volume 45 | may 2010 - ncsbn · 2014. 10. 14. · volume 45 | may 2010 2009 tuning analysis: a...

NCSBN reSearCh Brief

Volume 45 | May 2010

2009 TUNING Analysis:

A Comparison of

U.S. and International

Nursing Educational

Competencies

Report of Findings from the

2009 TUNING Analysis: A Comparison of U.S. and International Nursing Educational Competencies

National Council of State Boards of Nursing, Inc. (NCSBN®)

National Council of State Boards of Nursing, Inc. (NCSBN) | 2010

ii


ii 2009 TUNING ANALYSIS

Mission Statement

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Copyright ©2010 National Council of State Boards of Nursing, Inc. (NCSBN®)

All rights reserved. NCSBN®, NCLEX®, NCLEX-RN®, NCLEX-PN®, Nursys® and TERCAP® are registered trademarks of NCSBN and this document may not be used, reproduced or disseminated to any third party without written permission from NCSBN.

Permission is granted to boards of nursing to use or reproduce all or parts of this document for licensure related purposes only. Nonprofit education programs have permission to use or reproduce all or parts of this document for educational purposes only. Use or reproduction of this document for commercial or for-profit use is strictly prohibited. Any authorized reproduction of this document shall display the notice: “Copyright by the National Council of State Boards of Nursing, Inc. All rights reserved.” Or, if a portion of the document is reproduced or incorporated in other materials, such written materials shall include the following credit: “Portions copyrighted by the National Council of State Boards of Nursing, Inc. All rights reserved.”

Address inquiries in writing to NCSBN Permissions, 111 E. Wacker Drive, Suite 2900, Chicago, IL 60601-4277. Suggested Citation: National Council of State Boards of Nursing. (2010). Report of Findings from the 2009 TUNING Analysis: A Comparison of U.S. and International Nursing Educational Competencies. Chicago: Author.

Printed in the United States of America

ISBN# 978-0-9826465-0-2


iiiTABLE OF CONTENTS

TABLE OF CONTENTS

List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ivList of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vAcknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viiExecutive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1I. Background of Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7II. Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Methodology Reviewers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Survey Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Survey Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Sample Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Mailing Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Confidentiality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Return Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

III. Demographics, Experiences and Practice Environments of Participants . . . . . . . . . . . . . . . . . . . . 11Demographics/Past Experiences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Educational Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Employment Setting/Specialty Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

IV. Competency Statement Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Overview of Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Competency Statement Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Reliability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Competency Averages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14E .U . and U .S . Rating Comparisons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Correlation Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25TUNING Analysis Survey Nonresponder Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

V. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27VI. References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28Appendix A: 2009 TUNING Analyses Methodology Reviewers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Appendix B: 2009 U.S. Surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30Appendix C: 2009 TUNING Analysis Survey Nonresponder Study . . . . . . . . . . . . . . . . . . . . . . . . . . . 47Appendix D: U.S. Educational Comparison . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50


iv LIST OF TABLES

LIST OF TABLES

Table 1. Adjusted Return Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Table 2. Descriptive Age Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Table 3. Reliability Estimates (U.S. Study). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Table 4. Competency Averages (U.S. Study) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Table 5. Competency Averages (U.S. and E.U. Studies) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Table 6. Average Importance Differences (U.S. and E.U). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Table 7. Correlation Between Competency Averages (U.S. and E.U.) . . . . . . . . . . . . . . . . . . . . . . . . . 26


vLIST OF FIGURES

LIST OF FIGURES

Figure 1. Gender of TUNING Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Figure 2. Race/Ethnicity of TUNING Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Figure 3. Highest Nursing Degree . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Figure 4. Employment Facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Figure 5. Average Ratings (U.S. and E.U.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24


vi


vi 2009 TUNING ANALYSIS


viiACKNOWLEDGMENTS

ACKNOWLEDGMENTSThis study would not have been possible without support from a large number of entry-level nurses, nurs-ing educators and supervisors from all parts of the U .S . The time and attention they gave to completing the survey is greatly appreciated and the information they provided has increased our understanding of the core nursing educational competencies . The authors also gratefully acknowledge Dr . Mary Gobbi for her support and assistance with the European Union (E .U .) data, and the staff of NCSBN in the preparation of this document, which was essential for the completion of this study .


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viii 2009 TUNING ANALYSIS


1EXECUTIVE SUMMARY

A new initiative seeks to understand the role of nurses and nursing education from an international perspective . The goal of this study was to evaluate the consistency of nursing educational competen-cies globally . This study was conducted to evaluate the importance of nursing education competen-cies in the U .S . In addition, results from the current study were compared to the results of a similiar study, called TUNING, conducted in the following European Union (E .U .) countries: Denmark, Finland, Flanders, France, Germany, Hungary, Ireland, Italy, Lithuania, Malta, Norway, Netherlands, Portugal, Slovakia, Spain, Ukraine and the United Kingdom .

Survey DevelopmentA previous study was conducted in the E .U . to eval-uate education competencies that are important to the nursing profession; 17 E .U . countries took part in the study . The E .U . survey was used as the basis for creating the U .S . version . For this U .S . study, the 47 nursing education competency statements in the E .U . study were used . To stay congruent with previ-ous nursing surveys conducted by NCSBN, the U .S . survey also included questions about nurses’ prac-tice settings, past experiences and demographics .

The survey contained four sections . In the first section, the questions were related to nurse edu-cation . The second section contained the actual competencies, which were rated by an importance rating scale . The third section focused on work environments, including type and age of clients, employment setting and type of facility . The fourth section asked basic demographic information .

Survey Process

Sample Selection

Remaining congruent with the sampling method of the E .U . surveys and the methodology of previous NCSBN survey studies, respondents of this study were drawn from four samples . The first sample was drawn from recent NCLEX® registrants from nurs-ing programs who registered for the NCLEX-RN®

in May 2009 . The majority of these candidates

were scheduled to take the examination in June or July 2009 . The second sample was drawn from NCLEX-RN candidates who passed the examina-tion between May and August 2008 . By the time the current study was in progress, the majority of indi-viduals in this group had been working as registered nurses (RNs) for approximately one year . This group represents first-year RNs . Surveys for the recent NCLEX registrants and first-year RNs were admin-istered electronically . The second two samples, who were mailed paper surveys, were nursing educators and supervisors of nurses .

Mailing Procedure

A five-stage mailing process was used to engage participants in the study . A presurvey letter was sent to each participant through regular mail, except for the recent NCLEX registrants’ cohort . For the recent NCLEX registrants’ cohort, the sample was split in half randomly; one-half was sent the presurvey letter by regular mail and the other half by e-mail . A week later, an e-mail invitation with a login address and a unique access code was sent to the recent NCLEX registrants and first-year RNs; the paper survey, with a cover letter and postage-paid return envelope, was mailed to educators and supervisors . One week later, reminder e-mails were sent to the electronic survey nonresponders and reminder postcards were sent to paper survey nonresponders, reiterating the importance of the study and urging participation . Reminder e-mails and postcards were sent three times . The first two reminder communications were sent one week apart, starting from the initial invita-tion . The final notification was sent two weeks after the second reminder notification .

Return Rates

Of the 6,000 total Web surveys sent to recent NCLEX registrants, a total of 2,857 were completed and returned . There were 76 that were undeliver-able due to incorrect e-mail addresses, resulting in an adjusted return rate of 48 .23% .

EXECUTIVE SUMMARY


2 EXECUTIVE SUMMARY

Of the 2,500 total Web surveys sent to first-year RNs, a total of 590 were completed and returned . There were 175 that were undeliverable due to incorrect e-mail addresses, resulting in an adjusted return rate of 25 .38% .

Of the 2,751 surveys sent to RN educators, a total of 1,380 were completed and returned . There were four that were undeliverable due to incorrect addresses, resulting in an adjusted return rate of 50 .24% .

Of the 2,750 surveys sent to RN supervisors, a total of 657 were completed and returned . There were 166 that were undeliverable due to incorrect addresses, resulting in an adjusted return rate of 25 .43% .

Demographics, Experiences and Practice Environments of Participants

Demographics/Past Experiences

Demographic information, including gender, age, racial and ethnic backgrounds, and educational preparation are presented next, followed by a description of responders’ work environments .

Gender

The majority of survey responders reported being female . Educators had the highest percentage of females responding (96%) and first-year RNs had the lowest percentage (89%) .

Age

Participants in the study varied in reported age . The recent NCLEX registrant cohort was the young-est with an average age of 26 .87 . The first-year RN group had an average age of 32 .03 . The educator and supervisor group had an average age of 51 .48 and 50 .58, respectively .

Race/Ethnicity

Participants in the current study were consistent with the general ethnic distribution of nurses in the U .S . with 71% to 90% reporting being White across the four respondent groups . The second largest racial group represented was African-American (3% to 8%) .

Educational Background

Recent NCLEX registrants in the current sample listed RN baccalaureate degree in the U .S . most frequently (80%) as their highest nursing degree . For first-year RNs, 88% of the respondents selected either RN associate or RN baccalaureate degree . Nurse supervisors and nurse educators held higher degrees when compared to recent NCLEX regis-trants and first-year RNs .

Employment Setting/Specialty Area

Overall, the majority of respondents, regardless of survey group type, reported working in hospitals (ranging from 49% to 82%) . A large group of nurse supervisors reported working in long-term care (40%) . Approximately 36% of the recent NCLEX registrant sample was not working as an RN, which is likely reflective of the sample’s new graduation status . For the other three categories (first-year RN, educator and supervisor), more than 97% were working as an RN .

Competency Statement Characteristics

Reliability

Reliability indices were calculated to evaluate the internal consistency of the survey instruments . The survey ratings exhibited high reliability estimates .

Competency Averages

Descriptive statistics were calculated for each competency . Data were compared by the four respondent groups . The average competency rat-ings ranged from 2 .82 to 3 .73 for recent NCLEX registrants, from 2 .52 to 3 .70 for first-year RNs, from 2 .29 to 3 .86 for educators and from 2 .05 to 3 .75 for supervisors .

E.U. and U.S. Rating Comparisons

Data for the four U .S . respondent groups were com-pared to the four E .U . cohorts . Similar to the U .S . results, Competency 17 - Using nursing skills, medi-cal devices and interventions/activities to provide optimum care, demonstrates the ability to safely administer medicines and other therapies was rated


3EXECUTIVE SUMMARY

most important by E .U . respondents . Competency 27 - Demonstrates current and relevant knowledge of international and national policies that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty was rated least important by all groups, except E .U . employers .

Nonresponder SurveyIn order to ensure validity of the results, a survey of nonresponders was conducted to determine if the individuals in the U .S cohort sampling frame not responding would have rated the educational competency statements comparably . Based on the nonresponder data, the ratings for nonresponders were similar to the ratings of responders, which pro-vides support for the validity of the survey results .

ConclusionThere is evidence to suggest that the basic nurs-ing education competencies are equally important, regardless of nursing role or geographic setting . Average importance ratings were very similar for the 47 competencies . Correlations for the 47 com-petencies were high and statistically significant . A limitation of the study may be the construction of the competencies . Some of the education compe-tency statements were long and contained multiple concepts . The researchers of this study recommend that the education competency statements be revised to increase ease of use and interpretation prior to inclusion in future research studies .


4


4 2009 TUNING ANALYSIS

Report of Findings from the

2009 TUNING Analysis: A Comparison of U.S. and International Nursing Educational Competencies

National Council of State Boards of Nursing, Inc. (NCSBN®)


6


6 2009 TUNING ANALYSIS


7BACKGROUND OF STUDY

BACKGROUND OF STUDY

A new initiative seeks to understand the role of nurses and nursing education from an international perspective . The goal of this study was to evaluate the consistency of nursing educational competen-cies globally, as well as evaluate the importance of nursing competencies in the U .S . Results from the current study were compared to the results of a similiar study called TUNING, which was conducted in the following European Union (E .U .) countries: Denmark, Finland, Flanders, France, Germany, Hungary, Ireland, Italy, Lithuania, Malta, Norway, Netherlands, Portugal, Slovakia, Spain, Ukraine and the United Kingdom .

To better understand the initial E .U . research, below is a quote from Competencies in Education and Cross-Border Recognition: Evaluation of the Useful-ness of Learning Outcomes and Competences for International Recognition, published in 2007 .

The TUNING project was launched in 2000, in order to support universities across Europe in the implementation of the Bolo-gna Process at university level . TUNING proposes and promotes the redefinition of educational programs in an outcomes-oriented manner . Learning outcomes are expressed in terms of generic and subject-specific competences as well as ECTS [European Credit Transfer and Accumu-lation System] credits that are based on workload . Currently, universities from about 35 countries in Europe work together in the TUNING process . Since 2005, the TUNING project has also been extended to the Latin American continent, from which institutions in a further 18 countries also joined the process . The focus of the TUNING project is not on the various educational systems of countries, but on the educational struc-tures and content of educational programs . Across all the participating countries, the project aims at identifying reference points for generic and subject-specific competences for both first (Bachelor) and second (Master) cycle graduates in a series of subject areas . In order to be able to

understand individual curricula and make them comparable, a methodology has been designed according to which com-mon reference points could be identified . Within this methodology, the following five lines of approach were distinguished (González, J ., & Wagenaar, R ., 2005):

1 . definition of generic (general academic) competences;

2 . definition of subject-specific competences;

3 . the role of ECTS as an accumulation system;

4 . approaches to learning, teaching and assessment;

5 . the role of quality enhancement in the educational process .

These five lines of approach will allow universities to tune their curricula without losing their autonomy and at the same time stimulate their capacity to innovate (CoRe Project, 2007) .


