Competency-based management effects on satisfaction of nurses and patients

Purpose:To evaluate the effect of competency-based management in improving nurse and patient satisfaction.Methods:According to the competency-based management objectives and principles,821 nurses were classified into different levels based on clear nurse qualifications and post responsibilities.According to the different levels of nursing staff and training plans with different emphases,the goal was for the nursing staff to gradually achieve the corresponding level.Targeted training programs for different levels of nurses were formulated to enable nurses to gradually increase their competency levels.Results:After implementation of competency-based management,nurse job satisfaction and patient satisfaction increased significantly(P<0.01).Additionally,the reported nurse job burnout decreased(P<0.01).Conclusion:Competency-based management can promote nurses’enthusiasm,reduce job burnout,improve job satisfaction,as well as improve patient satisfaction.

Competency-based curriculum education in mental health nursing

Introduction: The essential problems in providing quality and safety services to patients, rapid changes in health care settings as well as information technology require educational revision. Competency-based curriculum focuses on set of skills that students should achieve. This study reviewed characteristics of competency-based curriculum in psychiatric nursing. Methods: A literature review about a competency-based curriculum in psychiatric mental health nursing was carried out by searching databases including Iran Medex, Iran Doc, and Pub Med with key words such as competency-based education, competency-based curriculum, and competency-based curriculum in psychiatric mental health nursing. No time limitation was considered. Results: Results revealed that over 30 literatures have been done about nursing curriculum, but just several studies were done regarding competency-based curriculum and just a few about competency-based curriculum in psychiatric mental health nursing. Conclusion: Competency-based curriculum development is one of the essential steps to facilitate teaching-learning process. The revision of curriculum may decrease theory-practice gap and pave the way for graduates to have essential competences for their roles.

Curriculum Reform of Programming and Algorithm Foundation for Competency-based Learning

It is important to transform knowledge-based learning to competency-based learning.This paper describes the exploration and practice of“programming and algorithm foundation”curriculum reform for competency-based learning.In order to cultivate students’ability of high-level program development,the intelligent learning system of“MOOC/SPOC+icoding online experiment and programming ability test Platform+Rain Classroom”is established.In the case of limited class hours,we make full use of online resources to build a student-centered method to internalize knowledge and ability.We guide students to complete the basic knowledge module of MOOC or SPOC,and complete the programming experiment on icoding platform.According to the feedback of learning outcome,teachers use offline classroom and rain classroom to sort out the key and difficult points,expanding the depth and breadth of the curriculum,and stimulate students’enthusiasm to participate in the curriculum.

Reform direction of medical education in China： implementing ＂competency-based＂ medical education

For over 100 years, medical education has achieved continuous development and progress all over theworld. Flexner＇s report in 1910 brought modern science into the curricula of medical schools. In the 1960s, problem-based learning （PBL） was born in Canada and quickly achieved wide use. From the beginning of the 21 st century, with increasing specialization in medicine, the ＂silo effect＂ has become more apparent. The inequality in healthcare and low efficiency of the entire health system has become prominent problems. These have brought about new challenges for medical education--how to implement accountable medical education so as to rectify the current situation. Therefore, ＂competency-based＂ medical education, as an important feature of the third generation medical education reform, has gradually become the trend. J However, currently in most medical schools in China, PBL is still flourishing, which indicates that we are still at the second generation of medical education reform.

Item-Level Analysis of the Revised Occupational Therapy Fieldwork Performance Evaluation Applied in Practice

Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in practice.

Virtual reality simulation in endoscopy training:Current evidence and future directions

Virtual reality simulation is becoming the standard when beginning endoscopic training. It offers various benefits including learning in a low-stakes environment, improvement of patient safety and optimization of valuable endoscopy time. This is a review of the evidence surrounding virtual reality simulation and its efficacy in teaching endoscopic techniques. There have been 21 randomized controlled trials(RCTs) that have investigated virtual reality simulation as a teaching tool in endoscopy. 10 RCTs studied virtual reality in colonoscopy, 3 in flexible sigmoidoscopy, 5 in esophagogastroduodenoscopy, and 3 in endoscopic retrograde cholangiopancreatography. RCTs reported many outcomes including distance advanced in colonoscopy, comprehensive assessment of technical and non-technical skills, and patient comfort. Generally, these RCTs reveal that trainees with virtual reality simulation based learning improve in all of these areas in the beginning of the learning process. Virtual reality simulation was not effective as a replacement of conventional teaching methods. Additionally, feedback was shown to be an essential part of the learning process. Overall, virtual reality endoscopic simulation is emerging as a necessary augment to conventional learning given the ever increasing importance of patient safety and increasingly valuable endoscopy time; although work is still needed to study the nuances surrounding its integration into curriculum.

