EducationService Liaison Committee Competency Workgroup

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Education-Service Liaison Committee Competency
Workgroup

• December 2, 1999

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Overview of the Mississippi Competency Model
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Process of Development

• Part of CIC grant to enhance education and
  practice skills of MS nurses, Model developed by
  LPN and RN educators.
• Purpose of Model- to facilitate articulation of
  MS nurses into higher degree programs and assist
  employers understanding nurses abilities and
  strengths

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Important Points - Model

• Designed for articulation
• Based on competencies at graduation
• Competency defined as a performance standard
  including skills, knowledge, abilities and
  understanding - Koerner,1992
• There are existing competencies. Much work has
  been done in this area

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Important Points - Model

• Assumptions-
• Competencies build on previous levels and cannot
  be taken out of context
• Based on competencies at graduation
• Assume novice level at graduation, always have
  some who exceed expectation
• Setting is not a limiting factor
• Model must be tested in practice

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Competencies

• Provider of Care
• care giver
• teacher
• communicator
• advocate

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Competencies

• Member of A Profession
• Scholar
• Collaborator
• Ethicist
• Researcher

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Competencies

• Manager
• Leader
• Facilitator
• Intrapreneur
• Decision Maker
• User of Information Technology

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Examples of Competency Based Practice using Model

• Given in Model document however, template for
  graduate nurse only!

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Proposed Uses of Model

• Guide educators in curriculum refinement,
  evaluation
• Clarify roles for public and employers
• Assist in development and validation of job
  descriptions

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Recommendations

• Test Model in practice possibly as a determinant
  of staffing mix
• Include Model in Ms nursing schools curricula
• Seek validation of outcomes with employers and
  graduates
• Clarify differentiate roles between graduates
• MONE plans to develop a template to use as a
  guide in evaluating congruency between
  competencies, job descriptions and evaluations

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And the Consultant further recommends..

• Continue to develop articulation plan
• Add doctoral competencies
• Demonstration grant to implement competency based
  practice
• Mississippi participate in a Leadership Institute
  to further develop a cadre of experts in
  competencies and educational outcomes.

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• All is not lost Lets eat!

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Charge - Education-Service Committee

• Template for job descriptions and evaluations-
• Suggest rethink that
• Realized MC Model is beginning competency
• Beginning competency Vs Continued competency
• Continued competency very complex issue
• Group has redefined Competency - knowledge,
  skills, attitudes and abilities/critical thinking
• Share with you what others have done and the
  outcomes- less that satisfactory

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Leaders in Competency Work

• MAIN Alliance- seminal work 1984- AD, BSN
• National Council
• Colorado
• California

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MAIN - Midwest Alliance

• 1984 began developed competencies for AD and BSN-
  first set based on educational prep
• Focus on differentiated practice sidelined due to
  shortage
• Multiple demonstration sites - outcome date cost
  effectiveness of DP model
• Widely disseminated information JoEllen Koerner

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National Councils Role

• 1985 - position paper on continued competence
• 1995- Defined competence, Standards for
  competence, Model for individual competence
• Regulatory Role of the Council- renewal issue
• Defined what model of competence should include

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Model Foundation

• Definition
• Setting standards to compare and evaluate
  individuals
• Identify behaviors which demonstrate
• Implement system to discipline failures to meet
  standards

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Definition of Competence

• The application of knowledge and the
  interpersonal, decision-making and psychomotor
  skills expected for the practice role, within the
  context of public health, safety and welfare.
  National Council Position Paper 1996

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Standards for Competence

• Must be applicable to every nurse in every
  practice role and address the continuum of
  practitioner experience, i.e. entry, continued
  competence, after disciplinary action.
• Behavior indicators facilitates competence
  assessment

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Continued competence assessment

• Use Knowledge, Skills, Abilities
• Use NCLEX, Random group assessment, peer review,
  certification, portfolio, retesting
• Dealing with removal of licenses, etc

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Indicators

• Apply knowledge and skills at the level required
  for a particular situation
• Determines actions needed to achieve desired
  outcomes
• Performs nursing activities in a safe/effective
  manner
• Demonstrates current knowledge necessary to
  provide safe client care
• Delegates in accordance with established
  guidelines
• Collaborates with appropriate professionals to
  attain client health care outcomes

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Colorado

• In 1988,(first) to develop a statewide
  articulation model - created competencies LPN, AD
  and BSN.
• Complex and detailed set of competency
  statements, job descriptions, and eval. tools
  were developed as well.
• However, wide scale implementation has not
  occurred.

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California

• Reviewed work of others - Colorado consulted
• Adapted competencies from Colorado, Mississippi,
  New Mexico, OK for LVN, RN care provider, RN care
  coordinator and APN
• Provided template to align curricula of all
  programs
• Competencies have functions where progression is
  indicated using modified Dreyfus Skill
  Acquisition Model- novice to expert
• Novice, Competent, Proficient and Expert

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California

• Novice education
• Competent education experience
• Proficient education experience goal
  directed growth (ce staying current
  certification higher ed)
• Expert education experience goal directed
  growth, not all nurses can become expert -
  intuitive grasp, see possibilities
• Dreyfus Assumption - situationally defined

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So where are we?Where do we go?

• MC Model defines beginning competency
• Definition of competency- KSAA
• Work from other states and National Council
• Views on DP Vs CBP
• Support from MHA, ONWR, Consultant
• Demonstration sites create /validate job
  profiles, outcome measures
• Tremendous Brain Power

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Definition of Competency

• Group has identified key elements as
• Knowledge, skills, abilities and attitudes
• Knowledge includes education plus CE
• Skills - Psychomotor skills
• Abilities- critical thinking, decision making
  judgement, setting priorities
• Attitude- Customer service, caring, values

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Future Direction

• Others not had success- Cal. Nov. 1999
• Previous efforts of this group unsuccessful with
  job descriptions
• Think how we can be successful, Create something
  of great use to MS. Nurses and agencies..

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Proposal

• Refine competence in terms of continued and
  beginning
• Develop model of competency based practice using
  concepts in MC Model
• Develop framework and processes others can use to
  define the work of nursing personnel, illicit
  knowledge, skills, abilities, attitudes needed to
  accomplish the work and a set of outcome measures
  to demonstrate the difference in patient care
  costs and quality
• Enlist agencies to serve as demonstration sites
  to test CBP model

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Future Plans

• Goals
• Timeline
• Approaches
• Group membership- Have who we need?
• Demonstration sites
• Marketing task force for demonstration sites
• email addresses, http//healthsci.clayton.edu/eich
  elberger/competencies.htm