INDUSTRY INSIGHTS CCI
Use of Competency Assessment Instruments in Credentialing By James X. Stobinski egarding nursing competency Mika Fukada tells us that, “Competence is an ability acquired through experience and learning.” (2018, p.1) and that competence is a prerequisite for competency. Fukada describes nursing competency, “… as a complex integration of knowledge including professional judgment, skills, values and attitude …” (2018, p. 1). She also states that competency is a behavioral characteristic which can be measured. Fukada’s statement on measuring competency intersects well with one section of the influential Future of Nursing Report from 2010 (IOM) which speaks to the need for a framework of lifelong learning.
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While Fukada maintains that competency can be measured the use of competency assessment instruments is not common in American nursing practice and the devices are not well-integrated into licensure and credentialing practices. The use of skills checklists, or competencies (used here as a noun), are far more common. The assumption here being that if the skill can be successfully performed that the individual possesses competency. For those who ascribe to a holistic definition of competency, as does Fukada, this
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OR TODAY | July 2022
assumption that the repetition of a skill equates to competency appears flawed and incomplete. The argument can be made that the measurement of the complex concept of competency could guide lifelong learning. There is an opportunity for those willing to initiate the use of these assessment instruments. But, as Machiavelli so clearly points out, “… there is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things.” (2020). A long-standing assumption in American nursing is that competency is measured when one passes the licensure examination. Competency is then somehow assumed to continue throughout a career unless evidence of some egregious error presents (Tilley). The use of competency assessment instruments would be disruptive to well-established current systems. Valid competency assessment instruments have the potential to enhance professional development by identifying areas for improvement. Instruments do exist for the assessment of general nursing competency; the Nurse Competence Scale (NCS) developed by Meretoja being one salient example (2004). The NCS has been used with perioperative nurses but is not specific to the specialty. The Competency and Creden-
tialing Institute (CCI) has begun the early use of true competency assessment in its certification and recertification processes. A valid and reliable instrument for the selfassessment of perioperative nursing competency does exist, the Perceived Perioperative Competence Scale-Revised (PPCS-R) developed by Gillespie and colleagues. (Jaensson, 2018). This instrument has been validated for use with American nurses by CCI and is one of the four components of the CFPN credential. The results of a self-assessment using the PPCS-R assists perioperative nurses early in their career to chart their professional development course (Kinlaw, 2021). CCI plans to begin using the PPCS-R in its recertification programs for other CCI credentials in 2022. Many licensure and credentialing programs default to the very familiar use of Continuing Education (CE) in their programs. The assumption being that CE will enhance competency. But, the link between CE and competency is not well-supported by research evidence. CCI believes that competency assessment instruments have great potential to enhance perioperative nursing competency if a supporting framework can be fashioned. CCI is accustomed to taking measured risks and in being an early adaptor of new methods. In the future you will see further efforts by
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