Competency Assessment: One Institution s Shift in Thinking Patricia Meehan MSN CCRN Colleen Nixon MSN CPHON

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1 Annual Conference July 20-22, 2016 INTRODUCTION We would like to take this opportunity to share with you our experiences at this year s ANPD conference. We attended many informative talks and our own presentations were well received. There were several posters with innovative ideas we may want to consider incorporating in to our own practice. Many of us have contributed to this newsletter a summary of a presentation we attended and what we learned. We hope you find this newsletter informative and that we get your ideas flowing as next year s conference is July in New Orleans, LA. Thank you for covering shifts and supporting us as we practiced our presentations. We look forward to having you join us at next year s conference. PRESENTATIONS BY BCH STAFF Attendees of the 2016 ANPD National Convention: Marilyn Moonan, Colleen Nixon, Lauren Danforth, Shelly Pignataro, Karen Conwell, Trish Meehan, Dennis Doherty and Greg Durkin Posters Integrative Nurse of the Future Core Competencies into a Pediatric Nurse Residency Program Karen Conwell MSN RN CPNP Ashley Waddell MSN RN Utilizing Our Resources: Collaborating to Support the Transition to Practice Karen Conwell MSN RN CPNP Dennis Doherty MSN RN-BC CCRN Partnering to Take Charge of Communication Skills Development Dennis Doherty MSN RN-BC CCRN Lauren Danforth BSN RN CCRN Competency Assessment: One Institution s Shift in Thinking Patricia Meehan MSN CCRN Colleen Nixon MSN CPHON Decentralized Educators Working in a Centralized Role: Does This Blended Model Work? Marilyn Moonan MSN RN CPN Shelly Pignataro MSN RN-BC Promoting Nurse Practitioner Professional Development through Nursing Education and Nurse Practitioner Collaboration Shelly Pignataro MSN RN-BC Karen Conwell MSN RN CPNP Podium Developing Competencies for the Nursing Professional Development Specialist Greg Durkin M.Ed. RN-BC Nursing Professional Development Certification Preparation Course (2-day)

2 Page 2 WHAT WE LEARNED: PATRICIA MEEHAN: I attended first my first Association for Nursing Professional Development Conference in Pittsburgh this July. One never knows what to expect but I was pleasantly surprised. The theme was to Inquire and that is what the Boston contingent did. The opening talk spoke to the group s new Scope and Standards which will aid educators to aligned and focus their pathways. Many of the presentations spoke to methods to support preceptors, transformative methods of delivery education, simulation ideas, and onboarding new graduates. One of my favorite presentations was on the brain s ability to retain information and encoding memories. Personally speaking I brought back some tools that I hope to embed into my education programs to enhance the process, increase knowledge and add creativeness into the process of education. Besides Trisha Meehan attending her first ANPD conference, there were other firsts in Pittsburgh.. First labor union, started in 1881 First federal hospital in America, founded in 1778 First heart, liver and kidney transplant in one operation at Presbyterian University Hospital, 1989 First community supported public television in the USA, 1954 KAREN CONWELL: Art Kohn s Boost One of the most exciting and insightful keynote presentations was from Duke University s Art Kohn. Dr. Kohn s research shows how neurological, cognitive, and social factors can improve learning, retention and behavior change. He quoted an unbelievable statistic - people forget 50% of what they learn within an hour and 70% within a day. In his session, Professor Art Kohn described his scientific research that demonstrated how to produce sustainable learning and behavior change. He reviewed a technique called Boosting It is based on the theory that what we do after training can be more important than what we do during training. It entails providing learners with a series of retrieval opportunities, known as boosters, in the hours and days after training, this in turn will cause the learner's brain to regard information as important and retain it. A booster can take many forms. It can be a multiple-choice question, a poll, or even a short-answer question. The experience can be very short. What is important is that learners need to retrieve the information from long-term memory, thereby signaling their brains that the information is valuable and should be retained. He challenged us as nursing educators to make our goal longterm retention and produce behavior change and to make our focus what we do after training more important than what we do during training. If we do nothing, clinical nurses will forget most of our training. However, if we provide them with a series of booster experiences, we will signal the learner s brain that that particular information is important and, in turn, they will be far more likely to remember it.

