Update Your Curriculum to Support Competency-Based Education & the New AACN Essentials

Cherokee Lee :

Hello, everyone. We’re so glad to have you here with us today with Peg Rauschenberger and Ann VanEerden. We’re going to be talking today on their experience, starting to update curriculum to support competency-based education in the new AACN essentials. And I’ve heard a little bit about this topic and it’s really fascinating what they’re doing, so thank you so much for being here with us today, I’m excited to learn. If we could just move on to the next slide so that we could go over housekeeping items. Awesome. So just a little bit of an introduction for our agenda. I’m going to go over some housekeeping items and we’ll go into introductions. I’ll let Peg and Ann introduce themselves. And then we just have kind of a question and answer set up today. So I’ll be asking them questions and they will be helping to answer them. Just some things to keep in mind, Peg and Ann will talk to us for about a half hour, 45 minutes, it can be flexible.

Cherokee Lee :

At the end of that, we’ll have a Q&A session for roughly 10 minutes, 10 to 15, if we have more questions, so please make sure that as we’re going throughout the webinar to just fill out your questions that you’d like to have answered. And then at the end, we’ll do a live Q&A with Peg and Ann. And we’ll go over all of those. If you see a question that you really like, and you want to have answered, please feel free to up vote that with a little thumbs up at the bottom of that question, and we’ll be sure to get to it. Also, we would really like to encourage you to use the chat feature. We will have somebody here monitoring the chat just to make sure that all of your questions are being answered in the meantime, or just helping you along the way, but we really want to encourage you to interact with each other and learn from each other. Without further ado, Peg, Ann, would you like to introduce yourselves for us?

Peg Rauschenberger:

Sure, sure. I’ll get started. I’m Peg Rauschenberger, I’m Dean Emerita of Nursing at Alverno College in Milwaukee, Wisconsin, and currently the associate Dean for New Initiatives, which is kind of exciting. We aren’t here representing AACN, but we are steeped in the work of competency-based education. Alverno college, a little background, Ann can build on this, but we have been doing a competency-based education since the seventies. In fact, we’re an ungraded system. Everything is judged and evaluated based on criteria and competency, so Ann and I have been spending some time talking to various audiences about how to do this, and it’s not as hard as you think, and hopefully interpreting some of AACN’s requirements for all of you. We want to be helpful, Ann?

Ann VanEerden:

Hello. My name is Ann VanEerden and I’m the Director of the Undergraduate Nursing Programs at Alverno College. I’ve been there since about 2008, and I’ve worked pretty much exclusively in the undergraduate program. I can’t tell you when I started there, how really revolutionary the concept of competency-based education was for me in terms of teaching and education, it just made sense, incredible sense to me. And I felt strongly that’s the way to go, which is why I’ve stayed here. Like Peg, we are working with other on behalf of Alverno. We are using our experience and basically our experience to help others through this process of moving toward competency-based education. And I think we’ll be sharing more information with you throughout the seminar today, so welcome.

Peg Rauschenberger:

I also wanted to say that Ann and I have this style of presenting where we add on to each other’s thoughts occasionally, so know that we aren’t being rude to each other, this is how we work.

Cherokee Lee :

That’s perfect. That’s exactly what we want. We want to hear from both of you as much as you want. And then also, I mean, I think that encourages what we’re looking for in the chat too. We just want to hear from everyone. Thank you so much Peg and Ann, why don’t we just go ahead and get started and we can move on to the next slide and go into the first question. Peg, I’m going to direct this one to you to start. How have you approached curriculum mapping, identifying gaps, and implementing a curriculum based on the New AACN Essentials’ domains and competencies?

Peg Rauschenberger:

Well, that’s certainly a big question. Maybe I should say a big task, that sounds worse than it really is. But first I do want to keep reiterating that AACN does not want nursing programs to create curriculum based on the Essentials. It is not a map for creating curriculum. The domains, competencies, and concepts presented in the Essentials provide a platform for curriculum design and program assessment. But the intent is to produce some consistency and clarity, absolute clarity regarding the outcomes expected of graduates, so they are to be incorporated into each of our very unique curricula. I’m always interesting when you think a nurse, is a nurse, is a nurse. Well, they’re not educated that way. All of us have such wonderfully creative, unique, innovative curricula. And so these Essentials are of course meant to be incorporated, but they aren’t the map for your curriculum.

