Transcript The Fate of Foreign Educated Nurses after 2005 – Bridging

PRIOR LEARNING ASSESSMENT
RESEARCH PROJECT
IN NURSING
Mount Royal College, Calgary, Alberta
2003- 2006
Purpose of the Research: To assess
the impact of PLAR on the
advancement of internationally
educated nurses into educational
programs and employment in nursing
OVERVIEW
• Development of the PLAR process
• Challenges
• Lessons learned
GENESIS OF THE PROJECT
• Response to the shortage of nurses
(predicted need of 211,000 by 2016)
• Intent to advance internationally
educated nurses (IEN’s) into
professional nursing education and
employment
• Build on previously acquired
knowledge and skills of the IEN
PROJECT STAGES: 2003-2006
• Stage One: Study and Development
• Stage Two: Implementation
• Stage Three: Evaluation
YEAR 1: Study & Development
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Survey of RN licensure processes & challenges
Survey of PLAR in nursing education programs
Interviews with nurse employers and managers
Interviews with IEN program managers
Literature reviews
“Barriers and Challenges” summary
CHALLENGES for IENs
Complex credentialing processes
Challenge of language fluency
Knowledge and practice deficits
Examination preparation
Lack of socialization and mentoring opportunities
Financial barriers
BN entry
Need for employment readiness skills
PLAR ASSESSMENT
•Establish level of English fluency (use
of variety of language tests)
• Preliminary Diagnostic Exam
• Competency Assessments
•assessment of “RN Entry to Practice”
competencies
• Clinical assessment
Preliminary Diagnostic Exam
Assessment of general nursing knowledge:
• Pharmacology
• Canadian standards of practice
• Legal and ethical standards
• General nursing skills and knowledge
Analysis, interview and plan
Competency Testing
Assessment of
• General nursing theory and nursing interventions
• Pharmacology and drug administration
• Communications and interactional skills
• Health assessment including physical assessment
• Nursing standards of practice in Canada
• Legal, ethical and professional practice decision-making
• Technology and common clinical skills
• Teaching and health promotion
• Clinical judgment, problem-solving and critical thinking
• Health care systems in Canada
Analysis, interview and plan
Assessment Strategies
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Modified OSCE’s
Triple Jump
Clinical Judgement Scenarios
Self Assessment of Standards of practice
STANDARDS USED for the
PLAR ASSESSMENT
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Comprehensiveness
Validity
Currency
Reliability
Authenticity
Sufficiency
COMPREHENSIVENESS
Survey of Nursing Registrars across Canada
• Language fluency
• “Culture” of Canadian nursing, nurse roles
• Educational opportunities & postassessment
• Accessibility and affordability
• Essentials of entry to practice
• Consistent standards and processes
VALIDITY
Determining a “Benchmark”
Canadian RN Entry to Practice competencies
2005 – 2009
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Clear, specific language
“Currency” and longevity
Thorough development process
Established validity
Used with all entry level nurses
RELIABILITY
Assessed reliability of tests and elements of
tests with 4th year graduating students
from BN classes at MRC
• Test-retest consistency
• Item analysis (item difficulty; item
discrimination; equivalence; etc)
• Marking guides & scoring checklists;
standardized tasks and performance
standards
AUTHENTICITY
Context-specific measures of assessment
• Complex, integrated, typical nursing “case
management” situations developed as basis for
modified OSCE testing and modified “Triple
Jump” assessment.
• OSCE: nurse-client interaction; ethical judgment;
medication administration; problem-solving;
health assessment
• Triple Jump: complex performance evaluation of
critical thinking
Addressing the Challenges
SUFFICIENCY
When do we have enough information?
• Variety of assessment measures
• “Triangulation”
• Benchmark competencies; performance
standards
• Assessment experience
Addressing the Challenges
GAPS AND DEFICITS
• Specialized language training
• Upgrading and orientation
• Meeting the standards of safe practice
• Adequate, timely, targeted programs
LESSONS LEARNED
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Comprehensive assessment
Nursing-specific language preparation
Competency benchmarks
Educational opportunities to “fill gaps”
Personal support measures
Self – knowledge; “Assessment as
intervention”
Bridge to Canadian Nursing Program
Level One:
Professional English for Nurses
Level Two:
Nursing Theory & Canadian Practice
• 4 courses, 3 hours per week of nursing
specific language training
• 3 courses, 9 hours of classes per week that address
Expectations of nursing practice in Canada
Level Three:
Preparation for Competencies
Assessment
• Workshops and practice sessions on guided
assessment and case-management scenarios
* Nursing Clinical Review – 360 hours supervised
clinical practice
KEY INNOVATIONS IN THIS
PROJECT
• Case management situations to assess
experiential learning and performance
(practice-theory integration)
• Dissemination of findings (January 2006)
– web based in both official languages
English as a Second Language
Assessment/Study Processes
• English for Nurses: a
nursing-specific approach
to language training
• Pre-post testing: showed
increase of over 1
“benchmark” point over
12 weeks of English as a
Second Language
Assessment/Study
Processes study
9
8
7
6
5
pretest
4
3
2
1
0
average
benchmark
posttest