Presentation on theme: "ASSESSMENT AND EVALUATION OF ADVANCED CLINICAL COMPETENCE"— Presentation transcript:
1ASSESSMENT AND EVALUATION OF ADVANCED CLINICAL COMPETENCE NURSE CLINICAL COMPETENCE SCALE (NCCS)NURSE COMPETENCE SCALE (NCS)Presented by: Anna-Lena Nieminen, RN, PHN, MSc, Doctoral studentSvenska Yrkeshögskolan / Health Care and Social Welfare. Department of Caring Science Faculty of Social and Caring Sciences, Åbo Akademi University, Vasa Finland.Supervisor: Lisbeth Fagerström, RN, PhD, DeanSvenska Yrkeshögskolan / Health Care and Social Welfare, Vasa Finland.
2CONTENT Educational Programme for Nurse Practitioners in Finland Assessment and Evaluation of Advanced Clinical Competence / InstrumentsNurse Competence ScaleNurse Clinical Competence Scale3. Investigation groupData collection5. Data analysis6. Preliminary Results7. Summary
3Educational Programme for Nurse Practitioners in Finland ProficientChronic and acute diseases (60 cr)Advance clinical skillsEvidence based practice and critical thinkingPharmacologyProbing and identifying caring needsAdvanceChronic and acute diseases (90 cr) => master levelAdvance clinical skills and physical assessmentHealth promotion (theoretical models )Nursing research methods
4AIMThe purpose of this study is to measure advanced clinical competences, by describing professional skills while comparing three groups with different educational and working background.Instruments for assessment and evaluation of advanced clinical competenceNurse Clinical Competence Scale (Nieminen & Fagerström 2005)Nurse Competence Scale (Meretoja 2004)Assessing the advanced clinical competence of practising clinical nurses in different work settings (environment) is imprtant for tex. Identifying areas for professional development and educational needs and also to making sure that nurse competencies are put to the best possible use in patient care and also a garanty for nusrses to maintain their advanced clinical competence.NCS was chosen because it has proven a high validity and reability to meassure nurses competence, especially in the area of specialist health care.When the educational programme for nurse practitioner started at Swedish Polytechninc, we found out that we needed an other instrument that has the ability to measure specific competencies and skills, i.e ; autonomous desicion making and problem solving skills.
5Nurse Competence Scale, Meretoja 2004 Nurses self-assessment of competence73-item instrument (of clinical indicators)VAS-scale mm(visual analogue scale)4-point scale (0= not applicable in my work, 1= used very sheldom, 2=used occasionally and 3= used very oftenDerived from Benner´s theory: from novice to expertCategories: Helping role(7 items), Teaching-coaching (16items), Diagnostic functions (7 items), Managing situations (8 items), Therapeutic interventions (10 items) and Work (professional) role (19 items)Each item is rated by using a VAS o-100 with the opposite ends labelled O meaning a very low level and 100 meaning a very high level of competence.The frequency with individual items are actually used in clinical practice is indicated on a fourpoint scale
6Nurse Clinical Competence Scale, Nieminen & Fagerström 2005 (unpubliched material) Nurses self-assessment of clinical competence65-item instrument (of clinical indicators)VAS-scale mm(visual analogue scale)4-point scale (0= not applicable in my work, 1= used very sheldom, 2=used occasionally and 3= used very oftenInterdisciplinary framework: caring- and nursing science, natural sciences, psychology etc.
7Nurse Clinical Competence Scale The BackgroundBased on ICN:s definition of Nurse Practitoners i.e: the expert knowledge base, complex decision-making skills and clinical competencies for expanded practiceExampel of items to be assessed:I take responsibibility for my own actionsI work independentlyI am systematic in my way of workingI am self critical about my way of workingI conduct physical assessment of the patientI have independent responsibility for the examination, care and treatment of patients with complicated- and uncomplicated illnessI provide individual advice on health promotion and illness prevention to the patient, taking national recommendations into considerationI take active responsibility for my own professional developmentExampel of statements to be assessed
8Investigation group R.N students in Nurse Practitioners program, n= 19 R.N working with proficient tasks within primary health care, n= 37R.N working with proficient tasks within health care at the hospital , n= 28
9Data Instruments - NCS and NCCS Theme-related additional questions- How do you describe your clinical competence?- How do you develope and maintain your clinical competence- What is the meaning of responsibility for you in your own work setting?Data were collected by......
