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Michelle M. Byrne RN, PhD, CNOR Kathryn Schroeter RN, PhD, CNOR
Portfolios: Implications for perioperative education, evaluation & competency Assessment Michelle M. Byrne RN, PhD, CNOR Kathryn Schroeter RN, PhD, CNOR
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CCI Research Committee:
Michelle Byrne, RN, PhD, CNOR - Chair Kathryn Schroeter, RN, PhD, CNOR – CCI Board Liaison Teresa Delarose, RN, MN, EdD, CNOR Cecil A. King, RN, MS, CNOR, APN Jane Leske, RN, PhD, APRN-BC Nancymarie Philips, RN, MSEd, CNOR Kathryn G. Sapnas, RN, PhD, CNOR, CCRN
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What do you think of when you think of a portfolio?
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Portfolio - formal definition
Mechanism for evaluation of competencies that may otherwise be difficult to assess, such as practice-based improvements, use of scientific evidence in practice, professional behavior and creative endeavors.
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Artist Portfolio Contents
Artistic products demonstrating a variety of media, foci, and technique. External review by peer or faculty
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Teacher Portfolio Contents
Academic credentials Faculty and peer evaluations Research and publications Service to institution or community Student evaluations Course materials-syllabi & assignments.
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Student Portfolio Contents
Progressive learning. Skill checklist Best exemplars of work. Development of self assessment skills. Reflective learning. Faculty evaluations.
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Physician Portfolio Contents
Course completion or contact hours Certificate requirements Licensing requirements Residency/fellowship applications Peer evaluation Publications and research
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Portfolios Dynamic and offer a fuller and richer image of the individual than paper and pencil evaluation tools.
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Informal definition: A Portfolio is a Scrapbook of your career
Photos Work products Educational offerings or attendance Annual evaluations Letters from employers or patients
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Your Portfolio! Mentoring / Precepting Perioperative Care Plan
Continuing Education Standards & Recommended Practices CQI Clinical Pathway
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Domains of Perioperative Nursing
Based on Perioperative Job Analysis Perioperative Nurse Competency Continuum Study Involvement of Task Force CNOR’s Thomson Prometric staff
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Domains of Perioperative Nursing
Patient assessment & Dx Identify expected outcomes & develop plan of care Intraoperative activities Communication Discharge planning
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Domains of Perioperative Nursing
Cleaning, disinfecting, packaging & sterilizing Emergency situations Management of personnel, services, & materials Professional activities
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Types of Professional Activities
Nursing care planning Clinical pathway development/utilization Development of educational resources Personal continuing education Application project re: AORN standards or PNDS Continuous quality improvement project Evidence-based practice initiative
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Types of Professional Activities
Risk management activities Mentoring / Precepting roles Leadership role Educational presentations Professional writing Academic course completion
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Reflective Learning Reflection is the process of learning from experience. Reflection allows you to use your experience to determine what you may do differently as a result of the learning. Reflection aids ongoing self-assessment & ensures your learning is current and relevant to your practice.
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Reflection Narratives
Thoroughly describe the activity/ project/ event. What happened or occurred? Clearly describe your role. What do you know now that you did not know before?
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Reflection Narratives
What have you learned? What would you do differently? How will you build on this experience? What are the implications for perioperative nursing practice?
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What’s in your portfolio?
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Contributions to professional organizations
Local chapter AORN State Nursing Association Sigma Theta Tau
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Educational Presentation
Staff workshop AORN chapter continuing education Staff orientation (At least three 1 hour presentations are required) Include time/date of presentation, objectives, outcomes, topic outline or handouts, learner evaluations.
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Evidence Based Practice
Provide examples of how research findings were used to validate or change your practice. Risk management Research utilization Research participation Policy/Procedure involvement PNDS
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Professional Writing AORN Journal article
Specialty assembly newsletter article Employer publication Chapter newsletter Letter to the editor
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Educational resources
Patient education guide Employee guide Perioperative inservice Instructional forms
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Continuing Education Narrative of HOW continuing education changed your practice. “After attending this conference, I have an increased awareness of fuel sources and how flammable prep agents are. I am much more verbal in communicating with other team members about the importance of letting prep solutions dry before giving the cautery to the surgeons.”
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Application of Recommended Practices or PNDS
How was this used in your professional practice? Policy/procedure creation or revision Medical legal cases
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Academic Courses Related to perioperative nursing
Either taught or taken—provide syllabus / grade Examples: Specific or general
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Precepting / Mentoring
Provide a narrative including name(s) / credentials of those whom you precepted or mentored along with contact information for a registered nurse colleague who can verify that the information is true and correct. Students, new staff, faculty, etc.
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Nursing Care Plan Provide a nursing care plan that you have developed or modified that illustrates how you were able to individualize a plan of care based on assessment data. Safety protocols, reporting, communication, environmental control, documentation, etc.
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Clinical Pathway Provide a copy of a clinical pathway for which you have participated in the development, revision or utilization for a specific patient population.
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Continuous quality initiative
Provide an example of a continuous quality improvement plan that you developed or participated in that improved perioperative patient care & outcomes. Survey data utilization Provision of technical assistance on a surgical product or new technology
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Certification is linked to continued competency.
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Continued Competency Defined as the application of knowledge and the interpersonal, decision-making, and psychomotor skills expected for the nurse’s practice role, within the context of public health and safety. (NCSBN 1996, 1998)
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Why continued competency?
Institute of Medicine (IOM): Mandate to reduce patient errors. Rate of change and information explosion demands ongoing learning from professionals.
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Do you believe that CE guarantees competency?
The Current Common Competency requirements for nursing licensing boards is continuing education. Do you believe that CE guarantees competency?
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How does one demonstrate learning?
It’s more than just sitting at an educational session at a conference… “You don’t know what you don’t know” “Remember what it was like to not know what you now know” “It was good enough when I graduated…”
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ANA Code of Ethics (Provision 5)
The nurse owes the same duties to self as to others, including the responsibility to preserve integrity & safety, to maintain competence, & to continue personal and professional growth.
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PEW Task Force on Health Care Workforce Regulation
Performance monitoring Proctoring Simulation Continuous clinical practice evaluation
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Monitoring may include:
Chart review Evaluation of clinical practice patterns Simulation Proctoring External Peer Review
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Portfolio Evaluation/rating process
Credibility Dependability Confirmability Adequacy and appropriateness of data Multiple raters
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Portfolio Review Evidence will be reviewed and judged as meeting or not meeting criteria. Two raters-third if disagreement. Reviewers-CNORs
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Assessment or Evaluation
Formative (professional growth and development) Vs Summative (final evaluation of criteria met/unmet)
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Portfolios-Developing a process for CNOR recertification/reactivation
Personal accomplishment Accountability Personal satisfaction Professional credibility Consumer confidence Recognition from others Marketability
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CCI Initiatives Publish information on portfolio utilization in competency assessment Pilot the portfolio project in 2007 Plan to implement the portfolio for recertification and reactivation of CNOR credential in 2008.
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For creator and evaluator!
Portfolios: Tips Time consuming — For creator and evaluator! But it doesn’t have to be!
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