Table 4 Critique of the existing CHNs CAT
From: Competency assessment for community health nurses: a focus group expert panel discussion
Criteria | Current CAT | Suggested recommendation from the literature |
|---|---|---|
Competency tool development process | Methodology not reported in the document | Comprehensive literature reviews are critically important for gathering evidence-based practice [24] on CHNs CAT. Methodology for instrument development includes involvement of panel experts through focus Group Discussion (FGD), Delphi approach o Face-to-face interview which should be done in a systematic process (see Table 2). The instrument must be pretested [24]. |
Methods/approaches used for assessment of competencies | Limited to direct observation of skill demonstrated by assessors | Adopt variety of assessment approaches. E.g. return demonstration, case presentations, case studies, certification recognized by the nursing profession, continuing education programmes related to the nurses individual practice, documentation review, examinations for skill assessment and/or clinical reasoning, nursing Research, skill assessment inventories (via self, peers, supervisors, and clients), observation of daily work, portfolio development and review, presenting at local, state and national meetings, publishing in a scholarly journal, quality improvement indicators, self-directed learning activities, Self-assessment tools, and simulations [13, 25]. |
Performance indicators | Tick boxes limited to two performance indicators (either DONE or NOT DONE) | Competency involves more than just technical and procedural skills [13]. Use findings from the literature and international regulatory documents. |
Level of competence | Not acknowledge | Adopt strong theoretical background [24] such as Benner’s framework of a competent nurse – from novice to expert to acknowledge level of competence [26]. |
Competencies assessed | Limited to procedural skill Other aspects of competencies such as thought process (critical thinking skill) and knowledge, communication and values are not assessed | Based on criteria such as high risk, low volume, problem prone procedures or situations, unusual incidents and regulatory requirements. Should also focus on new, changing, high-risk and problematic area of practice [25]. |
Frequency of competency | Not stated in the document | On-going and assessed at regular interval as identified by the organization [8, 27]. |
Who performed the competency assessment | Not mentioned in the document | Should be registered nurses skilled in the field of competence assessment and methodologies to ensure valid and reliable competency assessment processes [8, 28]. |