COMPETENCY BASED ASSESSMENT

1. COMPETENCY BASED ASSESSMENT

2. Contents • Terminologies • What is CBE? • Characteristics of CBE • Elements of CBE • Competency based assessment • Differences between traditional and competency based assessment • Types of CBA approaches

3. Whatis Competency basededucation? Competency based education focuses on learner performance often called learning outcomes in reaching specific goals and objectives of the curriculum.

4. How do we look at CBE? LearningTeaching Educational Outcomes

5. What is competence? • Competence equating to performance – that is the ability to perform nursing tasks • a psychological construct – that is the ability to effectively integrate cognitive, affective and psychomotor skills when delivering nursing care.

6. What is competency? • K- KNOWLEDGE • S- SKILLS • A- ABILITIES

7. Characteristics of CBE • Explicit & aligned with expected competencies. • criteria driven and focus on accountability • is grounded in real life experiences • Fosters learner’s ability to self assess • Individualized, providing more opportunity for independent study.

8. Competency based assessment • Competency assessment in nursing includes demonstration of theoretical content knowledge , technical skills and also assessment of a candidate’s attitudes and practice.

9. Designing Competency based assessment process • Identify units of competency • Develop competency profile • Identify evidence requirements • Review possible evidence gathering techniques • Select the appropriate technique • Prepare the evidence plan • Document the evidence • Review the assessment process

10. Differences between TA & CBA Traditional assessment CBA Actual performance Outcomes are determined by experts/research Independent of learning program Criterion referenced • Theoretical • Curricular outcomes defined by college/board • Integrated with learning • Norm referenced

11. Tools for assessment of competence • Assessment of competence must include more than one indicator • Technical skills can be assessed by standardized tools such as Nurse competence scale • Non technical skills can be assessed using paper and pencil tests, observational checklists and patient feedback or patient satisfaction.

12. Indicators for competence in clinical nursing practice • portfolios • examinations • peer review (assessment) • direct observation • self-assessment • interview • patient outcomes

13. PORTFOLIOS • Portfolios are a collection of evidence to demonstrate skills, knowledge, attitudes and achievements. • Portfolios may be used as a personal development tool or an assessment tool. • Portfolios rely on a level of self-regulation, writing and critical reflection skills.

14. Consider the need for clarity, defined limits and adequate preparation of individuals and assessors. • Confidence in the use of portfolios for both students and assessors will only develop with time and experience.

15. Evidences of portfolio Patient profile/community profile Notes of care given Reflective account of a critical practice incident Review of an individual patient’s needs and care Citation of published literature to justify particular aspect of care

16. Tips to use Portfolio in CBA • the evaluation tool should be clear and specific • a tripartite approach- student, mentor, assessor • assessors should be trained • consider formative assessment for reflective components • consider a summatively assessed clinical skills list • provide opportunities for assessors to network with each other to share experiences and encourage a consistent approach

17. Objective structured clinical examination • An OSCE is a series of stations/exercises through which students rotate individually to demonstrate a range of skills and knowledge. • OSCEs provide the opportunity for teaching and assessment. • OSCEs are costly and can be time-consuming. • Adequate preparation of participants, assessors and actors is important.

18. Peer Assessments • Peer assessment/review provides a mutually supportive approach for ensuring accountability and fostering professional growth. • peer review is often regarded as a mechanism for demonstrating professionalism and promoting professional development.

19. Who is a peer? • a colleague of equal status in the same ward • a colleague of equal status from another ward in the same specialty/department • someone of higher status in the same ward or another ward in the same specialty • someone of equal or higher status from another hospital.

20. Benefits of peer review • confirmation of previously held beliefs in an individual’s skills/lack of certain skills • provides clarity to self-assessment findings • provides a medium for sharing colleagues’ experiences • helps to identify problems • provides an opportunity for feedback on performance.

21. Issues with peer review • Assessment is dependent on the reviewer’s expertise and familiarity with the individual’s work and role expectations • can be a source of anxiety for both parties • issues around negative comments • risk of feedback being overcritical or judgmental • can cause disagreement among peers • depends on availability of peers or of opportunities for peer assessment.

22. Recommendations to use peer review in CBA • Use peer review in combination with portfolios to encourage self-reflection prior to seeking critical comment. • Define terms and scoring criteria and provide training for reviewers. • Reviewers should be familiar with the individual’s role expectations and relevant standards.

23. Direct Observation • ‘observation of nursing activities in the clinical setting instead of a contrived examination format’. Issues highlighted for consideration in relation to direct observation include: • the need for accuracy and consistency of assessment • awareness of the range of variables that can influence practice in the clinical setting • the role of personal characteristics.

24. Factors causing bias in direct observation • Familiarity • the assessor favoring or disfavoring the person being assessed • nervousness of the person being assessed • resource deficiencies with which an external assessor is unfamiliar • educators who are not sufficiently involved in practice • successful performance on one day is no guarantee of it on another.

25. Self assessment • Most common and most favored in nursing competence surveys • Formalised method of self monitoring and self reflection • cost-effectiveness • gives individuals conscious control over practice. • Helps nurses to identify own strengths in practice and the weaknesses.

