Determining Competency for Entry to Nursing Practice: A Grounded Theory Study

Abstract

<p>Critical Comparative Nursing Assessment (CCNA) is a theory about how the competence of completing Bachelor of Nursing students in New Zealand is determined. Semi-structured, audio-taped interviews and field notes were used to collect data from twenty-seven nurses with experience in undertaking competency assessment. A Glaserian grounded theory approach was used to guide the data collection and analysis. This utilised the processes of constant comparative analysis, theoretical sampling and saturation to generate a middle range substantive grounded theory. This is presented as a model consisting of four emergent categories that explain how nurses formulate professional judgements about competence. These are a) gathering, which describes the processes used to collect evidence of practice to inform decisions; b) weighing up, which explains how evidence is analysed using the processes of benchmarking and comparative analysis; c) judging brings into focus the tensions inherent in making professional judgements about competence and how nurses formulated these, and d) moderating, which describes the processes nurses use to validate decisions and ensure that professional responsibilities and public safety are upheld. The basic social psychological process of comparing integrates these categories to explain how nurses resolve the tensions associated with making decisions about competence. This research presents a new way of viewing and understanding how nurses assess competence. It identifies where the challengers and tensions related to the assessment of competence lie and suggests strategies that if implemented could further enhance the validity and reliability of assessment outcomes.</p>

Undergraduate paramedic student competency assessment: A grounded theory study explaining how assessors in Australia and New Zealand determine student competency to practice

“…While moderating assessment, procedures and outcomes instigated by regulatory bodies 38 has put in place a framework to facilitate reliable assessment outcomes, and the literature provides insight into the type of assessments used to assess the competence of undergraduate student paramedics, how assessors in academia and industry manage the complexity of the assessment processes and construct professional judgements about competence are not clear. 13,19 Against this background, the purpose of this enquiry was to discover how paramedic assessors in academia and ambulance services determine the professional competence of undergraduate paramedic students in Australia and New Zealand. The specific objectives were to investigate how:…”

“…The fundamental methodological elements guiding the research process were theoretical sampling, Constant Comparative Analysis (CCA), theoretical sensitivity, the use of the literature as data, and memo writing. 13,44,47 To prevent forcing data, we held semi-structured interviews. These were conducted by a member of the research team with extensive education and on-road experience, undertaking PhD study.…”

“…25 Here the underlying assumption is that a person has these attributes and will be able to apply them to a range of tasks in a variety of practice contexts. 13 There are several concerns with this approach, in that, generic competencies do not exist that can account for the individual nature of human activity, or can be applied across all disciplines in competency assessment. 25 This position is supported by others who suggest that high levels of professional expertise (competence) are domain specific.…”

“…25,29 Integrative competency assessment approaches incorporate general attributes and tasks (specific to a work practice) and address knowledge, abilities and attitudes. 13 The integrative perspective is considered a more comprehensive evaluation of performance 20 and underpins many professional standards used for assessing competence. 13 The integrated approach defines competence in a wholistic manner that acknowledges the richness of professional practice.…”

“…13 The integrative perspective is considered a more comprehensive evaluation of performance 20 and underpins many professional standards used for assessing competence. 13 The integrated approach defines competence in a wholistic manner that acknowledges the richness of professional practice. This approach to competency assessment incorporates professional judgement, with competence demonstrated by ‘complex structuring of attributes needed for intelligent performance in specific situations’.…”