Tool For Competence Research Articles

PREPARING THE NURSING WORKFORCE TO CARE FOR OLDER ADULTS IN THE 21ST CENTURY

Abstract Nurses entering the workforce may have limited education in gerontological nursing. Therefore, many nurses are unprepared to provide quality care to older adults. An unprepared nursing workforce could negatively influence older adults’ health outcomes. This study aimed to determine differences in senior nursing students’ knowledge, attitudes, and perceived competency about older adults based on enrollment in a bachelor of science in nursing degree (BSN), associate’s degree nursing (ADN), and practical nursing (PN) program that offers geriatric content in curricula. Albert Bandura’s social cognitive, triadic reciprocal determinism model provided the theoretical framework to underpin this research study. A non-experimental, descriptive survey design included a convenience sample of students enrolled in a BSN, ASN, and PN program. A total of 178 students participated in the study. Palmore Facts on Aging Quiz 2, Kogan’s Attitudes Toward Old People Scale, and the Hartford Geriatric Nurse Competency tool was used to collect data. From the results, it is clear that students enrolled in BSN, ADN, and PN programs demonstrated limited knowledge about facts on aging. Students’ attitudes toward older adults were positive, and a correlation was found between knowledge and attitudes. Students perceived competency about older adults was high but purely subjective. Students’ preference to work with older adults post-graduation in the PN group was higher than students in the BSN and ADN groups. These findings underscore the need to systematically design an evidence-based curriculum inclusive of geriatric content across (BSN, ADN, and PN) programs to prepare the nursing workforce to care for older adults.

Alternative Clinical Learning Experiences for Nursing Education Using Virtual Individual Patients.

Acute care pediatric clinical experiences for undergraduate nursing students can present a challenge given the limited availability of clinical sites, increased restrictions, and variations in direct patient care experiences. Unfolding virtual individual patient pediatric simulations were developed using complex pediatric disorders with multiple physiological, psychosocial, and developmental components. Ten unfolding simulations were implemented to standardize clinical experiences and replace clinical hours. Students were evaluated using the Quint Leveled Clinical Competency Tool, demonstrating overall progressing ability to use clinical reasoning skills. Unfolding virtual individual patients allow for deliberate, coordinated, and consistent exposure to clinical experiences and are a valuable substitution for traditional clinicals.

Psychometric Properties of the MacArthur-Bates Communicative Development Inventories-III (CDI-III) in 30 to 37 Months Old Persian-Speaking Children

Objective Early language skills predict the child’s future language skills and literacy. So, screening and assessment of speech and language at an early age are important. One cost-effective way of assessing a child’s communication is through parents reporting tools. MacArthur-Bates Communicative Development Inventories (CDIs) are the most widely used forms by professionals in more than 70 live languages worldwide to screen children’s communication skills. The main purpose of this study was to provide the Persian version of the third form of CDI (CDI-III) and determine its psychometric properties, including face and content validity and internal consistency in 30 to 37 months old Iranian Persian-speaking children. Materials & Methods In a cross-sectional methodological study of instrument validation, a Persian-adapted form of CDI-III was developed. At first, the English form was adapted to Persian, and a Delphi method was used to provide the initial list of the items. The face and content validity rates were examined by asking the opinion of ten Persian-speaking speech and language pathologists with at least three years of clinical experience in the field of child speech/language development and disorders. The final form was compiled based on the results of the content validity ratio (CVR) and content validity index (CVI) of the items. The final form consisted of three sections, including vocabulary, sentences, and use of sentences. The parents of 356 Persian-speaking children aged 30 to 37 months recruited by multi-stage cluster random sampling from health centers in Isfahan City were asked to complete the form. The Kuder-Richardson coefficient assessed internal consistency, and the Spearman coefficient examined correlation. Results The items with CVIs≥0.7 and CVRs≥0.6 remained, and other items were reviewed or removed based on the suggestions of panelists and developers. The final form included 100 words, 22 pairs of sentences, and 16 questions about using sentences. A total of 356 children (mean±SD age: 34.03±2.12 months) were included in the study. According to the English CDI-III guidelines, the data were divided into four age groups with two-month intervals: 30-31, 32-33, 34-35, and 36-37. The internal consistency of the whole form was 0.97, and internal consistency values of vocabulary, sentences, and sentence usage were calculated as 0.98, 0.88, and 0.88, respectively. The Spearman correlation values between the scores of the form sections and each section with age indicated a significant positive correlation between all sections of the form. Also, the significant positive correlation between age and all three parts showed that the number of expressive words, the grammatical complexity of sentences, and the proper use of sentences increase with age. Conclusion The Persian CDI-III form possesses a good face and content validity and internal consistency to be used as a valid tool for screening language competence of 30-37 months old Persian-speaking children. The results of the mean and standard deviation of the current study can be used as a comparison for screening children suspected of being language deficient.

