Transcript Portfolios - Competency & Credentialing Institute

Portfolios: Implications for perioperative
education, evaluation & competency
Assessment
Michelle M. Byrne RN, PhD, CNOR
Kathryn Schroeter RN, PhD, CNOR
CCI Research Committee:
Michelle Byrne, RN, PhD, CNOR - Chair
Kathryn Schroeter, RN, PhD, CNOR – CCI Board
Liaison
Teresa Delarose, RN, MN, EdD, CNOR
Cecil A. King, RN, MS, CNOR, APN
Jane Leske, RN, PhD, APRN-BC
Nancymarie Philips, RN, MSEd, CNOR
Kathryn G. Sapnas, RN, PhD, CNOR, CCRN
• What do you think of when
you think of a portfolio?
Portfolio - formal definition
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Mechanism for evaluation of
competencies that may otherwise
be difficult to assess, such as
practice-based improvements, use
of scientific evidence in practice,
professional behavior and creative
endeavors.
Artist Portfolio Contents
 Artistic
products
demonstrating a variety
of media, foci, and
technique.
 External review by peer
or faculty
Teacher Portfolio Contents
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Academic credentials
Faculty and peer evaluations
Research and publications
Service to institution or
community
Student evaluations
Course materials-syllabi &
assignments.
Student Portfolio Contents
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Progressive learning.
Skill checklist
Best exemplars of work.
Development of self
assessment skills.
Reflective learning.
Faculty evaluations.
Physician Portfolio Contents
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Course completion or contact hours
Certificate requirements
Licensing requirements
Residency/fellowship applications
Peer evaluation
Publications and research
Portfolios
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Dynamic and offer a fuller and richer
image of the individual than paper
and pencil evaluation tools.
Informal definition:
A Portfolio is a Scrapbook of your career
•Photos
•Work products
•Educational offerings or attendance
•Annual evaluations
•Letters from employers or patients
Your Portfolio!
Mentoring /
Precepting
Perioperative Care Plan
Continuing Education
CQI
Clinical
Pathway
Standards &
Recommended
Practices
Domains of Perioperative Nursing
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Based on Perioperative Job
Analysis
Perioperative Nurse
Competency Continuum
Study
Involvement of Task Force
CNOR’s
Thomson Prometric staff
Domains of Perioperative Nursing
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Patient assessment & Dx
Identify expected outcomes
& develop plan of care
Intraoperative activities
Communication
Discharge planning
Domains of Perioperative Nursing
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Cleaning, disinfecting,
packaging & sterilizing
Emergency situations
Management of personnel,
services, & materials
Professional activities
Types of Professional Activities
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Nursing care planning
Clinical pathway
development/utilization
Development of educational resources
Personal continuing education
Application project re: AORN
standards or PNDS
Continuous quality improvement
project
Evidence-based practice initiative
Types of Professional Activities
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Risk management activities
Mentoring / Precepting roles
Leadership role
Educational presentations
Professional writing
Academic course completion
Reflective Learning
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Reflection is the process of
learning from experience.
Reflection allows you to use
your experience to determine
what you may do differently as
a result of the learning.
Reflection aids ongoing selfassessment & ensures your
learning is current and relevant
to your practice.
Reflection Narratives
 Thoroughly
describe the
activity/ project/ event.
 What happened or
occurred?
 Clearly describe your role.
 What do you know now
that you did not know
before?
Reflection Narratives
 What
have you learned?
 What would you do
differently?
 How will you build on this
experience?
 What are the implications
for perioperative nursing
practice?
What’s in your portfolio?
Contributions to professional
organizations
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Local chapter AORN
State Nursing Association
Sigma Theta Tau
Educational Presentation
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Staff workshop
AORN chapter continuing
education
Staff orientation
(At least three 1 hour
presentations are required)
Include time/date of presentation,
objectives, outcomes, topic outline
or handouts, learner evaluations.