8 METHODOLOGY

A number of steps are necessary to perform an analysis of the core nursing education competencies .

Methodology ReviewersThere were three methodology reviewers, chosen for their expertise in survey studies and certifica-tion examination development, who reviewed the methodologies and procedures utilized in this study . All three reviewers indicated this methodol-ogy was psychometrically sound and in compliance with professional standards for survey studies . See Appendix A for a listing of methodology reviewers.

Survey DevelopmentA previous study was conducted in the E .U . to eval-uate education competencies that are important to the nursing profession; 17 E .U . countries took part in the study . The E .U . survey was used as the basis for creating the U .S . version . For this U .S . study, the 47 nursing education competency statements in the E .U . study were used . To stay congruent with previous nursing surveys conducted by NCSBN, the U .S . survey also included questions about the nurses’ practice settings, past experiences and demographics .

Following the sampling method of E .U . surveys, respondents of the present study were drawn from four samples . The first sample was drawn from senior nursing students or recent NCLEX® regis-trants from nursing programs who registered for the NCLEX-RN® in May 2009 . The majority of these can-didates were scheduled to sit for the examination in June or July 2009 . The second sample consisted of individuals who graduated from a nursing program within the past year . This sample was drawn among NCLEX-RN candidates who passed the examina-tion between May and August 2008 . By the time the current study was in progress, the majority of indi-viduals in this group had been working as registered nurses (RNs) for approximately one year . This group represents first-year RNs . Surveys for the recent NCLEX registrants and first-year RNs were admin-istered electronically . The second two samples, who

were mailed paper surveys, were nursing educators and supervisors of nurses .

The survey contained four sections . In the first sec-tion the questions were related to nurse education . The second section contained the actual education competency statements, which were rated by an importance rating scale . The third section focused on work environments, including type and age of clients, employment setting and type of facility . The fourth section asked basic demographic informa-tion . The Web and paper versions of the survey may be found in Appendix B.

Survey Process

Sample Selection

The E .U . TUNING survey for core nursing competen-cies was administered to four groups of individuals: supervisors of nurses, newly licensed nurses, recent nursing school graduates and other individuals who completed the survey, which includes professional association members, physicians and nursing edu-cators . This study primarily followed the respondent groups sampled in the E .U . TUNING survey . To stay congruent with other NCSBN survey studies, reg-istered nurse educators were also sampled for the present study .

Recent NCLEX registrants: This cohort consisted of a random sample of 6,000 candidates who were first-time NCLEX-RN test-takers who registered for the NCLEX-RN Examination between May 1 and May 30, 2009 . Please note that the E .U . study only sampled baccalaureate level nurses . To replicate the design of the E .U . study as much as possible, the researchers purposefully over-sampled bacca-laureate-level registrants in this group . The resulting responses show that this over-sampling strategy was successful, as 84% of the sample was at the bac-calaureate level and 16% held an associate degree .

First-year RNs: A random sample of 2,500 NCLEX-RN candidates were selected among those who had passed the NCLEX-RN between May 1 and August 31, 2008, and had provided valid e-mail addresses during registration . This sample

METHODOLOGY


9METHODOLOGY

included all graduates, regardless of degree level . The NCLEX-RN candidate pool includes nurses who hold an associate degree to those with doc-toral degrees, with the majority graduating at the baccalaureate level . There were 10 NCSBN member boards that opted out of this project; thus, candi-dates from those jurisdictions were not sampled .

Registered nurse educators (nursing school faculty): Finally, surveys were sent to 2,751 deans or directors of 917 RN nursing programs across all levels . Each dean/director sampled received three surveys . They were asked to distribute the surveys to a medical/surgical nursing instructor, an obstetrics/gynecol-ogy (OB-GYN)/pediatric nursing instructor and a mental health or community health nursing instruc-tor in their institution . All programs in the sample graduated at least nine NCLEX-RN candidates in 2008 .

Supervisors of newly licensed RNs (supervisors of nurses): In addition to nurses new to the profes-sion, 2,750 supervisors of newly licensed RNs were surveyed . This list came from a substantially larger mailing list of medical facilities, but the selection of the supervisors was based upon the number of RN employees . This criterion was applied to maximize the likelihood that supervisors sampled worked with newly licensed RNs .

Mailing Procedure

A five-stage mailing process was used to engage participants in the study . A presurvey letter was sent to each participant through regular mail, except for the recent NCLEX registrant cohort . The recent NCLEX registrant cohort sample was split in half randomly; one-half was sent the presurvey letter by regular mail and the other half was sent the presur-vey letter by e-mail . A week later, an e-mail invitation with a login address and a unique access code was sent to recent NCLEX registrants and first-year RNs; the paper survey, with a cover letter and postage-paid return envelope, was mailed to educators and supervisors . One week later, reminder e-mails were sent to the electronic survey nonresponders, and reminder postcards were sent to paper survey nonresponders, reiterating the importance of the study and urging participation . Reminder e-mails and postcards were sent three times . The first two

reminder communications were sent one week apart, starting with the initial invitation . The final notification was sent two weeks after the second reminder notification .

Confidentiality

All nurses surveyed were promised confidential-ity with regard to their participation and their responses . Files containing mailing information were kept separate from the data files . Preassigned code numbers were used to facilitate cost-effective follow-up mailings . The study protocol was reviewed and approved by NCSBN’s CEO for compliance with organizational and industry guidelines for research studies involving human subjects .

Return Rates

Of the 6,000 total Web surveys sent to recent NCLEX registrants, a total of 2,857 were completed and returned . There were 76 that were undeliver-able due to incorrect e-mail addresses, resulting in an adjusted return rate of 48 .23% .

Of the 2,500 total Web surveys sent to first-year RNs, a total of 590 were completed and returned . There were 175 that were undeliverable due to incorrect e-mail addresses, resulting in an adjusted return rate of 25 .38% .

Of the 2,751 surveys sent to RN educators, a total of 1,380 were completed and returned . There were four that were undeliverable due to incorrect addresses, resulting in an adjusted return rate of 50 .24% .

Of the 2,750 surveys sent to RN supervisors, a total of 657 were completed and returned . There were 166 that were undeliverable due to incor-rect addresses, resulting in an adjusted return rate of 25 .43% . Adjusted return rates are presented in Table 1.


10 METHODOLOGY

Figure 1. Gender of TUNING Respondents

0

10

20

30

40

50

60

70

80

90

100

Recent NCLEX Reg. 1st-year RN Educator Supervisor

Group

Female Male

Perc

enta

ge

91%

9%

89%

11%

96%

4%

93%

7%

Table 1. Adjusted Return Rates

Survey Format Sample Bad Addresses

Adjusted Sample

Adjusted Responses

Adjusted Return Rate

Recent NCLEX Reg . 6,000 76 5,924 2,857 48 .23%

First-Year RN 2,500 175 2,325 590 25 .38%

Educators 2,751 4 2,747 1,380 50 .24%

Supervisors 2,750 166 2,584 657 25 .43%

Total 14,001 421 13,580 5,484 40 .38%

Table 2. Descriptive Age Information

Survey N Average Standard Deviation

Recent NCLEX Reg . 2,853 26 .87 7 .61

First-Year RN 585 32 .03 9 .27

Educators 1,137 51 .48 8 .77

Supervisors 633 50 .58 8 .1


11DEMOGRAPHICS, EXPERIENCES AND PRACTICE ENVIRONMENTS OF PARTICIPANTS

and supervisor group had an average age of 51 .48 and 50 .58, respectively . Descriptive respondent age statistics are presented in Table 2.

Race/Ethnicity

Participants in the current study were consistent with the general ethnic distribution of nurses in the U .S ., with 71% to 90% reporting being White across the four respondent groups . The second largest racial group represented was African-American (3% to 8%) . See Figure 2 for racial/ethnic backgrounds compared among the four respondent groups.

Educational Background

As anticipated, based on the sampling method described earlier, the recent NCLEX registrants in the current sample listed RN baccalaureate degree

Demographics/Past ExperiencesDemographic information, including gender, age, racial and ethnic backgrounds, and educational preparation are presented next, followed by a description of responders’ work environments .

Gender

The majority of survey responders reported being female . Educators had the highest percentage of females responding (96%) and first-year RNs had the lowest percentage (89%) .

Age

Participants in the study varied in reported age . The recent NCLEX registrant cohort was the young-est, with an average age of 26 .87 . The first-year RN group had an average age of 32 .03 . The educator

DEMOGRAPHICS, EXPERIENCES AND PRACTICE ENVIRONMENTS OF PARTICIPANTS

Figure 2. Race/Ethnicity of TUNING Respondents

8% 8%

5% 3%1% 1% 0% 0%

4%

9%

1% 3%5% 5%

2% 1%0% 1% 0% 1%3% 3%

1% 1%1% 1% 0% 1%

78%

71%

90% 89%

0

10

20

30

40

50

60

70

80

90

100


Group

African-American Asian Indian Asian other

Hispanic Native American Other

Pacific Islander White – not of Hispanic origin

Percen

tage


12 DEMOGRAPHICS, EXPERIENCES AND PRACTICE ENVIRONMENTS OF PARTICIPANTSFi

gur

e 3.

Hig

hest

Nur

sing

Deg

ree

0%3%

0%2%

1%3%

10%

6%17

%

49%

0%

23%

80%

39%

6%

32%

1%4%

0%10

%0%

0%

13%

2%1%

0%

32%

18%

0%0%

5%0%

1%2%

Rece

nt N

CLEX

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ar R

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ing

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ram

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ase

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.RN

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iplo

ma

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.S.

RN -

Gen

eric

Doc

tora

te in

U.S

.

RN -

Gen

eric

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ter'

s D

egre

e in

U.S

.RN

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aste

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aste

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020406080100

Percentage

24% 15

%


13DEMOGRAPHICS, EXPERIENCES AND PRACTICE ENVIRONMENTS OF PARTICIPANTS

in the U .S . most frequently (80%) as their high-est nursing degree . For first-year RNs, 88% of the respondents selected either RN associate or RN baccalaureate degree . Nurse supervisors and nurse educators held higher degrees when compared to the recent NCLEX registrants and first-year RNs . See Figure 3 .

Employment Setting/Specialty Area

Overall, the majority of respondents, regardless of survey group type, reported working in hospitals (ranging from 49% to 82%) . A large group of nurse supervisors reported working in long-term care (40%) . Approximately 36% of the recent NCLEX registrant sample was not working as an RN, which is likely reflective of the sample’s new graduation

status . For the other three categories (first-year RN, educator and supervisor), almost all were working as an RN . See Figure 4 .

Figure 4. Employment Facility

3%8% 11% 8%

56%

82%

68%

49%

3% 6%2%

40%36%

2% 0% 0%2% 2%

20%

2%

0

10

20

30

40

50

60

70

80

90

100


Group

Perc

enta

ge

Community-based or ambulatory care facil ity/organiza�onHospitalLong-term careNot working as an RNOther


14 COMPETENCY STATEMENT FINDINGS

COMPETENCY STATEMENT FINDINGS

Findings relative to the competency statements are presented in this section . The methods used to col-lect and analyze the statements will be discussed . In addition, the U .S . findings are compared to the E .U . findings to see if there is consistency . A validation of survey findings with estimates provided by the subject matter expert panel will also be provided .

Overview of MethodsThe current study replicated the methodology of the E .U . TUNING survey whenever applicable . The present TUNING survey asked responders to answer one question about each competency statement . They were asked to rate the overall importance of the competency on a scale of 1 to 4, with 1 being not important to 4 being vital .

Staying congruent with the design of the E .U . study, only data from the baccalaureate-level recent reg-istrants sample were analyzed for competencies . Additional analyses were conducted to ascertain whether diploma, associate and baccalaureate- level recent registrants rated the competencies comparably (Appendix D) . There were essentially no differences in the average importance ratings between the U .S . associate and baccalaureate- prepared nurses . Because of the low prevalence of recent NCLEX registrants reporting graduation from RN diploma programs, any results comparing educational competency statement data to either associate or baccalaureate-prepared nurses should be interpreted cautiously .

The responder ratings were analyzed in two parts . First, average importance ratings were com-pared within the U .S . and the E .U . Next, average importance ratings were correlated to see if the

importance ratings for each of the 47 competencies were related across the cohorts . The correlation analysis used both U .S . data and E .U . data .

Competency Statement Characteristics

Reliability

Reliability indices were calculated to evaluate the internal consistency of the survey instruments . Cronbach’s alpha coefficients were calculated for the importance ratings (Cronbach, 1951) . As seen in Table 3, the survey ratings exhibited high reliability estimates.

Competency Averages

There were four groups of U .S . respondents who completed the surveys . The groups were recent NCLEX registrants, first-year RNs, educators and supervisors . Descriptive statistics were calculated for each competency . Data were compared by the four respondent groups .

Competency 17 - Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to safely administer medicines and other therapies was rated most important by all groups . In the E .U . survey, students and graduates also rated Competency 17 as the most important . Recent U .S . NCLEX registrants rated Competency 9 - Demonstrates the ability to recognize and inter-pret signs of normal and changing health/ill health, distress, or disability in the person (assessment/diagnosis) equally as important as Competency 17 .

Competency 27 - Demonstrates current and relevant knowledge of international and national policies that can be appropriately applied to nursing prac-tice, patient/client care and situations of uncertainty was rated least important by all four U .S . groups . In addition, four E .U . groups rated Competency 27 least important as well . The range of average rat-ings was 3 .86 to 2 .05 across the four respondent cohorts . Table 4 presents the U.S. competency rat-ings in survey order.

Table 3. Reliability Estimates (U.S. Study)

Importance

N Items N Cases Scale Reliability

Recent NCLEX Reg .

