COMPETENCY
APPRAISAL 1
DR. TOTHIE M. CASTILLO
CREATED GREAT CHALLENGES FOR LEADERS OF
ACUTE-CARE ORGANIZATIONS. ONE OF THE
GREATEST CHALLENGES IS ENSURING A COMPETENT
NURSING STAFF TO CARE FOR PATIENTS WITHIN THIS
CHANGING ENVIRONMENT PATIENTS ARE MORE
ACUTELY ILL AND HAVE SHORTER LENGTHS OF STAY,
PLACING GREATER DEMANDS ON NURSES WHO MUST
DEMONSTRATE COMPETENCY IN CARING FOR
INCREASINGLY COMPLEX PATIENTS IN A
CONTINUALLY CHANGING HEALTHCARE
ENVIRONMENT.
Methods to assess competencies include competency fairs,
Performance Based Development System and online programs.
Certain key people should be involved in the development of
competencies. The department managers can give input related
to department-specific competencies. Experienced staff
members can provide valuable insight into the competencies
that need to be assessed. Educators should be involved for
providing the input for the methods used to validate competencies.
Competencies are an important part of the work world.
They are a part of a continual process to help ensure
that the organization provides a high-quality care to its
customers and patients.
TRAINING IN NURSING COMPETENCY
Nursing competency training methods have focused
on basic nursing education, and little has been
studied on clinical nurses. For clinical competency
training methods for students, scenario simulation,
roleplay and objective structured clinical
examinations are often used. However, these
methods view nursing competency from a
behaviorist point of view, and the major focus is on
performance in many clinical settings.
Problem-based learning tutorial training is a well-
known method where students work in small
groups, present a nursing scenario with a problem
and situation, create their own learning tasks and
engage in active learning. This method involves
student-centered learning; instead of active
teaching, lessons that encourage active learning
are crucial for training thinking skills.
What is competence?
Competence: the ability of a nurse to demonstrate the
knowledge, skills, judgment and attitudes required to
perform activities within the defined scope of practice at
an acceptable level of proficiency.
What do we mean by competencies?
A competency is the capability to apply or use a
set of related knowledge, skills, and abilities
required to successfully perform "critical work
functions" or tasks in a defined work setting.
List of key competencies
• Business awareness. Knows what we do and how we do
it. ...
• Customer orientation. Identifies and prioritizes customer
needs and recognises constraints. ...
• Analysis/problem solving. ...
• Quick thinking/learning. ...
that believe in three types of competencies that are considered important for their employees. These three types include – core competencies, cross functional competencies an
What are the 3 types of competencies?
There are many organizations that believe in three types of competencies that are considered important for their employees. These three
types include – core competencies, cross functional competencies and functional competencies.
There are many organizations that believe in three types of
competencies that are considered important for their
employees. These three types include – core competencies,
cross functional competencies and functional competencies.
I.
Competency can be described as the behavioral
attributes, skills, and knowledge that are required
for putting in suitable performances while at the
job. While behavioral attributes refer to the
personality characteristics that are needed to be
successful on the job, skills refer to practical or
technical skills that are required for performing
the job satisfactorily and knowledge refers to the
experience and previous education that is
needed while on the job
What is competency?
Competency is the capability to apply or use the set of
related knowledge, skills, and abilities required to
successfully perform ‘critical work functions’ or tasks in a
defined work setting. Competencies often serve as the basis
for skill standards that specify the level of knowledge,
skills, and abilities required for success in the workplace as
well as potential measurement criteria for assessing
competency attainment. Competence is a measure of both
proven skills and proven knowledge.
COMPETENCE AND COMPETENCE ASSESSMENT
Key points
• Competence is a complex concept and debates continue
about the most appropriate definition and method of
assessment.
• In broad terms, competency standards recommend expected
levels of knowledge, attitudes, skills and behaviours.
• Competencies for professional nursing should reflect the
multifaceted nature of nursing practice, the broad range of
practice settings and cultural differences within the
Australian population.