Peg Rauschenberger:

Nursing programs, we do have that flexibility then to create our own curriculum. And that’s kind of freeing because what we’re saying is you don’t have to throw out what you have. What you have is absolutely fine, but we have to begin to look at each of our curricula and see where all of these essentials lie. I guess I’m saying the good thing about it is that most of us have already accomplished much of the hard work creating program, course, and unit outcomes. I can’t stress that enough, that you cannot start this whole mapping process until you have good outcomes written that are clear, that students can understand. Sometimes I’m guilty of this myself, those of us in academia can get a little wordy or a little abstract when we’re talking about outcomes.

Peg Rauschenberger:

Outcomes are meant to be usable and accessible to the students as well as to faculty and outside people who look on. But if you haven’t established those outcomes, you need to do that, or maybe take a look at them, make sure they’re clear. That would be where you need to start if your outcomes need a little work, and how to write a good outcome is the topic of a whole nother webinar, that we aren’t going to do today. But the process we have begun to do as far as mapping the Essentials. And I’m just going to share with you the process we’re using, it doesn’t mean it’s the process you have to use. And I’m going to again, say several times throughout the webinar we have until 2024 to implement this, so don’t think we’re under the gun, just a little gun, because it is work.

Peg Rauschenberger:

All right, so what we have done is to, we want to bring the family… Family, that’s how I think of faculty, bring the faculty together to establish a shared understanding of the purpose of the process and how to go about it. You can’t just send out an email to faculty and say this is what we’re doing. You have to come together and have a discussion about the Essentials, and why we’re doing it, and what it means for your particular curriculum. We decided to have the faculty who teach each course in the curriculum, be the person who does the mapping for that course, because they own it, and they know the most about what happens in those courses. Once we have established, you know what we’re doing, we’ve looked at our outcomes. And as administrators, if you’re an administrator it’s on you to create the time and space for faculty to do this work, it cannot be an add-on.

Peg Rauschenberger:

So we come together on Friday mornings and we bring food, and fun, and it’s bonding, you know? Anyway, as I said, the faculty teaching the course is going to map that particular course. And we’re using a template that we found on AACN Connect. If you have not gone on there, it is a treasure trove of things beyond the Essentials, but it’s always a place where faculty share all sorts of innovative things, so make that a regular stop when you’re doing some web searching, AACN Connect. Why recreate a template when you can use one or tweak one that’s already been created, so we found that, and we’re doing our mapping on it.

Peg Rauschenberger:

And if you go to AACN Connect in the search, just type in Essentials mapping template, and they’ll come up for you. There are wonderful ones for both the pre-licensure and graduate, because remember this isn’t just a pre-licensure thing, it is for graduate and DMP programs as well, so it is a bit daunting when you think about it. But again, not as much work as it sounds like. The template we’re using has a column for the domain, the second column lists all those competency statements. I’m hoping you are all at least familiar with the Essentials, by the time we’re having this particular conversation, but it has the competency statements. And then the third column lists the sub-competency. Those are different for pre-licensure versus graduate.

Peg Rauschenberger:

The next two columns, I’m not supposed to be watching the chat, but I’m going to repeat AACN Connect is where you find the template. The next two columns are then repeated several times. Course outcome is one and student assessment is the other, the faculty then go through the domains and identify if they have a course outcome that incorporates a particular competency or sub-competency, and they enter it into the template. No particular course has to have all of these in them. You may only have a couple, so don’t panic that there’s a lot of empty space if you’re the faculty filling out that template. Next to the outcome, what we list is I, R, or A. Meaning, is it introduced in this course? Is it reinforced in this course? Or is it assessed for mastery in this course?

Peg Rauschenberger:

On rare occasions you can have all three in a particular course, but often if you’re talking about say, if you’re talking about nursing process or something like that, it’s introduced somewhere, it’s reinforced in several, and then ultimately as they’re an advanced student you assess that they have mastery over it. I’ll talk about this in minute, but in the student assessment column, we also have a list of codes that they can show how the assessment happens. Is it an exam, a presentation, a simulation, a case study, is it in clinical performance, et cetera. We don’t just check and say it was assessed. How did we go about it? Because as we’ve talked in other arenas, doing competency-based education means new ways of teaching and new ways of assessing, so let’s start adding a little variety to our curriculum. All right, now I’ll tell you one problem that we have encountered is that faculty think too hard about the competencies. I hope Ann is nodding, because they begin to see more of them in their course than is really possible.

