CONTINUED COMPETENCE PANEL PRESENTATION

Transcription

1 CONTINUED COMPETENCE PANEL PRESENTATION Karen Plaus PhD, CRNA, FAAN National Board of Certification and Recertification for Nurse Anesthetists Cheryl Gross, MA, CAE American Osteopathic Association Pat Heeter National Board for Certification in Occupational Therapy James P. Henderson, PhD Castle Worldwide Jerry B. Reid, PhD The American Registry of Radiologic Technologists 1

2 Learning Objectives: To highlight state-of-the-art strategies for measuring continuing competence as a condition of recertification. To continue ICE's long standing educational efforts to assist member boards in developing lifelong learning policies and programs. Outline Introduction Karen Plaus Overview What is continued competence and why the need now Jerry Reid Organizational Examples American Osteopathic Association NBCOT NBCRNA ARRT Questions & Answers 2

3 Session Overview 1. What is Continued Competence? 2. Why is it Receiving Increased Attention? Continued Competence Defined (Version 1) The definition of continued competence is the same as the definition of competence at the point of initial certification, just at a later point in time. *Assumes you have defined competence at the point of initial certification. 3

4 Continued Competence Defined (Version 2) Continued competence is defined as being different (less focused/more focused, less stringent/more stringent, etc.) than competence at the point of initial certification. What is the Correct Way to Define? Either way so long as the construct of competence at the point of initial certification and at points beyond is clearly defined, widely communicated, and the requirements for initial certification and ongoing certification are consistent with the definition (if the same) or definitions (if they are different). 4

5 Certification: The Ice Handbook (2 nd Edition) Continued competence is the ability to provide service at specified levels of knowledge and skill, not only at the time of initial certification but throughout an individual s professional career. Why the Increased Attention? 1. Pace of Change 2. Consumer Expectations 3. Evolution of Certification Role certified Knowledge base required Better informed More demanding Maturation as a science Trailblazers 5

6 American Osteopathic Association Cheryl Gross, MA, CAE AOA Bureau of Osteopathic Specialists Organized in 1939 The official certifying body of the AOA 18 specialty certifying boards Nearly 90 specialty and subspecialty certifications Oversees and implements all certification and recertification policies and procedures 18 specialty certifying boards Oversees development and implementation of Osteopathic Continuous Certification (OCC) 6

7 AOA Certifications PRIMARY CERTIFICATION CAQ CAQ C S Q CAQ CAQ Influencing Factors on the Development of OCC Alllopathic MOC AOA CAP Program Performance Improvement Initiatives Patient Perception CMSS Conjoint Committee IOM Reports on Quality Care OCC FSMB and MOL 7

8 Osteopathic Continuous Certification By January 1, 2013, all AOA boards must implement a continuous certification process for diplomates Osteopathic Continuous Certification Five Components Similar between specialties Maintain uniqueness of specialty Required for all certificants with time-limited certifications Five Components of OCC Component 1 Unrestricted Licensure Component 2 Lifelong Learning / Self-Assessment Component 3 Cognitive Assessment Component 4 Practice Performance Assessment and Improvement Component 5 Continuous AOA Membership 8

9 General Process for Component 4 Physician Receives Report with Recommendations for Improvement Physician Submits Data Quality Improvement Data (CAP, Hospital, etc.) Patient Surveys Board Reviews Data Against National Benchmarks Communications Determination of Stakeholder Groups OCC Awareness Survey to Diplomates 3 years Development of Plan Determination of Healthy Budget Development and Communications of OCC Platform for Diplomates to Track Their Progress 9

10 Learning Lessons Diplomates not practicing as originally certified Diplomates who do not practice clinically Stages of Grief Boards as they developed plans Diplomates as they learn about OCC Document all announcements and presentations Develop speakers bureau and request form Still learning Questions? Cheryl Gross, MA, CAE Director, Division of Certification American Osteopathic Association 142 E. Ontario Street Chicago, IL (312)

11 National Board for Certification in Occupational Therapy Certification Renewal Programming Using Guided Self-Reflection Based on Practice Analysis and Assessment Pat Heeter, NBCOT James P. Henderson, PhD, Castle Worldwide Overview National Board for Certification in Occupational Therapy provides certification for the occupational therapy profession throughout the United States. Occupational Therapist, Registered Certified Occupational Therapy Assistant Current Certification Renewal Program is based on a 1999 study and has been in place since that year. Revision addresses new initiatives and reports. 11

