Competency-based Education Programs Research Articles

A study on the future competency-based pre-service elementary teacher education program

A study on the future competency-based pre-service elementary teacher education program

Fidelity of implementing a competency-based nursing programme during the COVID-19 pandemic: A case study.

The study describes the fidelity of implementing a competency-based nursing education (CBNE) programme during the COVID-19 pandemic in a low-resource setting. A descriptive case study research design integrating mixed methods underpinned by the fidelity of implementation framework was applied to assess teaching, learning and assessment during the COVID-19 pandemic. A survey, focus group and document analysis were applied to collect data from 16 educators, 128 students and eight administrators of a nursing education institution and accessing institutional documents. Data were analysed through descriptive statistics and deductive content analysis and packaging the outcome of the study according to the five elements related to the fidelity of implementation framework. The fidelity of implementing the CBNE programme was satisfactorily maintained as described in the fidelity of implementation framework. However, sequenced progression and programmatic assessments were not aligned with a CBNE programme within the context of the COVID-19 pandemic. This paper proposes strategies to enhance the fidelity of implementing competency-based education during educational disruptions.

Face and Content Validity of an Artificial Eye Model for Secondary Intraocular Lens Fixation via Yamane Technique.

To assess the face and content validity of an artificial eye model for secondary intraocular lens (IOL) fixation via the Yamane technique. Ophthalmologists and residents participated in a 90-minute simulation session on secondary IOL fixation via the Yamane technique. Hands-on practice of this technique was performed on an artificial eye, the Bioniko Okulo BR8. After, all ophthalmologists answered an 18-question survey assessing the face and content validity of the model. Survey responses were recorded on a 5-point double-headed Likert scale, ranging from strongly agree (1)-to-strongly disagree (5) (Figure 1). Twenty-three surveys were completed. Respondents rated the survey with a median response of 1 (strongly agree)-to-3 (neutral). Highest ratings for the model were received for "usefulness for training residents", and "easier to set up and clean-up compared to a cadaver". Lowest ratings were received for realism of the model compared to cadaveric eyes. Statistical analysis revealed no significant difference among identified groups. Ratings for face and content validity were viewed favorably, both with an overall median response of 2.00 (agree). The Bioniko Okulo BR8 shows promise as a valid tool for practicing secondary IOL fixation via the Yamane technique. Considering recent guidelines in competency-based ophthalmology education programs, this model may be a valuable tool over traditional techniques for teaching and improving surgical skill amongst trainees.

Competency and confidence in ECG interpretation among medical students.

To assess competency and confidence in ECG interpretation in medical students across years of medical school and evaluate the associations of various factors, a curriculum change, and student confidence with ECG competency. Four hundred and fourteen (414) third- to sixth-year medical students participated in this cross-sectional study conducted in 2019 in the Hebrew University of Jerusalem, Israel. A voluntary response sample of participants answered a validated, web-based questionnaire, composed of eight ECG strips. Participants were also asked about confidence and sources for ECG education and exposure. Competency and confidence across medical school years were compared using the ANOVA and chi-square tests. Competency was low overall (mean score, SD (standard deviation) 3.23±1.81 out of 8), and higher in sixth-year students compared to third-, fourth- and fifth-year students (4.37±1.69 vs. 2.90±1.82, 2.90±1.54, 2.50±1.56, respectively, F(3,337)=24.425, p<0.0001). There was no difference between students before and after the curriculum change. Work experience in medicine was associated with competency (odds ratio (OR), 7.97; 95% confidence interval (CI), 4.03-15.77, p<0.0001). The reported confidence level was low (median 2 out of 5) and was found to be correlated with the total score achieved (r(332)=0.5, p<0.0001). Student competency was shown to be insufficient throughout medical school. Competency and confidence in ECG interpretation seem to be significantly improved by increased and repetitive exposure to ECG. Thus, strategies to facilitate better ECG skills should involve an extended focus on ECG in the undergraduate and graduate curricula and include competency-based educational programs.