47 2,624 0 .98

First-year RN 47 532 0 .97

Educators 47 1,084 0 .96

Supervisors 47 521 0 .96


15COMPETENCY STATEMENT FINDINGSTa

ble

4. C

om

pet

ency

Ave

rag

es (U

.S. S

tud

y)

Comp #

Co

mp

eten

cy

Rec

ent

NC

LEX

Reg

.Fi

rst-

year

RN

Ed

ucat

ors

Sup

ervi

sors

NA

vg.

Std

. Err

.N

Avg

.St

d. E

rr.

NA

vg.

Std

. Err

.N

Avg

.St

d. E

rr.

1D

emo

nstr

ates

the

ab

ility

to

pra

ctic

e w

ithin

the

co

ntex

t o

f pro

fess

iona

l, et

hica

l, re

gul

ato

ry a

nd le

gal

co

des

, re

cog

nizi

ng a

nd re

spo

ndin

g t

o m

ora

l/et

hica

l dile

mm

as a

nd

issu

es in

day

to

day

pra

ctic

e .

2879

3 .60

0 .01

600

3 .50

0 .03

1362

3 .80

0 .01

644

3 .59

0 .02

2D

emo

nstr

ates

the

ab

ility

to

pra

ctic

e in

a h

olis

tic, t

ole

rant

, no

n ju

dg

men

tal,

carin

g a

nd s

ensi

tive

man

ner,

ensu

ring

tha

t th

e rig

hts,

bel

iefs

and

wis

hes

of d

iffer

ent

ind

ivid

uals

and

g

roup

s ar

e no

t co

mp

rom

ised

.

2879

3 .56

0 .01

599

3 .38

0 .03

1363

3 .68

0 .01

645

3 .50

0 .02

3D

emo

nstr

ates

the

ab

ility

to

ed

ucat

e, fa

cilit

ate,

pro

mo

te,

sup

po

rt a

nd e

nco

urag

e th

e he

alth

, wel

l-bei

ng a

nd c

om

fort

o

f po

pul

atio

ns, c

om

mun

ities

, gro

ups

and

ind

ivid

uals

who

se

lives

are

affe

cted

by,

illn

ess,

dis

tres

s, d

isea

se, d

isab

ility

or

dea

th .

2875

3 .56

0 .01

598

3 .32

0 .03

1362

3 .46

0 .02

642

3 .15

0 .03

4W

ithin

the

sco

pe

of h

is/h

er p

rofe

ssio

nal p

ract

ice

and

ac

coun

tab

ility

, dem

ons

trat

es a

war

enes

s o

f the

diff

eren

t ro

les,

resp

ons

ibili

ties

and

func

tions

of a

nur

se .

2872

3 .43

0 .01

598

3 .33

0 .03

1363

3 .44

0 .02

641

3 .36

0 .03

5W

ithin

the

sco

pe

of h

is/h

er p

rofe

ssio

nal p

ract

ice

and

ac

coun

tab

ility

, dem

ons

trat

es t

he a

bili

ty t

o a

dju

st t

heir

role

to

resp

ond

effe

ctiv

ely

to p

op

ulat

ion/

pat

ient

nee

ds .

Whe

re

nece

ssar

y an

d a

pp

rop

riate

is a

ble

to

cha

lleng

e cu

rren

t sy

stem

s to

mee

t p

op

ulat

ion/

pat

ient

nee

ds .

2871

3 .38

0 .01

594

3 .20

0 .03

1361

3 .20

0 .02

643

3 .10

0 .03

6D

emo

nstr

ates

the

ab

ility

to

acc

ept

resp

ons

ibili

ty fo

r hi

s/he

r o

wn

pro

fess

iona

l dev

elo

pm

ent

and

lear

ning

, usi

ng

eval

uatio

n as

a w

ay t

o re

flect

and

imp

rove

up

on

his/

her

per

form

ance

so

as

to e

nhan

ce t

he q

ualit

y o

f ser

vice

d

eliv

ery .

2868

3 .48

0 .01

595

3 .34

0 .03

1356

3 .51

0 .02

641

3 .39

0 .03

7D

emo

nstr

ates

the

ab

ility

to

und

erta

ke c

om

pre

hens

ive

and

sys

tem

atic

ass

essm

ents

usi

ng t

he t

oo

ls/f

ram

ewo

rks

app

rop

riate

to

the

pat

ient

/clie

nt t

akin

g in

to a

cco

unt

rele

vant

phy

sica

l, so

cial

, cul

tura

l, p

sych

olo

gic

al, s

piri

tual

an

d e

nviro

nmen

tal f

acto

rs .

2861

3 .51

0 .01

595

3 .34

0 .03

1361

3 .65

0 .01

641

3 .52

0 .02

8D

emo

nstr

ates

the

ab

ility

to

per

form

an

effe

ctiv

e ris

k as

sess

men

t an

d t

ake

app

rop

riate

act

ions

.28

573 .

490 .

0159

63 .

390 .

0313

583 .

460 .

0264

13 .

430 .

03

9D

emo

nstr

ates

the

ab

ility

to

reco

gni

ze a

nd in

terp

ret

sig

ns o

f no

rmal

and

cha

ngin

g h

ealth

/illn

ess,

dis

tres

s, o

r d

isab

ility

in

the

per

son

(ass

essm

ent/

dia

gno

sis)

.28

353 .

730 .

0158

93 .

670 .

0213

603 .

760 .

0164

23 .

740 .

02


16 COMPETENCY STATEMENT FINDINGSTa

ble

4. C

om

pet

ency

Ave

rag

es (U

.S. S

tud

y)

Comp #

Co

mp

eten

cy

Rec

ent

NC

LEX

Reg

.Fi

rst-

year

RN

Ed

ucat

ors

Sup

ervi

sors

NA

vg.

Std

. Err

.N

Avg

.St

d. E

rr.

NA

vg.

Std

. Err

.N

Avg

.St

d. E

rr.

10D

emo

nstr

ates

the

ab

ility

to

resp

ond

to

pat

ient

/clie

nt

need

s b

y p

lann

ing

, del

iver

ing

and

eva

luat

ing

ap

pro

pria

te

and

ind

ivid

ualiz

ed p

rog

ram

s o

f car

e w

hile

wo

rkin

g in

p

artn

ersh

ip w

ith t

he p

atie

nt/c

lient

, the

ir ca

reg

iver

s, fa

mili

es

and

oth

er h

ealth

care

wo

rker

s .

2860

3 .47

0 .01

593

3 .25

0 .03

1359

3 .57

0 .02

643

3 .40

0 .02

11D

emo

nstr

ates

the

ab

ility

to

crit

ical

ly q

uest

ion,

eva

luat

e,

inte

rpre

t an

d s

ynth

esiz

e a

rang

e o

f inf

orm

atio

n an

d d

ata

sour

ces

to fa

cilit

ate

pat

ient

cho

ice .

2862

3 .45

0 .01

593

3 .24

0 .03

1368

3 .38

0 .02

643

3 .18

0 .03

12D

emo

nstr

ates

the

ab

ility

to

mak

e so

und

clin

ical

jud

gm

ents

to

ens

ure

qua

lity

stan

dar

ds

are

met

and

pra

ctic

e is

ev

iden

ce b

ased

.28

533 .

550 .

0159

33 .

380 .

0313

683 .

600 .

0264

33 .

530 .

02

13D

emo

nstr

ates

the

ab

ility

to

use

mo

der

n te

chno

log

ies

to

asse

ss a

nd re

spo

nd a

pp

rop

riate

ly t

o p

atie

nt/c

lient

nee

d

(for

exam

ple

thr

oug

h te

lehe

alth

, mul

timed

ia a

nd w

eb

reso

urce

s) .

2848

3 .01

0 .01

590

2 .81

0 .03

1363

2 .79

0 .02

645

2 .61

0 .03

14D

emo

nstr

ates

the

ab

ility

to

ap

pro

pria

tely

use

a r

ang

e o

f nu

rsin

g s

kills

, med

ical

dev

ices

and

inte

rven

tions

/act

iviti

es

to p

rovi

de

op

timum

car

e .28

563 .

410 .

0159

23 .

310 .

0313

643 .

290 .

0264

43 .

230 .

03

15U

sing

nur

sing

ski

lls, m

edic

al d

evic

es a

nd in

terv

entio

ns/

activ

ities

to

pro

vid

e o

ptim

um c

are,

dem

ons

trat

es t

he

abili

ty t

o m

aint

ain

pat

ient

/clie

nt d

igni

ty, a

dvo

cacy

and

co

nfid

entia

lity .

2855

3 .55

0 .01

592

3 .44

0 .03

1364

3 .59

0 .02

644

3 .41

0 .03

16U

sing

nur

sing

ski

lls, m

edic

al d

evic

es a

nd in

terv

entio

ns/

activ

ities

to

pro

vid

e o

ptim

um c

are,

dem

ons

trat

es t

he a

bili

ty

to p

ract

ice

prin

cip

les

of h

ealth

and

saf

ety,

incl

udin

g m

ovi

ng

and

han

dlin

g, i

nfec

tion

cont

rol,

esse

ntia

l firs

t ai

d a

nd

emer

gen

cy p

roce

dur

es .

2848

3 .63

0 .01

591

3 .57

0 .02

1368

3 .65

0 .02

645

3 .54

0 .02

17U

sing

nur

sing

ski

lls, m

edic

al d

evic

es a

nd in

terv

entio

ns/

activ

ities

to

pro

vid

e o

ptim

um c

are,

dem

ons

trat

es t

he a

bili

ty

to s

afel

y ad

min

iste

r m

edic

atio

ns a

nd o

ther

the

rap

ies .

2851

3 .73

0 .01

592

3 .70

0 .02

1366

3 .86

0 .01

644

3 .75

0 .02

18U

sing

nur

sing

ski

lls, m

edic

al d

evic

es a

nd in

terv

entio

ns/

activ

ities

to

pro

vid

e o

ptim

um c

are,

dem

ons

trat

es t

he a

bili

ty

to c

ons

ider

em

otio

nal,

phy

sica

l and

per

sona

l car

e ne

eds,

in

clud

ing

mee

ting

the

nee

d fo

r co

mfo

rt, n

utrit

ion,

per

sona

l hy

gie

ne a

nd e

nab

ling

the

per

son

to m

aint

ain

the

activ

ities

ne

cess

ary

for

dai

ly li

fe .

2849

3 .47

0 .01

589

3 .31

0 .03

1368

3 .54

0 .02

646

3 .41

0 .02



ble

4. C

om

pet

ency

Ave

rag

es (U

.S. S

tud

y)

Comp #

Co

mp

eten

cy

Rec

ent

NC

LEX

Reg

.Fi

rst-

year

RN

Ed

ucat

ors

Sup

ervi

sors

NA

vg.

Std

. Err

.N

Avg

.St

d. E

rr.

NA

vg.

Std

. Err

.N

Avg

.St

d. E

rr.

19U

sing

nur

sing

ski

lls, m

edic

al d

evic

es a

nd in

terv

entio

ns/

activ

ities

to

pro

vid

e o

ptim

um c

are,

dem

ons

trat

es t

he

abili

ty t

o re

spo

nd t

o a

per

son’

s ne

eds

thro

ugho

ut t

he li

fe

span

and

hea

lth/i

llnes

s ex

per

ienc

e e .

g . p

ain,

life

cho

ices

, re

valid

atio

n, d

isab

ility

or

whe

n d

ying

.

2850

3 .41

0 .01

590

3 .24

0 .03

1360

3 .37

0 .02

641

3 .19

0 .03

20D

emo

nstr

ates

the

ab

ility

to

info

rm, e

duc

ate

and

sup

ervi

se

pat

ient

/car

egiv

ers

and

the

ir fa

mili

es .

2838

3 .37

0 .01

587

3 .20

0 .03

1339

3 .24

0 .02

632

3 .13

0 .03

21D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

th

eorie

s o

f nur

sing

and

nur

sing

pra

ctic

e th

at c

an b

e ap

pro

pria

tely

ap

plie

d t

o n

ursi

ng p

ract

ice,

pat

ient

/clie

nt

care

and

situ

atio

ns o

f unc

erta

inty

.

2827

3 .06

0 .02

583

2 .88

0 .04

1364

2 .78

0 .02

642

2 .91

0 .03

22D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

orie

s co

ncer

ning

the

nat

ure

and

cha

lleng

e o

f pro

fess

iona

l p

ract

ice

that

can

be

app

rop

riate

ly a

pp

lied

to

nur

sing

p

ract

ice,

pat

ient

/clie

nt c

are

and

situ

atio

ns o

f unc

erta

inty

.

2827

2 .98

0 .02

582

2 .78

0 .03

1361

2 .70

0 .02

640

2 .70

0 .03

23D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

na

tura

l and

life

sci

ence

s th

at c

an b

e ap

pro

pria

tely

ap

plie

d

to n

ursi

ng p

ract

ice,

pat

ient

/clie

nt c

are

and

situ

atio

ns o

f un

cert

aint

y .

2831

3 .09

0 .01

583

2 .86

0 .03

1364

3 .00

0 .02

641

2 .79

0 .03

24D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

so

cial

, he

alth

and

beh

avio

ral s

cien

ces

that

can

be

app

rop

riate

ly

app

lied

to

nur

sing

pra

ctic

e, p

atie

nt/c

lient

car

e an

d

situ

atio

ns o

f unc

erta

inty

.