26. Patient outcomes • Patient oucomes and patient views are very valuable in assessment of competence. • Patients may find it difficult to differentiate between the caring aspect and technical aspect • Anxiety over nurses response to competence assessment • May not separate caring and judging

27. Tips to use CBA • Timing and environment must be conducive to assessment • It should be a supportive process that is beneficial rather than punitive. • It is part of the developmental process • It must allow for the provision of supportive feedback • Link with appropriate opportunities for professional development

28. Recognize and minimize bias in the assessment process. • Develop different methods of assessment for different domains of competence • Observational contexts must be limited, defined and calibrated . • Adequate training in the field of competency assessment to assessors • Reliable competency assessment processes.

29. Criticisms of CBA • Difficulties and inconsistencies in implementing non-graded assessment systems: • Inconsistencies in judgments between assessors. • Limited understanding of the design and implementation of assessment tools. • Difficulty in separating summative purposes of assessment with formative purposes.

30. 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 behaviors. • A key challenge in competence assessment is ensuring objectivity. • •

31. Assessment of competence should use more than one indicator. • 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 self-reflection.

32. Conclusion Nursing as a profession is constantly under assault and variety of other roles encroach upon the nursing roles. The competency movement has contributed to this continuing debate. The distinguishing aspects of nursing, the ways in which it can be developed and implemented by its practitioners, and the recognition of what is unique in nursing are the features that have been enhanced by the scrutiny. All nurse educators should be encouraged to explore and implement the innovative assessment approaches such as CBA and OBA in order to ensure that nursing education in India is on par with the developed countries.

33. References 1. Lenburg, C. Redesigning Expectations for Initial and Continuing Competence For Contemporary Nursing Practice Online Journal of Issues in Nursing. 1999. Available http://www.nursingworld.org /ojin 2. Artis, LH. Identifying core competencies for the Army Nurse. Research paper, US Army Command and General Staff College; Kansas 2003. 3. Standards Of Professional Nursing Practice. American Nurses Associatio(ANA). Scope and Standards of Nursing Practice, 2004 4. Entry to Practice Competencies For Ontario Registered Nurses as of January 1, 2005.College of Nurses of Ontario. Pub. No. 41037; 2004 5.

34. 5. Common Competencies for Registered Nurses. WPSEAR: ANMC Australia; March 2006 6. Practice Standards for Nurses in India. Teaching Material for Quality Assurance Model: Nursing. Indian Nursing Council, New Delhi.2006 7 Accreditation Council for Graduate Medical Education. ACGME Outcome Project. 2005. www.acgme.org/Outcome

36. OUTCOME BASED ASSESSMENT 1 MRS HEMALATHA R PROFESSOR AND PRINCIPAL UNIVERSAL COLLEGE OF NURSING

37. What is outcome based education (OBE)? Why do we choose OBE? What instructional strategies go with OBE? How to design assessment tasks in line with OBE? CONTENTS 2

38. an emphasis on the results of learning (outcomes); a focus on learning by doing; a focus on what learners can do as well as learning of content; opportunities for the recognition of prior learning Outcome based approach 3

39. Outcomes are more detailed and specific statements derived from the goals. What you want the end result of your efforts to be. It is not what you are going to do to the student Use active verbs such as articulate, illustrate, conduct, synthesize, analyze, etc. Terms: construct, locate, dissect, categorize, compose, invent….. outcomes 4

40. Identify and solve problems Work in a team Organise and manage Collect, analyse and evaluate information Communicate effectively Use science and technology Recognise problem solving contexts Abilities 5

41. Fuzzy: Students will understand and apply Principles of pediatric nursing in different situations In between: Students can articulate how principles of pediatric nursing can help in different situations. Precise: Students will describe how applying Pediatric nursing principles can facilitate change in the care of Ms Liza , a terminally ill child. outcome statements 6

42. 1. Students will be able to compare and contrast various leadership styles. 2. Students will be able to identify when students are cheating. 3. Students will be able to locate all of the items they need for a balanced diet. 4. Students will demonstrate care when using the hospital equipment. Outcome statements 7

43. Normal teaching: What topics do I teach? OBE: What do I intend my students to be able to do after my teaching that they could not do before, and to what standard? What is OBE? 8

44. Normal teaching: What teaching methods do I use? OBE: How do I supply learning activities that will help them achieve those outcomes? What is OBE? 9

45. Normal teaching: Teaching is conceived as a process of transmitting contents to the students. OBE: It is stated clearly not what the lecturer is going to teach, but what the outcome of that teaching is intended to be and at what standard. 10

46. 1. Clear goals 2. Standard referenced 3. Learning for all Principles of obe 11

47. To address mismatches between employers and graduates. Students main concerns are GRADES, employers are looking for KNOWLEDGE, ATTITUDE and SKILLS. Why OBE? 12

48. Tells students what they are supposed to learn, how and to what standard. OBE addresses both declarative and functional knowledge Why obe? 13

49. We need Teaching and Learning activities that require students to Apply Invent Generate new ideas Diagnose and solve problems T-l activities in obe 14

50. Problem-based learning Cooperative learning Blended learning Discovery learning TEACHING LEARNING ACTIVITIES 15