Good Perceived Understanding of and Satisfaction with Competency-Based Education: The 2021 Survey of Faculty and Preceptors in the Future Education Model Graduate Demonstration Programs

Upon completion, participant will be able to articulate perceived understanding of and satisfaction with competency-based education and demonstration programs among faculty and preceptors.

Development of entrustable professional activities for advanced practice nurses education

BackgroundEntrustable professional activity (EPA) framework has gained popularity within competency-based healthcare education programmes across disciplines, professions, and countries. As opposed to traditional time-based approach, EPAs bridge the gaps between competency framework and clinical practice, however, limited information on nursing EPAs highlights a need to develop EPAs specific to graduate nursing education to promote patient safety and quality patient care. ObjectivesThis paper described comprehensively the four-stage approach used to develop and pilot test a set of core EPAs for advanced practice nurse (APN) education. MethodThe four-stage approach used to develop and pilot the EPAs included: 1) team formation, 2) development of conceptual framework, 3) identifying and reviewing core EPAs, and 4) pilot testing the EPAs. Post pilot test and surveys were conducted for the EPA developers, APN preceptors and interns to explore their perceptions and experiences using the EPAs. ResultsA framework of nine core EPAs was developed for APN education, including: 1) perform an initial assessment and formulate management plans, 2) manage follow-up care for a clinical encounter, 3) plan, perform and evaluate care procedures, 4) recognise and manage patients requiring urgent care, 5) manage care transitions within and between health care organisations, 6) recognise and manage pharmacological needs of patients, 7) collaborate with patients, families, and community to improve health through disease prevention and health promotion, 8) participate in health quality improvement initiative, and 9) develop self and others for professional practice. ConclusionDespite the stakeholders having generally positive attitudes towards the use of EPAs, it has its drawbacks. More research is needed to examine the psychometric properties of the EPA assessment tools and evaluate the effectiveness of EPAs in graduate nursing education. Additionally, the described set of core APN EPAs needs more refinement and rigorous testing before it can be implemented on a larger scale.

Competency-Based Education at a Madrasah Aliyah in Sumedang: Eliciting the Organized Programs

The competency-based education program is a flagship program launched by a Madrasah Aliyah (or, MA; Islamic based senior high school) in Sumedang to produce graduates who are competent and skillful, especially in the automotive, culinary, fashion, and technology. Students are expected to be able to compete in the professional fields. In this article, the implementation of the program is discussed, which is seriously trying to increase the competence of graduates. The method used in this present study is a mixed method with the techniques of documentation, observation studies and questionnaires to determine the students' number of inputs, their interest in the competency program in that school, and the existing programs. The results show that 100% of the students chose and followed the competency program according to their desires and talents, and because of willingness to get better opportunities after graduating. Moreover, it was found that the four competences offered have increased students’ participation in learning. Future recommendations are provided in this article.

Validation of Strategic Coaching Model for FlexIT-Pro Online-based Competency-based Education Program

Competency-based education (CBE) is a growing movement of higher education institutions to educate non-traditional adult learners. Coaching quality influences CBE's success as coaches share learning responsibility with students. FlexIT-Pro is a modified CBE program. After years of effective coaching, we developed a FITP Strategic Coaching Model and implemented it. This paper will present the Strategic Coaching Model, the assessment of the model, and the modified version of the model.

Pediatric Chronic Tracheostomy Care: An Evaluation of an Innovative Competency-Based Education Program for Community Health Care Providers.