12 Background Five core competencies for health professionals (U.S. Institute of Medicine, 2003 and 2010): Provide Client-Centered Care Work in Interprofessional Teams Employ Evidence-Based Practice Apply Quality Improvement Utilize Informatics Institute for Credentialing Excellence (2008 and 2009) emphasizes assessment and stakeholder needs in certification renewal. Assumptions NBCOT stakeholders expect occupational therapy professionals to: Maintain competence at least at the level required for initial certification. Advance in competence through lifelong learning. Specialize in practice setting and client population. Stay current with respect to new research, treatments, modalities; evidence-based practices; service delivery systems; information systems. Work in a manner consistent with prevailing standards of professional practice. Use high quality resources for building competence. 12

13 Theoretical Perspective The underlying concept, reflection-in-action (Schön, 1983; Thompson and Thompson, 2008), is that occupational therapy professionals think about what they are doing, even while doing it. While practicing they ask themselves (for example) What features do I notice when I recognize this thing? What are the criteria by which I make this judgment? What procedures am I enacting when I perform this skill? How am I framing the problem that I am trying to solve? Assumptions Occupational therapy professionals: Have accumulated a reservoir of professional experience that is a rich resource for continued learning. Need to prepare for ever-changing responsibilities in their practice. Seek to improve their practice and are motivated to learn new concepts and skills. Are in the best position to direct their own learning and want to apply what they learn directly to their practice setting. 13

14 Purpose of the Program The objective is that occupational therapy professionals participating in the program will translate new knowledge into practice in such a way that it becomes embedded in their performance and leads to improved outcomes for clients and other stakeholders Certification Renewal Practice Analysis Study Entry-level proficiency has adequately been assessed by the certification examinations. Identified professional knowledge and skill, clinical reasoning, and other abilities that are essential to continuing competence. Supplied the basis for self assessment, assessment, and individual professional development activities. 14

15 Guided Self-Reflection Certificants review their current practice and record key information about their work setting. The online system asks probing questions and guiding questions. Guided self-reflection addresses the five core competencies: Provide Patient-Centered Care, Work in Interprofessional Teams, Employ Evidence-Based Practice, Apply Quality Improvement, and Use Informatics, plus Professional Responsibility. Guided Self-Reflection Directions: In self-reflection, consider your level of proficiency in occupational therapy and what it means to you and your practice. Use the scale to reflect on your confidence about your ability to perform competently in the following responsibilities and tasks. Whether confident or not, certificants can mark the area as a focus for professional development. 15

16 Guided Self-Reflection Provide Client Centered Care: Do I identify, respect, and care about clients differences, values, preferences, and expressed needs; relieve pain and suffering; coordinate continuous care; listen to, clearly inform, communicate with, and educate clients; share decision making and management; and continuously advocate disease prevention, wellness, and promotion of healthy lifestyles, including a focus on population health. 1 Confident 2 Not confident area to be considered for growth Guided Self-Reflection Two types of self-assessment augment information provided by certificants: multiple-choice questionnaires and simulation. Short multiple-choice self-assessments focus on knowledge of many topics validated by the certification renewal practice analysis. Animated case simulation exercises focus on the interaction of knowledge, skill, and professional judgment. 16

17 Professional Development Plan Results of the self reflection are available to the certificant 24/7 through a secure online portal enabling review and updates to be made at any time. Updates may include re-direction in response to changes in work or personal situations. Professional Development Plan As an outgrowth of guided self-reflection, certificants specify professional development goals and construct a personalized professional development plan (divided by Year 1, 2, 3 of the certification cycle). The system offers suggestions for continuing education and other professional development activities to facilitate the individual s decision making. Professional development activities are coded to the content framework from the certification renewal practice analysis. 17

18 Professional Development Plan As certificants complete the professional development program they have designed, the system records the professional development activity. The system offers certificants the opportunity to rate each professional development activity as it is completed. Certification Renewal Cycle 18

19 Evaluation The system invites certificants to evaluate the efficacy of the professional development plan relative to their needs at points specified by the individual Sources Cited: Committee on Planning a Continuing Health Professional Education Institute; Institute of Medicine. (2010). Redesigning Continuing Education in the Health Professions. Washington, DC: National Academies Press. Committee on Quality of Health Care in America, Institute of Medicine. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press. Davis, D., Fox, R., and Barnes, B.E. (2003) The Horizon of Continuing Professional Development: Five Questions in Knowledge Translation. In Davis, D., Barnes, B.E., and Fox, R., (Eds.), The Continuing Professional Development of Physicians. Chicago, IL: American Medical Association Press. Greiner, A.C., and Knebel, E., Editors, Committee on the Health Professions Education Summit (2003). Health Professions Education: A Bridge to Quality. Washington, DC: National Academies Press. Henderson, J.P. (2008). Practices and Requirements of Renewal Programs in Professional Licensure and Certification. Washington, DC: Institute for Credentialing Excellence. Knapp, L.G. and Kendzel, J.G. (2009). Future Trends in Certification, in Certification: The ICE Handbook. Washington, DC: Institute for Credentialing Excellence. Knapp, L.G. and List, C. (2009). Recertification and Continuing Competency, in Certification: The ICE Handbook. Washington, DC: Institute for Credentialing Excellence. Schön, D.A. (1983). The Reflective Practitioner. London: Temple Smith. Thompson, S. and Thompson, N. (2008). The Critically Reflective Practitioner. New York, NY: Palgrave Macmillan. 19

