By James X. Stobinski, Ph.D., RN, CNOR, CSSM (e)

Brandon Bennett, in a recent editorial in this publication, raised the issue of the orientation of nurse managers and leaders entering the OR. I agree with Bennett’s thoughts regarding perioperative nurse leaders, but I would like to extend that perspective and consider the continuum of a career to include the education and training processes for all nurses in perioperative nursing. I believe it is time to question long held assumptions here also.

We have long assumed that some amount of classroom teaching combined with a lengthy precepted learning experience is enough to establish competency for the complex specialty of perioperative nursing. How a nurse attains a level of competency can be explained in the tenets of Patricia Benner’s “Novice to Expert Theory of Skill Acquisition” (Stobinski, 2008). This initial orientation and pre-licensure education are a necessary foundational component for perioperative nursing competency. All of us completed a pre-licensure educational course, passed the NCLEX exam and then eventually entered the field of perioperative nursing. But … a degree, especially a degree taken decades ago, cannot meet continuing professional development (CPD) needs over the course of a career.

Although operating room nursing was among the first recognized nursing specialties, and has existed for over a century, little has changed in our methods for bringing nurses into the profession. The issue of how to maintain competency in practice is a prominent concern for nursing but especially so in perioperative nursing. The building blocks of competency in any nursing specialty include pre-licensure education and the subspecialty education upon entry to the OR, but there is one more essential ingredient – ongoing education and training throughout a career. This is the Continuous Professional Development (CPD) which keeps us current and safe in our practice.

The rapid pace of change demands the attention of our specialty and the fresh look which Bennett spoke to previously. This rapidity of change also demands that we have meaningful CPD over the entire course of our career. The need for lifelong learning was also advanced by Missi Merlino, the current president of the board of directors for AORN, in her recent column in the AORN Journal (2019). As the CEO of the Competency and Credentialing Institute, which administers the CNOR credential, I concur with Merlino on this need. I believe that certification and the attendant ongoing professional development activities can address the issue of maintenance of competency.

Nurses holding credentials administered by CCI have access to our Learning Management System (LMS), a rich repository of learning activities which have been vetted by certified perioperative nurses to be relevant to current practice. In addition, we have assembled these activities based in part on recommendations from the Institute of Medicine (US) Committee on Planning a Continuing Health Professional Education (2010). The report published by this select group stressed the need to move beyond a reliance on CE activities to more meaningful methods such as self-assessment, individualized learning plans and reflective learning. These methods have a solid basis in the evidence-based literature and have the potential to facilitate lifelong learning and enhance competency levels. These concepts are incorporated within the CCI system which is available without additional charge to nurses holding CCI certifications.

The resources available in the CCI LMS are possible, in part, because of the generous support of our partners. CCI will expand this repository over time and is committed to keeping it current. Please stay current with CCI through our various social media channels as we will soon announce new partnerships and initiatives to meet the ongoing professional development needs of the perioperative nursing community.

– James X Stobinski, Ph.D., RN, CNOR, CSSM (E), if the CEO of the Competency and Credentialing Institute. He may be contacted at 720-257-4372 or jstobinski@cc-institiute.org.

References

1. Institute of Medicine (US) Committee on Planning a Continuing Health Professional Education Institute (2010). Redesigning Continuing Education in the Health Professions. Washington (DC): National Academies Press. Available from: https://www.ncbi.nlm.nih.gov/books/NBK219811/ doi: 10.17226/12704.

2. Merlino, M. (2019). Creating Our Future Through Lifelong Learning. AORN Journal (100)1, pp. 2-4.

3. Stobinski, J.X. (2008) Perioperative nursing competency. AORN Journal (88)3. pp. 417-436.