ObjectiveTo evaluate the immediate and sustained knowledge retention and sense of self-efficacy of homecare nurses following completion of a standardized competency-based tracheostomy education course. Safe discharge of children requiring tracheostomy with or without ventilation relies on the competence of homecare nurses.Study DesignPragmatic, randomized controlled trial of 44 homecare nurses. Participants were randomized into the intervention group (n = 21), which received the tracheostomy course, or the control group (n = 23), which received an enterostomy and vascular access course. Multiple-choice question (MCQ) knowledge assessments and self-efficacy questionnaires were administered to both groups pre-course and post-course at 6 week, 3 month, 6 month, and 12 month follow-ups.ResultsTwenty participants in the intervention group and 19 in the control group were included. Four withdrew from the study and two crossed over from the control into the intervention arm. The change in mean self-efficacy scores (total score = 100) was significantly higher in the intervention group than in the control group at 6 weeks (intervention (mean ± SD): 18.6 ± 14.5; control: 6.6 ± 20.4; p = 0.04) and 3 months (intervention: 19.6 ± 14.2; control: 5.2 ± 17.0; p = 0.007), and trended higher at 6 months (intervention: 18.0 ± 14.5; control: 6.9 ± 24.1; p = 0.1). The change in mean MCQ assessment scores (total score = 20) trended higher in the intervention group than in the control group at 6 weeks (intervention (mean ± SD): 1.8 ± 2.2; control: 1.6, ± 2.9; p = 0.8).ConclusionsHomecare nurses who attended the tracheostomy course demonstrated a higher sense of self-efficacy at long-term follow-up.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT04559932.

Effects of a Competency-Based Education Program for Inpatient Psychiatric Nurses: A Pre-Post Intervention Study

Purpose: This study aimed to develop a competency-based educational program for strengthening the competency of psychiatric nurses and evaluate its effects.Methods: The study used a quasi-experimental design. Participants included 64 psychiatric nurses in South Korea: 33 nurses (32 females, 1 male) in the experimental group and 31 nurses (26 females, 5 males) in the control group. A competency-based education program for psychiatric nurses was developed through a literature review and discussion with 12 experts. The program addressed eight topics and provided 24 hours of education over 4 days, for 6 hours each day. The collected data via questionnaires were analyzed statistically.Results: The education program enhanced overall clinical nursing competence and strengthened professional self-growth competence. The management and teaching competencies of both the experimental and the control groups also increased significantly.Conclusion: The findings of this study presented an educational program to strengthen the clinical competency of psychiatric nurses and it was proven that the education had a capacity-building effect.

Optimizing the integration of family caregivers in the delivery of person-centered care: evaluation of an educational program for the healthcare workforce

BackgroundWhile family caregivers provide 70-90% of care for people living in the community and assist with 10-30% of the care in congregate living, most healthcare providers do not meaningfully involve family caregivers as partners in care. Recent research recommends that the healthcare workforce receive competency-based education to identify, assess, support, and partner with family caregivers across the care trajectory.ObjectiveThis paper reports a mixed-methods evaluation of a person-centered competency-based education program on Caregiver-Centered Care for the healthcare workforce.MethodsThis foundational education was designed for all healthcare providers and trainees who work with family caregivers and is offered free online (caregivercare.ca). Healthcare providers from five healthcare settings (primary, acute, home, supportive living, long-term care) and trainees in medicine, nursing, and allied health were recruited via email and social media. We used the Kirkpatrick-Barr health workforce training evaluation framework to evaluate the education program, measuring various healthcare providers’ learner satisfaction with the content (Level 1), pre-post changes in knowledge and confidence when working with family caregivers (Level 2), and changes in behaviors in practice (Level 3).ResultsParticipants were primarily healthcare employees (68.9%) and trainees (21.7%) and represented 5 healthcare settings. Evaluation of the first 161 learners completing the program indicated that on a 5-point Likert scale, the majority were satisfied with the overall quality of the education (Mean(M) = 4.69; SD = .60). Paired T-tests indicated that out of a score of 50, post-education changes in knowledge and confidence to work with family caregivers was significantly higher than pre-education scores (pre M = 38.90, SD = 6.90; post M = 46.60, SD = 4.10; t(150) = − 16.75, p < .0001). Qualitative results derived from open responses echoed the quantitative findings in satisfaction with the education delivery as well as improvements in learners’ knowledge and confidence.ConclusionHealth workforce education to provide person-centered care to all family caregivers is an innovative approach to addressing the current inconsistent system of supports for family caregivers. The education program evaluated here was effective at increasing self-reported knowledge and confidence to work with family caregivers.

