Merging competency validation and performance evaluation

A new way to look at competencies, from the pages of our Briefings on Long-Term Care newsletter:

Making sure nurses are competent in their skill sets is one of the most important responsibilities of a director of nursing. But as the need for validation goes beyond technical skills and focuses on professional development as a whole, the traditional methods of assessing competencies need to be examined in a new light.

"It has always been important to validate competencies, but how some institutions are choosing to look at it is taking a different spin," says Sheila St. Cyr, MS, RN-BC, OCN, performance-based development system coordinator at the University of Oklahoma (OU) Medical Center in Oklahoma City. "Now we're not just looking at technical skills, we're validating interpersonal skills as well. It used to be more about the technical skills checklist. And that's just not how it should be."

With the recent shift in focus, directors of nursing must arm themselves with the necessary tools and information to think beyond simply validating skill sets.
St. Cyr says there are two main areas of assessment on which to focus: competency validation and performance evaluation. Recently, the shift has been to combine the two efforts rather than have an instructor simply check off that a nurse is able to complete a particular skill.

Developing a definition of competency validation for your facility must take place prior to any assessments, says Diana Swihart, PhD, DMin, MSN, CS, APRNBC, clinical nurse specialist in nursing education at the Bay Pines (FL) VA Healthcare System.

When you begin working with staff members to validate competencies, St. Cyr says one of the best strategies toward education is to play the what-if game. "Use a questioning technique with staff members," she says. Give your nurses a scenario, then ask the following questions:

• What complications can happen?
• What are the signs or symptoms?
• Would you need to call the doctor?
• What assessments would you need to make?

Other methods for validation, adds Swihart, can include:

• Case studies, which can help measure critical thinking
• Quality improvement monitors, which are a strong determinant of competency because they reflect an individual's overall performance
• Mock events, which are useful in measuring cognitive knowledge

What methods are used at your organization?