Peg Rauschenberger:

And in some ways I get that. But just because something is mentioned, doesn’t mean it’s a true outcome in a course. And we all know that competencies are rarely exhibited in isolation, so most demonstrations integrate several competencies, sub-competencies. We have these competencies at Alverno that include analysis, and problem solving, and social interactions, and things like that. Let’s not get off on that, but you can’t do problem solving without analyzing something first, so that same is true with all of these competencies, they’re intertwined, so faculty tend to just like students read too much into questions on exams, sometimes faculty read too much. We have to say no, what is a true outcome of this course for your students? Okay. That’s a little challenge we have had. Once all the courses are mapped, it becomes very clear where there are gaps.

Peg Rauschenberger:

That’s your gap analysis, are there blanks all along the line? We don’t touch on that competency at all. Or is it introduced, introduced, introduced nobody ever reinforces it or really takes a look at their performance in it, so there are different kinds of gaps. Is it missing all together or are we not scaffolding it the way we need to. Once you’ve identified those gaps, that’s when the curriculum work begins, and that is more difficult. The mapping is a little tedious, but it’s thinking then about your curriculum and where you need to go with it and what you need to fill those gaps with. Again, I’m going to say it again. We have until 2024 to get going on this. All right, I hope I answered that question.

Ann VanEerden:

If you don’t mind Peg, I’m just going to add a few comments, a little bit more information to your response. And that is before we actually got to the mapping that you talked about, we did begin the process with all of our faculty together, and we talked about it more in terms of… Our beginning meetings were more of a book club with the book being the Essentials. And that was really, and as Peg said, we’re not saying how to do this, but I will tell you that, that was really I think, a benefit to our faculty to begin that way. We have many experienced faculty, we also have many new faculty, we have a number of faculty who are certified nurse educators, and we have some faculty that are not certified nurse educators, so it was really great to have everyone together with different levels of experience and expertise in terms of nursing education working with curricula.

Ann VanEerden:

We began with the book club and in doing so, like I said, the book was the Essentials, but we would have a breakup, maybe pages I think it was pages four to nine or something, so that people could read the history of the Essentials. Our new faculty have heard about the Essentials. They know that they were used to develop the curriculum, but really have no experience in terms of what they were, where they come from, what is their purpose, why do we use them, that sort of thing. We looked at that and we had discussion questions for everyone that we did on Google Docs, and shared, and broke into small groups and then shared out. We also looked at factors or what AACN calls the design influencers. And we talked about that, why we had to change it and shape it for nursing education in the 21st century, because we have different design influencers than we had 10 or 15 years ago, even.

Ann VanEerden:

That was I think, a great way to set this up for everyone. Before we actually got into looking at the domains, and competencies, and sub-competencies, it was something we could do with faculty that teach at all levels in the undergrad, as well as in the graduate programs. And I think it was really a very dynamic process. Another part of that process was looking at, when Peg was talking about program outcomes and course outcomes and all that we really did look, we went all the way back, we went all the way back to the college’s institutional outcomes. And we went through a process where when we got into the nursing program outcomes, we looked at and talked about where the domains were within each of those outcomes. What we ended up doing is we really all walked away with the sense of our curriculum being a very cohesive curriculum, so that everything from the top flowed to the bottom, into the assessment outcomes.

Ann VanEerden:

And that’s where we’re going with the mapping, and the competencies, and the sub-competencies. But I think again, I said, it’s not the way you have to do it, but I think it was a really very, very dynamic experience for us. As we had people together, a lot of our faculty kind of, they not only were talking about what we wanted them to talk about, but then they were also looking at different teaching strategies, different ways of assessing in their courses. And while we’re still doing the gap analysis, it really generated a lot of conversation and energy amongst the group as opposed to, and I have seen this with some schools, as opposed to saying, here’s your course, what competencies are in your course, kind of thing? I felt it was a much more complete, exciting dynamic and energizing process than if it was just handed to them as another thing to do. I also just-

Peg Rauschenberger:

And we-

Ann VanEerden:

Yeah, go ahead.