A Systems Thinking approach for the creation of effective competency-based medical education programs

Successful and sustainable implementation of Competency-based Medical Education (CBME) programs is a significant and daunting challenge facing medical education worldwide. Our manuscript endorses for the first time, Systems Thinking as a concept for transforming and redesigning CBME programs employing the full 7-system elements as advocated by the Biomatrix Systems Theory. The majority of internationally recommended actions and processes for such an endeavor are highlighted, each within its system element. New innovative ideas such as having competency-structured clinical training activities as well as re-writing medical textbooks following a novel competency-based roadmap for their disease monographs etc. are also highlighted. Furthermore, the need for innovative partnerships as well as novel medical rotations that may facilitate the creation of “master clinicians” are also stressed.

The impact of nursing staff education on diabetes inpatient glucose management: a pilot cluster randomised controlled trial

BackgroundAn increasing number of patients in hospital have diabetes, with most of them cared for by non-specialist staff. The effect of diabetes education for staff on patient outcomes, as well as the most effective method of staff education is unclear. Therefore, the aim of this study was to compare diabetes outcomes in medical wards where nursing staff were offered one face-to-face (F2F) session followed by access to online education (online), F2F education only, or standard care (control).MethodsWe conducted a pilot cluster randomised controlled trial involving 16-weeks baseline/rollout followed by a 28-week post-intervention period across three medical wards (clusters) in a Sydney Teaching Hospital. The online ward provided an online competency-based diabetes education program and 1-h F2F teaching from a diabetes nurse educator (DNE), the F2F ward provided four separate 1-h teaching sessions by a DNE, with no additional sessions in the control ward. The primary outcome was length of stay (LOS); secondary outcomes included good diabetes days (GDD), hypoglycaemia and medication errors. Poisson and binary logistic regression were used to compare clusters.ResultsStaff attendance/completion of ≥ 2 topics was greater with online than F2F education [39/48 (81%) vs 10/33 (30%); p < 0.001]. Among the 827/881 patients, there was no difference in LOS change between online [Median(IQR) 5(2–8) to 4(2–7) days], F2F [7(4–14) to 5(3–13) days] or control wards [5(3–9) to 5(3–7) days]. GDD improved only in the online ward 4.7(2.7–7.0) to 6.0(2.3–7.0) days; p = 0.038. Total patients with hypoglycaemia and appropriately treated hypoglycaemia increased in the online ward.ConclusionsThe inclusion of online education increased diabetes training uptake among nursing staff. GDD and appropriate hypoglycaemia management increased in the online education wards.Trial registrationProspectively registered on the Australia New Zealand Clinical Trials Registry (ANZCTR) on 24/05/2017: ACTRN12617000762358.

Multi-source feedback following simulated resuscitation scenarios: a qualitative study.

BackgroundThe direct observation and assessment of learners’ resuscitation skills by an attending physician is challenging due to the unpredictable and time-sensitive nature of these events. Multisource feedback (MSF) may address this challenge and improve the quality of assessments provided to learners. We aimed to describe the similarities and differences in the assessment rationale of attending physicians, registered nurses, and resident peers in the context of a simulation-based resuscitation curriculum.MethodsWe conducted a qualitative content analysis of narrative MSF of medical residents in their first postgraduate year of training who were participating in a simulation-based resuscitation course at two Canadian institutions. Assessments included an entrustment score and narrative comments from attending physicians, registered nurses, and resident peers in addition to self-assessment. Narrative comments were transcribed and analyzed thematically using a constant comparative method.ResultsAll 87 residents (100%) participating in the 2017-2018 course provided consent. A total of 223 assessments were included in our analysis. Four themes emerged from the narrative data: 1) Communication, 2) Leadership, 3) Demeanor, and 4) Medical Expert. Relative to other assessor groups, feedback from nurses focused on patient-centred care and communication while attending physicians focused on the medical expert theme. Peer feedback was the most positive. Self-assessments included comments within each of the four themes.ConclusionsIn the context of a simulation-based resuscitation curriculum, MSF provided learners with different perspectives in their narrative assessment rationale and may offer a more holistic assessment of resuscitation skills within a competency-based medical education (CBME) program of assessment.

