Sherpas, Backpacks, and Tools of the Trade

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Sherpas, Backpacks, and Tools of the Trade

• Scaling the Competency Summit
• Mary Hoeppner, EdD, RN
• University of Minnesota

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Before We Leave Camp Settling on The Language
for the Climb

• What is competency?
• What are competency sets?
• Are competency models different from competency
  sets?

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Settling on the Language for the Climb

• Whats the difference between capacity and
  competency?
• Whats an indicator and what do they have to do
  with competencies?

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What is Competency?

• A simultaneous integration of the knowledge,
  skills, attitudes required for performance in a
  designated role and setting
• Dorothy del Bueno, 1978

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What is Competency?

• A cluster of related knowledge, skills
  attitudes that affect a major part of ones job
  (a role or responsibility) that correlates with
  performance on the job, can be measured against
  well-accepted standards, and that can be improved
  via training and development.
• Lucia Lepsinger, 1999

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Common Elements

• Comprised of knowledge, skill and ability
  elements
• Simultaneous integration
• Linked to performance
• In a specific role and setting

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Competency Measurement/Evaluation

• True competency can only be measured in context
• Example
• Test out on CPR vs perform CPR
• Successfully demonstrate learning in a classroom
  vs perform what the class was designed to teach
  in an actual emergency in a functional role

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What are Competency Sets?

• Developed by groups of professionals
• Clusters of knowledge, abilities, skills, and
  attitudes (KSAs) statements
• Describe what practitioners in that profession
  are able to do

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Foundational Competencies

• Core Public Health Practice
• Council on Linkages Between Academia and Practice
  (COL)
• What public health professionals should be able
  to know, do the attitude they bring to their
  work
• Divided into 8 domains
• 64 competencies and 4 attitudes (68)

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Core Competency Domains

• Analytic/Assessment Skills
• Policy Development Program Planning Skills
• Communication Skills
• Cultural Competency Skills
• Community Dimensions of Practice
• Basic Public Health Skills
• Financial Planning Management Skills
• Leadership Systems Thinking Skills

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THE Bioterrorism/Emergency Readiness
Competencies

• CDC (aka Gebbie, Columbia)
• Developed for use by all Public Health
  professionals who are involved in planning,
  responding, and/or recovering from an emergency
• Cross-cutting competencies (1-9)
• Role specific competencies

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Other Competency Sets

• Well over 100 specialized competency sets and
  growing
• http//healthlinks.washington.edu/
• nwcphp/comps/dev
• Northwest Center for Public Health Practice,
  University of Washington

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What are Competency Models?

• A meeting of Human Resources and
  Education/Training theory and practices
• Groupings of competency sets
• Targeted to a specific role
• Linked to job design, job tasks and role
  requirements
• Linked to evaluation measures/performance
  appraisal

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Building Competency

• More specialty competency
• sets
• Specialty competency
• sets
• BT/ER competency set
• Core Public Health
• Competency set

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Example Public Health Manager

• Core Public Health Competency Set
• Foundational Public Health
• BT/ER Competency Set
• Bioterrorism/Emergency Readiness
• Public Health Leadership Competency Set
• Communication, Strategic Planning, Systems
  Thinking, Team Building
• Core Competencies for Supervisors, Managers and
  Executives
• Fiscal Management, Human Resource Management

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What is Capacity?

• Ability of an organization to perform in a
  specific need
• Dimensions of capacity
• Human capital
• Physical capital
• Economic capital
• Social capital
• Cultural capital
• Knowledge, skills and attitudes (KSAs)

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Capacity Competency Not the Same Thing

• Individual competence contributes to capacity but
  is not capacity
• Individual performance is developed through
  training that reflects competencies
• Competencies are comprised of KSAs

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Reproduced with permission Public Health
Reports, 2005 Vol 120, Suppl 1, pg,11
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Packing Our Backpack Instructional Objectives

• Provide focus
• Reflect learning needs assessment
• Convey instructional intent
• Target evaluation measures
• As a set, reflect what is accepted as evidence
  that the overall purpose or goal is achieved by
  the learner

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Level of Specificity

• General Learning Objectives versus Specific
  Instructional Objectives
• Purpose/Goal vs. Measurable Behavior

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Domains of Learning

• Cognitive
• Affective
• Psychomotor
• Each domain contains different levels of
  learning, arranged from low to high
• Each higher level includes the levels that
  precede it

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Cognitive Domain Cognitive Process

• 1956 2001
• Knowledge
• Comprehension
• Application
• Analysis
• Synthesis
• Evaluation

