Longitudinal Assessment to Evaluate Continued Certification and Lifelong Learning in Healthcare Professionals: A Scoping Review.

The balance of lifelong learning with assessment for continued certification is a challenge faced by healthcare professions. The value of single-point-in-time assessments has been questioned, and a shift to longitudinal assessments (LA) has been undertaken to assess lifelong learning over-time. This scoping review was conducted to inform healthcare certifying organizations who are considering LA as an assessment tool of competence and lifelong learning in healthcare professionals. A search of 6 databases and grey literature yielded 957 articles. After screening and removal of duplicates, 14 articles were included. Most articles were background studies informing the underpinnings of LA in the form of progress testing, pilot studies, and process of implementation. Progress testing is used in educational settings. Pilot studies reported satisfaction with LA's ease of use, online format, and provision of lifelong learning. Implementation processes reveal that key aspects of success include stakeholder participation, phased rollout, and a publicly available content outline. Initial outcomes data affirm that LA addresses knowledge gaps, and results in improved performance on maintenance of certification exams. Future research is needed to substantiate validity evidence of LA and its correlation with high-stakes exam performance when assessing lifelong learning and continued competence of healthcare professionals over time.

Concept analysis of longitudinal assessment for professional continued certification.

BACKGROUND: This concept analysis presents a scholarly epistemological approach to defining the attributes, empirical referents, antecedents, and consequences of a knowledge maintenance approach-known as longitudinal assessment-to professional certification. AIM: The analysis reports on the efforts of the National Board of Certification and Recertification for Nurse Anesthetists to explore this educational method as an approach to meet requirements for continued professional certification. METHOD: Using the classical approach to concept analysis, the authors explore the structure and function of longitudinal assessment and define the characteristics of the concept in a way that is meaningful to the continued certification of nursing and medical professionals. CONCLUSION: This analysis establishes a link between the goal and outcome of the continued certification process, including continuing education in nursing and medical practice, and the desirable characteristics of longitudinal assessment, which include proven principles of educational psychology. Through exploring model and borderline cases, the authors seek to demonstrate that longitudinal assessment is the best approach to foster lifelong learning of continuously evolving scientific, theoretical, and clinical knowledge in support of safe care for patients.

The Perceived Value of Certification in Nonsurgical Pain Management.

Chronic pain is a growing epidemic in America. Challenges in patients' access to care, and in reimbursement to Certified Registered Nurse Anesthetists (CRNAs) who provide pain services, have resulted in a voluntary subspecialty certification in nonsurgical pain management (NSPM) for CRNAs. An evaluation was conducted of perceptions of CRNAs toward the value of certification in NSPM. An invitation to complete the Perceived Value of Certification Tool (PVCT) was sent to 474 CRNAs who identified the subspecialty practice of NSPM upon application for recertification to the NBCRNA. Data were collected on 18 factors related to the perceived value of certification in the NSPM subspecialty. Exploratory factor analysis using principal components analysis with varimax rotation was conducted to assess the latent structure of the PVCT and to identify potential constructs of CRNAs' perceptions. Reliability was assessed using Cronbach α coefficients. Of 64 CRNAs who provided data, a 3-factor solution emerged that explained 72.25% of the overall variance: personal satisfaction, professional recognition, and competence, each with excellent to good reliability (F1: α = 0.95, F2: α = 0.94, F3: α = 0.88). Identification of the 3 constructs in this study will assist with future efforts of examination validation for the subspecialty of NSPM certification for CRNAs.

Computer-Based Case Simulations for Assessment in Health Care: A Literature Review of Validity Evidence.

Simulation for education and training in health-care professions has been widely applied. However, its value as an assessment tool for competence is not fully known. Logistical barriers of simulation-based assessments have led some health-care organizations to utilize computer-based case simulations (CCSs) for assessment. This article provides a review of the literature on the identification of psychometrically sound, CCS instruments designed to measure decision-making competence in health-care professionals. CINAHL, MEDLINE, and Ovid databases identified 84 potentially relevant articles published between January 2000 and May 2017. A total of 12 articles met criteria for inclusion in this review. Findings of these 12 articles indicate that summative assessment in health care using CCSs in the form of clinical scenarios is utilized to assess higher order performance aspects of competence in the form of decision-making. Psychometric strength was validated in eight articles and supported by four replication studies. Two of the eight articles reported evidence of construct validity and support the need for evidence based on a theoretical framework. This literature review offers implications for further research on the use of CCS tools as a method for assessment of competence in health-care professionals and the need for psychometric evidence to support it.

The use of nalmefene for intrathecal opioid-associated nausea in postpartum patients.

The aim of this study was to compare the severity of nausea and incidence of emesis in laboring parturients who received intravenous nalmefene or placebo following an intrathecal opioid (ITO). We randomly assigned 60 ASA class I or II multiparous women to receive nalmefene or placebo. Subjects received fentanyl, 25 micrograms, and morphine, 250 micrograms, intrathecally on request for analgesia. Thirty minutes after vaginal delivery, the experimental group received nalmefene, 20 micrograms, and the placebo group received an equivalent volume of normal saline intravenously. Visual analog scale nausea scores and data about episodes of emesis were obtained during labor and during the first 24 hours postpartum. There were no significant differences in age, weight, duration of labor, volume of intravenous fluids infused, time from last meal to delivery, or time from administration of the ITO to injection of the study drug. There were no significant differences in mean visual analog scale nausea scores or frequency of emesis for any time interval. Nalmefene, 20 micrograms, given intravenously within 30 minutes of vaginal delivery does not significantly reduce the nausea and vomiting associated with the use of ITOs for labor analgesia.