1. Clinical Skills Observer Training ROLE OF THE CLINICAL SKILLS OBSERVER Evaluate all candidates fairly and objectively

2. Clinical Skills Observer Training CLINICAL SKILLS OBSERVER QUALIFICATIONS

3. Clinical Skills Observer Training APPROVAL PROCESS HCP CSO training is mandatory – training from other testing vendors is not accepted Trained by Test Site Coordinators Training Includes: Training on local procedures for handling testing materials securely Review of CSO Training Powerpoint Watching CSO Training video Shadowing experience CSO during an exam

4. Clinical Skills Observer Training APPROVAL PROCESS After training is complete, the Test Site Coordinator submits a CSO Request and supporting documentation to the state HCP office for approval. Approval letter and certificate are sent to the Test Site Coordinator to copy for test site records and then given to the evaluator

5. Clinical Skills Observer Training MAINTAINING “APPROVED” STATUS CSOs must administer at least two clinical skills exams per year CSOs may be removed from the list for: Inactivity Change of employment Lack of affiliation with an approved program Expiration/loss of nursing license Violating the confidentiality agreement

6. Clinical Skills Observer Training MAINTAINING APPROVED STATUS CSOs who jeopardize test security or engage in misconduct will be permanently removed from the “approved” list. CSOs who are removed from the list for other reasons must retrain and resubmitted to the HCP office before testing

7. Clinical Skills Observer Training HANDLING TESTING MATERIALS Test site coordinator provides materials to CSO on “as needed” basis. CSO must handle testing materials following state and local procedures CSO must take care to prevent exposure of test content and candidate personal information.

8. Clinical Skills Observer Training HANDLING TESTING MATERIALS CSOs may not: Photocopy or reproduce test materials, OR Sell or disclose the content of the tests to any person or organization, OR Teach students using testing materials, OR

9. Clinical Skills Observer Training ADMINISTERING EXAMS Must be administered and answered in English – no translation No resources allowed other than information in exam packet Exam is to be administered in one uninterrupted session

10. Clinical Skills Observer Training ADMINISTERING EXAMS A CSO must evaluate all skills by a candidate before evaluating another candidate Candidates may not be rotated among CSOs at skills stations Candidates may not be rotated as a group from one skill to another

11. Clinical Skills Observer Training VOLUNTEERS/RESIDENTS Skills can be demonstrated on a manikin, if appropriate CNAs and students in nurse aide training programs cannot be volunteers/residents Preferred: Healthcare providers or students not be volunteers/residents

12. Clinical Skills Observer Training MISCELLANEOUS CSOs should not be instructors in nurse aide training programs RULE: If a CSO is an instructor, he/she cannot administer the clinical skills exam to a student if he/she has had any role in that student’s training Test site coordinators have open access to testing at any time.

13. Clinical Skills Observer Training CLINICAL SKILLS EXAM OVERVIEW Several skills incorporated into a scenario Designed to more closely replicate what nurse aides encounter on the job Contains critical and non-critical tasks

14. Clinical Skills Observer Training CLINICAL SKILLS EXAM OVERVIEW Four testing scenarios Total LTC exam time– 1 hour, 15 minutes 15 minutes for instructions and candidate and volunteer/resident preparation 1 hour for skills demonstration

15. Clinical Skills Observer Training CLINICAL SKILLS EXAM MATERIALS 1.Cover Sheet – completed by test site coordinator prior to the exam 2.Candidate Information pages 1.Scenario & Candidate Instructions 2.Documentation Sheet 3.Volunteer/Resident Information – includes instructions and volunteer consent form

16. Clinical Skills Observer Training CLINICAL SKILLS EXAM MATERIALS 4.Clinical Skills Observer Information pages 1.Equipment List and CSO Instructions 2.Scenario & Candidate Instructions 3.Documentation Sheet 5.Clinical Skills Examination Evaluation Grid - marked by the CSO as the candidate performs tasks 6.Clinical Skills Score Sheet – completed by the test site coordinator

17. Clinical Skills Observer Training CRITICAL SKILLS 1.General in nature 2.Requires candidate to demonstrate safety and infection control at all times when performing skills 3.Candidate must measure vital signs accurately