Peg Rauschenberger:

I was just going to say, we find that new faculty who come to us with no teaching experience, tend to teach the way they were taught. And often that is the lecture/exam kind of format. And so understanding competency-based is a real growth process for them. Ann is absolutely right that having this time to bring our faculty together and just simply chat about what they do in their classroom is great. Also, and I’m not doing a commercial, but we had all of our faculty at one point when I was Dean, I purchased for each one of them, a book called Make It Stick. That includes all sorts of great, innovative, active learning strategies for competency-based, so it’s their chance to talk about, I tried this, I tried that, this worked, this I need to tweak, so it’s so much richer than just ending up with a map.

Ann VanEerden:

Mm-hmm (affirmative), mm-hmm (affirmative). Yeah. And as I indicated, I have worked with some schools who have literally sent an email to their faculties saying, please, what sub-competencies do you assess for in your class? And do it on your own for your own class. And when I work with these groups, then we have to like, go way back up to what Peg was saying. We’ve got to look at the program outcomes first. And then we look at the course outcomes and then we’ll get to your own individual courses,, so that’s just something to think about and I think a fuller approach to the whole process. And I do think that when we had the book clubs and we actually had people reading four pages of the document at a time, and then discussing, I think it helped our faculty to make better sense of why AACN is making this change and how it will influence nursing education in a positive way, and the future of nursing.

Peg Rauschenberger:

And we built the reading time into the time.

Ann VanEerden:

We did. Yeah. Yeah.

Peg Rauschenberger:

We didn’t make them do it before they came.

Ann VanEerden:

Yeah, because they probably wouldn’t have time to do it before they came.

Peg Rauschenberger:

Even five pages, you know what I mean?

Ann VanEerden:

Yeah.

Cherokee Lee :

That’s so wonderful. In fact, I was just looking at the next question and I wonder if some of this is kind of leading into that, so I just want to kind of skip ahead to that question and just ask you Ann, how has your approach to assessments changed with the shift of competency-based practices?

Ann VanEerden:

Okay. Well, thank you. At Alverno college, our approach to assessment really hasn’t changed because this is what we’ve always done since the early 1970s. We look at assessments in a variety of different ways, not a test, right? Okay, so we look first there’s assessment of learning, and this is a standard space measurement for accountability, certification, progression. NCLEX is an example of assessment of learning. Second, we look at assessment for learning, and these are diagnostic measurements used to provide developmental feedback to the learner and to the teacher. And then lastly, we look at assessment as learning, and this is a metacognitive process whereby self-assessment, and peer feedback, and instructor feedback are used to help students set and monitor progress toward learning goals. As part of the competency-based framework, we assess not only to assign what we call a progress code as Peg said it, an ungraded system, or to give a grade, but we also use formative assessments regularly to help students gauge their learning, identify their strengths, and gaps in understanding.

Ann VanEerden:

We use assessments to scaffold learning as Peg was just talking about. And so when we do that mapping, we’re looking at what level is this the introduction, is this the mastery, but we’re always building in that scaffolding. Assessments inform our classroom practices and pedagogy in real time, they allow us the teachers to identify parts of lessons that didn’t land or didn’t really work for a given set of students. And then we can adjust our teaching and our activities to improve student learning and advance our students. Our performance based assessments in a competency-based framework go beyond assessing discrete packets of knowledge meaning what we would think of maybe as an objective assessment to evaluating knowledge in practice through integrated work projects judged against clearly communicated criteria. And criteria is so critical to the assessment process, so in order to assess what a student can actually do with their learning, we have students create exhibits, presentations, health education materials, infographics, portfolios.

Ann VanEerden:

We have them engage in debates, do role playing, case studies, and simulations all as a means of assessment. With our approach success on assessment means that a student has met that criteria, that very specific criteria for the assessment. And the student has also provided evidence as to how the criteria were met, so that’s part of that metacognitive process. When students self-assess to determine whether or not they have met the criteria for an assessment and to provide evidence of how the criteria were met. They often say that the self-assessment is like writing a paper after a paper. And with the new Essentials this is not going to change, that self-assessment is really critical to the process. What will be changing for us because of the New Essentials is what Peg described.