Translation and Validation of the Greek Version of the Evidence-Based Practice Competency Questionnaire for Registered Nurses (EBP-COQ Prof©).

(1) Background: Evidence-based nursing is the benchmark of the nursing profession. It is widely recognized that evidence enhances knowledge, skills, and competencies in nursing education and thus the quality of patient care. Although several proposals have been introduced to reinforce nurses through education in evidence-based practice (EBP) for clinical practice, there is no validated EBP competence tool to determine how nurses approach evidence-based nursing in healthcare practices in Greece. Therefore, the aim of the present study was to translate and validate the Greek version of the Evidence-Based Practice Competency Questionnaire, Professional version (EBP-COQ Prof©). (2) Methods: A cross-sectional study was conducted in a sample of registered nurses working in the public sector. (3) Results: 414 clinical nurses were recruited in total with a response rate of 75.3% and a mean age of 43 years old. Most of the nursing personnel were females, 354 (85.5%), and there were 60 (14.5%) males. Confirmatory factor analysis (CFA) showed a confirmation of the developer’s four-factor design. The estimated association between items on each scale showed a strong relationship. The competence questionnaire showed a high internal consistency between the components of attitude, knowledge, skills, and utilization. (4) Conclusions: The competence questionnaire shows a strong relationship between four the components, highlighting the four factors that should be promoted to improve the use of EBP nursing practices.

Elevating the IP Competency

<h3>Background</h3> Assessing Infection Prevention competency is a challenge as this profession's responsibilities are vast. Developing an annual competency tool and process aligning with the APIC Competency Model and utilizing Evidence-Based Practices (EBP) is crucial to meet the professional development needs of IPs' with varying experience levels. The goals of this initiative are to standardize the competency process across an academic healthcare system, assess a wide IP skill set and experience level, and improve documentation of competency for regulatory agencies. <h3>Methods</h3> A standard competency tool was developed utilizing EBPs to support a system IP team caring for ambulatory, pediatric, adult, and behavioral health patients. This tool outlined APIC IP domains and an in-depth evaluation of selected domains with case studies requiring research, observation, and analysis. Competencies were completed by self-evaluation and manager consultation. A post competency survey was developed to assess experience and opportunities to improve for future years. <h3>Results</h3> A standard annual competency tool was initiated with 11 IPs. Survey results included 55% of IPs felt they were pushed outside of their comfort zone, 91% felt it was beneficial to their professional development and 63% responded they gained new knowledge/skills they could apply to practice. The in-depth assessment scored in every competency assessment category from novice to expert. Regulatory surveyors provided high regards for an IP specific competency. <h3>Conclusions</h3> The standardized competency tool using EBPs to evaluate competency was successful and well received. This tool elevated leaderships confidence in assessing IP gaps in knowledge and experience to foster individualized and team professional development. This assessment allowed for our expert IPs to showcase their knowledge and foster the development of novice IPs to prepare for certification. The process is a robust method to show evidence of competency for regulatory agencies and will be developed for all department team members based on job description.

Using a Milestone Framework for Assessing Resident, Fellow, and Faculty Competence in Diversity, Equity, and Inclusion.

