Responses to Peers

Response to Abby’s post below:
My nursing organization assess nursing competency by having us do an annual check off for the flu shot. We must also complete an annual CPR course. We have a staff member that specifically just works on policies and procedures for my specific department. When the policies and/or procedures are updated they are then sent out to staff members it applies to. We must then read over the policy and present any questions or concerns after doing so. This would be known as quality improvement. Quality improvement allows medical staff to continuously utilize the safest and most effective methods in patient care (Rubenfeld, Scheffer, 2015). Obviously, we must obtain our licenses and keep them up to date. Also as registered nurses we must complete our 25 CEU hours biannually.

In all honesty, I don’t think there is a “formal tool” to measure competency. “A major challenge is lack of discipline-specific assessment and evaluation tools related to the critical thinking concept (Robert, Peterson, 2013). Efforts have been made on how to properly teach critical thinking for nurses and I’m sure this will be an ongoing process for sometime. Critical thinking has many different definitions. Trying to do what is right and safe by the patient without complicating things more is how my brain thinks of critical thinking.

I do believe that competency can be measured in different ways. I may not have all the answers (I certainly don’t) but I can ensure I will find someone who will help me reach an appropriate answer. I believe that being competent includes not “always having an answer,” sometimes we might not be sure and it is appropriate to inform the patient of this. It is dangerous to just guess at something that is possibly life-threatening.

Resources

Rubenfeld, M. G., & Scheffer, B.K. (2015). Critical thinking TACTICS for nurses: Achieving the IOM competencies (3rd ed.). Sudbury, MA: Jones and Bartlett.

Robert, R. R., & Petersen, S. (2013). Critical thinking at the bedside: Providing safe passage to patients. Medsurg Nursing, 22(2), 85-93, 118. Retrieved from http://americansentinel.idm.oclc.org/login?url=https://search-proquest-com.americansentinel.idm.oclc.org/docview/1350295511?accountid=169658

Response to Christn’s post below:
The word “competencies” can be defined as a very specific end point that can be assessed, and is more detailed than a general list of areas for improvement (Rubenfeld & Scheffer, 2015). The IOM Core Competencies are designed to provide a framework that streamlines clinician and nursing efforts in providing adequate and appropriate patient care. These competencies include: patient-centered care, working in interdisciplinary teams, employing evidence-based practices, the application of quality improvement, and the utilization of informatics (Institute of Medicine, 2003).

The organization that I work for manages this, as a whole, through computer-based learning and competencies modules. These are assigned quarterly, and reflect the appropriate information based on the location of employment and job description. Some modules are repeatedly assigned annually to keep competencies up-to-date, while others are assigned based on changes in evidence-based practices, or as the result of current issues that may arise.

Upon hire the processes is a little different during the first 6-9 months, as nurses are assigned to a preceptor who is in charge of a department-specific checklist. This checklist addresses procedural competencies that must be achieved and mastered in order for them to be practiced independently. Very rarely are additional competencies determined by this process following the initial checklist.

I think computer-based learning can be very informational and helpful, and allows the learner to address the information at their own pace within the quarterly timeframe. However, I think it has its short-comings as well, as there is no peer-to-peer evaluation or accountability. Although I work within a department with close-knit coworkers who readily help each other out in reviewing competencies when someone is unsure, I can see the computer-based model lacking as an all-inclusive learning tool in other departments where this may not be the case.

Institute of Medicine (US) Committee on the Health Professions Education Summit; Greiner AC, Knebel E, editors. Health Professions Education: A Bridge to Quality. Washington (DC): National Academies Press (US); 2003. Chapter 3, The Core Competencies Needed for Health Care Professionals. Available from: https://www.ncbi.nlm.nih.gov/books/NBK221519/

References:

Institute of Medicine. (2003). Committee on the Health Professions Education Summit; Greiner AC, Knebel E, editors. Health Professions Education: A Bridge to Quality. Washington (DC): National Academies Press (US); 2003. Chapter 3, The Core Competencies Needed for Health Care Professionals. Available from: https://www.ncbi.nlm.nih.gov/books/NBK221519/

Rubenfeld, M. G., & Scheffer, B. K. (2015). Critical thinking tactics for nurses (3rd ed.). Burlington, MA: Jones & Bartlett

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