Exploring newly qualified midwives' experiences of acquiring competence and confidence during midwifery training in Zimbabwe

Background/Aims In Zimbabwe, a 1-year hospital-centred competency-based midwifery training model aims to prepare graduates for clinical practice according to the International Confederation of Midwives Global Standards for Midwifery Education. This model exposes students to various interactive environments from which they gain experiences through a transformational learning process. Their experiences of this programme have never been investigated. This study aimed to explore newly qualified midwives' experiences of acquiring competence and confidence during midwifery training in Zimbabwe. Methods An exploratory qualitative study was conducted at three of the 22 hospital-based midwifery training institutions in Zimbabwe. The study used a classical grounded theory approach and in-depth interviews to achieve data saturation with 35 participants. Purposive sampling was used to select participants followed by theoretical sampling. Sampling stopped when no new analytical insights were being identified. Data were analysed using constant comparison. Results The interviews revealed the reflective experiences of newly qualified midwives during midwifery training. The main theme ‘being transformed’ emerged, and a model related to transformational learning process was developed with the following stages: ‘being engaged’, ‘entering into a relationship’ and ‘being challenged’ during the learning process. Conclusions: The core theme, being transformed, highlights students' educational journeys to becoming professionally qualified midwives. Respectful teaching and creating positive inter-team relationships are essential in implementing competency-based midwifery education programmes. Midwifery education policies should sufficiently support students during training to transform and prepare them for competent midwifery practice.

Need to review anaesthesia curriculum and education!

Need to review anaesthesia curriculum and education!

Person-Centered Care for Family Caregivers: Co-Designing an Education Program for the Healthcare Workforce

Background: Research recommends the healthcare workforce receive competency-based education to support family-caregivers [FCGs}. typically, education has been directed at FCG’s to increase their care skills rather that at healthcare providers to provide person-centered care to FCGs. Objectives: We present the co-design process used to create a competency-based education program for the healthcare workforce that ensures a person-centered focus on FCGs and introduce our Health Workforce Caregiver-Centered Care Education. Approach: Co-design is the act of creating with stakeholders to ensure useable results that meet stakeholder’s needs. We began by coining the concept “caregiver-centered care,” defined as a collaborative working relationship between families and healthcare providers aimed at supporting FCGs in their caregiving role, decisions about care management, and advocacy. From this definition we co-designed, then validated the Caregiver-Centered Care Competency Framework in a Delphi Process. Stakeholders (n= 101) including FCGs, providers, policy makers, community organizations, researchers, and educational designers then used effective practices for health workforce education to co-design the ‘foundational’ level of a Caregiver Centered Care education. Results: Teaching and learning resources include six competency-aligned educational modules with videos and interactive exercises that encourage reflection. With the COVID-19 pandemic, we moved the education online (caregivercare.ca). In the first four months online, 815healthcare providers completed the education. We continue to use mixed methods to evaluate the Caregiver-Centered Care Education, for acceptability and effectiveness, in five care contexts (primary, acute, home, supportive living, long-term care). Conclusion: We expect that our education will support caregiver-centered care in all healthcare settings.

Person-centered care for family caregivers of people living with dementia: Co-designing an education program for the healthcare workforce.