Graduating residents and fellows who can competently provide equitable and inclusive care to a diverse patient population requires data to monitor progress and outcomes. This data must be continuously gathered and used to guide improvements at the individual program level and at the sponsoring institution level for trainee and faculty growth and development. Recognizing the need for data, the Accreditation Council for Graduate Medical Education (ACGME) updated its 2021 annual Resident/Fellow and Faculty Surveys to include items related to equity and inclusion. Yet, accessible data on the structural competency level of our residents and faculty specific to the areas of health equity, social responsibility, diversity, inclusion, and social determinants of health is limited.1Our aim was to develop and implement a quick, evidence-based, structural competency tool to monitor trainee and faculty proficiency over time. A literature review was completed to identify key competency elements. To facilitate implementation, we framed our assessment to parallel the structure and format of the ACGME's core competency milestone model. Literature-identified elements were plotted in each of the core competency domains with progression delineated across 5 levels resulting in a comprehensive 8-page milestone document. The milestone was then iteratively revised by multiple stakeholders (experts in diversity, equity, and inclusion, ethics, and medical education; faculty; learners; program directors) to create an annotated and referenced 2-page master milestone and an abbreviated milestone with domain threads across levels (eg, Medical Knowledge) for inclusion within each graduate medical education (GME) program's required milestone assessment form and for faculty self-assessment. For example, an element in the domain of Patient Care level 3 (Identifies and incorporates mitigation strategies to address structural risks in patient care) progresses to level 4 (Develops and collaborates with patient on plan of care cognizant of patient's intersectionalites and its influences on their health care values, decisions…). In the Professionalism domain, level 3 (Reconciles personal beliefs and identities with professional role; develops strategies to mitigate own implicit biases; recognizes the contribution of bias to iatrogenic risk and health disparities) progresses to level 4 (Speaks up in the moment [allyship]; utilizes incident reporting mechanism to address microaggressions and/or lateral workplace violence).The milestone was approved by the Graduate Medical Education Committee (GMEC) for inclusion as a required formative trainee assessment in every program beginning in January 2021 and as a request for faculty to complete as a needs assessment. Data are not used for trainee progress (Clinical Competency Committee reviews) or annual faculty performance reviews. Trainee milestone data across programs revealed a consistent progression in the institutional average competence by year of training from 3.1 (postgraduate year [PGY]-1) to 4.4 (PGY-6). The same progression held within each residency and fellowship program. Faculty self-assessment (N&gt;100) revealed that, on average, greater than 50% of the faculty perceived themselves to be at level 4 or higher: range between domains of 53%–79% at or above level 3 by competency domain with SD 1.1 to 1.7. Programs utilize the data as part of their annual program evaluations outlining measurable action steps. At the GMEC level, the data guide GME-wide diversity, equity, and inclusion educational sessions for trainees and faculty.This structural milestone innovation meets our need for data to monitor our trainees' and faculty's competence to guide ongoing program improvements. Formatted like existing ACGME Milestones, implementation within existing trainee competency assessment systems and/or as a faculty self-assessment is seamless, enhancing its utility, feasibility, and transferability. That said, we recognize that milestones are not static; the specific domain inclusions will need to evolve as we do on our equity journey.

Preliminary validation of a new competency tool for evaluating assessment skills in professional psychology trainees.

Preliminary validation of a new competency tool for evaluating assessment skills in professional psychology trainees.

219 Analyzing the NJ ACTS Education and Offering Inventory to Assess Training across the CTSA Consortium

OBJECTIVES/GOALS: The New Jersey Alliance for Clinical and Translational Science (NJ ACTS) interest in developing a comprehensive education and training program for enhancing the quality, efficacy, and safety of the clinical research enterprise led to the release of a survey distributed nationwide to assess initiatives in the translational science workforce. METHODS/STUDY POPULATION: Twenty-one hubs responded to the survey and data was exported from REDCap to Excel. Respondent demographics were categorized to formalize roles and data was categorically divided into sections based on training type (engagement, basic, postgraduate etc…) utilizing conditional formatting. The limitation in this survey was a branching logic defect aligned with questions on competency tool usage and the roles that they play which led to only six hubs having the advantage to respond to all questions. RESULTS/ANTICIPATED RESULTS: Summary findings showed that the majority of respondents for the survey (30%) were the Director of Operations’. Further; the Joint Task Force (JTF) domain Scientific Concepts and Research Design’ was the most preferred Hard Skill (81%) while the least preferred was Investigational Product Development and Regulation’ (29%). In spite of only six hubs receiving the short competency assessment; 50% of those hubs stated they would utilize ‘In House Assessment Tools’ and 83% stated they used the tools to ‘Develop Personalized Training Plans’. The assessment of this Inventory was indeed necessary to identify trends in available trainings across the CTSA consortium. DISCUSSION/SIGNIFICANCE: The internal cross training catalogue will help to develop an infrastructure for the NJ ACTS community to work along with other CTSA hubs while creating comprehensive clinical research training initiatives and programs.

