ABSTRACT
BACKGROUND AND PURPOSE: Educators, employers, and regulatory agencies face substantive challenges in evaluating nursing competency. Evidence on what competency is and how to measure it can mitigate the challenges. METHODS: Participants (N = 67) completed three high-fidelity simulation tests. Each video-recorded test was scored by three raters using a 41-item instrument. Exploratory factor analysis was used to define the latent structure of the instrument. RESULTS: A five-factor solution accounted for 56% of the variance, minimized negative loadings, and minimized the number of cross-loadings. The factors were minimally correlated (each r < .30). CONCLUSIONS: The factors, Vigilant Action, Role Nuances, Precision, Procedural Skills, and Risk Reduction, represent integrated dimensions of competency that can be linked to specific tasks underlying safe practice.
ABSTRACT
BACKGROUND AND PURPOSE: There is growing evidence that simulation testing is appropriate for assessing nursing competence. We compiled evidence on the validity and reliability of the Nursing Performance Profile (NPP) method for assessing competence. METHODS: Participants (N = 67) each completed 3 high-fidelity simulation tests; raters (N = 31) scored the videotaped tests using a 41-item competency rating instrument. RESULTS: The test identified areas of practice breakdown and distinguished among subgroups differing in age, education, and simulation experience. Supervisor assessments were positively correlated, r = .31. Self-assessments were uncorrelated, r = .07. Interrater agreement ranged from 93% to 100%. Test-retest reliability ranged from r = .57 to .69. CONCLUSIONS: The NPP can be used to assess competence and make decisions supporting public safety.
Subject(s)
Clinical Competence , Computer Simulation , Educational Measurement/methods , Nurses , Female , Humans , Male , Middle Aged , Nursing Evaluation Research , Reproducibility of ResultsABSTRACT
Few options are available to nursing regulatory boards for the evaluation of nursing competency in registered nurses who are reported for practice breakdown. To address this deficiency, the authors conducted funded research through collaboration between their respective institutions: a state nursing regulatory board, a community college nursing program, and a state university nursing program. Through this collaboration, a competency evaluation process that used high-fidelity simulation was developed and was called the nursing performance profile (NPP). The NPP process consisted of evaluation of videotaped performances of registered nurses providing simulated patient care in three successive situations. Nurses who were experienced in both practice and supervision rated the performances according to scoring guidelines developed by the authors. Findings showed that the NPP process has the potential to (1) provide regulators, educators, and employers with a quantitative picture of nurse performance across nine areas essential to safe practice, and (2) establish a basis for recommending a specific remediation plan or continuing professional development.
