Development of a Primary Care Competency Evaluation Tool for Clinicals in an Accelerated BSN Program

Background: In response to the rapidly changing health care arena, a new pre-licensure nursing education curriculum was developed and funded by a $2.5 million grant from Health Resources & Services Administration (HRSA) Nurse Education, Practice, Quality and Retention – Registered Nurses in Primary Care (NEPQR - RNPC) grant. The newly developed curriculum focuses on interprofessional primary care and is reflected in didactic, clinical, and simulation learning experiences. To capture accurate clinical experiences with a primary care focused BSN program, the initial question was as follows: How do we best evaluate the formation of primary care competencies in our students? One of the challenges in developing such an evaluation tool included ensuring that an evidence-based foundation would capture key primary, ambulatory care, acute care, and care coordination competencies that are measurable from the first to the last clinical semester in one continuous tool.

Purpose: A new clinical evaluation tool was developed with consideration of multiple evidence-based recommendations, resources, and tools to complement professional nursing practices with patient focused indicators for a more wholistic approach. This process would allow clinical instructors to evaluate student achievement of primary care competencies learned across the curriculum and applied in the clinical setting in one continuous document. The purpose of this poster is to describe the processes used in the development of the evidence-based competency evaluation tool.

Description: The existing acute care clinical evaluation tool was reviewed through the lens of Pender’s health promotion model as the framework for the initial step in the development of the comprehensive clinical competency evaluation tool. Using a cross-walk technique, multiple resources for primary, ambulatory care, and acute care competencies were reviewed and thematic analysis was conducted. The integration of primary care competencies with competencies required by accrediting bodies was an essential step in remaining true to the clinical focus. Themes were established to ensure the tool would provide a complete and comprehensive evaluation of the nursing students’ skills progression as the complexity of clinical patient care increases with each new semester built upon the previous semester’s learning trajectory. Once the initial competency indicators were identified as appropriate, the competency evaluation tool was built using Bloom’s taxonomy as a foundation for student progression toward competency. Levels were created with the intention of quantifying the progression toward a clinical grade. The evaluation tool allows for assessment at varied points in time within a semester as well as across the program. The clinical evaluation tool is comprehensive of primary, ambulatory care, acute care, and care coordination competencies.
Projected outcomes: This evaluation tool has been in use for 1.5 semesters. As a comprehensive, evolving tool over the student’s progress in in the program, there have been some challenges. Development is ongoing based on its use in the program.