18. Clinical Skills Observer Training CRITICAL SKILLS CSO marks tasks related to safety and infection control Test site coordinator determines whether or not the candidate measured vital signs within acceptable margins of error

19. Clinical Skills Observer Training NON-CRITICAL SKILLS – 80% Accuracy Required Tasks related to performing skills in the scenario

20. Clinical Skills Observer Training PREPARING THE EXAMINATION AREA Administered in care-giving situation or a laboratory setting that has access to running water and closely resembles the environment in which nurse aides function All equipment and supplies provided by the test site

21. Clinical Skills Observer Training PREPARING THE EXAMINATION AREA Supplies are listed in the CSO Information in the clinical skills exam packet CSO does not gather the supplies and equipment for the exam, but must make sure that everything is accessible to the candidate and the candidate knows where to retrieve them

22. Clinical Skills Observer Training PREPARING THE CANDIDATE & VOLUNTEER/RESIDENT Remind both that cell phones and electronic devices are not permitted; allow them to secure if needed Confirm the candidate’s identify as shown on the cover sheet Provide candidate with sheets on packet labeled “Candidate Information” to review while preparing the volunteer/resident

23. Clinical Skills Observer Training PREPARING THE VOLUNTEER/RESIDENT Take the volunteer/resident to testing area and instruct him/her to remove shoes, put on a hospital gown over his/her clothes, and sit in the hospital bed Review the volunteer/resident Information & answer questions Have volunteer/resident sign information sheet/consent form

24. Clinical Skills Observer Training PREPARING THE CANDIDATE Bring candidate into testing area and review the Scenario & Candidate Instructions together Candidate may take notes on the information sheet and refer to the information sheet and his/her notes during the examination

25. Clinical Skills Observer Training PREPARING THE CANDIDATE CSO demonstrates how to operate the bed, wheelchair, and other equipment (if needed) Answer candidates questions, if any. Candidate and CSO each sign their respective copies of the Information Sheet.

26. Clinical Skills Observer Training ADMINISTERING THE EXAM When the candidate is ready to begin the exam, the CSO will mark the start time on the evaluation grid. The CSO must mark each task as it is performed An explanation must be provided for all tasks marked “No”

27. Clinical Skills Observer Training ADMINISTERING THE EXAM Although the scenario and evaluation grid are in a logical order, the candidate can go out of sequence as long as he/she observes standard precautions and does not endanger the volunteer/resident, the CSO, or the candidate.

28. Clinical Skills Observer Training ADMINISTERING THE EXAM If a candidate makes mistake or forgets a task, he/she may correct and re- demonstrate the skills as long as the error or omission is noted before the exam is finished and the allotted time for the exam is not exceeded.

29. Clinical Skills Observer Training ADMINISTERING THE EXAM Candidates are required to demonstrate hand washing the first time it is needed in the exam; in all subsequent instances that require hand hygiene, the candidate need only verbalize that he/she would was hands or use hand sanitizer

30. Clinical Skills Observer Training ADMINISTERING THE EXAM During the exam, the CSO may give the candidate up to three attempts to obtain the correct vital signs measurements. This is the only time when the CSO may provide feedback to the candidate If multiple blood pressure readings are required, the candidate must observer or verbalize, without prompting, the correct waiting time between attempts.

31. Clinical Skills Observer Training ADMINISTERING THE EXAM The CSO may not prompt the candidate, answer questions from the candidate about a skill, or indicate whether a skill was performed correctly. The CSO may periodically remind the candidate that the resident/volunteer is wearing a hospital gown

32. Clinical Skills Observer Training ADMINISTERING THE EXAM If the candidate does anything during the exam that compromises infection control or resident safety, the CSO will mark that task “no” and provide an explanation of the action(s) that were incorrectly (or not done at all)

33. Clinical Skills Observer Training FINISHING THE EXAM CSO marks the end time on the evaluation grid CSO collects all pages of the clinical skills examination packet – the candidate may not take the scenario or instruction sheet! The CSO will advise the candidate on how his/her results will be communicated

34. Clinical Skills Observer Training FINISHING THE EXAM All clinical skills exam packets (used or unused) must be returned to the test site coordinator - CSOs may not keep unused packets for use at a later time