3 Page 3 MARILYN MOONAN: We were all energized by the opening general session: Nursing Professional Development 2016: Scope and Standards of Practice Update, presented by Mary Harper, PhD, RN-BC & Patsy Maloney, EdD, RN- BC, CEN, NEA-BC. For the past year, a group of nursing professional development specialists has been revising the current NPD Scope and Standards, which describe our specialty. The Scope and Standards of Practice Update was presented during this session. The Scope and Standards were last revised in The American Nurses Association (ANA) recommends revision every 5 years. In essence, the scope of practice was broadened, due to increasing demands. It is best represented by the NPD Practice Model. NPD practitioners are RNs who influence professional role competence & professional growth of learners in a variety of settings. The roles of the NPD practitioner include: Learning facilitator (educator) Change Agent Mentor Leader Champion for Scientific Inquiry Advocacy for NPD Specialty Partner for Practice Transition The Association for Nursing Professional Development (ANPD) is advocating for 2 levels of practice for NPD Practitioners: NPD Generalists: BSN with or without NPD certification OR MSN with NPD certification NPD Specialists: MSN with NPD certification (or graduate degree in related field with BSN & NPD cert.) Responsibilities of NPD practitioners include: Onboarding/Orientation Competency management Education Professional role development Research/evidence-based practice/quality improvement Collaborative partnership I found this session to be very helpful in defining my role. The education coordinator /clinical nurse educator role varies so much from unit to unit and from program to program. In this regard, the scope and standards clarify what the Association for Nursing Professional Development (ANPD) defines as our roles and responsibilities. It helps me, personally, to focus on what is important when I am presented with so many competing requests. As a side note, there is a new book that further defines the scope and standards: Nursing Professional Development: Scope & Standards of Practice 3 rd Edition by Harper, M. & Maloney, P. You can purchase this from the ANPD website. It costs $35.00 and is well worth the money. It further describes the practice model, standards, responsibilities, and much more. The speakers emphasizes that we have a pivotal role in helping our organization adapt to the demands of healthcare change. There are bridges all over the city of Pittsburgh bridges to be exact. The bridges connect three major rivers, the Allegheny River, the Monongahela River and the Ohio River.

4 Page 4 SHELLY PIGNATARO: Dr. Marlene Kramer, PhD, RN, FAAN presented an uplifting and thoughtful discussion around the challenges of integrating clinical nurses into the professional nursing practice role. Dr. Kramer validated the five most common nursing professional development challenges including: 1. The understanding/teaching the concept of professional practice 2. Incorporating structure/process/ practices and outcomes into Education 3. Distinguishing between part task/newtonian science and the holistic professional complex theory 4. Understanding the multiple patient/simultaneity complexity confronting majority of nurses in PNP 5. Understanding deficiencies in education/orientation of others including clinical nurses, unit managers, MDs and nurse executives Using humor and her fascinating experiences as a nurse and nurse scientist, Marlene energized the crowd as she discussed the differences between the Newtonian/Industrial models that are often in our medical models of healthcare practices where there is the thought that there is only one way to do things. Instead, Dr. Kramer suggested that we adopt a more complex science mentality in which we accept that the universe is not stable, predictable or as controllable as we thought it to be and that due to the multiple systems and structures there is a need for continuous evolvement in order to meet the demands of the practice environments. One suggestion by Dr. Kramer was the need to shift nursing mentality to that of a true profession versus a nursing job. This included shifting the terminology and nomenclature from bedside or staff nurse to clinical nurses at the bedside or nurse manager to unit manager. Her thought process is that it is insulting to the profession of nursing to say that a nurse manager manages nurses as we are well trained professionals that need to work with all members of the team and therefore are not managed but rather are practicing inter-professionally with all members of the healthcare system. Another highlight of Dr. Kramer s discussion included the importance of understanding and appreciating practice transitions. As she stated no one on orientation should be labeled- they are in a transition period and therefore may not be acting/responding as they may normally. By understanding that there is a transition period and advocating this for our learners we can shift the thinking and solidify nursing as a professional practice. In summary, Dr. Kramer highlighted that Newtonian science is not wrong; it just doesn t explain everything or capture the essence of what nurses do. However, it is important to know that reimbursement structures for care are based on Newtonian science so as nurses we must advocate for changes in mentality around the complexities of what we do. Additionally, everyone needs to understand the terminology shift from delivery systems to professional nursing practice. As educators we must embrace and teach/learn the essence of the structures, processes and outcomes as well as the Newtonian vs. Complex Adaptive systems in which we work. Finally, as nursing professional development practitioners we must work with the leadership in our organization to communicate the ANPD goals and structure for nursing professional development practice and how it relates to our practices here at Boston Children s Hospital. Enjoying the views of Pittsburgh!

