By James X. Stobinski, Ph.D., RN, CNOR, CNAMB, CSSM(E)
The subject of nursing competency is an important consideration for nursing certification programs accredited by either the National Commission for Certifying Agencies (NCCA) or by the Accreditation Board for Specialty Nursing Certification (ABSNC). Nursing specialty certification boards, to maintain accreditation standards, must establish programs that maintain or enhance the competency levels of their certificants.
The maintenance of competency is also a critical concern for facilities which employ health care workers as their accreditation standards also address competency assessment. Last month, I spoke to assumptions regarding nursing competency. I would now like to address how accredited certification bodies, such as the Competency and Credentialing Institute, are uniquely positioned to facilitate competency assessment.
Assessing and documenting the competency of staff requires a tremendous commitment of resources. Licensure and registration programs, for those professions such as nursing which have these programs, make only a cursory and incomplete attempt at documenting competency. It is possible for an employing facility to assess competency but is a daunting, complex task. Often facilities will use a proxy for competency such as an annual skills fair. From a theoretical perspective competency is composed of three parts – knowledge, skills and attitude. (Tripathi Agrawal, 2014) Even the best of skills fairs assess only one component of competency – skills. While familiar and commonly used, skills fairs have an issue of both face and criterion validity when used as an assessment of competency (Middleton, 2019).
The use of checklists, often termed competencies, is inherently problematic in the complex setting of the operating room. Wright (2019) states that, “The perioperative environment has so many technical skills and equipment that turn over constantly – if leaders have a competency for every technology, they are not going to make it.” Thus, attempts to measure competency using an endless series of checklists is a futile exercise.
Common in health care facility accreditation standards is a requirement to document the competency of staff members, their training and their ability to deliver safe care. Certifying bodies which administer voluntary credentials, such as the CCI CNOR and CSSM credentials, have a unique position in American health care. These organizations possess resources and expertise which can be helpful to employers addressing and documenting the competency of staff. Certifying bodies administer psychometrically sound, legally defensible, secure examinations of knowledge specific to a role such as perioperative nursing. Passing these exams documents knowledge levels.
Certification bodies may also measure personality factors and soft skills such as critical thinking and adaptability thus covering the second constituent part of competency – attitude. A common criticism of pre-licensure education programs is that graduates do not possess critical thinking skills. Certification programs, for example the recently launched CFPN credential, can assess these skills, provide feedback to the nurse and then through subsequent reflective learning exercises assist that nurse to develop these skills. And finally, a progressive and innovative recertification program for certified nurses can guide that nurse to refine and document their skills thus serving as an adjunct to skills fairs.
Certification bodies are uniquely positioned to assist both the individual nurse and the employer to fully document all aspects of competency. Stakeholders such as employers may be well-served by an investment in maintaining the voluntary specialty certification for their health care professionals. Not-for-profit certification boards have the potential to be a great resource. In uncertain, resource-constrained times such as this pandemic it may be helpful for health care facilities to re-examine the benefits of certification for their staff and ultimately for the benefit of their patients and families.
– James X. Stobinski, Ph.D., RN, CNOR, CNAMB, CSSM(E), is CEO of the Competency and Credentialing Institute.
References
- Middleton, F. (2019). The four types of validity. Accessed October 23, 2021 at: https://www.scribbr.com/methodology/types-of-validity/#:~:text=There%20are%20four%20main%20types%20of%20validity%3A%201,to%20a%20different%20test%20of%20the%20same%20thing%3F
- Tripathi, K & Agrawal, M. (2014). Competency based management in organizational context: A literature review. Global Journal of Finance and Management. 6(4) pp. 349-356. ISSN 0975-6477. Accessed October 23, 2021 at: gjfmv6n4_10.pdf (ripublication.com)
- Wright, D. (2019). Shift Your Competency Mindset. Accessed September 5th, 2021 at:
- https://www.aorn.org/about-aorn/aorn-newsroom/periop-today-newsletter/2019/2019-articles/mindset