10AGE Age N range SD mean a) Students, AP 17 27-49 6,32 39,8 b) Nurses in primary health care3528-608,0446,9c) Nurses in hospital settings2628-618,0845,01Notera att i grupp a finns enbart en man, likaså i grupp c och ingen i grupp b.
11Work experience in years rangeSDmeana)Students,NP184-235,8812,8b)Nurses in primary health care375-389,1822,3c)Nurses in hospital settings284-347,5119,4
14Data analysis Statistics -Descriptive Content analysis -Anova test (obtained by empirical study using SPSS)All data were entered into a computer database and analyzed using SPSS 10.1.Significance was set at P <0.05.Descriptive statistics. And Anova test was used (analys of variance). Anova pga att man inte är begränsad till två jämförelse grupper, utan man kan ha flera. Får fram skillnader och motsättningar hos data. Det finns dels en inom grupp skillnad och en mellan grupp skillnad.Descriptive statistics (obtained by empirical study using SPSS)Content analysis ( obtained by the team categories/classification rose after analyzing the results at the first part)( obtained by the team categories/classification rose after analyzing the results at the first partThe methods of data annalysis used were coding, category identifaction and pattern recontion
15NCCS The statement: I am acting independently F=3,258 (d.f.=2;80);p=.044
16NCCS p< .05 Acting independently Making own decisons a) Students b) Nurses in primary health care c) Nurses in hospital settingsActing independentlyF=3,25 (d.f.=2;80); p= .044Mean a) 8,5 b) 9,2 c) 9,1Making own decisonsF=3,790 (d.f.=2;80); p= .027Mean a) 8,4 b) 9,3 c) 8,7Preventing medical problemsF= 5,79 (d.f.=2;80); p= .004Mean a) 5,9 b) 8,1 c) 8,2Providing individual advice on health promotion and illness preventionF=4,08 (d.f.=2;80); p= .004Mean a) 6,1 b) 8,4 c) 8,4P= in group a) .050 b) .799 c) .759P= in group a) .009 b) .379 c) .243P= in group a) .088 b) .173 c) .529P= in group a) .070 b) .709 c) .146
17NCS p< .05 Mapping out patients education needs carefully a) Students b) Nurses in primary health care c) Nurses in hospital settingsMapping out patients education needs carefullyF=2,91(d.f.=2;81);p=.060Mean a) 7,0 b) 6,9 c) 8,2Recognizing family members´ needs for guidandeF=3,74 (d.f.=2;81);p=.028Mean a) 7,7 b) 5,9 c) 6,7Arranging expert help for patient when neededF=5,94(d.f.=2;81);p=.004Mean a) 6,3 b) 8,2 c) 8,0Utilising nursing research findings in relationship with patientsMean a) 5,7 b) 4,9 c) 6,32/4 har signifikanta skillnaderp= in group a) .162 b) .615 c) .559P= in group a) .542 b) .520 c) .776P= in group a) .001 b) .427 c) .072P= in group a) .539 b) .347 c) .385
18NCCSThe statement: ”I am coherent in compiling information concerning the state of the patients illness and health resourses. ”P in group a) .364 b) c) .786F=1,122 (d.f.=2;80); p= .331
19NCCSThe statement:”I create and utlize clinical strategies based on evidense based practice”P= in group a) b) .568 c).487F=1,091 (d.f.=2;78); p=.341
20NCCS The statement: I reflect on my actions Bra resultat att alla verkar vara reflekterande vårdareP= in group a) .569 b) .433 c) .461F=2,023 (d.f.=2;80); p=.139
21Preliminay results from the theme related questions Responsibility is:OrganizationalEducationalRole and professionalismCaring for the patient as the ”source to work”
22Caring in responsibility Limitate FreedomLonely IndependenceScaring Tempting and ChallengingBurdensome Pleasant
23Summary Useful instruments for assessing clinical competence Describes the competence level of the investigation groupsLongitudinal studiesPrefering one of the tools (NCCS or NCS)The main aspect of caring where related to the inner dimension of responsibilityReflect om my actionsTest which evaluation tools are better suited for measuring advanced clinical competence verb är borta