Ann VanEerden:

Like most of you, we are in the beginning stages of conducting a gap analysis, so we’re examining our existing assessments and assessment criteria to identify the competencies and sub-competencies that we currently assess, and also to identify which competencies and sub-competencies we will need to assess. We intend to use the language of the AACN document, domains, and competencies as we move forward in this process. For example, as part of the process, any assessment criteria that included the wording of patient centered care will now be changed to person centered care. All right. Peg, do you want to add anything? Would you like to add anything to that?

Cherokee Lee :

Oh, Peg you’re on mute.

Peg Rauschenberger:

I’m muted.

Ann VanEerden:

You are.

Peg Rauschenberger:

Have I not learned in the last two years yet on Zoom? We are a step ahead I must say, at Alverno because we’ve been doing this since the seventies. But it is changing and I think as we talk to some of the schools around the United States as they’re moving into this, we’re finding that some think that the clinical arena is the only place where you show hands on abilities, competencies, and it’s more than clinical skills, it is clinical judgment. And there are ways that students can demonstrate that beyond just their clinical experiences. And so that’s where getting innovative, and it’s a fair amount of work when you start setting up all these learning experiences. But once you do, and I’ll be talking about this a little bit later this morning, those students get motivated and that makes it take off like a shot.

Ann VanEerden:

Mm-hmm (affirmative). Yeah.

Cherokee Lee :

Actually I was just going to ask what is the student’s role in these new strategies? I mean, are they clearly defined? Do they know what they’re doing?

Ann VanEerden:

Yeah.

Peg Rauschenberger:

All right. I think that we can agree that any mode of curriculum delivery is best if the student is a committed partner, even when we were doing strictly lecture and exam kind of thing, which I don’t think any of us really do totally anymore, but that’s the classic model you have in your head of university. But we at Alverno have been reading and implementing the research on active learning for decades, as well as all of you have. I mean, active learning became the buzzword quite some time ago. And so active learning means the student participates in it. And I think we all have experienced though, especially when they’re starting out those students who enter the classroom, sit in their seat and wait for us to just pour that knowledge and those skills into them.

Peg Rauschenberger:

I’m going to sit here and maybe absorb it by osmosis or something, but most students learn very quickly that they have to work in order to learn, I hope. But competency-based education does require a new level of commitment from students along with more or maybe different kinds of work from them. In some cases, this will be a significant change for students. We see it, especially in our transfer students who come in from other colleges and universities. And it’s like, as Ann talked about the self-assessments, we make them write, which is a paper after they write the paper. And so it is kind of a wake up call, and sometimes there’s some resistance, because it’s work. We have found though that in the long run, students eventually become strongly committed to competency-based education and they have stronger feelings of self-efficacy and self confidence, so what does it take though for us to get them committed? How do we give them a little nudge along in the process to being committed to competency-based?

Peg Rauschenberger:

Well, traditionally, and I’m making generalizations, but traditionally learning outcomes are focused on memorization, comprehension, and passing tests. In competency-based learning the focus is placed on deep, deep understanding that is demonstrated then through application. This means that learning outcomes are proven by action and focus on building the skills that students need to become skilled nursing professionals. And skills, meaning not just sticking people with things. When students come in, that’s often I can’t wait to start an IV or something, and the skills are so much more than that, as we all know. But transparent goals and outcomes help the student take responsibility for their learning path, so I always say to my students, I make us go over the outcomes for the course on the first day of the course, because I tell them, how can you work toward a goal if you don’t know what it is. Because students often get that syllabus and never look at the outcomes or the unit outcomes, what are you supposed to accomplish in the learning this week?

Peg Rauschenberger:

I use the language of outcomes with them from day one and tell them, so what was the learning outcome regarding that for today? That ownership in turn helps them become better learners as students, but it’s also setting them up for their future, that lifelong learning and taking accountability for that learning. If you take a look at, and I did, and I have over time at the literature on student motivation in competency-based education, especially. Most of it addresses students who are in high school programs, but I’m going to tell you that our lived experience at Alverno, which… All right, there is a book called Learning That Lasts, I don’t know if you’re going to mention it at all Ann, at some point, edited by Marcia Mentkowski that we all wrote some time ago. But it talks about how you don’t just learn for an exam and then it’s gone, learning that lasts. Our lived experience validates what…. The literature says about high school students is very similar, it’s very similar.