• 2001 - ?
• Remember
• Understand
• Apply
• Analyze
• Evaluate
• Create

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Examples Cognitive Domain Learning Objectives

• List the events that created the French
  Revolution. (Knowledge/Remember)
• State the meaning of the word concentration.
  (Comprehension/Understanding)
• Differentiate pre and post causes of renal
  failure. (Analysis/Analyze)
• Evaluate the results of current research about
  the correlation between obesity and Type 2
  diabetes. (Evaluation/Evaluate)

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Application Exercise 1 Cognitive Domain
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Application Exercise 1 Review

• 1. d
• 2. b
• 3. c
• 4. a
• 5. f
• 6. e

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Affective Domain

• Receiving
• Responding
• Valuing
• Organization
• Characterization by Value or Value Complex

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Examples Affective Domain Learning Objectives

• From a list of volunteer activities, select three
  that match personal interests and preferences.
  (Responding)
• Explain the impact of belief systems on
  compliance with health directives. (Valuing)
• Integrate 3 activities that support personal
  emotional health in to a daily schedule.
  (Organization)

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Application Exercise 2 Affective Domain
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Application Exercise 2 Review

• 1. b
• 2. c
• 3. e
• 4. d
• 5. a

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Psychomotor Domain

• Perception
• Set
• Guided Response
• Mechanism
• Complex Overt Response
• Adaptation
• Origination

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Examples Psychomotor Domain Learning Objectives

• Identify the correct meter for a waltz.
  (Perception).
• Display correct positioning of feet for
  addressing the tee. (Guided Response)
• Modify strength at which volleyball is hit based
  on location of opponents. (Adaptation)
• Compose a sonata. (Origination)

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Application Exercise 3 Psychomotor Domain
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Application Exercise 3 Review

• 1. d
• 2. b
• 3. f
• 4. g
• 5. a
• 6. c
• 7. e

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Another Backpack Item

• Identifying the level of skill development
  targeted by the training

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Council on Linkages Aware

• Basic level of mastery
• Can identify the concept or skill
• Have limited ability to perform the skill

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Council on Linkages Knowledgeable

• Intermediate level of mastery of the competency
• Can apply and describe the skill

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Council on Linkages Proficient/Advanced

• Advanced level of mastery
• Able to synthesize, critique or teach
• the skill to others

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Skill Level Competency

• CDC Competencies Public health workers need to
  be competent
• Per del Bueno, Lucia and Lepsinger
• Competency requires the ability to apply KSAs

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Skill Level Competency

• Knowledgeable Intermediate level of mastery can
  apply and describe
• Proficient Advanced level of mastery of the
  competency individuals are able to synthesize,
  critique or teach the skill.

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Starting the Climb U of MN MCLPH Model

• Domains of Learning arranged from simple to
  complex
• i.e. It is a higher level of learning to be able
  to evaluate than remember
• COL skill levels arranged from less skilled to
  higher skilled
• i.e. Training at the Awareness Level is less
  skilled than Proficient/Advanced level training

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Univ. of Minnesota Midwest Center for
Life-Long-Learning in Public Health Mary
Hoeppner January, 2002
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Skill Level Application Exercise 4
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Application Exercise 4 Review

• 1. K
• 2. A
• 3. K
• 4. A
• 5. P
• 6. P
• 7. K
• 8. K
• 9. P

• 10. K
• 11. A
• 12. K
• 13. A
• 14. P
• 15. P
• 16. A
• 17. A
• 18. K

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What We Know

• BT/ER competencies are built on the core Public
  Health competencies
• Cross-cutting BT/ER competencies (1-9) are for
  every person who is PH responder
• The language of learning objectives can be
  correlated to the level of skill we want to
  develop

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Digging in Use of Competency Indicators

• Discrete items that reflect KSAs that are related
  to the desired competency
• Develop through research
• Write in behavioral terms
• Use to evaluate progress toward competency, we
  measure the indicators
• Example How quickly aspirin is given to
  patients who are suspected of having a heart
  attack

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Development of U of MN CPHP BT/ER Indicators

• Developed in 2003 for BT/ER Needs Assessment
  Survey
• Literature review
• Key informant interviews/focus groups with nearly
  100 PH health care professionals in MN WI
• Approximately 450 potential indicators
• Data reduction using qualitative techniques

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Development of U of MN CPHP BT/ER Indicators

• 29 cross-cutting indicators
• 90 role specific indicators
• Indicators correlated to cross-cutting and role
  specific competencies
• Used to create 13 role specific surveys

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UMNCPHP BT/ER Role Specific Survey Tools

