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
The three pieces in this section introduce the Festschrift celebrating the works and influence of Omega: Journal of Death and Dying's founding editor, Robert Kastenbaum. Robert Fulton, an early Associate Editor of the Journal begins with some personal reflections on Kastenbaum. Klass and Doka then describe the nature of the Festschrift. A closing coda by Robert Kastenbaum's wife, Beatrice Kastenbaum, reminds us of the person behind the work.
Subject(s)
Euthanasia, Active/history , Famous Persons , Professional Role/history , Right to Die/history , Attitude to Death , History, 20th Century , History, 21st Century , HumansABSTRACT
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.
Subject(s)
Clinical Competence/standards , Cooperative Behavior , Nursing Staff/standards , Quality Assurance, Health Care/standards , Safety Management/standards , Education, Nursing, Continuing , Humans , Nursing Staff/organization & administration , Quality Assurance, Health Care/organization & administration , Safety Management/organization & administrationABSTRACT
Staff nurse preceptors contribute importantly to student learning and to academic program outcomes; however, academic-clinical partnerships can offer focused learning opportunities for preceptors as well. This study addressed different interest levels in evidence-based practice across clinical settings by testing the effectiveness of a workshop designed to increase preceptor knowledge and endorsement of evidence-based practice. Nurse preceptor participants (N = 160) recruited from seven hospitals during 2009 to 2011 had an average age of 43.9 (SD = 11.5) and an average of 17.0 (SD = 11.2) years of nursing experience. Participants' scores on the Evidence-Based Practice Beliefs Scale improved significantly from pretest to posttest (M(pre) = 59.0, SD(pre) = 8.4, M(post) = 66.4, SD(post) = 6.8, p < .001), which was confirmed by subgroup analyses. At follow-up (1 to 25 months), 52% of the nurse preceptors reported increased use of evidence-based practice. This study indicates that a short collaborative, content-focused workshop can promote preceptor endorsement of evidence-based practice.