Peg Rauschenberger:

It comes down to intrinsic motivation versus extrinsic, okay. Meaning extrinsic or controlled motivation comes from systems such as reward and punishment, which is a traditional kind of grading. That is their goal, they want a grade, they want a score on an exam and those kinds of motivations can be useful in the short term, but don’t last. And don’t help the students want to seek more. They just… I got the grade, thank goodness, and I move on. Now you’re hearing us talk about exams, we do have exams and students have to pass NCLEX and they have to get a certain score on our exams, so don’t think that we’re anti exams. But sometimes when that’s the only motivation is a grade of some sort we’re missing out, we’re missing out. Self-determination theory, if you take a look at that explains that motivation will increase when students experience several things. One, competence. I can be successful, okay. I feel like I can be successful.

Peg Rauschenberger:

Relatedness, I have meaning to this process and I’m connected to those outcomes. I’m not just a body in the seat, I am related to this and people are dedicated to helping me to learn. And then some autonomy, when we’re talking about competency-based education, if you look at some of the literature on that, when you go to the extreme, some of it competency-based is where you work through at your own pace and all of, that’s not the Essentials or AACN attempt. They’re thinking semesters and not the self-paced kind of learning. There’s a place for that for certain things, but it doesn’t tend to work very well in nursing programs, but that’s a whole nother discretion we can have another day. But they need some autonomy, some control over the process of their learning so that they own it. We can’t forget though that motivation, and I think we can all speak from experience ebbs and flows. I have some days I’m more motivated than others.

Peg Rauschenberger:

Faculty commitment, clear explanations of expectations and processes, pertinent feedback to students, and enthusiasm. Some people call me the cheerleader, that’s sort of… My one class was so unmotivated I remember I even got pompoms and I was going, you can do it, you can do it. That was a bit much. I only did it once, but our enthusiasm can shape that intrinsic motivation by helping them to see that becoming competent is going to make them feel like the true professional they’re becoming. We have found in the long run that students become strongly committed to competency-based education. Again, because of those feelings of self-efficacy. In a nutshell, what it takes to get them committed, cognitive understanding of the necessity of being able to do something with what they know and that competency-based learning and how it works, okay.

Cherokee Lee :

Wonderful.

Peg Rauschenberger:

They have a cognitive understanding of it. Then they need that emotional acceptance. They need to move from, just tell me what I need to know. And we have all heard that. And I even feel that way sometimes. The book was Learning That Lasts and Make it Stick. I’m sorry, the chat pops up, some of them I respond to. Okay, emotional acceptance. Again, they need to move into taking ownership, taking responsibility for their own learning. And we can again, nudge them along the way. And lastly, they need the motivation. And what really gets them motivated is success, so you can set up experiences that they can be successful at and feel like I can actually do things with what I’m learning, I can make judgements, I can act as a nurse because I have practiced and demonstrated it in other ways. And it’s very motivating then to continue with that process, so that’s what we need from students and it falls on us to kind of set it up so it can happen even though it’s internal to them, you know what I’m saying?

Cherokee Lee :

Right. I think it takes a skilled educator to be able to instill that motivation. I’m sure you’re both amazing at it.

Ann VanEerden:

I was just going to add a couple points here and that is that one of the ways that we set this up and this is again, just maybe unique to Alverno, but I doubt it. Is that in our classrooms, there’s this… I know I state it, but it’s definitely unstated that we all learn from each other, there’s not a hierarchy, we don’t go by titles, we go by first names. And so I respect every student, I can learn from every student, just as every student can learn from me and every student can learn from other students. And so I set that up pretty early on in the classroom. If somebody is a CNA in an emergency room, I’m like, oh my gosh, there’s so much I can learn from you because I have never worked in an emergency department at all, and set that up and really foster that in the classroom, that’s again on us.

Ann VanEerden:

But once they have those early successes and they share with their peers and their peers learn from that, or become engaged because of it, it’s a great positive experience for students. The other thing that I was going to mention Peg here, in terms of what is the student’s role in these new strategies? I would like to just highlight and add to everything you said that peer feedback is a really important part of supporting students. And so we start at the very beginning with the scaffolding. Not only are you going to do your self-assessment, but you’re going to do some peer assessment, you’re going to provide your peers with feedback.