• Leader/Managers
• Environmental Health
• PH Clinical Staff
• Communicable Disease Staff
• PH Information Staff
• Laboratory Staff

• Technical Support Staff
• Other PH Professionals
• Physicians
• ER/ICU Nurses
• EMT/Paramedics
• Veterinarians
• Medical Examiners

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Survey Distribution

• All State Local PH Agency Staff
• Infectious Disease MD/RNs
• ER, FP, IM MDs
• EMTs/Paramedics
• Medical Examiners
• Certified Industrial Hygienists

• ER/ICU Nurses
• Ambulatory Care Managers, RNs, LPNs
• Veterinarians
• Occupational Health Nurses
• Community Agency Nurses Health Educators in
  Non-Profit Agencies
• Hospital Laboratory Staff

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Validity of Indicators

• 4,558 useable surveys returned for state partner
  reports total returned 6,000
• Cross-cutting indicators ranked as Very
  Important to Important 98.5 (28 of 29) by 75
  of all responders
• Beginning psychometric testing by role

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Competency Mapping

• What is it
• A process for correlating a competency to an
  indicator
• In Public Health correlating specialty
  competency sets to the COL Core PH competency set
• Also correlating the BT/ER competency set to the
  COL and any to other specialty competency sets
• Beginning to create a competency model

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Competency Mapping

• UMNCPHP indicators mapped to COL and BT/ER
• Trainings conducted with state partners, offered
  nationally
• Mapping guide tool on UMNCPHP website
  www/publichealthplanet.org

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UMNCPHP Competency Map
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Traversing the Peaks Teaching Methods

• Training methods can also be correlated to
  targeted levels of learning
• Different methods work best to help learners meet
  different kinds and levels of objectives
• e.g. Lecture is great for conveying information
  but lousy for teaching a skill

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• Lecture
• Assigned reading
• DVD/Video
• Demonstration
• Structured lab experiments
• Interviewing
• Group projects
• Role play

Field trips Plays/Theatre Case studies Return
demonstration Journaling Taking/analyzing
polls Panel presentation Games
Debate Arts and crafts creating Critiquing
Articles/research
A A K K K P
P Sherpas, Backpacks and Tools of the
Trade Mary Hoeppner U of MN, September 23, 2005
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Teaching Methods and Learning Objectives

• Language of learning objectives guides teaching
  methods/strategies
• e.g. Analyze the training using a set of
  competency indicators.
• Communicate to the instructor what kind of
  methods to be used
• Tell the students what to expect

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Transfer to Practice

• The more closely we mimic the situation in which
  the KSAs need to be applied, the more likely the
  learner will be able to perform with competency
• Importance of drills and application exercises

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Up the Final Step Level of Learning Competency
Evaluation

• Evaluation approach is dictated by the learning
  objectives
• Evaluation strategies should reflect the level of
  learning
• Language of learning objectives let the student
  know how they will be evaluated/what to expect

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Distance Based Evaluation Options Awareness

• Pre-post test
• True/False questions
• Matching exercises
• Multiple choice
• State basic messages received (affective)
• Fill in the blank questions
• Identify needed elements to perform a skill

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Distance Based Evaluation Options Knowledgeable

• Moderated discussion
• Response to posted questions (short answer)
• Role play perspective taking
• Simulations/Games
• Analysis of information presented, conclusions
  drawn
• Prioritize
• Manipulate elements

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Distance Based Evaluation Options Proficient

• Critique of articles, research
• Debate
• Submission of portfolio of work
• Manipulate to create new
• Creation of a plan for _____, including
• delineation of resources needed
• strategies to acquire them
• rationale for choices
• evaluation of plan strengths and opportunities
  for improvement

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Distance Based Teaching and Evaluation Methods
Application Exercise 5
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View from The Top Whats on the Horizon?

• Integration of Competencies Workplace
  Performance Measures
• Accreditation
• Credentialing
• For UMNCPHP Correlation of UMNCPHP Indicators to
  CDC Performance Goals

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View from The Top Whats on the Horizon?

• Who should DLCs partner with inside and outside
  of their organizations?
• What is the current scope of the trainings
  offered in terms of competency sets?
• What skill level is being addressed by current
  program offered?

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View from The Top Whats on the Horizon?

• How does DL training evaluation blend with
  evaluation from other training formats?
• How can DLCs apply their special talents and
  gifts to create the most effective learning by
  matching method to level in a virtual classroom?
• Cost effectiveness whats the bang for the buck?

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Sherpas, Backpacks, and Tools of the Trade

• Mary Hoeppner
• University of Minnesota Center for Public Health
  Education Outreach
• hoepp001_at_umn.edu