Transcript At the COPA… Looking at QSEN and Competency Outcomes

At the COPA…
Looking at QSEN and Competency Outcomes
Performance Assessment Models
University of Colorado Denver College of Nursing
Amy Barton, RN, PhD
Gail Armstrong, RN, ND
Gayle Preheim, RN, EdD, CNAA BC, CNE
New Academic Year, New Campus, New School
Name, New Curricular Paradigm
Where do we want to go, and what have we
learned from our experience?

Progress, far from consisting in change,
depends on retentiveness. When
experience is not retained…infancy is
perpetual. Those who cannot remember
the past are condemned to repeat it. This
is the condition of children and barbarians
in whom instinct has learned nothing from
experience.

George Santayana (1905)
Colorado’s QSEN team’s approach

Several collaborative
workshops were held for
CON faculty and our
clinical partners
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What is QSEN
How does QSEN interface
with COPA?
What safety and quality
initiatives are occurring in
the clinical agencies?
Integration of QSEN with COPA
A framework and process developed by
Carrie Lengerg to promote intial and
continuing competence by integrating:
Competence for contemporary practice
Outcomes to be achieved for practice
Performance of essential competencies
Assessment structured for competence

The COPA Model

Creates “end-result”
competence
outcomes focusing on

eight practice based
core competencies
based on today’s
nursing needs
Focuses on learner
competence and
continued
development
Summary of COPA Process
Create outcome statements that are:
Clear, precise, realistic, practice based,
measurable
↓
Use interactive learning strategies that are most
effective in achieving competence
↓
Evaluate the student through Competency
Performance Evaluations (CPEs)
Lots of overlap between COPA and
QSEN
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Both models:
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Based in a value model
that emphasizes
competence to protect
patient safety
Rely on collaborative work
with clinical agencies to
define the most current
trends in nursing practice
Employ an integrative
paradigm in defining what
is “nursing practice”
Eight Core COPA practice
competencies and QSEN KSAs
COPA Competency
1) Assessment and Intervention skills
2) Communication Skills
3)
4)
5)
6)
7)
8)
Critical Thinking Skills
Human Caring/Relationship skills
Teaching Skills
Management Skills
Leadership Skills
Knowledge Integration Skills
QSEN KSA
Patient Safety
Teamwork/Collab
Informatics
EBP
Patient Cent. Care
Patient Cent. Care
Quality Improv.
Teamwork/Collab.
EBP
Dr. Christine Tanner’s Integrative Model of Clinical
Judgment
Tanner, C.A. (2007) Thinking Like a Nurse: a research based model of clinical judgment. Journal of
Nursing Education, 45(6), 204-211.
Importance of a Developmental
Approach to KSAs

“The biggest difference between a novice
and an expert is a sense of salience.” Patricia
Benner
Beginning
Intermediate
Advanced
Health Assessment
Fundamentals
OB
Peds
Med/Surg II
Public Health
Med/Surg I
Mental Health
Senior Integ.
Practicum
Specific Examples of CON’s
curricular updates


Health Assessment
 Substantive introduction to EBP
Fundamentals of Nursing
 Safety: National Patient Safety Goals, 5 Million Lives Campaign, IOM To
Err Is Human, Fall Program in VA hospitals from DOD, CHA Armband
Initiative
 EBP: IOM’s Quality Chasm
 Patient Centered Care: Picker Institute Report, Patient Centered Care:
What does it take? ,Harvard Hospitals’ Collaborative: When Things Go
Wrong: Responding to Adverse Events, Transcultural Nursing Care
 Quality Improvement: IOM’s Crossing the Quality Chasm and More on
Quality; articles on 10/08 Medicare’s policy to withhold payment for
hospital errors; Atul Gawande’s article on Dr. Pronovost’s work on QI in
the ICU environment
 Teamwork & Collaboration: SBAR, TeamSTEPPS, IHI’s work on Rapid
Response Teams
 Informatics: Graves and Corcoran, “The Study of Nursing Informatics”
What have we learned?

Our faculty suffer
from the silo
phenomenon; they
are most comfortable
being autonomous
and independent of
other courses/faculty
What else have we learned?

Our faculty have not
historically thought
much about the
education-service
chasm. QSEN
facilitates a much
more smooth
transition from school
into practice for our
new graduates.
And what else have we learned?

In our BS curriculum
there are developmental
gaps that do not support
students as they
transition from our
beginning level classes to
our intermediate level
classes and then into our
advanced level classes.
We need to purposefully
bridge these transitions
for our students.
How are we responding to these
lessons?

QSEN Implementation Team (5 members)
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Two members of the QSEN grant team, the Director of the
Learning Laboratory, the Director of the Simulation Laboratory,
and a clinical liaison employed by the CON and our largest
clinical partner (UCH)
Explicit facilitation of the threading of the QSEN KSAs
throughout our BS Program:
 Here is what the classes before and after yours are covering
in QSEN – how will you build upon these KSAs and prepare
students for the next developmental stage?
 How are the QSEN KSAs present in your Learning Laboratory
activities? In your simulation activities? In your clinical
roation activities?
 What competence outcomes for your class overlap with the
QSEN KSAs?
Development of common
faculty/clinical partner QSEN resources
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Development of QSEN
modules on
HealthStream for
fculty and clinical
partners
EBP and Evidence Based Educational models
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We know that evaluation and
collection of the right data are
important:
Participation in QSEN survey to
our May ’08 graduating seniors
After our “intervention group”
graduates, we will survey them
about their percpetion of the
impact of QSEN content on
their practice
We will also survey our clinical
partners about any differences
they see in our new grads
whose curriculum had a strong
QSEN foundation
Ongoing reflections…

The Chinese symbol for
crisis is the symbol of
danger over the symbol
for opportunity
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Danger: How do we
broaden our BS faculty’s
perspective enough so that
QSEN is not “another thing
to add to my course?”
Opportunity: Our first
group of students are truly
asking new questions
Strategic planning for
the future is the most
hopeful indication of
our increasing social
intelligence.
William Hastie
One last thought….
It’s not because things
are difficult that we
dare not venture. It
is because we dare
not venture that they
are difficult.
Seneca (mid 1st
century Roman
philosopher)
Many thanks…

Any questions?