Ann VanEerden:

And that’s actually a very fun journey to watch if you have the opportunity to see students early on, and then later in their academic career, when they start out giving peer feedback, everybody’s meeting the criteria, everybody’s doing a great job, but when it comes down to toward the end of their senior year, their last semester, they provide meaningful feedback to their peers almost to the point that there’s not a lot left for the faculty to give in terms of feedback, because that’s really a competency that they develop over time, something that they will need in their professional practice, so I would just add that the student’s role in the new strategies would be providing feedback to their peers.

Peg Rauschenberger:

Well, and the other thing is learning how to accept feedback without being crushed, that feedback is on a performance. And we do talk about that. It is not on your character, who you are as a person, but we all know that, that we feel like it’s criticism of us when someone gives us some negative feedback. And so it’s helping in some ways, desensitizing but sensitizing, do you understand what I’m saying? That understanding, I need this feedback, I want this feedback, this is going to help me, so I’m going to share with you I’m a product of an Alverno education. And of course, I went there back when they first started doing this, when the dinosaurs walked the earth. But I went on to grad school and someone said to me, you went to Alverno, didn’t you? Because I kept asking, well, tell me what more I could have done instead of just accepting the B- on the paper. They said, you keep asking, what more could I have done? Our students become that way? And they love that in the employment arena that students seek feedback and are not hurt by it.

Cherokee Lee :

Absolutely. Thank you so much. I know we’re a little bit, we’re kind of at the end of the presentation here. I want to skip to the last question. And then before I do that, just encourage the audience to ask any questions that you have now, if you don’t mind putting that just in the Q&A section at the bottom, it’s just right next to the chat, so that it’s readily available. So just be thinking about that as I ask this last question to Peg and Ann, and I’ll give you about five minutes to answer this last question, then we’ll go into the Q&A, but what impact do you think the competency-based approach will have on the advancement of the nursing profession?

Ann VanEerden:

Okay, well, I’m going to be referring to some of the work that Peg had initially indicated from Learning That Lasts. And one of the authors defined learning as a process that leads to change, which occurs as a result of experience and increases the potential for improved performance and for future learning. Ask what can the graduates do as a result of their education? Competency-based education is learning That lasts, it’s learning for one’s own sake, and for the sake’s sake of others. One of the goals of learning is to prepare citizens for the world and multiple public’s who are served. Because competency-based education is integrative, meaning integrating learning, development, and performance in college and beyond. Students enter the workforce, not only with the knowledge, but also with the ability to use that knowledge, so I think that initially the impact of competency-based education will be better prepared nurses who are workforce ready. Employers have identified skills such as compassion, empathy, communication, the ability to work on a team, attention to detail, flexibility, clinical decision making, leadership, as all required of, or as all desired of employers.

Ann VanEerden:

As you can see these skills easily connect to the domains and competencies of AACNs New Essentials. There was a study in 2019 of some dieticians who had graduated from a competency-based education, this was in Australia, but it highlighted that the dietician communicated for better patient care. They demonstrated sound scientific inquiry and problem solving skills for effective practice. They used effective critical thinking skills and evidence based practice. They demonstrated leadership and patient advocacy in a professional manner, and they had sound entrepreneur and business management skills. These were all competencies or domains, that was a part of their education. In Learning That Lasts, a study that of Alverno college alum noted that in addition to demonstrating the competencies required for graduations, students also accomplished the following outcomes. They had a sense of responsibility for their own learning and the ability and desire to continue learning independently, which I think is just fantastic, as it speaks to the future of nursing.

Ann VanEerden:

They had self knowledge and the ability to assess their own performances critically and accurately. And that’s what Peg and I were just talking about. And they had an understanding of how to apply knowledge and competencies in different contexts, meaning they could transfer their knowledge and competencies. The Essentials were designed to bridge the gap between education and practice. The core competencies were informed by lived experiences of those deeply entrenched in various areas where nursing practice and the synthesis of knowledge intersect. I think that this will allow nurses to have a shared vision. The shared competencies will allow nurses to have a shared vision it’ll promote and foster future nursing practice at advanced levels. It will represent a unified voice of the profession, so I would say based on my experience with competency-based education, I do believe that it will enhance and strengthen the advancement of the nursing profession. And as I said, make individuals, graduates more workforce ready. Peg, I know you did some work with the workforce group, so you might want to add to that?

