Portfolios: Implications for perioperative education, evaluation

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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 CNORs
• 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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Whats 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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(No Transcript)
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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 takenprovide 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 nurses 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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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?

• Its more than just sitting at an educational
  session at a conference
• You dont know what you dont 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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Portfolios Tips
Time consuming For creator and evaluator!
But it doesnt have to be!