Nurses’perception on competency requirement and training demand for intensive care nurses

Objectives Various authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units(ICUs).Nurses’perception of training is an element that must be studied in order to adopt appropriate educational measures.This study aimed to evaluate nurses’perception of the importance of intensive care training in Spain.Methods A descriptive,cross-sectional,multicentre study was conducted on a national level in Spain.Totally 85 ICUs took part in the study.The questionnaire used was developed using the Delphi method and had 66 items to investigate nurses’perception on competency requirements and training needs.The evaluation was conducted by a 10-point Likert scale.Results The sample was 568 Spanish nurses.Significant differences were found on an academic level,in terms of gender and hospital type,and in the professional experience of the nurse when it comes to evaluating the different training items;the differences in overall questionnaire scores among these groups were statistically significant(P<0.05).The nurses analyzed believe that previous training and professional experience in other care services are necessary before starting work in an ICU.Conclusion Implementation of training programs tailored to the needs of critical nurses had benefits for nurses and the health system.Nurses benefited from training focused on the skills and knowledge of each moment of their working life.Nurses have a different evaluation of their training needs throughout their professional cycle.Therefore,their training must be adapted to the professional stage of each nurse.

Pre-service Teachers’ Beliefs of Competence With Teaching Socially Sensitive Issues

This paper is part of a larger cross-sectional, phenomenological study that examined pre-service teachers’ belief of the competencies they possess to teach socially sensitive issues at secondary level in Trinidad and Tobago. Purposive sampling resulted in 39 pre-service social studies teachers (Years 2 to 4) who were exposed to a methodology course in a social studies specialisation programme and nine social studies lecturers, at the University of Trinidad and Tobago. The study is located in the mixed methods paradigm, with a quan/QUAL design. This paper represents discussions and findings from two questionnaires and four focus groups analysed through the IBM SPSS Statistics 22 software for the quantitative analysis and content and micro-interlocutor analyses for the qualitative analysis. The findings show that pre-service teachers believe they have the competencies to teach socially sensitive issues;yet they had not obtained these from the designated methodology course. Further that both contextual and personal factors affect the teaching of socially sensitive issues. Six themes, with accompanying competencies emerge from the data and frame affective teaching of socially sensitive issues. Arising out of the findings, the author developed a competency-based framework that has implications for curriculum development and transformational pedagogy.

Nursing Students’ Notions about Palliative Care Bogota D.C. 2016

Training in palliative care is a necessity for health care systems. Nursing education should guarantee the development of basic skills in this field of health care. The objective of the study is to explore the notions about palliative care of a group of students from a nursing institute, in the light of the skills established by the Colombian Network of Education in Palliative Care. The method used is a qualitative one, using the analysis of narratives as a research tool in the classroom. The results allow us to infer that the students rely on notions about palliative care in some subject areas, without being able to consolidate an understanding that allows the integral intervention in people with palliative needs. It is necessary to reinforce the training process for symptom control, spirituality, and the organization of palliative care within the health care system.

Simulation-based mastery learning in gastrointestinal endoscopy training

Simulation-based mastery learning(SBML)is an emerging form of competencybased training that has been proposed as the next standard method for procedural task training,including that in gastr-ointestinal endoscopy.Current basic gastrointestinal endoscopy training relies on the number of procedures performed,and it has been criticized for its lack of objective standards that result in variable skills among trainees and its association with patient safety risk.Thus,incorporating simulators into a competency-based curriculum seems ideal for gastrointestinal endoscopy training.The curriculum for SBML in gastrointestinal endoscopy is currently being developed and has promising potential to translate into the clinical performance.Unlike the present apprenticeship model of“see one,do one,teach one,”SBML integrates a competency-based curriculum with specific learning objectives alongside simulation-based training.This allows trainees to practice essential skills repeatedly,receive feedback from experts,and gradually develop their abilities to achieve mastery.Moreover,trainees and trainers need to understand the learning targets of the program so that trainees can focus their learning on the necessary skills and trainers can provide structured feedback based on the expected outcomes.In addition to learning targets,an assessment plan is essential to provide trainees with future directions for their improvement and ensure patient safety by issuing a passing standard.Finally,the SBML program should be planned and managed by a specific team and conducted within a developed and tested curriculum.This review discusses the current state of gastr-ointestinal endoscopy training and the role of SBML in that field.