2827

3 .10

0 .01

582

2 .87

0 .03

1359

3 .00

0 .02

640

2 .80

0 .03

25D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f eth

ical

th

eory

, law

and

hum

aniti

es t

hat

can

be

app

rop

riate

ly

app

lied

to

nur

sing

pra

ctic

e, p

atie

nt/c

lient

car

e an

d

situ

atio

ns o

f unc

erta

inty

.

2827

3 .07

0 .01

582

2 .86

0 .03

1366

2 .96

0 .02

642

2 .72

0 .03

26D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f te

chno

log

y an

d h

ealth

care

info

rmat

ics

that

can

be

app

rop

riate

ly a

pp

lied

to

nur

sing

pra

ctic

e, p

atie

nt/c

lient

ca

re a

nd s

ituat

ions

of u

ncer

tain

ty .

2826

3 .01

0 .02

583

2 .79

0 .03

1365

2 .87

0 .02

641

2 .71

0 .03

27D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f in

tern

atio

nal a

nd n

atio

nal p

olic

ies

that

can

be

app

rop

riate

ly

app

lied

to

nur

sing

pra

ctic

e, p

atie

nt/c

lient

car

e an

d

situ

atio

ns o

f unc

erta

inty

.

2828

2 .82

0 .02

583

2 .52

0 .04

1337

2 .29

0 .02

631

2 .05

0 .03

28D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f pro

ble

m

solv

ing

, dec

isio

n m

akin

g a

nd c

onfl

ict

theo

ries

that

can

be

app

rop

riate

ly a

pp

lied

to

nur

sing

pra

ctic

e, p

atie

nt/c

lient

ca

re a

nd s

ituat

ions

of u

ncer

tain

ty .

2827

3 .25

0 .01

582

3 .08

0 .03

1335

3 .08

0 .02

638

3 .04

0 .03


18 COMPETENCY STATEMENT FINDINGSTa

ble

4. C

om

pet

ency

Ave

rag

es (U

.S. S

tud

y)

Comp #

Co

mp

eten

cy

Rec

ent

NC

LEX

Reg

.Fi

rst-

year

RN

Ed

ucat

ors

Sup

ervi

sors

NA

vg.

Std

. Err

.N

Avg

.St

d. E

rr.

NA

vg.

Std

. Err

.N

Avg

.St

d. E

rr.

29D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

orie

s re

late

d t

o p

erso

nal a

nd p

rofe

ssio

nal d

evel

op

men

t so

as

to

enha

nce

pro

fess

iona

l pra

ctic

e .28

252 .

970 .

0258

22 .

780 .

0313

382 .

670 .

0263

42 .

600 .

03

30D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

re

sear

ch p

roce

ss a

nd c

urre

nt n

ursi

ng re

sear

ch t

hat

can

be

app

rop

riate

ly a

pp

lied

to

nur

sing

act

ions

/act

iviti

es t

o

pro

vid

e nu

rsin

g c

are

that

is r

igo

rous

and

evi

den

ce b

ased

.

2821

3 .08

0 .01

582

2 .80

0 .03

1345

2 .82

0 .02

636

2 .46

0 .03

31D

emo

nstr

ates

the

ab

ility

to

co

mm

unic

ate

effe

ctiv

ely

(incl

udin

g t

he u

se o

f new

tec

hno

log

ies)

: with

pat

ient

s,

fam

ilies

and

so

cial

gro

ups,

incl

udin

g t

hose

with

co

mm

unic

atio

n d

ifficu

lties

.

2833

3 .49

0 .01

584

3 .40

0 .03

1340

3 .56

0 .02

632

3 .38

0 .03

32D

emo

nstr

ates

the

ab

ility

to

ena

ble

pat

ient

s an

d t

heir

care

giv

ers

to e

xpre

ss t

heir

conc

erns

and

can

resp

ond

ap

pro

pria

tely

e .g

. em

otio

nal,

soci

al, p

sych

olo

gic

al, s

piri

tual

o

r p

hysi

cal c

onc

erns

.

2832

3 .41

0 .01

585

3 .24

0 .03

1342

3 .49

0 .02

633

3 .35

0 .03

33D

emo

nstr

ates

the

ab

ility

to

ap

pro

pria

tely

rep

rese

nt t

he

pat

ient

/clie

nt's

per

spec

tive

and

act

to

pre

vent

ab

use .

2833

3 .53

0 .01

585

3 .39

0 .03

1340

3 .55

0 .02

634

3 .50

0 .03

34D

emo

nstr

ates

the

ab

ility

to

ap

pro

pria

tely

use

co

unse

ling

sk

ills

to p

rom

ote

pat

ient

wel

l-bei

ng .

2824

3 .21

0 .01

580

2 .97

0 .03

1345

2 .96

0 .02

636

2 .82

0 .03

35D

emo

nstr

ates

the

ab

ility

to

iden

tify

and

man

age

chal

leng

ing

beh

avio

r (u

sing

co

mm

unic

atio

n te

chni

que

s to

p

rom

ote

pat

ient

wel

l-bei

ng) .

2828

3 .22

0 .01

584

3 .07

0 .03

1338

3 .18

0 .02

630

3 .05

0 .03

36D

emo

nstr

ates

the

ab

ility

to

reco

gni

ze a

nxie

ty, s

tres

s an

d

dep

ress

ion

(usi

ng c

om

mun

icat

ion

tech

niq

ues

to p

rom

ote

p

atie

nt w

ell-b

eing

) .28

323 .

290 .

0158

43 .

090 .

0313

243 .

290 .

0263

03 .

120 .

03

37D

emo

nstr

ates

the

ab

ility

to

giv

e em

otio

nal s

upp

ort

and

id

entif

y w

hen

coun

selin

g o

r o

ther

inte

rven

tions

are

nee

ded

.28

343 .

290 .

0158

43 .

100 .

0313

413 .

300 .

0263

43 .

060 .

03

38D

emo

nstr

ates

the

ab

ility

to

iden

tify

and

use

op

po

rtun

ities

fo

r he

alth

pro

mo

tion

and

hea

lth e

duc

atio

n ac

tiviti

es .

2831

3 .24

0 .01

585

3 .00

0 .03

1330

3 .20

0 .02

632

2 .78

0 .03

39D

emo

nstr

ates

the

ab

ility

to

acc

urat

ely

rep

ort

, rec

ord

, d

ocu

men

t an

d re

fer

care

usi

ng a

pp

rop

riate

tec

hno

log

ies .

2829

3 .47

0 .01

586

3 .33

0 .03

1327

3 .55

0 .02

635

3 .45

0 .03

40D

emo

nstr

ates

the

ab

ility

to

real

ize

that

pat

ient

/clie

nt

wel

l-bei

ng is

ach

ieve

d t

hro

ugh

the

com

bin

ed re

sour

ces

and

ac

tions

of a

ll m

emb

ers

of t

he h

ealth

care

tea

m .

2840

3 .37

0 .01

586

3 .23

0 .03

1341

3 .29

0 .02

632

3 .28

0 .03

41D

emo

nstr

ates

the

ab

ility

to

lead

and

co

ord

inat

e a

team

, d

eleg

atin

g c

are

app

rop

riate

ly a

nd m

eani

ngfu

lly .

2836

3 .25

0 .01

587

3 .04

0 .03

1337

3 .04

0 .02

632

3 .09

0 .03



ble

4. C

om

pet

ency

Ave

rag

es (U

.S. S

tud

y)

Comp #

Co

mp

eten

cy

Rec

ent

NC

LEX

Reg

.Fi

rst-

year

RN

Ed

ucat

ors

Sup

ervi

sors

NA

vg.

Std

. Err

.N

Avg

.St

d. E

rr.

NA

vg.

Std

. Err

.N

Avg

.St

d. E

rr.

42D

emo

nstr

ates

the

ab

ility

to

wo

rk a

nd c

om

mun

icat

e co

llab

ora

tivel

y an

d e

ffect

ivel

y w

ith o

ther

nur

ses

in t

he b

est

inte

rest

of t

he p

atie

nt/c

lient

.28

333 .

510 .

0158

73 .

370 .

0313

383 .

560 .

0263

33 .

480 .

02

43D

emo

nstr

ates

the

ab

ility

to

wo

rk a

nd c

om

mun

icat

e co

llab

ora

tivel

y an

d e

ffect

ivel

y w

ith a

ll su

pp

ort

sta

ff to

p

riorit

ize

and

man

age

time

effe

ctiv

ely

whi

le q

ualit

y st

and

ard

s ar

e m

et .

2840

3 .44

0 .01

588

3 .27

0 .03

1334

3 .41

0 .02

633

3 .41

0 .03

44D

emo

nstr

ates

the

ab

ility

to

ass

ess

risk

and

act

ivel

y p

rom

ote

th

e w

ell-b

eing

, sec

urity

and

saf

ety

of a

ll p

eop

le in

the

w

ork

ing

env

ironm

ent

(incl

udin

g t

hem

selv

es) .

2839

3 .45

0 .01

588

3 .29

0 .03

1365

3 .37

0 .02

647

3 .22

0 .03

45D

emo

nstr

ates

the

ab

ility

to

crit

ical

ly u

se t

oo

ls t

o e

valu

ate

and

aud

it ca

re a

cco

rdin

g t

o re

leva

nt q

ualit

y st

and

ard

s .28

363 .

130 .

0158

82 .

900 .

0313

582 .

720 .

0264

82 .

820 .

03

46W

ithin

the

clin

ical

co

ntex

t, d

emo

nstr

ates

the

ab

ility

to

ed

ucat

e, fa

cilit

ate,

sup

ervi

se a

nd s

upp

ort

nur

sing

stu

den

ts

and

oth

er h

ealth

care

stu

den

ts o

r w

ork

ers .

2839

3 .25

0 .01

588

3 .00

0 .03

1359

2 .86

0 .02

643

2 .66

0 .03

47D

emo

nstr

ates

an

awar

enes

s o

f the

prin

cip

les

of h

ealth

care

fu

ndin

g a

nd u

ses

reso

urce

s ef

fect

ivel

y .28

333 .

030 .

0158

72 .

730 .

0313

532 .

590 .

0264

82 .

480 .

03



E.U. and U.S. Rating Comparisons

The U .S . groups (recent NCLEX registrants, first-year RNs, educators and supervisors) were compared to results from the E .U . TUNING survey . Table 5 and Figure 5 present these results.

Table 5. Competency Averages (U.S. and E.U. Studies)

Co

mp

#

Competency

Recent NCLEX

Reg. U.S.

First-year RN U.S.

Educators U.S.

Supervisors U.S.

Students E.U.

Graduates E.U.

Employers E.U.

Others E.U.*

Avg. Avg. Avg. Avg. Avg. Avg. Avg. Avg.

1 Demonstrates the ability to practice within the context of professional, ethical, regulatory and legal codes, recognizing and responding to moral/ethical dilemmas and issues in day to day practice .

3 .60 3 .50 3 .80 3 .59 3 .40 3 .38 3 .46 3 .26

2 Demonstrates the ability to practice in a holistic, tolerant, non judgmental, caring and sensitive manner, ensuring that the rights, beliefs and wishes of different individuals and groups are not compromised .

3 .56 3 .38 3 .68 3 .50 3 .42 3 .46 3 .22 3 .49

3 Demonstrates the ability to educate, facilitate, promote, support and encourage the health, well-being and comfort of populations, communities, groups and individuals whose lives are affected by, illness, distress, disease, disability or death .

3 .56 3 .32 3 .46 3 .15 3 .41 3 .43 3 .37 3 .38

4 Within the scope of his/her professional practice and accountability, demonstrates awareness of the different roles, responsibilities and functions of a nurse .

3 .43 3 .33 3 .44 3 .36 3 .35 3 .41 3 .47 3 .16

5 Within the scope of his/her professional practice and accountability, demonstrates the ability to adjust their role to respond effectively to population/patient needs . Where necessary and appropriate is able to challenge current systems to meet population/patient needs .

3 .38 3 .20 3 .20 3 .10 3 .00 3 .15 3 .04 3 .15

6 Demonstrates the ability to accept responsibility for his/her own professional development and learning, using evaluation as a way to reflect and improve upon his/her performance so as to enhance the quality of service delivery .

3 .48 3 .34 3 .51 3 .39 3 .33 3 .39 3 .36 3 .23

7 Demonstrates the ability to undertake comprehensive and systematic assessments using the tools/frameworks appropriate to the patient/client taking into account relevant physical, social, cultural, psychological, spiritual and environmental factors .

3 .51 3 .34 3 .65 3 .52 3 .23 3 .28 3 .19 3 .30

8 Demonstrates the ability to perform an effective risk assessment and take appropriate actions .

3 .49 3 .39 3 .46 3 .43 3 .37 3 .35 3 .26 3 .23


21COMPETENCY STATEMENT FINDINGS


Co

mp

#

Competency

Recent NCLEX

Reg. U.S.

First-year RN U.S.

Educators U.S.

Supervisors U.S.

Students E.U.

Graduates E.U.

Employers E.U.

Others E.U.*


9 Demonstrates the ability to recognize and interpret signs of normal and changing health/illness, distress, or disability in the person (assessment/diagnosis) .

3 .73 3 .67 3 .76 3 .74 3 .49 3 .42 3 .53 3 .60

10 Demonstrates the ability to respond to patient/client needs by planning, delivering and evaluating appropriate and individualized programs of care while working in partnership with the patient/client, their caregivers, families and other healthcare workers .

3 .47 3 .25 3 .57 3 .40 3 .24 3 .35 3 .26 3 .57

11 Demonstrates the ability to critically question, evaluate, interpret and synthesize a range of information and data sources to facilitate patient choice .

3 .45 3 .24 3 .38 3 .18 3 .12 3 .18 3 .02 3 .22

12 Demonstrates the ability to make sound clinical judgments to ensure quality standards are met and practice is evidence based .