5 D ENNIS DOHERTY: One of the sessions which jumped out to me when I was looking at the concurrent sessions was Fostering Reflective Practice among Novice Nurses: A Critical Role for Preceptors. Dr. Marilyn Asselin and PhD. Candidate Robbin Miraglia presented on their research on using reflection as a strategy to change behavior. Reflection is a valuable strategy to promote criticalthinking and reasoning, generate new knowledge, and promote share learning. A key point the presenters made is the reflection is skill that must be practiced and they see reflection as something that preceptors educated on so that they can facilitate reflection in their preceptees. When describing reflection it has been viewed as thinking back, seeing things differently, or dealing with emotions. In reality the outcome of a full reflective practice is that the participant gains insight to bring into future practice. Robbin Miraglia presented two reflective narratives from her qualitative research. Both were from novice nurses and described experiences with poor patient outcomes. In the first narrative the reflection did not progress beyond the individuals emotions of selfdoubt. There was no insight to be applied to future practice. In the second reflection the nurse identified things that she would do differently in the future. Robbin and Dr. Asselin identify preceptors as the individuals who need skill in coaching through reflective practice Page 5 as they have the insight to the individuals practice. In my role as clinical instructor there is a focus on reflection through assignments such as weekly journals. I can see that many of my students likely do not complete a full reflective practice exercise in these assignments and this session will give me something to look for in the future. Examining my experience as nurse, preceptor, and professional development specialist I see room to incorporate more formal reflective practice into our orientation curriculum. Do you have a space for formal reflective practice in your orientation program? If you do I would love to hear more about what you are doing. Dennis and Lauren practicing mindfulness :)

6 Page 6 COLLEEN NIXON : The talk that excited me the most was called: Flipping the Classroom to Improve Engagement, presented by Dawn Nelson. I have to admit, I had not heard of a flipped classroom, but the idea behind this instructional strategy that reverses the traditional learning environment by delivering instructional content, often online, outside of the classroom. It moves information traditionally presented in a classroom, to be assigned ahead of the class, so the studying is done ahead of the class, at their own pace, and attendees come prepared to engage in concepts in the classroom with the guidance of the presenter. Using this strategy, the learner has expectations, understands the objectives in advance and comes to the class prepared to discuss/review the content. This also encourages ownership by the learner as well as a more prepared learner. The idea of the flipped classroom was introduced in 2007, by two high school teachers who discovered a solution in a technology magazine: software that could record a PowerPoint slide show with voice and notes. The resulting video file could be easily shared. In the spring of 2007, they began recording all their lectures and turned them into video presentations. The next year, they decided to use the technique for all their classes. The called it prebroadcasting." Students would view the presentation before school. In class, they would discuss it, experiment with the material and receive assistance from their teachers. This type of class is how CPR is offered at BCH. The online module is assigned ahead of the class and participants come in prepared during their scheduled time to demonstrate the skills they have learned. I am excited to try and take one or two of the upcoming educational sessions we will be offering in the fall for new hires and flip the classroom to evaluate the effectiveness of this type of learning. Experience from others has shown more staff engagement and participation and better use of critical thinking with an overall increase in retention of education. Submit an Abstract for 2017 Convention Inspire your nursing professional development peers and present at the 2017 Annual Convention, July in New Orleans, LA! Share opinions, experiences, lessons learned and fresh approaches. Deadline is fast approaching: September 6th at 11:59pm!

7 Page 7 POSTERS: Congratulations to Shelly Pignataro who received the Excellence in Professional Development Leader/Communicator Practice Award. Shelly was nominated by Marilyn Moonan and Herminia Shermot and the award is judged on the following criteria Provides support and direction to carry out organizational goals. Promotes nursing professional development as a practice specialty. Uses effective communication skills. Demonstrates leadership on a professional level, maintaining appropriate competencies and involvement in activities at community, national, or international levels. Influences change processes. Integrates ethical principles in all aspects of practice. Way to go Shelly! Greg getting ready to teach the Nursing Professional Development Certification Preparation Course (2-day)