Characterization of Reflective Capacity of Anesthesiology Trainees in an Irish Tertiary Referral Teaching Hospital.

Reflective practice is associated with improved accuracy of medical diagnosis and superior performance in complex situations. Systematic observation of trainees' reflective capacities constitutes a basis for an effective support of reflective practice within the training paradigm. We set out to examine the reflective capacity among anesthesiology trainees in a tertiary referral hospital. We invited 61 anesthesiology trainees in Cork University Hospitals, Ireland, to participate. Each trainee was invited to respond to 2 investigator-written vignettes prepared by the investigators and suitable for evaluation using the Reflection Evaluation for Learners' Enhanced Competencies Tool (REFLECT) and to produce and then respond to a written vignette based on their own experience. All responses were assessed by 2 independent assessors who had undergone training in the application of the REFLECT rubric, which gives quantifiable scores. Interrater reliability was assessed by weighted kappa coefficient. Association between years of training in medicine and level of reflective capacity was examined using correlation and multiple regression analyses, controlling for age. Twenty-nine trainees agreed to participate, the overall REFLECT Level was 2.16 (SD 0.7), corresponding to "thoughtful action," indicating low to moderate reflective ability. Cronbach's alpha for the 5 items of the REFLECT scale was excellent (r = 0.92). Weighted kappa was very satisfactory (k = 0.81). A strong association was demonstrated between years in medicine and scores on REFLECT, controlling for age of participant (F = -2.57, Beta coefficient = -0.30). Respondents with less experience had greater mean REFLECT scores than respondents with more experience (F = 5.5, P = .02; post hoc mean difference = 0.7, P = .03 for ≤32 months vs ≥99 months). There was a significant effect for gender (t = -4.3, P = .001), with women's responses receiving greater REFLECT scores than men's responses (mean difference = 0.67, P = .001). Overall, participants demonstrated low to moderate reflective capacity, as assessed by the REFLECT rubric. Reflective capacity of the anesthesiology trainees appears to decrease as years of medical training progress. However, our respondents were not sampled over time to fully support this conclusion. Further research is needed on the psychometric properties of the REFLECT rubric and the generalizability of our findings.

Item-Level Analysis of a Newly Developed Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT) Using the Rasch Measurement Model.

The Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT) is a tool designed specifically to observe and measure registered dietitian nutritionists’ (RDNs) nutrition-focused physical exam (NFPE) competence in authentic acute care settings. The initial INSPECT items were generated and tested for content and face validity using expert RDNs’ input. The INSPECT was further examined for inter-rater, intra-rater, and internal consistency using clinical supervisor observations of RDNs performing NFPE on patients in real-life acute care settings. These previous studies showed the INSPECT to have excellent content validity, acceptable face validity, good inter-rater reliability, moderate to strong intra-rater reliability, and excellent internal consistency. In the current study, the Rasch measurement model was applied to examine the item-level properties of the INSPECT. Results confirm that the INSPECT measured a single construct. All items fit the established criteria for clinical observations of >0.5 and <1.7, had positive point measure correlations, met the Wright Unidimensionality Index criteria of ≥0.9, exhibited one latent construct with >40% variance explained by the Rasch dimension as well as a sub-dimension based on item difficulty from the principal component analysis of the first contrast Rasch residuals. Rasch rating scale analysis revealed that the rating scale and majority of the items (39/41) fit the Rasch model. Rasch item hierarchy analysis matched the a priori hypothesized hierarchy for the top-most and bottom-most items. Ceiling effects were seen for three items (hand hygiene, personal protective equipment, and patient position) and one item (handgrip using hand dynamometer) reached the floor effect. Rasch reliability assessment demonstrated high person reliability (0.86), high item reliability (0.96), and person separation of 3.56 ability levels. The principal component analysis of residuals revealed two factors based on item difficulty, one for micronutrient exam and another for macronutrient exam, initial steps, and bedside manner. The resulting two factors may likely be due to a sub-dimension of the latent NFPE trait. Overall, the INSPECT items were found to have good item-level psychometrics. Continued testing of the INSPECT with RDNs at different ability levels will help to determine cut-off scores ranging from novice to expert. Establishing cut-off scores for the INSPECT will further enhance the utility of the tool.