20 Questions? Pat Heeter Director Examination Product Development 12 South Summit Avenue Suite 100 Gaithersburg MD (301) National Board of Certification and Recertification for Nurse Anesthetists Karen Plaus, PhD, CRNA, FAAN 20

21 NBCRNA Background Certification required since 1945 Evolution of certification program CAT, Alternative Item Types Recertification introduced in 1978 CE, Practice, RN Licensure Continued Professional Certification ICE 2007: Benchmark Study Recertification Task Force : Practice Analysis : CPC Program CPC Committee 2011: Development Process Process Literature Review Best Practices Considerable Debate Ideal Program 21

22 Continued Professional Certification Component rollout started in 2009 with state and national presentations Full program proposal at the 2011 AANA Annual Meeting Comments collected via 51 state meeting presentations; s; 10,831 survey results; 280 blog questions; phone, letter and personal communications CPC Committee formed to collect information, conduct additional literature reviews, and make recommendations regarding the proposed program from all the evidence Final program approved by the NBCRNA BOD in January 2012 RCTF Recommendations Final CPC Program Components CPC Subcommittee Work CPC Program Begins Introduction of Proposal CPC Subcommittee Work CPC Program Completion and Testing 22

23 NBCRNA Program Components Begins January 1, 2016 Recertification cycle is every 4 years Progress audit every two years with a reminder letter sent to individuals not completing at least half of the required components Continuing education credits 15 Assessed Credits 10 Professional Activity Units ( non-assessed ) Non-assessed units are self monitored by the certificant, but audited by the NBCRNA as necessary NBCRNA Program Components Self Study Modules Evidence-based self-study modules on the four core competencies to be completed every 4 years Work Requirements In recognition of the role of local credentialing bodies, the NBCRNA will no longer monitor practice hours as a part of the CPC program beginning 2016 Employment facilities and credentialing departments will monitor as required by their policies Difficult to accurately document Re-entry Challenges 23

24 Recertification Examination Exam every 8 years (every other recertification cycle) For individuals certified before January 1, 2024 the first exam would be for diagnostic purposes only The diagnostic exam will require extra CE above the minimum CE requirement for failure to meet pre-establish standards in each content area Nurse anesthetists will be required to achieve a passing score on all subsequent exams to maintain certification Nurse anesthetists certified January 1, 2024 and after will be required to achieve a passing score on the exam to maintain certification Lessons Learned Communications Patient Safety Focus Credentialing Mission and Vision Recurring Themes Timing Announcement Empirical Evidence Mistrust and Misunderstanding NBCRNA Positive Comments 24

25 Questions? Karen Plaus PhD, CRNA, FAAN CEO 8725 West Higgins Road Chicago, IL Toll free: (855) American Registry of Radiologic Technologists Jerry Reid, PhD 25

26 ARRT Background Founded 1922 Medical Imaging & Radiation Therapy 15 Certification Programs 315,000 Certificants 9 Board Members 65 Staff ARRT s Pillars of Initial Certification 26

27 Education Education Education Ethics Ethics Ethics ARRT s Pillars of Ongoing Certification Reasons to require More 1. Pace of Change Accelerating 1.1 Knowledge base 1.2 Safety concerns 2. Certification Trends 2.1 IOM/ICE/Etc. 2.2 Other certification organizations 27

28 Time-Limited Certification Rationale Once Certified, Forever Qualified Once Certified, Forever Learning, Evolving, and Developing CQR Program CQR = Continuing Qualifications Requirements Definition = Same at entry and at points beyond Cycle = Every 10 Years Purpose = Assist Registered Technologists document their continued qualifications in the categories of certification held. 28

29 CQR Components Professional Profile Promote reflective practice Structured Self Assessment (SSA) Identify knowledge gaps Targeted CE Remediate knowledge gaps Communications Announced Concept Early Included Details as Developed Online Video ( Consistent Messaging 29

30 Suggestions 1. Focus on Concept First 1.1 Avoid premature focus on tools 1.2 Integrate into theory of competence 2. Adopt a Structured Approach 2.1 Decide what the credential means 2.2 Create a statement of purpose 2.3 Document with a strategic plan Goals, Objectives, Strategies Questions Jerry B. Reid, Ph.D. Executive Director, The American Registry of Radiologic Technologists , Ext jerry.reid@arrt.org 30

31 Questions & Discussion 31