chapter 1: Overview of the competency movement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Key concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Why is competence important? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 What is competence in nursing? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 The role of nursing professional development educators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 Competency-based education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 Evidence-based practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Competencies for nursing professional development educators . . . . . . . . . . . . . . . . . . . . . . . . . . .10 Difference between NPD competencies and academic educator competencies . . . . . . . . . . . . . . . .11 Chapter 2: Developing educator competencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Performing a nursing professional development research study . . . . . . . . . . . . . . . . . . . . . . . . . . .15 Origins of the competencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 Ongoing research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 Validating the results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 Refining the results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 Chapter 3: Creating a framework for educator competencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 Key concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 Using ANA standards to build a framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 Standards of practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 Standards of professional performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 Measuring outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 Choosing a model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
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Benners novice-to-expert theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 Ordering the competencies to reflect the novice-to-expert continuum . . . . . . . . . . . . . . . . . . . . . .25 Final list of competencies by category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 What educators are able to do: Doing the right thing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27 How educators approach practice: Doing the thing right . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 Development of individual attributes: Right person doing it . . . . . . . . . . . . . . . . . . . . . . . . . . .29 Chapter 4: Methods to validate competencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 How do you measure competence? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 Competency checklists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33 Other tools to validate competence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34 Post-tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34 Case studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34 Simulated events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 Observations of daily work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 Differentiating competencies and performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 Differentiating levels of competence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 Section II: Applications of the competencies to practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39 Chapter 5: Self-assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 Using the checklist as a self-assessment tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 What should be assessed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 Be honest with yourself . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 Chapter 6: Criterion-based position descriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45 Developing position descriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45 Before writing a position description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46 Chapter 7: Orientations for new educators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63 Using the checklist to create an orientation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63 Chapter 8: Performance appraisals and professional development plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 Types of performance appraisals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 Performance appraisals for staff educators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74 Professional development plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78 Reflect on development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
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Chapter 9: Professional portfolios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 Key concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 Why create a portfolio? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 Building a portfolio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83 Using a portfolio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84 Helping others develop professional portfolios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84 Chapter 10: Documenting cultural competence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87 Key concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87 Cultural competence and NPD educators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88 Components of cultural competence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89 Strategies to promote cultural competence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Section III: Future trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93 Chapter 11: Potential applications of the competencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95 Graduate nursing education programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95 Scope and Standards of Nursing Professional Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96 Resource for certification exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96 Job function analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97 Development plan for new role . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97 ANCC Magnet Recognition Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98 Need for additional research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98 Appendix: Nursing professional development competency tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101 Nursing education instructional guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125 Continuing education exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .129 Continuing education evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134
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CHAPTER ONE
Learning objective
After reading this chapter, the participant should be able to discuss key components of competence and competency-based education
Key concepts
Before beginning a discussion of nursing professional development educator competencies, it is important to first discuss the key concepts and definitions. Most of these concepts have been defined by the American Nurses Association (ANA) in their Scope and Standards of Practice for Nursing Professional Development. Competence: A persons capacity to perform his or her job function. Competency statement: A statement that describes a general or broad area of behavior/performance that is requisite for being competent in a particular role and work setting.
Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
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Continuing competence: Ongoing professional nursing competence according to level of expertise, responsibility, and domains of practice, and as evidenced by behavior based on beliefs, attitudes, and knowledge matched to and in the context of a set of expected outcomes as defined by nursing scope of policy, code of ethics, standards, guidelines, and benchmarks that ensure safe performance of professional activities. Continuing education: Systematic professional learning experiences designed to augment the knowledge, skills, and attitudes of nurses and therefore enrich the nurses contribution to quality healthcare and their pursuit of professional career goals. Nursing professional development: The lifelong process of active participation by nurses in learning activities that assist in developing and maintaining their continuing competence, enhance their professional practice, and support achievement of their career goals. Nursing professional development educator: A registered nurse whose practice is in nursing education and who facilitates lifelong learning in a variety of healthcare, educational, and academic settings. Performance criteria: Statements that define the critical or essential behaviors that represent a particular competency. These outcomes require integration of learning and application of that learning. Staff development: The systematic process of assessment, development, and evaluation that enhances the performance or professional development of healthcare providers and their continuing competence, according to the National Nursing Staff Development Organization (NNSDO).
Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
The issue of continued competence will remain a challenge to the health profession for many years. With the never-ending changes in science and technology, the healthcare environment, patient expectations, and regulations, health professionals need to attain and maintain competence throughout their careers. However, definitions of competence and strategies to document competence vary, and there is little evidence to support specific, successful methods for validating competence.
Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
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Competency-based education
Competency-based education (CBE) is one approach that NPD educators use to assess and validate competence. CBE reflects a pragmatic concern that nurses are able to do a task, rather than simply know how to do a task. Competency models began to evolve during the 1960s as an approach to education, and today CBE models constitute a widely applied approach to validating competence. With CBE, learning is self-directed, which allows educators to act as facilitators to promote learners goals. The CBE approach is compatible with adult developmental needs. Common characteristics of CBE include a learner-centered philosophy, real-life orientation, flexibility, clearly articulated standards, a focus on outcomes, and criterion-reference evaluation methods. CBE emphasizes outcomes in terms of what individuals must know and be able to do, and allows flexible pathways for achieving those outcomes. A comparison of CBE and traditional education is provided in Figure 1.1.
Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
FIGURE 1.1
Characteristic
Basis of instruction
Pace of instruction
Focus of instruction
Method of evaluation
Criterion referenced
Benefits of a competency-based approach include encouraging teamwork enhancing skills and knowledge increasing staff retention reducing staff anxiety increasing productivity improving nursing performance ensuring compliance with The Joint Commission (formerly known as the Joint Commission on Accreditation of Healthcare Organizations) standard that requires that all members of the staff are competent to fulfill their assigned responsibilities
Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
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The American Nurses Credentialing Centers (ANCCs) Magnet Recognition Program objectives include promoting quality in a milieu that supports professional nursing practice and promoting positive patient outcomes. Designated hospitals focus on outcomes and involvement of nurses in the decision-making process is consistent with the tenets of the CBE approach for individuals.
Evidence-based practice
Just as nurses are encouraged to use evidence-based data in their clinical practice, educators need to base their practice on current evidence. One way of determining if educators are fulfilling their responsibilities is to identify if competencies expected in their role are based on research or evidence of best practice. According to Melnyk, evidence-based practice (EBP) is a problem-solving approach to clinical practice that incorporates the best evidence from well-designed studies, patient values, and patient preferences (Melnyk 2004). This definition not only incorporates research data, but also acknowledges patient values. The current focus on EBP has caused increased scrutiny of clinicians and their preparation. Why is there such an emphasis on EBP? First and foremost, it can lead to better patient outcomes, but it also is a response to pressures for cost containment from payers and healthcare facilities. If better and more efficient treatments are incorporated into practice, then the length of stay should decrease, as well as overall costs. Another reason for the focus on EBP is that consumers today are much more knowledgeable about treatment options. For example, it is not uncommon for patients to go to the Internet to find out more information about a specific disease, test, or treatment. Ultimately, EBP provides opportunities for nurses to be more effective, and it acknowledges the value of nursing clinical judgment. Advantages of EBP are outlined in Figure 1.2.
Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
FIGURE 1.2
Produces better patient outcomes and/or educational outcomes Responds to pressure for cost containment from payers, healthcare facilities, and educational administrators Acknowledges increased consumer awareness of treatment and care options and learners savviness regarding educational strategies Provides opportunities for nursing care and nursing education to be individualized, streamlined, more effective, and dynamic Acknowledges the value of clinical judgment and critical thinking
Cileska et al. described a research study relating to the frequency with which staff nurses used various sources of knowledge (Cileska et al.2001). The top six sources were 1. experience 2. information learned in nursing school (although the average time since completion of a basic program was 18 years) 3. workplace sources 4. physician sources 5. intuition 6. past usual practice Information from textbooks and journals ranked in the bottom six sources. The staff nurses were also asked to identify the one most common source from which they learned about research findings. Although 39% identified nursing journals, additional analyses showed that the primary journals the nurses read were not research journals but practice-focused journals published by professional nursing organizations. Nursing is a complex profession, requiring a good knowledge base and critical-thinking skills. The function of nursing education is to produce a competent practitioner, adept in basic knowledge and with the ability to apply critical thinking. Nurse educators must address a wide range of
Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
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skills and assist nurses in their integration of theory and practice. New approaches to education and practice should be based on research and evidence of best practices. NPD educators need to conduct research and utilize research findings on the best approaches to education and documentation of competency.
