A Practical Approach to Competency Assessment

Abstract

ssessing clinical performance is difficult. Mem-A bers of the Nursing Service Clinical Practice Committee at the Carl T. Hayden Veterans Affairs Medical Center in Phoenix developed a comprehensive program of competency assessment based on performance measures. This article describes the committee's process of developing and implementing the program and inc a blueprint for comfor all nursing staff who provide patient care. assessment includes Assessment of clinical performance has historically posed a problem in healthcare (Krichbaum, Rowan, Duckett, Ryden, & Savik, 1994) because of the complexity of the clinical environment, the difficulties inherent in the process of evaluation, and the absence of uniform standards of practice for all staff.Evaluation is the process of renderingjudgment to determine the worth, merit, or quality of a particular product or service. Accurate assessment or evaluation of any service or product first depends on the quality of the definition of that service or product. A concise definition of a service or product leads to a more effective evaluation. There have been many attempts to define or describe quality clinical performance. Evaluating the clinical performance of employees requires that each of the following be identified or developed:what is valued criteria and standards for performance reliable and valid means for measuring the achievement of standards (Krichbaum et al., 1994). The process of evaluating clinical performance parallels the process of evaluating the quality of healthcare. Explicit criteria (i.e., value-free names for variables of interest) and standards (i.e., statements that specify the expected level of performance in relation to criteria) are also essential to the quest for quality healthcare (Krichbaum et al., 1994).Clinical performance in a healthcare setting is a complex phenomenon that reflects a staff member's aptitudes, abilities, cognitions, skills, and affect. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that a process be developed and implemented to ensure that the competen-

Clinical competence assessment in nursing: a systematic review of the literature

“…Some authors report favourably on work which claims to measure clinical competence in nursing (Aggleton et al . 1987, Inman & Haugen 1991, Krichbaum et al .…”

“…Some authors report favourably on work which claims to measure clinical competence in nursing (Aggleton et al 1987, Inman & Haugen 1991, Krichbaum et al 1994, Gurvis 1995, Clafin 1997, Nicol & Freeth 1998, Arthur 1999, Eichelberger & Hewlett 1999, Hardcastle 1999, Lofmark et al 1999, O'Connor et al 1999, Stephens 1999, Andre 2000. However, very few of these studies address reliability and validity.…”

The development of clinical competencies for use on a paediatric oncology nursing course using a nominal group technique

“…There is no doubt that the assessment of clinical competence is a difficult and tenacious concern for nurses in education and clinical practice (Squier, 1981; Coates & Chambers, 1992; Chambers, 1994, 1998; Claflin, 1997; Bradshaw, 1997, 1998; Walton & Reeves, 1999). Nonetheless, clinical assessment is required to provide effective and detailed feedback to students on their level of competence, achievement and performance, and contributes to their overall academic award.…”