A key challenge in competence assessment is ensuring
objectivity.
• A range of indicators and tools have been developed
for competence assessment but empirical evidence
regarding their effectiveness in measuring competence
is lacking.
• It is generally accepted that assessment of competence
should use more than one indicator.
• Assessment of initial competence may require a
different approach to assessment of continuing
competence
Regardless of the tool or indicator, it is essential
that there is adequate preparation of the
individual being assessed, the assessors and
mentors.
• It has been suggested that the first step in
competence assessment should be selfreflection.
ATTRIBUTES OF NURSING COMPETENCY
Nursing competency can be divided into the following three theories:
behaviorism, trait theory, and holism.
A. Behaviorism refers to competency as an ability to perform individual
core skills, and is evaluated by demonstration of those skills.
Trait theory considers competency as individual traits necessary for
effectively performing duties (knowledge, critical thinking skills, etc.).
Holism views competency as a cluster of elements, including knowledge,
skills, attitudes, thinking ability and values that are required in certain
contexts.
Nursing competency is generally viewed as a complex
integration of knowledge including professional
judgment, skills, values and attitude, indicating that
holism is widely accepted. In nursing practice, nurses
are required to apply their acquired knowledge, skills
and innate individual traits to each situation and be
able to adapt that knowledge and those skills to
different circumstances
There are definitions of holistic, integrated nursing
competency:
1) By analyzing graduation achievement goals as
they relate to enhancing the development of
nursing competency (the Conference for Nursing
Education model),
b) the International Competency Standards
Framework for general nurses (International
Council of Nurses)3 and
c) the Scope and Standards of Nursing Practice
(American Nurses Association),4
TheImportance of Nurse
Competency Testing and On-
Going Education
It might surprise many to know that the according to
Healthcare Research it has been reported that one out of
every 25 patients in the hospitals are said to have been
harmed by medical care. This stunning statistic
accentuates the need to develop a clinical staff that is
providing optimal care at all times.
In order to reduce risk and ensure optimal patient outcomes, it is
important to be able to assess a clinician's skills, abilities, and
knowledge, as well as to help remediate and increase
competency in areas that may show deficiencies. Developing a
well-rounded and capable workforce requires a diverse array of
methods, and clinical competency testing can be an important
tool to help assess and develop the necessary level of
competency of hospital clinical staff.
In addition to evaluating clinical competency, most
organizations see tremendous value in providing
their staff with educational materials that help
reduce the risk of on the job injury and increase
compliance with outside organizations
Healthcare workers have one of the highest rates of work
related injuries. These injuries can take many forms such as
exposure to blood and air-borne pathogens, musculoskeletal
lifting injuries, and needle stick injuries. Developing tools
to educate employees about issues that affect workplace
safety and compliance with industry standards, is
recognized as a necessary part of staff development and risk
management.
Most hospital organizations understand the need for
both testing and on-going education and many opt to
develop these materials in-house. However, this can be
a costly, labor-intensive process that may not always be
managed in a way that will ensure both valid and
reliable results.
• What processes do you use now to measure a clinical
technical competency?
• Could clinical competency tests help with employee
development? Could this development lead to greater
patient outcomes and safer patient care?
• Are your clinical education staff developing competency
testing materials? How often are these materials
updated? Are they current and clinically relevant?
• Could your educators' time be better used in other ways?
• Are you able to collect and analyze data on tests to see how
your staff performs against national averages?
• Is your organization meeting regulatory mandates;
empowering your employees with the knowledge and skills
they need to ensure delivery of safe, quality care and
services?
• Might education and training reduce your workers’
compensation liability (e.g., back injuries, needle sticks, etc.)?
Employee assessment and education tools can be an
integral part of achieving a goal-oriented program for
improvement and quality assurance if managed in a way
that ensures both valid and reliable results. However,
achieving this may not be an easy task.