Game-Based Learning for Competency Abilities in Blended Museum Contexts for Diverse Learners

Museums offer a lifelong edutainment environment with flexible choices for the public and provide fruitful interdisciplinary learning resources to support competency-based education.However,the lack of proper scaffolding and supports in museums negatively affect learner learning.Further,the individual differences need to be considered to effectively support the diverse learners learning in museums.In this study,an innovative learning model to support competency education for lifelong learning in museums is proposed.A game-based learning service named CoboFun that offers various types of problem-solving activities was developed to facilitate learners’interaction with exhibits and their peers in the museum.To examine the service design of CoboFun,learners’perceptions were evaluated and the differences in their cognitive styles were examined(Field Independent(FI)and Field Dependent(FD)).The results showed that both FI and FD learners enjoyed learning with CoboFun but that flexible learning tools needed to be provided to satisfy the different needs for the learners with different cognitive styles.

Hidden Constructs on Graduate Employability Decisions: The Principal Component Factor

This study adopted the quantitative research design to unearth hidden factors which go into graduate employability decisions. Purposive sampling technique was used to select graduates, institutions and industries within Takoradi, Cape Coast, Kumasi and Accra metropolis all in Ghana. Three different questionnaires inter-spaced with interviews were designed and used to collect data from the field according to a pre-determined stratified scheme. A total of 200 informants including 68 industries, 120 graduates and 12 institutions were used. The data was coded and keyed into SPSS version 20. Tables and Charts were used to explore the data. Principal component (PC) analysis was employed to extract hidden factors industries consider in graduate employability decisions. The PC method identified and extracted six hidden factors: ability to set SMART goals and structure actions;ability to demonstrate a willingness to embrace new systems, processes, technology and ideas;a determined, committed, resilient, and focused person;a person with passion for driving profit;ability to deconstruct a problem or situation;and clear and unprompted ability to present information to a group. These six hidden factors could explain 68.8% of the variances in graduate employability decisions. We recommend that internships be properly planned and executed with the involvement of industry players, facilitators of learning, and the ministry of trade and industries. In addition, facilitators should inculcate into students’ important traits and attributes identified in this study.

AB038.Assessing a novel approach to teaching ophthalmoscopy to medical student

Background:To determine if practice using an online fundus photograph program results in a long-term increase in proficiency with the direct ophthalmoscope in medical students.Methods:This study was a prospective medical education trial.Students were enrolled to participate in an objective structured clinical examination(OSCE)using five patients with ocular findings.Students who matched a minimum of 6 discs 17 months prior to the study were assigned to the intervention group and were compared to students who did not participate in the exercise.Participants:46 second-year medical students at Queen’s University:15 in the intervention group,31 in the control group.Students were evaluated using the Queen’s University Ophthalmoscopy OSCE Checklist(QUOOC).Students were asked to calculate the cup-to-disc ratio,comment on disc margins and if there was any macular pathology.Students participated in a summative OSCE as part of the curriculum in which all students attempted to match fundus photographs.Results:Students in the intervention group performed significantly better on the QUOOC with a mean score of 78.3%(+/−4.2%)compared to the control who had a mean score of 69.4%[+/−4.2%(P=0.007)].The intervention group was significantly more accurate at matching optic nerve photographs with 100%(15/15)of the students correctly identifying the correct optic nerve on first attempt compared to 53.3%(16/30)in the control group(P=0.0014).Conclusions:The use of an online peer fundus photograph program leads to a long-term increase in examination technique,proficiency in ophthalmoscopy and accuracy at matching optic nerve photographs.

Emerging Themes in Medical Education Research

Purpose: We aim to provide a broad overview of emerging themes in medical education, with recommendations for future research. Following a brief overview of recent changes in medical education and their implications, we focus on suggestions and examples for making progress in this field. Principal findings: In this article, we briefly review the context that has led to the emergence of the competency-based model of medical education. A critical implication is that medical educators must now focus on the development and maintenance of high quality assessment instruments to support valid decisions around advancement and promotion of learners. Rater cognition and "collective competence" are emerging issues that may have profound implications for the identification and assessment of competencies. Conclusions: While competency-based education represents the future, larger systemic effects must be identified and monitored to effect meaningful change in medical education.The authors conclude with a call for increased support for research in medical education and argue that the most promising and fruitful area of medical education scholarship for the future lies in the field of assessment of individual competence.