Inter-Rater and Intra-Rater Reliability of the INSPECT (Interactive Nutrition Specific Physical Exam Competency Tool) Measured in Multi-Site Acute Care Settings.

Even as new medical modalities, diagnostics, and technologies are rapidly changing healthcare, providing patients with safe, high-quality care remains the central focus. To provide safe patient care, healthcare providers are obligated to demonstrate and maintain the necessary competence. As more healthcare disciplines move toward a competency-based education model, it is essential to extend the competence verification from the academic educational level to the patient’s bedside. The nutrition-focused physical exam (NFPE) is a competency recently adopted by registered dietitian nutritionists (RDNs) for assessing patients’ nutritional status. Being a newly acquired skill, validated tools are required to measure NFPE competence during routine clinical practice. The Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT) is a new tool developed specifically to observe and measure RDNs’ NFPE competence in clinical settings. The INSPECT was designed and validated for content using expert RDNs’ input in the first and second phases of the study. This current study aimed to assess the reliability of the INSPECT through multi-site observations by clinical supervisors evaluating RDNs’ NFPE competency during patient assessment. The INSPECT exhibited good inter-rater reliability (ICC = 0.78 for the first assessment and ICC = 0.68 for the second assessment), moderate to strong intra-rater reliability for 37 of 41 items (Spearman rho = 0.54 to 1.0), and excellent internal consistency (Cronbach’s α = 0.86 for the first assessment and α = 0.92 for the second assessment). In total, 10 out of the 11 INSPECT subsets showed good to excellent internal consistency (α ranging from 0.70 to 0.98). The results demonstrate that the INSPECT is a reliable tool, is stable over time, and has good agreement and excellent consistency between raters. The INSPECT can be a valuable tool to measure, promote and maintain RDNs’ NFPE competence in authentic acute care settings.

Psychometric analysis of Persian version of patient safety competency self-evaluation in psychiatric wards.

BACKGROUND:Assessment of the patient safety competency is necessary for the growth of nursing and safe care profession as well as evaluation of the nurses' educational needs. The present study was conducted to determine psychometric properties of the Persian version of the patient safety competency self-evaluation (PSCSE) tool in Iranian psychiatric wards.MATERIALS AND METHODS:All nurses (n = 209) working in two psychiatric hospitals of Kerman, Iran, were included in the present cross-sectional study using census method. This tool contains 41 items: six items are related to knowledge, 14 items deal with attitude, and 21 items are about skill dimension. Psychometric properties of the questionnaire including its content and face validity were also examined. The factor structure of the questionnaire was evaluated using exploratory factor analysis. The internal consistency and reliability were assessed by test–retest method with an interval of 14 days. Cronbach's alpha and corrected item-total correlation were used to measure reliability.RESULTS:The content validity index was 0.65 and the content validity ratio was 0.89. Item 14 was removed from the skill domain because it was not related to the psychiatric ward. According to the results of factor analysis, there was a significant relationship between the questions and the relevant factors. The correlation coefficient for test–retest with 14 days interval was intraclass correlation coefficient = 0.92 for the whole instrument and 0.89, 0.89, and 0.92 for the domains of knowledge, attitude, and skill, respectively. The internal consistency coefficient (Cronbach's alpha) of the whole tool was 0.95 and 0.95, 0.79, and 0.95 for the domains of knowledge, attitude, and skill, respectively. Finally, PSCSE Questionnaire was obtained with 40 items in dimensions of knowledge (6 items), attitude (14 items), and skills (20 items).CONCLUSION:Persian version of the nurses' competency tool in ensuring patient safety in psychiatric wards has acceptable psychometric characteristics.