3 .55 3 .38 3 .60 3 .53 3 .26 3 .30 3 .32 3 .24

13 Demonstrates the ability to use modern technologies to assess and respond appropriately to patient/client need (for example through telehealth, multimedia and web resources) .

3 .01 2 .81 2 .79 2 .61 2 .72 2 .99 2 .99 2 .79

14 Demonstrates the ability to appropriately use a range of nursing skills, medical devices and interventions/activities to provide optimum care .

3 .41 3 .31 3 .29 3 .23 3 .42 3 .39 3 .52 3 .14

15 Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to maintain patient/client dignity, advocacy and confidentiality .

3 .55 3 .44 3 .59 3 .41 3 .55 3 .43 3 .49 3 .43

16 Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to practice principles of health and safety, including moving and handling, infection control, essential first aid and emergency procedures .

3 .63 3 .57 3 .65 3 .54 3 .54 3 .46 3 .58 3 .54

17 Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to safely administer medications and other therapies .

3 .73 3 .70 3 .86 3 .75 3 .63 3 .57 3 .49 3 .60

18 Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to consider emotional, physical and personal care needs, including meeting the need for comfort, nutrition, personal hygiene and enabling the person to maintain the activities necessary for daily life .

3 .47 3 .31 3 .54 3 .41 3 .33 3 .43 3 .43 3 .54




Co

mp

#

Competency

Recent NCLEX

Reg. U.S.

First-year RN U.S.

Educators U.S.

Supervisors U.S.

Students E.U.

Graduates E.U.

Employers E.U.

Others E.U.*


19 Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to respond to a person’s needs throughout the life span and health/illness experience e .g . pain, life choices, revalidation, disability or when dying .

3 .41 3 .24 3 .37 3 .19 3 .41 3 .41 3 .58 3 .47

20 Demonstrates the ability to inform, educate and supervise patient/caregivers and their families .

3 .37 3 .20 3 .24 3 .13 3 .23 3 .23 3 .37 3 .27

21 Demonstrates current and relevant knowledge of the theories of nursing and nursing practice that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .

3 .06 2 .88 2 .78 2 .91 3 .17 3 .20 3 .23 2 .99

22 Demonstrates current and relevant knowledge of theories concerning the nature and challenge of professional practice that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .

2 .98 2 .78 2 .70 2 .70 3 .07 3 .11 3 .14 2 .97

23 Demonstrates current and relevant knowledge of the natural and life sciences that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .

3 .09 2 .86 3 .00 2 .79 2 .87 2 .99 3 .07 2 .93

24 Demonstrates current and relevant knowledge of the social, health and behavioral sciences that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .

3 .10 2 .87 3 .00 2 .80 2 .96 3 .04 3 .09 2 .99

25 Demonstrates current and relevant knowledge of ethical theory, law and humanities that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .

3 .07 2 .86 2 .96 2 .72 3 .02 3 .21 3 .03 3 .10

26 Demonstrates current and relevant knowledge of technology and healthcare informatics that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .

3 .01 2 .79 2 .87 2 .71 2 .76 2 .96 2 .96 2 .98

27 Demonstrates current and relevant knowledge of international and national policies that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .

2 .82 2 .52 2 .29 2 .05 2 .61 2 .81 2 .91 2 .77

28 Demonstrates current and relevant knowledge of problem solving, decision making and conflict theories that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .

3 .25 3 .08 3 .08 3 .04 3 .14 3 .28 3 .24 3 .35




Co

mp

#

Competency

Recent NCLEX

Reg. U.S.

First-year RN U.S.

Educators U.S.

Supervisors U.S.

Students E.U.

Graduates E.U.

Employers E.U.

Others E.U.*


29 Demonstrates current and relevant knowledge of theories related to personal and professional development so as to enhance professional practice .

2 .97 2 .78 2 .67 2 .60 3 .12 3 .25 3 .31 3 .18

30 Demonstrates current and relevant knowledge of the research process and current nursing research that can be appropriately applied to nursing actions/activities to provide nursing care that is rigorous and evidence based .

3 .08 2 .80 2 .82 2 .46 2 .98 3 .13 3 .13 2 .95

31 Demonstrates the ability to communicate effectively (including the use of new technologies): with patients, families and social groups, including those with communication difficulties .

3 .49 3 .40 3 .56 3 .38 3 .33 3 .36 3 .36 3 .20

32 Demonstrates the ability to enable patients and their caregivers to express their concerns and can respond appropriately e .g . emotional, social, psychological, spiritual or physical concerns .

3 .41 3 .24 3 .49 3 .35 3 .30 3 .30 3 .25 3 .36

33 Demonstrates the ability to appropriately represent the patient/client's perspective and act to prevent abuse .

3 .53 3 .39 3 .55 3 .50 3 .24 3 .28 3 .17 3 .20

34 Demonstrates the ability to appropriately use counseling skills to promote patient well-being .

3 .21 2 .97 2 .96 2 .82 3 .18 3 .24 3 .29 3 .22

35 Demonstrates the ability to identify and manage challenging behavior (using communication techniques to promote patient well-being) .

3 .22 3 .07 3 .18 3 .05 3 .08 3 .22 3 .24 3 .12

36 Demonstrates the ability to recognize anxiety, stress and depression (using communication techniques to promote patient well-being) .

3 .29 3 .09 3 .29 3 .12 3 .24 3 .39 3 .32 3 .47

37 Demonstrates the ability to give emotional support and identify when counseling or other interventions are needed .

3 .29 3 .10 3 .30 3 .06 3 .29 3 .34 3 .23 3 .23

38 Demonstrates the ability to identify and use opportunities for health promotion and health education activities .

3 .24 3 .00 3 .20 2 .78 3 .20 3 .19 3 .19 3 .12

39 Demonstrates the ability to accurately report, record, document and refer care using appropriate technologies .

3 .47 3 .33 3 .55 3 .45 3 .24 3 .34 3 .31 3 .50

40 Demonstrates the ability to realize that patient/client well-being is achieved through the combined resources and actions of all members of the healthcare team .

3 .37 3 .23 3 .29 3 .28 3 .30 3 .34 3 .10 3 .28

41 Demonstrates the ability to lead and coordinate a team, delegating care appropriately and meaningfully .

3 .25 3 .04 3 .04 3 .09 3 .20 3 .08 3 .16 2 .94




Co

mp

#

Competency

Recent NCLEX

Reg. U.S.

First-year RN U.S.

Educators U.S.

Supervisors U.S.

Students E.U.

Graduates E.U.

Employers E.U.

Others E.U.*


42 Demonstrates the ability to work and communicate collaboratively and effectively with other nurses in the best interest of the patient/client .

3 .51 3 .37 3 .56 3 .48 3 .44 3 .38 3 .35 3 .49

43 Demonstrates the ability to work and communicate collaboratively and effectively with all support staff to prioritize and manage time effectively while quality standards are met .

3 .44 3 .27 3 .41 3 .41 3 .39 3 .23 3 .23 3 .19

44 Demonstrates the ability to assess risk and actively promote the well-being, security and safety of all people in the working environment (including themselves) .

3 .45 3 .29 3 .37 3 .22 3 .30 3 .29 3 .43 3 .15

45 Demonstrates the ability to critically use tools to evaluate and audit care according to relevant quality standards .

3 .13 2 .90 2 .72 2 .82 3 .07 3 .15 3 .19 2 .83

46 Within the clinical context, demonstrates the ability to educate, facilitate, supervise and support nursing students and other healthcare students or workers .

3 .25 3 .00 2 .86 2 .66 3 .24 3 .18 3 .23 2 .93

47 Demonstrates an awareness of the principles of healthcare funding and uses resources effectively .

3 .03 2 .73 2 .59 2 .48 3 .07 3 .07 3 .22 2 .88

*This group of respondents includes professional association members, physicians and nursing educators .

Figure 5. Average Ratings (U.S. and E.U.)

.00

.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47

Competency

Ave

rage

Ra�

ng

Recent NCLEX Reg. U.S. Mean Educators U.S. Mean

Supervisors U.S. Mean Graduates E.U. Mean

Employers E.U. Mean

First-year RN U.S. Mean

Students E.U. Mean

Others E.U. Mean



Ratings for the 47 competency statements appear to be consistent . Recent U .S . NCLEX registrants, first-year RNs, educators and supervisors appear to have rated the competency statement similarly . Fig-ure 5 shows how similar the importance ratings were across the 47 competency statements with each line representing one of the eight U .S . and E .U . cohorts .

An unweighted average was calculated for each competency by averaging each mean within the U .S . and E .U . categories . The goal was to identify which competencies were most disparate . Table 6 shows the five most disparate average ratings when comparing all U.S. groups to all E.U. groups. No difference in this comparison was greater than .50 points . In the difference column, negative values represent a higher E .U . rating .

Correlation Analysis

To evaluate the relationship among the U .S . respon-dent cohorts and the E .U . cohorts, a correlation study was conducted using the 47 average impor-tance values . All correlations were positively related and statistically significant . The relationship among all groups, except Employers-E .U ., had correlations above .76 . Table 7 presents this data .

TUNING Analysis Survey Nonresponder Study

In order to ensure the validity of the results, NCSBN conducted a telephone survey of nonresponders to determine if the nurses not responding would have rated the nursing competency statements differently than the survey responders . If there are no system-atic differences in responders versus nonresponders, it would seem that the results are not biased and the nonresponder study provided evidence to support the validity of survey results . A stratified random sample of recent NCLEX registrants, first-year RNs, educators and nursing supervisors who did not participate in the survey were contacted via telephone . Of the potential contacts, a telephone interview was obtained from a total of 121 nurses: 30 recent NCLEX registrants, 30 first-year RNs, 30 edu-cators and 31 nursing supervisors . The study found that the majority of nonresponders either did not receive the initial survey invitation or were too busy to respond . More importantly, the study found that the nonresponders rated the competency state-ments similarly to how responders rated them; this similarity supports validity of the results of the study . See Appendix C for the results of the nonresponder study.

Table 6. Average Importance Differences (U.S. and E.U.)

Comp # CompetencyU.S.

AverageE.U.

Average Difference

29 Demonstrates current and relevant knowledge of theories related to personal and professional development so as to enhance professional practice .

2 .76 3 .22 -0 .46

27 Demonstrates current and relevant knowledge of international and national policies that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .

2 .42 2 .77 -0 .35

47 Demonstrates an awareness of the principles of healthcare funding and uses resources effectively .

2 .71 3 .06 -0 .35

22 Demonstrates current and relevant knowledge of theories concerning the nature and challenge of professional practice that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .

2 .79 3 .07 -0 .28

33 Demonstrates the ability to appropriately represent the patient/client's perspective and act to prevent abuse .

3 .49 3 .22 0 .27



Table 7. Correlation Between Competency Averages (U.S. and E.U.)

Measure

Recent NCLEX

Reg.-U.S.First-year RN-U.S.

Educators- U.S.

Supervisors-U.S.

Students- E.U.

Graduates- E.U.

Employers- E.U.

Others- E.U.*

Recent NCLEX Reg .-U .S .

.988** .962** .947** .856** .838** .675** .798**

First-year RN-U .S . .959** .962** .864** .853** .706** .793**

Educators-U .S . .961** .801** .826** .619** .823**

Supervisors-U .S . .821** .820** .633** .793**

Students-E .U . .926** .842** .765**

Graduates-E .U . .816** .858**

Employers-E .U . .655**

Others-E .U .

* This group of respondents includes professional association members, physicians and nursing educators .** Correlation is significant at the 0 .01 level (2-tailed) .


27CONCLUSION

There is evidence to suggest that basic nursing education competencies are equally important, regardless of nursing role or geographic setting . Average importance ratings were very similar for the 47 competencies . Correlations for the 47 com-petencies were high and statistically significant .

A limitation of the study may be the construction of the education competency statements . Some of the competencies were long and contained multiple concepts . The researchers of the present study recommend that the education competency statements be revised to increase ease of use and interpretation prior to inclusion in future research studies .

While the competencies are similar, organizations should consider undertaking an international study on the role of the RN . Specifically, organizations representing different countries should identify basic nursing roles or activities and evaluate them across geographies .

CONCLUSION


28 REFERENCES

REFERENCES

CoRe Project . (2007) . Competencies in education and cross-border recognition: Evaluation of the useful- ness of learning outcomes and competencies for international recognition final report . Retrieved January 6, 2010, from http://www .dashe .nl/publications/documents/CoRe20Final20Report .pdf

Cronbach, L .J . (1951) . Coefficient alpha and the internal structure of tests . Psychometrika, 16, 297-334 .


29APPENDIX A

APPENDIX A: 2009 TUNING ANALYSES METHODOLOGY REVIEWERS

Ira Bernstein, PhD, is a professor in the department of clinical sciences at the University of Texas South-western Medical Center . He also holds joint appointments at the University of Texas School of Health Professions and at the University of Texas at Arlington . For the last 10 years, Bernstein has served as con-sulting editor for a number of peer review journals, such as Behavior Research Methods and Educational and Psychological Measurements . Bernstein is an expert in the field of measurement and psychometrics . He was one of the researchers funded by the NCSBN Joint Research Committee (JRC) in 2009 .

Deirdre Knapp, PhD, is director of the Assessment, Training and Policy Studies Division at the Human Resources Research Organization (HumRRO) . She also serves as vice president of her organization . Knapp has more than 25 years of experience in conducting and managing personnel and testing related research . Her research emphasis is on designing and administering performance assessments . In that capacity, Knapp is a leader in the field of job analyses and practice analyses . Prior to her 20 years of service in HumRRO, she worked as a research psychologist at the U .S . Army Research Institute for the Behavioral and Social Sciences (ARI) .

