By James X. Stobinski
This month, I would like to return to the topic of skills obsolescence. Kaufman offers a classic definition of skill obsolescence as “… the degree to which professionals lack the up-to-date knowledge or skills necessary to maintain effective performance in their current or future work roles.” (1) Skill obsolescence is an inevitable result of technological progress, and the technology-intensive operating room is a place of rapid change, lending particular importance to this issue. The high risk for skill obsolescence among perioperative nurse leaders and managers increases the need for quality, ongoing professional development materials for these nurses.
Another factor contributing to the salience of this issue is the lack of standardized education and career paths for perioperative nurse leaders. There is no widely accepted method for bringing nurses into this demanding role. A long-held belief in our field is that operating rooms are best led by experienced perioperative nurses who possess clinical proficiency. This dates to the 1880s and Caroline Hampstead, a nurse documented as working exclusively in the operating room at Johns Hopkins Hospital. (2) Caroline Hampstead blazed the path for operating room nurses to lead and manage operating rooms, but the knowledge and skills needed for this role in modern operating rooms are expanding exponentially.
There are thousands of American perioperative nurse leaders and managers if we consider acute care hospitals and ambulatory surgery centers. Leadership succession planning and retention of current early-career leaders are imperative due to the large numbers of experienced, mature perioperative leaders. Graduate education requirements and certification pipelines constrict the supply of these essential leaders. Structured leadership programs can facilitate the professional development of perioperative nurse leaders, boost their ability to manage complex surgical care processes, and facilitate their growth as mentors for their staff. But there is a paucity of these programs beyond large healthcare systems.
There is also a lack of consensus on the core curriculum, the essential body of knowledge, required to lead an operating room. A widely used resource for OR leaders is the Kaye, Urman & Fox text, Operating Room Leadership and Perioperative Practice Management, but we lack other authoritative references specific to leading and managing operating rooms. (3) These diverse factors bring us to differing competence levels, with the employer prescribing the education and training needed to perform competently in the role. Unlike the practice of nursing, where a competency-based examination, the NCLEX, controls admission to the profession, we have no standardized, widely used test of the knowledge and skills needed to lead an operating room.
From the perspective of an economist, perioperative leadership skills can be seen as a form of human capital. The resources devoted to learning and maintaining these skills can be seen as an investment that increases productivity and earning potential. Education, training and experience raise the value of this human capital, and skills obsolescence occurs when that capital depreciates due to technological change, new clinical techniques and innovation. These issues underscore the need for professional development materials specific to the work of perioperative nurse leaders, who possess a different skill set than nurse clinicians.
One of the responsibilities of a profession is to establish the education standards and entry requirements for the profession. The issue of skills obsolescence takes on increasing relevance for perioperative nurse leaders if we consider the lack of standardization for education and training for the role and the scarcity of resource materials. There are great opportunities in developing education and training resources to enhance and maintain the skill set of perioperative nurse leaders. This is both a challenge and an opportunity, but the need is clear.
– James X. Stobinski, Ph.D., RN, CNOR(E), CSSM(E), CNAMB(E), is a faculty member at Central Michigan University and director of hospital and ASC surgical education relationships with the National Institute of First Assisting (NIFA).
References
Kaufman, H. G. (1974). Obsolescence and professional careers. AMACOM, New York.
Hamlin, L. (2020). From theatre to perioperative: A brief history of early surgical nursing. Journal of Perioperative Nursing, 33(4), E19-E24.
Kaye, A. D., Urman, R. D., & Fox, C. J., III (Eds.). (2019). Operating room leadership and perioperative practice management (2nd ed.). Cambridge University Press.