Evaluation of competency-driven training for facilitators delivering a psychological intervention for children in Lebanon: a proof-of-concept study.

The mounting evidence for effective delivery of psychological interventions by non-specialists in low- and middle-income settings has led to a rapid expansion of mental health and psychosocial support trainings globally. As such, there is a demand for strategies on how to train and implement these services to attain adequate quality. This study aims to evaluate the added value of a competency-driven approach to training of facilitators for a group intervention for children with severe emotional distress in Lebanon. In a controlled before and after study, 24 trainees were randomly allocated to participate in either a competency-driven training (CDT) or training-as-usual (TAU) (1 : 1) for a psychological intervention for children with severe emotional distress. We assessed the change in demonstrated competencies, using standardised role-plays, before and after the training. Measures included the 13-item Working with children-Assessment of Competencies Tool (WeACT), the 15-item ENhancing Assessment of Common Therapeutic factors (ENACT) and the 6-item Group facilitation: Assessment of Competencies Tool (GroupACT). The trainer in the experimental arm used pre-training and during training competency assessment scores to make real-time adjustment to training delivery. Due to COVID-19 pandemic restrictions, all activities were done remotely. CDT resulted in significantly better outcomes on increasing competencies on the WeACT (repeated measures analysis of variance; F(1, 22) = 6.49, p < 0.018) and on the GroupACT (Mann-Whitney U = 22, p < 0.003), though not statistically significant on the ENACT. There is no significant between-group difference on the reduction of harmful behaviours, mainly because both forms of training appear equally successful in eliminating such behaviours. This proof-of-concept study demonstrates the potential of CDT, using standardised assessment of trainee competencies, to contribute to better training outcomes without extending the duration of training. CDT can result in up to 18% greater increase in adequate competency, when compared to TAU. The study also yields recommendations for further enhancing the benefits of competency-driven strategies. A fully powered trial is needed to confirm these findings.

Supplemental Material for Preliminary Validation of a New Competency Tool for Evaluating Assessment Skills in Professional Psychology Trainees

Supplemental Material for Preliminary Validation of a New Competency Tool for Evaluating Assessment Skills in Professional Psychology Trainees

Developing and piloting a self-assessment tool for medication review competence of practicing pharmacists based on nationally set competence criteria

BackgroundNew competence requirements have emerged for pharmacists as a result of changing societal needs towards more patient-centred practices. Today, medication review competence can be considered as basic pharmaceutical competence. Medication review specific competence criteria and tools for self-assessing the competence are essential in building competences and a shared understanding of medication reviews as a collaborative practice. The aim of this study was to develop and pilot a self-assessment tool for medication review competence among practicing pharmacists in Finland.MethodsThe development of the self-assessment tool was based on the national medication review competence criteria for pharmacists established in Finland in 2017 and piloting the tool among practicing pharmacists in a national online survey in October 2018. The pharmacists self-assessed their medication review competence with a five-point Likert scale ranging from 1 for “very poor/not at all” to 5 for “very good”.ResultsThe internal consistency of the self-assessment tool was high as the range of the competence areas’ Cronbach’s alpha was 0.953–0.973. The competence areas consisted of prescription review competence (20 items, Cronbach’s alpha 0.953), additional statements for medication review competence (11 additional items, Cronbach’s alpha 0.963) and medication review as a whole, including both the statements of prescription review and medication review competence (31 items, Cronbach’s alpha 0.973). Competence items closely related to routine dispensing were most commonly self-estimated to be mastered by the practicing pharmacists who responded (n = 344), while the more clinical and patient-centred competence items had the lowest self-estimates. This indicates that the self-assessment tool works logically and differentiates pharmacists according to competence. The self-assessed medication review competence was at a very good or good level among more than half (55%) of the respondents (n = 344).ConclusionA self-assessment tool for medication review competence was developed and validated. The piloted self-assessment tool can be used for regular evaluation of practicing pharmacists’ medication review competence which is becoming an increasingly important basis for their contribution to patient care and society.