Recent research recommends the healthcare workforce receive competency-based education to identify, assess, support and partner with family-caregivers [FCGs} across the care trajectory.[1 2] Although the risk of FCG anxiety, burden, and loneliness to FCG's wellbeing is widely documented, typically education has been targeted towards FCG's to increase their care skills rather to educate healthcare providers to support FCG's caregiving and wellbeing.[3] OBJECTIVES: We will present the co-design process used to create a competency-based education program for the healthcare workforce that ensures a person-centered focus on FCGs and introduce our Health Workforce Caregiver-Centered Care Education focused on dementia. Co-design is the act of creating with stakeholders to ensure the results meet their needs and are usable. We began by coining the concept "caregiver-centered care," defining it as: a collaborative working relationship between families and healthcare providers aimed at supporting FCGs in their caregiving role, decisions about services, care management, and advocacy [4 5] . From this definition, and working with multi-level interdisciplinary stakeholders we designed[6] and validated[7] a Caregiver-Centered Care Competency Framework in a Modified Delphi Process. Stakeholders (n= 101) including FCGs, health providers, policy makers, community organizations, research team, script writer, and educational designers then used effective practices for dementia education for the health workforce [8-11] to co-design the first or 'foundational' level of a Caregiver Centered Care education program. Teaching and learning resources include six competency-aligned educational modules with videos and interactive exercises that encourage reflection. With the COVID-19 pandemic, we moved the education online (caregivercare.ca). In the first two months online, November 9, 2020-January 9, 2021, 352 healthcare providers completed the education. To date, learners' qualitative evaluations have been positive, "Very good information for professionals working with caregivers; especially relevant to homecare, geriatricians, allied health, and others working within the Seniors' Health realm. Engaging format that really evokes empathy for caregivers." We continue to use mixed methods to evaluate the Caregiver-Centered Care Education, for acceptability and effectiveness, in five care contexts (primary, acute, home, supportive living, long-term care). We expect that our education will support caregiver-centered care in all settings providing dementia-related care.

A Data Capture and Analysis Tool for a Future Education Model Future Graduate Program

Understand the development and application of the digital tool for multi-purposes student and program evaluation and improvement. Tool Requirement ACEND Future Graduate Future Education Model programs are required to assess and report competency-based education student and program outcomes, graduated student Commission on Dietetic Registration examination pass rates, student and employer feedback. There is a paucity of available tools for program directors and coordinators to streamline data collection, analyze and report outcomes in an efficient and comprehensive manner. Tool Development Required program data is often fragmented in various locations. For example, didactic course competency performance indicators (PIs) are captured via rubrics in a learning management system such as Canvas and through clinical education management, EXXAT for supervised experiential learning. Program outcomes are collected elsewhere. Few tools are compatible with each other. To consolidate multiple data sites, Pacific created a unified tool with Microsoft Access application. Unique Characteristics Microsoft Access is a relational database system with the capacity to import excel spreadsheets from other systems such as Canvas and EXXAT. As relational database, software is “aware” of how the data are organized and related across the database tables. Forms and surveys are created from tables or queries for user-friendly entering data into the database in real time. Reports are generated and linked to curriculum mapping, expected program thresholds, survey results, and competency PI outcomes per student, course, cohort and program. Evaluation and Application This new tool efficiently assesses and tracks program and student competency PIs. Its ability to manage and organize large amounts of program data provides ‘real time’ evaluation and reporting for program quality improvement and ongoing evaluation.

The use of EPA assessments in decision-making: Do supervision ratings correlate with other measures of clinical performance?

Background Entrustable professional activities (EPAs) have been introduced as a framework for teaching and assessment in competency-based educational programs. With growing use, has come a call to examine the validity of EPA assessments. We sought to explore the correlation of EPA assessments with other clinical performance measures to support use of supervision ratings in decisions about medical students’ curricular progression. Methods Spearman rank coefficients were used to determine correlation of supervision ratings from EPA assessments with scores on clerkship evaluations and performance on an end-of-clerkship-year Objective Structured Clinical Examination (CPX). Results Both overall clinical evaluation items score (rho 0.40; n = 166) and CPX patient encounter domain score (rho 0.31; n = 149) showed significant correlation with students’ overall mean EPA supervision rating during the clerkship year. There was significant correlation between mean supervision rating for EPA assessments of history, exam, note, and oral presentation skills with scores for these skills on clerkship evaluations; less so on the CPX. Conclusions Correlation of EPA supervision ratings with commonly used clinical performance measures offers support for their use in undergraduate medical education. Data supporting the validity of EPA assessments promotes stakeholders’ acceptance of their use in summative decisions about students’ readiness for increased patient care responsibility.