Michael Rosenfeld, PhD, is president of Rosenfeld and Associates . His recent research focused on the development of job analysis procedures as a basis for designing assessment measures, documenting their validity and using the results of job analysis in curriculum design . Throughout his 30-plus years of experi-ence in the testing industry, he has worked on many important testing issues, such as the Americans with Disabilities Act (ADA) . Rosenfeld is a lead auditor for the American National Standards Institute in their program accrediting credentialing organizations . He also serves as co-editor of the CLEAR Exam Review, a professional testing journal . Prior to his work with Rosenfeld and Associates, Rosenfeld conducted and managed a wide variety of applied research projects for both the American Institutes for Research (AIR) and Educational Testing Service (ETS) .


30 APPENDIX B

APPENDIX B: 2009 U.S. SURVEYS

Page 1

National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First Year

This survey is part of an international research study on the importance of specific nursing competencies for Registered Nurses (RNs). The results of the survey will compare U.S. academic nursing competencies with European academic nursing competencies. This study is being conducted by NCSBN with permission from your board of nursing. Please complete this survey as soon as possible. This is your opportunity to contribute to international nursing knowledge.

Instructions:

Please read each question carefully and respond by selecting the option that most closely represents your answer. Choose the answer that best applies to your practice and select the appropriate response(s). A few questions ask you to enter information. Your answers will be kept confidential. Your individual responses to the questions will not be released.

Survey Progression:

To progress through the survey, please use the navigation buttons located at the bottom of each page:

Continue to the next page of the survey by clicking the Continue to the Next Page link.

Go back to the previous page in the survey by clicking on the Previous Page link. This will allow you to move back in the survey to look over the previous answers.

Finish the survey, by clicking the Submit the Survey link on the Thank You page.

Introduction

Section 1

Other


31APPENDIX B

Page 2

National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First Year1. What is the highest nursing degree you completed or are about to complete?

Indicate how important you think it is that a graduating nurse (you) should have acquired the following competencies in his/her educational program in order to practice as a professional registered nurse.

For each of the skills listed below rate the importance of the skill or competency using the following scale:

1 = not important, 2 = important, 3 = very important, 4 = vital

SPECIFIC COMPETENCIES – where possible these competencies should be demonstrated in both nursing practice and theoretical assessments.

2. What is the month and year you graduated? Please select from the dropdown menus.

Month Year

MM/YYYY

Section 2

RN - Diploma in U.S.

RN - Associate Degree in U.S.

RN - Baccalaureate Degree in U.S.

RN - Generic Masters Degree in U.S.

RN - Masters (Nurse Practitioner)

RN - Masters (Clinical Nurse Specialist)

RN - Generic Doctorate in U.S. (e.g., ND, PhD, DNP)

Any nursing program NOT located in the U.S.

Other (please specify)

Other

Other


32 APPENDIX B

Page 3

National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearA. Competencies: professional values and the role of the nurse

Importance

1. Demonstrates the ability to practice within the context of professional,

ethical, regulatory and legal codes, recognizing and responding to

moral/ethical dilemmas and issues in day to day practice.

2. Demonstrates the ability to practice in a holistic, tolerant, non

judgmental, caring and sensitive manner, ensuring that the rights, beliefs

and wishes of different individuals and groups are not compromised.

3. Demonstrates the ability to educate, facilitate, promote, support and

encourage the health, well-being and comfort of populations, communities,

groups and individuals whose lives are affected by, illness, distress,

disease, disability or death.

4. Within the scope of his/her professional practice and accountability,

demonstrates awareness of the different roles, responsibilities and

functions of a nurse.

5. Within the scope of his/her professional practice and accountability,

demonstrates the ability to adjust their role to respond effectively to

population/patient needs. Where necessary and appropriate is able to

challenge current systems to meet population/patient needs.

6. Demonstrates the ability to accept responsibility for his/her own

professional development and learning, using evaluation as a way to

reflect and improve upon his/her performance so as to enhance the quality

of service delivery.


33APPENDIX B

Page 4

National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearB. Competencies: nursing practice and clinical decision making

Importance

7. Demonstrates the ability to undertake comprehensive and systematic

assessments using the tools/frameworks appropriate to the patient/client

taking into account relevant physical, social, cultural, psychological,

spiritual and environmental factors.

8. Demonstrates the ability to perform an effective risk assessment and

take appropriate actions.

9. Demonstrates the ability to recognize and interpret signs of normal and

changing health/illness, distress, or disability in the person

(assessment/diagnosis).

10. Demonstrates the ability to respond to patient/client needs by

planning, delivering and evaluating appropriate and individualized

programs of care while working in partnership with the patient/client, their

caregivers, families and other healthcare workers.

11. Demonstrates the ability to critically question, evaluate, interpret and

synthesize a range of information and data sources to facilitate patient

choice.

12. Demonstrates the ability to make sound clinical judgments to ensure

quality standards are met and practice is evidence based.

13. Demonstrates the ability to use modern technologies to assess and

respond appropriately to patient/client need (for example through

telehealth, multimedia and web resources).

14. Demonstrates the ability to appropriately use a range of nursing skills,

medical devices and interventions/activities to provide optimum care.

15. Using nursing skills, medical devices and interventions/activities to

provide optimum care, demonstrates the ability to maintain patient/client

dignity, advocacy and confidentiality.


provide optimum care, demonstrates the ability to practice principles of

health and safety, including moving and handling, infection control,

essential first aid and emergency procedures.


provide optimum care, demonstrates the ability to safely administer

medications and other therapies.


provide optimum care, demonstrates the ability to consider emotional,

physical and personal care needs, including meeting the need for comfort,

nutrition, personal hygiene and enabling the person to maintain the

activities necessary for daily life.


provide optimum care, demonstrates the ability to respond to a person’s

needs throughout the life span and health/illness experience e.g. pain, life

choices, revalidation, disability or when dying.

20. Demonstrates the ability to inform, educate and supervise

patient/caregivers and their families.

Other


34 APPENDIX B

Page 5

National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearC. Knowledge and cognitive competencies

Importance

21. Demonstrates current and relevant knowledge of the theories of

nursing and nursing practice that can be appropriately applied to nursing

practice, patient/client care and situations of uncertainty.

22. Demonstrates current and relevant knowledge of theories concerning

the nature and challenge of professional practice that can be appropriately

applied to nursing practice, patient/client care and situations of

uncertainty.

23. Demonstrates current and relevant knowledge of the natural and life

sciences that can be appropriately applied to nursing practice,

patient/client care and situations of uncertainty.

24. Demonstrates current and relevant knowledge of the social, health and

behavioral sciences that can be appropriately applied to nursing practice,


25. Demonstrates current and relevant knowledge of ethical theory, law

and humanities that can be appropriately applied to nursing practice,


26. Demonstrates current and relevant knowledge of technology and

healthcare informatics that can be appropriately applied to nursing

practice, patient/client care and situations of uncertainty.

27. Demonstrates current and relevant knowledge of international and

national policies that can be appropriately applied to nursing practice,


28. Demonstrates current and relevant knowledge of problem solving,

decision making and conflict theories that can be appropriately applied to

nursing practice, patient/client care and situations of uncertainty.

29. Demonstrates current and relevant knowledge of theories related to

personal and professional development so as to enhance professional

practice.

30. Demonstrates current and relevant knowledge of the research process

and current nursing research that can be appropriately applied to nursing

actions/activities to provide nursing care that is rigorous and evidence

based.


35APPENDIX B

Page 6

National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearD. Communication and interpersonal competencies (including technology for communication)

E. Leadership, management and team competencies

Importance

31. Demonstrates the ability to communicate effectively (including the use

of new technologies): with patients, families and social groups, including

those with communication difficulties.

32. Demonstrates the ability to enable patients and their caregivers to

express their concerns and can respond appropriately e.g. emotional,

social, psychological, spiritual or physical concerns.

33. Demonstrates the ability to appropriately represent the patient/client’s

perspective and act to prevent abuse.

34. Demonstrates the ability to appropriately use counseling skills to

promote patient well-being.

35. Demonstrates the ability to identify and manage challenging behavior

(using communication techniques to promote patient well-being).

36. Demonstrates the ability to recognize anxiety, stress and depression

(using communication techniques to promote patient well-being).

37. Demonstrates the ability to give emotional support and identify when

counseling or other interventions are needed.

38. Demonstrates the ability to identify and use opportunities for health

promotion and health education activities.

39. Demonstrates the ability to accurately report, record, document and

refer care using appropriate technologies.

Importance

40. Demonstrates the ability to realize that patient/client well-being is

achieved through the combined resources and actions of all members of

the healthcare team.

41. Demonstrates the ability to lead and coordinate a team, delegating

care appropriately and meaningfully.

42. Demonstrates the ability to work and communicate collaboratively and

effectively with other nurses in the best interest of the patient/client.

43. Demonstrates the ability to work and communicate collaboratively and

effectively with all support staff to prioritize and manage time effectively

while quality standards are met.

44. Demonstrates the ability to assess risk and actively promote the well-

being, security and safety of all people in the working environment

(including themselves).

45. Demonstrates the ability to critically use tools to evaluate and audit

care according to relevant quality standards.

46. Within the clinical context, demonstrates the ability to educate,

facilitate, supervise and support nursing students and other healthcare

students or workers.

47. Demonstrates an awareness of the principles of healthcare funding and

uses resources effectively.


36 APPENDIX B

Page 7


1. Which of the following best describes most of your clients on the last day you worked? (Select all that apply.)

2. Which of the following best describes the ages of the majority of your clients? (Select all that apply.)

Section 3: Work Environment

Well clients, possibly with minor illnesses

OB (Maternity) clients

Clients with stabilized chronic conditions

Clients with unstabilized chronic conditions

Clients with acute conditions, including clients with medical, surgical or critical conditions

Clients at end of life

Clients with behavioral/emotional conditions

Not working as an RN


Newborns (less than 1 month)

Infants/children (1 month-12 years)

Adolescent (ages 13-18)

Young Adult (ages 19-30)

Adult (ages 31-64)

Older Adult (65-85)

Older Adult (over 85)




37APPENDIX B

Page 8

National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First Year3. Which of the following choices best describes your employment setting/specialty area on the last day you worked? If you work mainly in one setting, fill in the appropriate box for that one setting. If you worked in more than one setting, fill in the appropriate boxes for all settings where you spent at least one-half of your time. (Select no more than two answers.)

Critical care (e.g., ICU, CCU, step-down units, pediatric/neonatal intensive care, emergency department,

post-anesthesia recovery unit)

Medical-surgical unit or any of its sub-specialties (e.g., oncology, orthopedics, neurology)

Pediatrics

Nursery

Labor and delivery

Postpartum unit

Psychiatry or any of its sub-specialties (e.g., detox)

Operating room, including outpatient surgery and surgicenters

Nursing home, skilled or intermediate care

Assisted Living

Other long-term care (e.g., residential care, developmental disability)

Rehabilitation

Subacute unit

Transitional care unit

Physician/APRN/Dentist office

Occupational health

Outpatient clinic

Home health, including visiting nurses associations

Public health

Student/school health

Hospice care

Prison/correctional facilities/jails




38 APPENDIX B

Page 9


4. Which of the following best describes the type of facility/organization where your employment setting/specialty area is located?

1. What is your gender?

2. What is your age in years?

Section 4: Demographic Information

Hospital

Long-term care

Community-based or ambulatory care facility/organization (including public health department, visiting

nurses association, home health, physician/APRN/dentist’s office, clinic, school, prison, etc.)



Male

Female


39APPENDIX B

Page 10

National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First Year3. Which of the following is most descriptive of your racial/ethnic background? (Select one answer.)

4. What is your primary language?

We appreciate your participation in this important work.

To finalize your survey, please click the Submit button on this page.

If we need additional information in order to clarify the results of this study, we may call and/or e-mail some participants. If you would be willing to answer a few additional questions by phone or e-mail, please provide your contact information where you can be reached during the day or early evening.

Additional Information:

Thank you!

Name:

Email Address:

Phone Number:

African American

Asian Indian

Asian Other

Hispanic

Native American

Pacific Islander

White – not of Hispanic origin


English

English and another Language

Another Language


40 APPENDIX B


41APPENDIX B


42 APPENDIX B


43APPENDIX B


44 APPENDIX B


45APPENDIX B


46 APPENDIX B


47APPENDIX C

APPENDIX C: 2009 TUNING ANALYSIS SURVEY NONRESPONDER STUDY

IntroductionThe National Council of State Boards of Nurs-ing (NCSBN®) conducted a study to evaluate the importance of nursing competencies in the U .S . Respondents of the study were drawn from four samples: recent NCLEX registrants, registered nurses (RNs) obtaining their license within the last year (first-year RN), nursing educators and supervi-sors of nurses .

Out of the 6,000 recent NCLEX registrants who were invited to take the survey online, 2,857 surveys were submitted . In addition, 590 out of 2,500 first-year RNs, 1,380 out of 2,751 nursing educators and 657 out of 2,750 supervisors of nurses returned the sur-veys, separately .

NCSBN wanted to contact a sample of the invitees who chose not to participate in the survey and com-pare a sample of competency statements, as well as demographic information, against the 2009 TUN-ING Analysis Survey responders .

Background of StudyA new initiative seeks to understand the role of nurses and nursing education from an international perspective . This study was conducted to evalu-ate the importance of nursing competencies in the U .S . In addition, results from the current study were compared to the results of a similiar study, called TUNING, conducted in the following European Union (E .U .) countries: Denmark, Finland, Flanders, France, Germany, Hungary, Ireland, Italy, Lithuania, Malta, Norway, Netherlands, Portugal, Slovakia, Spain, Ukraine and the United Kingdom .

