PRIOR LEARNING ASSESSMENT RESEARCH PROJECT IN NURSING Mount Royal College, Calgary, Alberta Purpose of the Research: To assess the impact of PLAR on the advancement of internationally educated nurses into educational programs and employment in nursing

OVERVIEW Development of the PLAR process Challenges Lessons learned

GENESIS OF THE PROJECT Response to the shortage of nurses (predicted need of 211,000 by 2016) Intent to advance internationally educated nurses (IEN’s) into professional nursing education and employment Build on previously acquired knowledge and skills of the IEN

PROJECT STAGES : Stage One: Study and Development Stage Two: Implementation Stage Three: Evaluation

YEAR 1: Study & Development Survey of RN licensure processes & challenges Survey of PLAR in nursing education programs Interviews with nurse employers and managers Interviews with IEN program managers Literature reviews “Barriers and Challenges” summary

CHALLENGES for IENs Complex credentialing processes Challenge of language fluency Knowledge and practice deficits Examination preparation Lack of socialization and mentoring opportunities Financial barriers BN entry Need for employment readiness skills

PLAR ASSESSMENT Establish level of English fluency (use of variety of language tests) Preliminary Diagnostic Exam Competency Assessments assessment of “RN Entry to Practice” competencies Clinical assessment

Preliminary Diagnostic Exam Assessment of general nursing knowledge: Pharmacology Canadian standards of practice Legal and ethical standards General nursing skills and knowledge Analysis, interview and plan

Competency Testing Assessment of General nursing theory and nursing interventions Pharmacology and drug administration Communications and interactional skills Health assessment including physical assessment Nursing standards of practice in Canada Legal, ethical and professional practice decision-making Technology and common clinical skills Teaching and health promotion Clinical judgment, problem-solving and critical thinking Health care systems in Canada Analysis, interview and plan

Assessment Strategies Modified OSCE’s Triple Jump Clinical Judgement Scenarios Self Assessment of Standards of practice

STANDARDS USED for the PLAR ASSESSMENT Comprehensiveness Validity Currency Reliability Authenticity Sufficiency

COMPREHENSIVENESS Survey of Nursing Registrars across Canada Language fluency “Culture” of Canadian nursing, nurse roles Educational opportunities & post- assessment Accessibility and affordability Essentials of entry to practice Consistent standards and processes

VALIDITY Determining a “Benchmark” Canadian RN Entry to Practice competencies 2005 – 2009 Clear, specific language “Currency” and longevity Thorough development process Established validity Used with all entry level nurses

RELIABILITY Assessed reliability of tests and elements of tests with 4 th year graduating students from BN classes at MRC Test-retest consistency Item analysis (item difficulty; item discrimination; equivalence; etc) Marking guides & scoring checklists; standardized tasks and performance standards

AUTHENTICITY Context-specific measures of assessment Complex, integrated, typical nursing “case management” situations developed as basis for modified OSCE testing and modified “Triple Jump” assessment. OSCE: nurse-client interaction; ethical judgment; medication administration; problem-solving; health assessment Triple Jump: complex performance evaluation of critical thinking

Addressing the Challenges SUFFICIENCY When do we have enough information? Variety of assessment measures “Triangulation” Benchmark competencies; performance standards Assessment experience

Addressing the Challenges GAPS AND DEFICITS Specialized language training Upgrading and orientation Meeting the standards of safe practice Adequate, timely, targeted programs

LESSONS LEARNED Comprehensive assessment Nursing-specific language preparation Competency benchmarks Educational opportunities to “fill gaps” Personal support measures Self – knowledge; “Assessment as intervention”

Bridge to Canadian Nursing Program Level Two: Level One: Nursing Theory & Canadian Practice 3 courses, 9 hours of classes per week that address Expectations of nursing practice in Canada Level Three: Preparation for Competencies Assessment Workshops and practice sessions on guided assessment and case-management scenarios * Nursing Clinical Review – 360 hours supervised clinical practice Professional English for Nurses 4 courses, 3 hours per week of nursing specific language training

KEY INNOVATIONS IN THIS PROJECT Case management situations to assess experiential learning and performance (practice-theory integration) Dissemination of findings (January 2006) – web based in both official languages

English as a Second Language Assessment/Study Processes English for Nurses: a nursing-specific approach to language training Pre-post testing: showed increase of over 1 “benchmark” point over 12 weeks of English as a Second Language Assessment/Study Processes study