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Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
assessment, and a preceptor report (Vezina et al. 1996). Although these tools may help with educational competencies, they do not provide specific performance expectations for particular competencies.
Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
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FIGURE 1.3
Quality of Care
C o m p et en ce
g n lo fe Li
Continuing Education
g in n ar Le
C o n ti n u in g
Staff Development
Academic Education
The National League for Nursing (NLN) identified core competencies of nurse educators. This effort arose from a Think Tank on Graduate Preparation for the Nurse Educator Role held in December 2001. Members of the Think Tank included faculty and administrators from associate degree, baccalaureate degree, and graduate nursing programs, as well as representatives from staff development and the higher education community. This group generated a list of eight competencies, with several ideas under each competency to further define its scope. Following the Think Tank, the Task Group on Nurse Educator Competencies began an extensive search of the literature to determine if the eight competencies were documented in evidence-based literature, or if there was a need to modify them. The final list had eight overall competencies, with 66 task statements identified to further describe the competencies. The overall competency statements are outlined in Figure 1.4 on page 13.
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Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
FIGURE 1.4
1. Facilitate learning 2. Facilitate learner development and socialization 3. Use assessment and evaluation strategies 4. Participate in curriculum design and evaluation of program outcomes 5. Function as change agents and leaders 6. Pursue continuous quality improvements in the nurse educator role 7. Engage in scholarship 8. Function within the educational environment
Source: Adapted from the National League for Nursing. (2005.) Core competencies of nurse educators with task statements. New York: NLN. Retrieved on June 28, 2006, from www.nln.org/profdev/corecompetencies.pdf.
In many instances there are different expectations in the NPD role and academic role with respect to publishing. One of the task statements for the competency on facilitating learner development and socialization deals with dissemination of information through publications. The term publish or perish is frequently used with academic educators, who must publish to gain tenure. It is an expectation in many universities that faculty publish in peer-reviewed journals in their field. In most NPD educator roles, this is not a required competency. One of the task statements under the competency of engaging in scholarship relates to demonstrating skills in proposal writing for initiatives that include, but are not limited to, research, resource acquisition, program development, and policy development. Grant writing is a task that is more commonly seen in academic education. Many NPD educators do not have any experience with grant writing and may not have the resources to develop expertise in that area. In many settings, academic educators are expected to write grants and receive funding for their research projects.
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References
Alspach, J. G. 1995. The Educational Process in Nursing Staff Development. St. Louis: Mosby Year Book. American Nurses Association. 2000. Scope and Standards of Practice for Nursing Professional Development. Washington, DC: American Nurses Association. American Nurses Credentialing Center. 2006. ANCC Magnet Recognition Program. Silver Spring, MD: ANCC. Retrieved on June 29, 2006, from www.nursingworld.org/ancc/magnet.html. Cileska, D. K., Pinelli, J., DiCenso, A., and Cullum, N. 2001. Resources to enhance evidencebased nursing practice. AACN Clinical Issues 12 (4): 520528. Dickenson-Hazard, N. 2004. Global health issues and challenges. Journal of Nursing Scholarship 36 (1): 610. Gordon, B. N., and Franklin, E. M. 1993. An orientation for inexperienced educators. Journal of Nursing Staff Development 9 (2): 7577. Johnson, S. 2002. Development of educator competencies and the professional review process. Journal for Nurses in Staff Development 18 (2): 92102. Kelly-Thomas, K. J. 1998. Clinical and Nursing Staff Development: Current Competence, Future Focus. 2nd ed. Philadelphia: Lippincott, Williams & Wilkins. Kotecki, C. N., and Eddy, J. R. 1994. Developing an orientation program for a nurse educator. Journal of Nursing Staff Development 10 (6): 301305. Melnyk, B. M. 2004. Integrating levels of evidence into clinical decision making. Pediatric Nursing 30 (4): 323325. National League for Nursing. 2005. Core competencies of nurse educators with task statements. New York: NLN. Retrieved on June 28, 2006, from www.nln.org/profdev/corecompetencies.pdf. National Nursing Staff Development Organization. 1999. Strategic Plan 2000. Pensacola, FL: National Nursing Staff Development Organization. Vezina, M., Chiang, J. J., Laufer, K., Garabedian, C., Padre, H., and Sanders, N. 1996. Competency-based orientation for clinical nurse educators. Journal of Nursing Staff Development 12 (6): 311313.
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Competencies for Staff Educators: Tools to Evaluate and Enhance Nursing Professional Development
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