MethodologySample Selection

A random sample of 30 invitees from the educator, recent NCLEX registrant and first-year RN groups, and 31 nursing supervisors who did not respond to

the 2009 TUNING Analysis Survey was contacted via telephone .

Survey Instrument and Process

There were a total of 121 nonresponders who were contacted via phone . First, nonresponders were asked about their reasons for not complet-ing the survey . In order to facilitate the gathering of data from nonresponders, NCSBN developed a list of possible reasons why invitees may not have responded to the survey based on prior research . Possible reasons included too busy, did not care, do not like/trust surveys, did not receive or other . Sec-ond, nonresponders were asked for demographic information in order to provide background, such as employment setting/specialty and length of time since they graduated with a nursing degree . In addition, nonresponders were asked to rate the importance of 10 competencies that were listed in the 2009 TUNING Analysis Survey . Nonresponders were thanked for their time and their data was recorded in a Microsoft Excel 2007 spreadsheet .

Nonresponder Results

Reasons for Not Responding

There were 63% (19/30) of recent NCLEX registrants, 60% (18/30) of first-year RNs, 97% (29/30) of educa-tors and 100% (31/31) of supervisors who did not receive the survey; 30% of recent NCLEX registrants and 37% of first-year RNs were too busy to return the survey . None of the nonresponders indicated

Table C-1. Reasons For Not Responding

Group Too Busy Did Not Care

Do Not Like/Trust Surveys

Did Not Receive It Total

Recent NCLEX

Reg .9 2 0 19 30

First-year RN

11 1 0 18 30

Educator 1 0 0 29 30

Supervisor 0 0 0 31 31


48 APPENDIX C

Table C-2. Average Importance Rating of Competencies

Competency

Responder Nonresponder

Recent NCLEX Reg.

First-year RN Educators Supervisors

Recent NCLEX Reg.

First-year RN Educators Supervisors

N Avg. N Avg. N Avg. N Avg. N Avg. N Avg. N Avg. N Avg.

Demonstrates the ability to practice in a holistic, tolerant, non judgmental, caring and sensitive manner, ensuring that the rights, beliefs and wishes of different individuals and groups are not compromised .

2879 3 .56 599 3 .38 1363 3 .68 645 3 .50 30 3 .63 30 3 .67 30 3 .80 31 3 .84

Within the scope of his/her professional practice and account-ability, demonstrates awareness of the different roles, responsibilities and functions of a nurse .

2872 3 .43 598 3 .33 1363 3 .44 641 3 .36 30 3 .43 30 3 .63 30 3 .73 31 3 .52

Demonstrates the ability to perform an effective risk assessment and take appropriate actions .

2857 3 .49 596 3 .39 1358 3 .46 641 3 .43 30 3 .93 30 3 .83 30 3 .73 31 3 .52

Demonstrates the ability to critically question, evaluate, interpret and syn-thesize a range of information and data sources to facilitate patient choice .

2862 3 .45 593 3 .24 1368 3 .38 643 3 .18 30 3 .63 30 3 .53 30 3 .73 31 3 .61

Demonstrates the ability to appro-priately use a range of nurse skills, medical devices and interventions/activities to provide optimum care .

2856 3 .41 592 3 .31 1364 3 .29 644 3 .23 30 3 .70 30 3 .47 30 3 .47 31 3 .55

Demonstrates the ability to inform, educate and supervise patient/ caregivers and their families .

2838 3 .37 587 3 .20 1339 3 .24 632 3 .13 30 3 .50 30 3 .27 30 3 .50 31 3 .32

Demonstrates current and relevant knowledge of the research process and current nursing research that can be appropriately applied to nursing actions/activities to provide nursing care that is rigorous and evidence based .

2821 3 .08 582 2 .80 1345 2 .82 636 2 .46 30 3 .23 30 3 .20 30 3 .07 31 2 .71

Demonstrates the ability to appropri-ately use counseling skills to promote patient well-being .

2824 3 .21 580 2 .97 1345 2 .96 636 2 .82 30 3 .37 30 3 .17 30 3 .13 31 3 .00

Demonstrates the ability to accurately report, record, document and refer care using appropriate technologies .

2829 3 .47 586 3 .33 1327 3 .55 635 3 .45 30 3 .60 30 3 .47 30 3 .73 31 3 .81

Demonstrates an awareness of the principles of healthcare funding and uses resources effectively .

2833 3 .03 587 2 .73 1353 2 .59 648 2 .48 30 3 .17 30 2 .97 30 3 .00 31 2 .68

that they do not like/trust surveys as a reason for not returning the survey . See Table C-1.

Employment Setting/Specialty

Nonresponders were asked to provide their set-ting/specialty area . The largest percentages, 43 .0% of recent NCLEX registrants and 33 .3% of first-year RNs, worked in the medical-surgical unit or any of its sub-specialties (e .g . oncology, orthopedics,

neurology), while 37% of the recent NCLEX reg-istrants, 37% of the first-year RNs and almost all nursing supervisors cited specialties other than those on the list . None of the educators contacted specified their specialties .

Importance Ratings

In general, the importance ratings between nonre-sponders and responders were very similar, with no


49APPENDIX C

competency importance rating differing by more than half a point . See Table C-2.

SummaryThe nonresponder study suggests that the main reasons individuals did not complete the study were they were either too busy or did not receive the survey . Overall, these results provide important information about why individuals do not complete surveys . More importantly, the ratings of the activ-ity statements were quite similar, which indicates that the results of the survey are not systematically biased . The nonresponder study provides support for the validity of the 2009 TUNING Analysis Survey results .


50 APPENDIX DA

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. Err

.D

if.

1D

emo

nstr

ates

the

ab

ility

to

pra

ctic

e w

ithin

the

co

ntex

t o

f pro

fess

iona

l, et

hica

l, re

gul

ato

ry a

nd le

gal

co

des

, rec

og

nizi

ng a

nd re

spo

ndin

g t

o m

ora

l/et

hica

l dile

mm

as a

nd is

sues

in d

ay t

o d

ay p

ract

ice .

323 .

810 .

0849

03 .

580 .

0322

903 .

600 .

01-0

.02

2D

emo

nstr

ates

the

ab

ility

to

pra

ctic

e in

a h

olis

tic, t

ole

rant

, no

n ju

dg

men

tal,

carin

g a

nd s

ensi

tive

man

ner,

ensu

ring

tha

t th

e rig

hts,

bel

iefs

and

wis

hes

of

diff

eren

t in

div

idua

ls a

nd g

roup

s ar

e no

t co

mp

rom

ised

.32

3 .81

0 .08

490

3 .51

0 .03

2290

3 .57

0 .01

-0 .0

6

3D

emo

nstr

ates

the

ab

ility

to

ed

ucat

e, fa

cilit

ate,

pro

mo

te, s

upp

ort

an

d e

nco

urag

e th

e he

alth

, wel

l-bei

ng a

nd c

om

fort

of p

op

ulat

ions

, co

mm

uniti

es, g

roup

s an

d in

div

idua

ls w

hose

live

s ar

e af

fect

ed b

y, il

lnes

s,

dis

tres

s, d

isea

se, d

isab

ility

or

dea

th .

323 .

780 .

0749

03 .

540 .

0322

863 .

560 .

01-0

.01

4W

ithin

the

sco

pe

of h

is/h

er p

rofe

ssio

nal p

ract

ice

and

acc

oun

tab

ility

, d

emo

nstr

ates

aw

aren

ess

of t

he d

iffer

ent

role

s, re

spo

nsib

ilitie

s an

d

func

tions

of a

nur

se .

323 .

690 .

0948

83 .

440 .

0322

853 .

430 .

010 .

00

5W

ithin

the

sco

pe

of h

is/h

er p

rofe

ssio

nal p

ract

ice

and

acc

oun

tab

ility

, d

emo

nstr

ates

the

ab

ility

to

ad

just

the

ir ro

le t

o re

spo

nd e

ffect

ivel

y to

p

op

ulat

ion/

pat

ient

nee

ds .

Whe

re n

eces

sary

and

ap

pro

pria

te is

ab

le t

o

chal

leng

e cu

rren

t sy

stem

s to

mee

t p

op

ulat

ion/

pat

ient

nee

ds .

323 .

560 .

1348

93 .

370 .

0322

833 .

380 .

010 .

00

6D

emo

nstr

ates

the

ab

ility

to

acc

ept

resp

ons

ibili

ty fo

r hi

s/he

r o

wn

pro

fess

iona

l dev

elo

pm

ent

and

lear

ning

, usi

ng e

valu

atio

n as

a w

ay t

o

refle

ct a

nd im

pro

ve u

po

n hi

s/he

r p

erfo

rman

ce s

o a

s to

enh

ance

the

qua

lity

of s

ervi

ce d

eliv

ery .

323 .

660 .

1248

83 .

490 .

0322

813 .

480 .

010 .

01

7D

emo

nstr

ates

the

ab

ility

to

und

erta

ke c

om

pre

hens

ive

and

sys

tem

atic

as

sess

men

ts u

sing

the

to

ols

/fra

mew

ork

s ap

pro

pria

te t

o t

he p

atie

nt/

clie

nt t

akin

g in

to a

cco

unt

rele

vant

phy

sica

l, so

cial

, cul

tura

l, p

sych

olo

gic

al,

spiri

tual

and

env

ironm

enta

l fac

tors

.

323 .

660 .

1048

43 .

470 .

0322

793 .

510 .

01-0

.05

8D

emo

nstr

ates

the

ab

ility

to

per

form

an

effe

ctiv

e ris

k as

sess

men

t an

d t

ake

app

rop

riate

act

ions

.32

3 .63

0 .11

483

3 .49

0 .03

2276

3 .49

0 .01

0 .01

9D

emo

nstr

ates

the

ab

ility

to

reco

gni

ze a

nd in

terp

ret

sig

ns o

f no

rmal

and

ch

ang

ing

hea

lth/i

llnes

s, d

istr

ess,

or

dis

abili

ty in

the

per

son

(ass

essm

ent/

dia

gno

sis)

.31

3 .84

0 .07

480

3 .73

0 .02

2258

3 .73

0 .01

-0 .0

1

10D

emo

nstr

ates

the

ab

ility

to

resp

ond

to

pat

ient

/clie

nt n

eed

s b

y p

lann

ing

, d

eliv

erin

g a

nd e

valu

atin

g a

pp

rop

riate

and

ind

ivid

ualiz

ed p

rog

ram

s o

f ca

re w

hile

wo

rkin

g in

par

tner

ship

with

the

pat

ient

/clie

nt, t

heir

care

giv

ers,

fa

mili

es a

nd o

ther

hea

lthca

re w

ork

ers .

323 .

630 .

0948

43 .

440 .

0322

783 .

470 .

01-0

.03

11D

emo

nstr

ates

the

ab

ility

to

crit

ical

ly q

uest

ion,

eva

luat

e, in

terp

ret

and

sy

nthe

size

a r

ang

e o

f inf

orm

atio

n an

d d

ata

sour

ces

to fa

cilit

ate

pat

ient

ch

oic

e .32

3 .47

0 .10

485

3 .43

0 .03

2279

3 .47

0 .01

-0 .0

4

APPENDIX D: U.S. EDUCATIONAL COMPARISON


51APPENDIX DA

pp

end

ix D

. U.S

. Ed

ucat

iona

l Co

mp

aris

on

Comp #D

iplo

ma

Ass

oci

ate

Bac

cala

urea

teA

sso

c-B

acc

Co

mp

eten

cyN

Avg

Std

. Err

.N

Avg

Std

. Err

.N

Avg

Std

. Err

.D

if.

12D

emo

nstr

ates

the

ab

ility

to

mak

e so

und

clin

ical

jud

gm

ents

to

ens

ure

qua

lity

stan

dar

ds

are

met

and

pra

ctic

e is

evi

den

ce b

ased

.31

3 .65

0 .10

483

3 .51

0 .03

2274

3 .56

0 .01

-0 .0

5

13D

emo

nstr

ates

the

ab

ility

to

use

mo

der

n te

chno

log

ies

to a

sses

s an

d

resp

ond

ap

pro

pria

tely

to

pat

ient

/clie

nt n

eed

(fo

r ex

amp

le t

hro

ugh

tele

heal

th, m

ultim

edia

and

web

reso

urce

s) .

303 .

200 .

1348

33 .

060 .

0422

703 .

000 .

020 .

05

14D

emo

nstr

ates

the

ab

ility

to

ap

pro

pria

tely

use

a r

ang

e o

f nur

sing

ski

lls,

med

ical

dev

ices

and

inte

rven

tions

/act

iviti

es t

o p

rovi

de

op

timum

car

e .32

3 .59

0 .10

483

3 .45

0 .03

2275

3 .40

0 .01

0 .04

15U

sing

nur

sing

ski

lls, m

edic

al d

evic

es a

nd in

terv

entio

ns/a

ctiv

ities

to

pro

vid

e o

ptim

um c

are,

dem

ons

trat

es t

he a

bili

ty t

o m

aint

ain

pat

ient

/clie

nt d

igni

ty,

advo

cacy

and

co

nfid

entia

lity .

323 .

590 .

1148

53 .

530 .

0322

723 .

550 .

