Best practices for implementing new competencies: Five strategies to get staff up-to-date

Nurse Manager Website, October 5, 2005

Learning objectives: After reading this article, you will be able to
1. list five practices for implementing new competencies
2. list one advantage and disadvantage to each of these approaches

Unfortunately, new competencies do not evolve annually, allowing ample time for appropriate education and training. They can pop up at any time, with varying degrees of urgency. Here are suggestions for the implementation of new competencies to share with your nurse educators.

Competency skills fairs
Some organizations have implemented day-long or half-day competency-assessment days. These are called by various names, such as "skill fairs," "competency days," "competency skills labs," etc. The premise is generally the same: Various competencies are assessed during a specified time period and at an identified location, usually a classroom setting. These events can be held at specified times throughout the year (e.g., annually, semiannually, or quarterly).

  • Advantage: Competency days allow you to address the maximum number of people with a minimum number of observers.
  • Disadvantage: Competencies that require demonstration of actual patient care interactions/procedures are not suitable for this approach.

Drills and simulations
An evaluation form must be completed after each drill. This form serves as a record of behavior, a competency assessment, and a format for documenting strengths and areas for improvement. Examples of drills and simulations include mock codes, internal and external disasters, and hazardous spill clean-up.

  • Advantage: Drills and simulations require little or no additional staffing.
  • Disadvantage: They may disrupt other programs or patient care activities.

Performance improvement monitors
This approach relies on data from performance improvement (PI) documentation. PI indicators are useful when evaluating both interpersonal competencies and abilities to perform clinical skills.

  • Advantage: PI monitors are a regular and reliable source of data.
  • Disadvantage: They do not guarantee that the competency was consistently evaluated if multiple persons had input into the performance evaluation.

Return demonstration/observation
Return demonstration, which involves direct observation of skill performance, can take place during the previously mentioned skills fair or on the job.

  • Advantage: Return demonstrations/observations allow the assessor to actually see the employee's behavior and application of knowledge.
  • Disadvantage: They may influence the behavior of the staff member being assessed because he or she is aware that an evaluation is taking place.

Self-assessment requires that employees complete a written exercise designed to identify the employees' beliefs and knowledge about their job performance. The employees' assessment is compared to other as-
sessments. Any disparity must be addressed so job performance improves.

  • Advantage: Self-assessment helps employees recognize their own beliefs and values and how these issues may affect their job performance.
  • Disadvantage: They do not provide an opportunity for evaluation of the actual behaviors.

Source: This article was excerpted from the book Competency Management for the Obstetrics Unit, written by Adrianne Avillion, DEd, RN; Barbara Brunt, MA, MN(c), RN, BC; Gwen Valois, MS, RN, BC; and Jane Alberico, MS, RN, CEN, and published by HCPro, Inc.