Evidence Based Practice
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Provide examples of how
research findings were used
to validate or change your
practice.
Risk management
Research utilization
Research participation
Policy/Procedure
involvement
PNDS
Professional Writing
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AORN Journal article
Specialty assembly
newsletter article
Employer
publication
Chapter newsletter
Letter to the editor
Educational resources
 Patient
education guide
 Employee guide
 Perioperative inservice
 Instructional forms
Continuing Education
 Narrative
of HOW
continuing education
changed your practice.
“After attending this conference, I
have an increased awareness of
fuel sources and how flammable
prep agents are. I am much more
verbal in communicating with other
team members about the
importance of letting prep solutions
dry before giving the cautery to the
surgeons.”
Application of Recommended
Practices or PNDS
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How was this used in your
professional practice?
Policy/procedure creation or
revision
Medical legal cases
Academic Courses
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Related to perioperative nursing
Either taught or taken—provide
syllabus / grade
Examples: Specific or general
Precepting / Mentoring
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Provide a narrative
including name(s) /
credentials of those whom
you precepted or mentored
along with contact
information for a registered
nurse colleague who can
verify that the information is
true and correct.
Students, new staff, faculty,
etc.
Nursing Care Plan
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Provide a nursing care plan
that you have developed or
modified that illustrates
how you were able to
individualize a plan of care
based on assessment data.
Safety protocols, reporting,
communication,
environmental control,
documentation, etc.
Clinical Pathway
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Provide a copy of a
clinical pathway for which
you have participated in
the development, revision
or utilization for a specific
patient population.
Continuous quality initiative
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Provide an example of a
continuous quality
improvement plan that you
developed or participated in
that improved perioperative
patient care & outcomes.
Survey data utilization
Provision of technical
assistance on a surgical
product or new technology
Certification is linked to
continued competency.
Continued Competency
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Defined as the application of
knowledge and the interpersonal,
decision-making, and psychomotor
skills expected for the nurse’s
practice role, within the context of
public health and safety.
(NCSBN 1996, 1998)
Why continued competency?
Institute of Medicine (IOM):
Mandate to reduce patient errors.
 Rate of change and information
explosion demands ongoing learning
from professionals.
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The Current Common Competency
requirements for nursing licensing
boards is continuing education.
Do you believe that CE
guarantees competency?
How does one demonstrate learning?
It’s more than just sitting at an
educational session at a
conference…
“You don’t know what you don’t
know”
“Remember what it was like to not
know what you now know”
“It was good enough when I
graduated…”
ANA Code of Ethics
(Provision 5)
 The nurse owes the same duties
to self as to others, including the
responsibility to preserve
integrity & safety, to maintain
competence, & to continue
personal and professional growth.
PEW Task Force on Health Care
Workforce Regulation
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Performance monitoring
Proctoring
Simulation
Continuous clinical
practice evaluation
Monitoring may include:
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Chart review
Evaluation of clinical
practice patterns
Simulation
Proctoring
External Peer Review
Portfolio
Evaluation/rating process
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Credibility
Dependability
Confirmability
Adequacy and
appropriateness of data
Multiple raters
Portfolio Review
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Evidence will be reviewed
and judged as meeting or
not meeting criteria.
Two raters-third if
disagreement.
Reviewers-CNORs
Assessment or Evaluation
 Formative
(professional
growth and development)
Vs
 Summative
(final
evaluation of criteria
met/unmet)
Portfolios-Developing a process for CNOR
recertification/reactivation
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Personal
accomplishment
Accountability
Personal
satisfaction
Professional
credibility
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Consumer
confidence
Recognition from
others
Marketability
CCI Initiatives
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Publish information on
portfolio utilization in
competency assessment
Pilot the portfolio project in
2007
Plan to implement the
portfolio for recertification
and reactivation of CNOR
credential in 2008.
Portfolios: Tips
Time consuming —
For creator and evaluator!
But it doesn’t have to be!