Counselling Skills and Competencies Tool: Scale Development and Preliminary Data

This paper reports on the development of the Counselling Skills and Competencies Tool (CSCT) as a practical instrument that can be used in teaching and assessing counselling skills and competencies. Members of an entry-level counselling course, experienced and beginning counsellors, and people not involved in the counselling profession, assisted in the development and validation process. The outcome was a 23-item, six-scale tool measuring Attending, Reflecting, Questioning, Therapeutic Alliance, Core Counselling Conditions, and Facilitating the Session. The CSCT includes the range of skills and competencies expected of beginning counsellors, was constructed in a way that assists feedback to trainees, and received good interrater and test-retest reliability with this sample. Used appropriately, it has the potential to improve counsellors’ assessment skills in training, and in turn the effectiveness of their subsequent practice.

20.4 EVALUATING COMPETENCIES OF NONSPECIALIST PROVIDERS IN CHILD AND ADOLESCENT MENTAL HEALTH: THE UNICEF-WHO EQUIP INITIATIVE

As delivery of psychological interventions by nonspecialists becomes more commonplace, assurance that training and supervision methods achieve minimum competency standards is needed. The United Nations Children’s Fund and World Health Organization (UNICEF-WHO) Ensuring Quality in Psychological Support (EQUIP) platform is a digital tool to provide guidance on conducting competency-based trainings of nonspecialists. The platform includes competency assessment tools for adults (the ENhancing Assessment of Common Therapeutic Factors [ENACT] tool) and for children (Working with children—Assessment of Competencies Tool [WeACT]), as well as a suite of treatment-specific competency tools for adult- and child-focused psychological interventions. Role-play based (RPB) competency assessment tools were evaluated in a range of global settings for feasibility and acceptability. Study sites included Ethiopia, Kenya, Lebanon, Nepal, the occupied Palestinian territory, Peru, Uganda, and Zambia. In addition, a US pilot of the tool was conducted in New York City (NYC). Acceptability and feasibility were evaluated through both qualitative assessments and evaluation of interrater reliability (IRR) and responsivity to change. IRR ranged from 0.54 to 0.80 across sites and tools. The use of microcompetency video demonstrations of helpful vs potential harmful/unhelpful techniques helped increase IRR. Most individual competencies showed responsivity to change when evaluated pre- vs posttraining. For child competencies, youth drama clubs were feasibly trained to be actors in the standardized role-plays. Competencies were also modified for remote delivery of psychological interventions, which is of particular importance to deliver services during the COVID-19 pandemic. RPB assessments of competencies can be implemented in diverse settings ranging from refugee camps in low-income countries to urban centers of high-income countries (HICs). Rater training and standardized actors require a significant time investment, which can then yield high rates of IRR for observational assessments. With the transition to more remote care, RPB structured competency assessments are increasingly feasible even in low-resource settings. Reciprocal learning with the NYC site demonstrated that the tool can also be beneficial in an HIC.

ROLE OF MOBILE APPLICATIONS IN THE FORMATION OF INFORMATION COMPETENCE OF STUDENTS

"This article deals with the topical issue for modern education about the role of mobile technologies in the formation of students’ information competence. The aim of the article is to consider the main trends in the formation of students’ information competence using mobile technologies in the learning process. The authors of the article give the concept of mobile learning, analyze its advantages and disadvantages. In this paper, mobile applications are considered as a tool for shaping information competence of students. Developed in the study mobile application «TopTaskerGeo» confirms the relevance of introducing mobile technologies in the learning process in order to informatize the educational environment and determines the effectiveness of mobile learning methods in the formation of informational competence of students. According to the survey conducted by the authors, there is an increase in students’ interest in mobile learning and information competence. Despite the fact that there is a small proportion of surveyed students who do not accept innovations and prefer traditional teaching methods, lessons using the mobile application «TopTaskerGeo» are interactive and contribute to the rapid development of information and communication skills. The value of this study is the development and implementation of the mobile application «TopTaskerGeo» in the education system in the study of academic disciplines. "

Content and Face Validation of a Novel, Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT) to Evaluate Registered Dietitians' Competence: A Delphi Consensus from the United States.