01-0

.02

16U

sing

nur

sing

ski

lls, m

edic

al d

evic

es a

nd in

terv

entio

ns/a

ctiv

ities

to

pro

vid

e o

ptim

um c

are,

dem

ons

trat

es th

e ab

ility

to p

ract

ice

prin

cip

les

of h

ealth

and

sa

fety

, inc

lud

ing

mo

ving

and

han

dlin

g, i

nfec

tion

cont

rol,

esse

ntia

l firs

t ai

d

and

em

erg

ency

pro

ced

ures

.

323 .

690 .

0948

33 .

580 .

0322

673 .

630 .

01-0

.05

17U

sing

nur

sing

ski

lls, m

edic

al d

evic

es a

nd in

terv

entio

ns/a

ctiv

ities

to

pro

vid

e o

ptim

um c

are,

dem

ons

trat

es t

he a

bili

ty t

o s

afel

y ad

min

iste

r m

edic

atio

ns

and

oth

er t

hera

pie

s .32

3 .81

0 .07

484

3 .71

0 .02

2269

3 .73

0 .01

-0 .0

2

18U

sing

nur

sing

ski

lls, m

edic

al d

evic

es a

nd in

terv

entio

ns/a

ctiv

ities

to

p

rovi

de

op

timum

car

e, d

emo

nstr

ates

the

ab

ility

to

co

nsid

er e

mo

tiona

l, p

hysi

cal a

nd p

erso

nal c

are

need

s, in

clud

ing

mee

ting

the

nee

d fo

r co

mfo

rt,

nutr

itio

n, p

erso

nal h

ygie

ne a

nd e

nab

ling

the

per

son

to m

aint

ain

the

activ

ities

nec

essa

ry fo

r d

aily

life

.

323 .

530 .

1148

33 .

480 .

0322

683 .

470 .

010 .

01

19U

sing

nur

sing

ski

lls, m

edic

al d

evic

es a

nd in

terv

entio

ns/a

ctiv

ities

to

pro

vid

e o

ptim

um c

are,

dem

ons

trat

es t

he a

bili

ty t

o re

spo

nd t

o a

per

son’

s ne

eds

thro

ugho

ut t

he li

fe s

pan

and

hea

lth/i

llnes

s ex

per

ienc

e e .

g . p

ain,

life

ch

oic

es, r

eval

idat

ion,

dis

abili

ty o

r w

hen

dyi

ng .

323 .

530 .

1148

43 .

400 .

0322

683 .

410 .

01-0

.01

20D

emo

nstr

ates

the

ab

ility

to

info

rm, e

duc

ate

and

sup

ervi

se p

atie

nt/

care

giv

ers

and

the

ir fa

mili

es .

323 .

410 .

1148

23 .

390 .

0322

583 .

360 .

010 .

03

21D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

the

orie

s o

f nur

sing

an

d n

ursi

ng p

ract

ice

that

can

be

app

rop

riate

ly a

pp

lied

to

nur

sing

pra

ctic

e,

pat

ient

/clie

nt c

are

and

situ

atio

ns o

f unc

erta

inty

.31

3 .26

0 .15

476

3 .09

0 .04

2254

3 .05

0 .02

0 .04

22D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

orie

s co

ncer

ning

the

na

ture

and

cha

lleng

e o

f pro

fess

iona

l pra

ctic

e th

at c

an b

e ap

pro

pria

tely

ap

plie

d t

o n

ursi

ng p

ract

ice,

pat

ient

/clie

nt c

are

and

situ

atio

ns o

f un

cert

aint

y .

323 .

220 .

1447

43 .

050 .

0422

552 .

970 .

020 .

08


52 APPENDIX DA

pp

end

ix D

. U.S

. Ed

ucat

iona

l Co

mp

aris

on

Comp #D

iplo

ma

Ass

oci

ate

Bac

cala

urea

teA

sso

c-B

acc

Co

mp

eten

cyN

Avg

Std

. Err

.N

Avg

Std

. Err

.N

Avg

Std

. Err

.D

if.

23D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

nat

ural

and

life

sc

ienc

es t

hat

can

be

app

rop

riate

ly a

pp

lied

to

nur

sing

pra

ctic

e, p

atie

nt/

clie

nt c

are

and

situ

atio

ns o

f unc

erta

inty

.32

3 .16

0 .16

476

3 .09

0 .04

2257

3 .08

0 .02

0 .00

24D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

so

cial

, hea

lth a

nd

beh

avio

ral s

cien

ces

that

can

be

app

rop

riate

ly a

pp

lied

to

nur

sing

pra

ctic

e,

pat

ient

/clie

nt c

are

and

situ

atio

ns o

f unc

erta

inty

.32

3 .22

0 .14

472

3 .10

0 .04

2257

3 .10

0 .02

-0 .0

1

25D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f eth

ical

the

ory

, law

and

hu

man

ities

tha

t ca

n b

e ap

pro

pria

tely

ap

plie

d t

o n

ursi

ng p

ract

ice,

pat

ient

/cl

ient

car

e an

d s

ituat

ions

of u

ncer

tain

ty .

323 .

090 .

1647

53 .

090 .

0422

543 .

070 .

020 .

02

26D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f tec

hno

log

y an

d

heal

thca

re in

form

atic

s th

at c

an b

e ap

pro

pria

tely

ap

plie

d t

o n

ursi

ng

pra

ctic

e, p

atie

nt/c

lient

car

e an

d s

ituat

ions

of u

ncer

tain

ty .

323 .

190 .

1547

43 .

060 .

0422

543 .

000 .

020 .

06

27D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f int

erna

tiona

l and

na

tiona

l po

licie

s th

at c

an b

e ap

pro

pria

tely

ap

plie

d t

o n

ursi

ng p

ract

ice,

p

atie

nt/c

lient

car

e an

d s

ituat

ions

of u

ncer

tain

ty .

322 .

810 .

1847

32 .

920 .

0422

572 .

810 .

020 .

11

28D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f pro

ble

m s

olv

ing

, d

ecis

ion

mak

ing

and

co

nflic

t th

eorie

s th

at c

an b

e ap

pro

pria

tely

ap

plie

d t

o

nurs

ing

pra

ctic

e, p

atie

nt/c

lient

car

e an

d s

ituat

ions

of u

ncer

tain

ty .

323 .

410 .

1447

43 .

300 .

0322

553 .

230 .

020 .

06

29D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

orie

s re

late

d t

o

per

sona

l and

pro

fess

iona

l dev

elo

pm

ent

so a

s to

enh

ance

pro

fess

iona

l p

ract

ice .

323 .

090 .

1647

43 .

010 .

0422

532 .

960 .

020 .

05

30D

emo

nstr

ates

cur

rent

and

rele

vant

kno

wle

dg

e o

f the

rese

arch

pro

cess

an

d c

urre

nt n

ursi

ng re

sear

ch t

hat

can

be

app

rop

riate

ly a

pp

lied

to

nur

sing

ac

tions

/act

iviti

es t

o p

rovi

de

nurs

ing

car

e th

at is

rig

oro

us a

nd e

vid

ence

b

ased

.

323 .

340 .

1447

03 .

130 .

0422

533 .

070 .

020 .

06

31D

emo

nstr

ates

the

ab

ility

to

co

mm

unic

ate

effe

ctiv

ely

(incl

udin

g t

he u

se

of n

ew t

echn

olo

gie

s): w

ith p

atie

nts,

fam

ilies

and

so

cial

gro

ups,

incl

udin

g

tho

se w

ith c

om

mun

icat

ion

diffi

culti

es .

323 .

690 .

0847

93 .

450 .

0322

563 .

490 .

01-0

.04

32D

emo

nstr

ates

the

ab

ility

to

ena

ble

pat

ient

s an

d t

heir

care

giv

ers

to e

xpre

ss

thei

r co

ncer

ns a

nd c

an re

spo

nd a

pp

rop

riate

ly e

.g . e

mo

tiona

l, so

cial

, p

sych

olo

gic

al, s

piri

tual

or

phy

sica

l co

ncer

ns .

323 .

630 .

1147

83 .

380 .

0322

563 .

410 .

01-0

.03

33D

emo

nstr

ates

the

ab

ility

to

ap

pro

pria

tely

rep

rese

nt t

he p

atie

nt/c

lient

's

per

spec

tive

and

act

to

pre

vent

ab

use .

323 .

630 .

1047

83 .

510 .

0322

573 .

530 .

01-0

.02

34D

emo

nstr

ates

the

ab

ility

to

ap

pro

pria

tely

use

co

unse

ling

ski

lls t

o p

rom

ote

p

atie

nt w

ell-b

eing

.32

3 .28

0 .12

475

3 .23

0 .03

2251

3 .21

0 .02

0 .02

35D

emo

nstr

ates

the

ab

ility

to

iden

tify

and

man

age

chal

leng

ing

beh

avio

r (u

sing

co

mm

unic

atio

n te

chni

que

s to

pro

mo

te p

atie

nt w

ell-b

eing

) .32

3 .41

0 .12

479

3 .25

0 .03

2251

3 .22

0 .01

0 .03


53APPENDIX DA

pp

end

ix D

. U.S

. Ed

ucat

iona

l Co

mp

aris

on

Comp #D

iplo

ma

Ass

oci

ate

Bac

cala

urea

teA

sso

c-B

acc

Co

mp

eten

cyN

Avg

Std

. Err

.N

Avg

Std

. Err

.N

Avg

Std

. Err

.D

if.

36D

emo

nstr

ates

the

ab

ility

to

reco

gni

ze a

nxie

ty, s

tres

s an

d d

epre

ssio

n (u

sing

co

mm

unic

atio

n te

chni

que

s to

pro

mo

te p

atie

nt w

ell-b

eing

) .32

3 .41

0 .12

478

3 .29

0 .03

2256

3 .30

0 .01

-0 .0

1

37D

emo

nstr

ates

the

ab

ility

to

giv

e em

otio

nal s

upp

ort

and

iden

tify

whe

n co

unse

ling

or

oth

er in

terv

entio

ns a

re n

eed

ed .

323 .

500 .

1148

03 .

290 .

0322

563 .

290 .

010 .

00

38D

emo

nstr

ates

the

ab

ility

to

iden

tify

and

use

op

po

rtun

ities

for

heal

th

pro

mo

tion

and

hea

lth e

duc

atio

n ac

tiviti

es .

323 .

380 .

1347

93 .

240 .

0322

543 .

250 .

020 .

00

39D

emo

nstr

ates

the

ab

ility

to

acc

urat

ely

rep

ort

, rec

ord

, do

cum

ent

and

refe

r ca

re u

sing

ap

pro

pria

te t

echn

olo

gie

s .32

3 .53

0 .13

478

3 .45

0 .03

2253

3 .48

0 .01

-0 .0

3

40D

emo

nstr

ates

the

ab

ility

to

real

ize

that

pat

ient

/clie

nt w

ell-b

eing

is

achi

eved

thr

oug

h th

e co

mb

ined

reso

urce

s an

d a

ctio

ns o

f all

mem

ber

s o

f th

e he

alth

care

tea

m .

323 .

440 .

1348

03 .

370 .

0322

623 .

370 .

010 .

00

41D

emo

nstr

ates

the

ab

ility

to

lead

and

co

ord

inat

e a

team

, del

egat

ing

car

e ap

pro

pria

tely

and

mea

ning

fully

.32

3 .47

0 .12

478

3 .28

0 .03

2260

3 .24

0 .02

0 .04

42D

emo

nstr

ates

the

ab

ility

to

wo

rk a

nd c

om

mun

icat

e co

llab

ora

tivel

y an

d

effe

ctiv

ely

with

oth

er n

urse

s in

the

bes

t in

tere

st o

f the

pat

ient

/clie

nt .

323 .

530 .

1147

83 .

490 .

0322

573 .

510 .

01-0

.02

43D

emo

nstr

ates

the

ab

ility

to

wo

rk a

nd c

om

mun

icat

e co

llab

ora

tivel

y an

d

effe

ctiv

ely

with

all

sup

po

rt s

taff

to p

riorit

ize

and

man

age

time

effe

ctiv

ely

whi

le q

ualit

y st

and

ard

s ar

e m

et .

323 .

410 .

1148

03 .

400 .

0322

623 .

440 .

01-0

.04

44D

emo

nstr

ates

the

ab

ility

to

ass

ess

risk

and

act

ivel

y p

rom

ote

the

wel

l-b

eing

, sec

urity

and

saf

ety

of a

ll p

eop

le in

the

wo

rkin

g e

nviro

nmen

t (in

clud

ing

the

mse

lves

) .32

3 .63

0 .10

481

3 .43

0 .03

2260

3 .46

0 .01

-0 .0

3

45D

emo

nstr

ates

the

ab

ility

to

crit

ical

ly u

se t

oo

ls t

o e

valu

ate

and

aud

it ca

re

acco

rdin

g t

o re

leva

nt q

ualit

y st

and

ard

s .32

3 .31

0 .12

477

3 .14

0 .03

2261

3 .13

0 .02

0 .01

46W

ithin

the

clin

ical

co

ntex

t, d

emo

nstr

ates

the

ab

ility

to

ed

ucat

e, fa

cilit

ate,

su

per

vise

and

sup

po

rt n

ursi

ng s

tud

ents

and

oth

er h

ealth

care

stu

den

ts o

r w

ork

ers .

323 .

470 .

1248

03 .

260 .

0322

613 .

250 .

020 .

02

47D

emo

nstr

ates

an

awar

enes

s o

f the

prin

cip

les

of h

ealth

care

fund

ing

and

us

es re

sour

ces

effe

ctiv

ely .

323 .

250 .

1347

93 .

080 .

0422

563 .

010 .

020 .

06

volume 45 | may 2010 - ncsbn · 2014. 10. 14. · volume 45 | may 2010 2009 tuning analysis: a...

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