The nutrition-focused physical examination (NFPE) is an integral component of nutrition assessment performed by registered dietitian nutritionists (RDNs) to determine signs of malnutrition and other nutrition-related complications. Increased use of this essential skill among RDNs and the transformation of dietetics education to a competency-based model in the near future calls for appropriately validated tools to measure RDNs’ NFPE competence. To fill the need for a validated competency tool, this study developed an Interactive Nutrition-Specific Physical Exam Competency Tool (INSPECT) utilizing the initial 70 items identified in the first phase of the study. The second phase of this study aimed to test the preliminary version of the INSPECT for content and face validity. An expert panel of 17 members provided consensus recommendations through the Delphi process. Internal consistency of the consensus was measured with Cronbach’s alpha (α) and α of ≥0.70 was defined as acceptable a priori. Inter-rater agreement among the expert panel was determined using the intraclass correlation coefficient (ICC) and an a priori ICC of 0.75 to 0.9 was established as good and >0.9 as excellent agreement. The results showed acceptable face validity (α = 0.71) and excellent content validity for the INSPECT, with an internal consistency of α = 0.97 in the first round and α = 0.96 in the second round. The inter-rater agreement was also excellent with ICC = 0.95 for each of the Delphi rounds. A total of 52 items were retained from the preliminary version of the INSPECT. Open feedback from the experts allowed for the consolidation of 11 similar items for better scoring and evaluation and thus, a total of 41 items were included in the final version of the INSPECT. The final version of the INSPECT is currently being studied in real-life, multi-site clinical settings among practicing RDNs to examine construct validity, reliability, and item-level psychometric properties. Ultimately, the validated INSPECT will be available for the competency evaluation of RDNs practicing in clinical settings.

CULTURAL COMPETENCE OF HEALTH CARE WORKERS ON MATERNAL HEALTH CARE SERVICE UTILIZATION AMONG MOTHERS OF MOUNT ELGON CONSTITUENCY BUNGOMA, KENYA

Purpose: To determine cultural competence of health care workers on maternal health care service utilization among mothers of Mt. Elgon Constituency in Bungoma County.&#x0D; Methodology: A descriptive-analytical cross-sectional study design was adopted using mixed methods for data collection. Cultural competence tool was used to assess health care workers cultural competence. Qualitative data was collected using key informant interviews (KII) and focus group discussion (FGD). Data entry and analysis was done using SPSS Version 25 software. Descriptive and inferential statistical analyses were used. Bivariate and multivariate logistic regressions were applied and odds ratio used to determine the strength of association. A p-value of ≤ 0.05 was considered as statistical significance threshold.&#x0D; Findings: Unemployment (OR: 0.6; 95% CI: 0.4 – 0.9; p = 0.02); lack of mobile clinic (OR: 0.7; 95% CI: 0.4 – 1.0; p = 0.06 ); use of interpreter (OR: 0.2; 95% CI: 0.01 – 0.81; p = 0.02); service provided in public facilities (OR: 0.5; 95% CI: 0.3 – 0.8; p = 0.004); being too busy (OR: 0.5; 95% CI: 0.3 – 0.9; p = 0.02); consulting health care workers (OR: 0.5; 95% CI: 0.2 – 0.9; p = 0.03); not consulting elders (OR: 0.7; 95% CI: 0.4 – 1.0; p = 0.08) and culturally incompetent ( 100%) were significantly associated with utilization of maternal and child health services. The determinants of maternal health care service utilization in Mt. Elgon Sub-County are women who are employed (OR: 2.8; 95% CI: 1.1 – 7.3; p=0.03) and cultural incompetence of health care workers (100%).&#x0D; A unique contribution to theory, practice, and policy: The study findings have identified cultural competence gaps among health care workers which need to be addressed by policy makers to increase utilization in the study area and other similar environment