Peg Rauschenberger:

I did do some work with… What I did though, is I reached out to the major healthcare systems in our area and asked them and ask them what they were doing to assess their nurses. And they are moving to a competency-based, not just the old skills fair that hospitals used to have, but they’re going to a competency-based system of evaluation of their nurses, so they are seeing the value of assessing what people can do with what they know. It is happening in the profession and if we get them ready for thinking that way in their pre-licensure education, they’re going to be a step ahead.

Cherokee Lee :

Wonderful. Well, my goodness, what a wealth of information this has been, I’ve learned a lot. I’m not even a nurse, but I feel like I’ve learned a lot from you both. And I’m actually really looking forward to going back and watching this again. I do just want to jump into the Q&A portion of this. The first one it looks like is directed to Ann here. It says, where could I learn more about assessment of learning versus assessment for learning versus assessment as learning? Is there a source that you would recommend?

Ann VanEerden:

There is a book that… I’m trying to think. Peg you can help me. I think it’s Assessment and Learning. I think that might be the title.

Peg Rauschenberger:

Yeah, I don’t have the citation right in front of me.

Ann VanEerden:

Yes, we do have a list of references we can provide to you and it would be on there, but it is a book that was published by Alverno College a number of years ago. But if you’d like, we can get you that list of references and we’ll make sure to highlight that one.

Cherokee Lee :

Wonderful. Thank you.

Ann VanEerden:

Sure.

Cherokee Lee :

Oh, I’m sorry. Did I interrupt?

Ann VanEerden:

No.

Cherokee Lee :

Okay. I see this question here that I think is a really great almost wrap up, but feel free to continue asking questions if you’d like. This says how do you get buy-in of this teaching and learning process from preceptors in the community, for example, who are not education based practitioners?

Peg Rauschenberger:

I’ll start and then you can continue, Ann. It’s almost impossible to absolutely educate every preceptor especially if you have an APRN program, et cetera. But anytime someone is in one of those experiences, anytime a student’s in one of those experiences, there are outcomes for that course. And so what you need to instill in the student is that they need to demonstrate performance of those outcomes in order to be successful. And then what I do talk about with the preceptor as the faculty for the course is here are the outcomes I’m expecting the student to do, and we’re expecting that they don’t just talk about it, that they can demonstrate it. I’m not sure if you talk about buy-in, because I think most practitioners want competent students and competent practitioners at the end of the process. But in the handbook I give them, I talk about its competency base and they must perform, but that’s what I reiterate when I talk to them.

Ann VanEerden:

In many cases because our students have this as a part of their education, they speak to it well when they’re speaking with their preceptors. And when they do, students have to self-assess and they send their self-assessments to their preceptors, which really, I think without saying it, I think it’s really helpful in guiding to preceptors who this is all new to. But I do want to reiterate that going back to what Peg said at the very beginning, it’s all about clearly stated public course outcomes, unit outcomes, self-assessment or assessment outcomes with clearly stated criteria. We do all of that work, the preceptor isn’t creating criteria or anything, we do all of that work. And I think that really facilitates the role of the preceptor. It’s like, we’re helping him out without even having to do a lot of one on one or anything like that, it’s well laid out.

Cherokee Lee :

Wonderful. Well, I don’t see any other questions. I’m going to give it just one or two more seconds here, just to make sure that we get them all answered. But in the meantime, I found this to be very empowering. I found this to be very, you don’t have to reinvent the wheel and there are all of these resources out there where you can really apply these now, even though of course it does take work. But we just really appreciate you so much for taking the time to come back for the audience members who don’t know these two presented for us at our, what was called Reaction Conference, so you can actually go back and re-watch their presentation on our website on goreact.com, under our resources page, and then just click on webinars and you can see them there.

Cherokee Lee :

Oh, thank you, Jordan, our techie is putting up their resources there. This has been recorded, this will be on our website as well, so keep an eye out for this. We’ll also email you a follow up so that you can come back and just easily click on this webinar and re-watch. But in the meantime, thank you so much, both Peg and Ann for just taking the time again, to meet with us. This has been incredible, and I am just grateful that you were here. Thank you everyone. Have a great day.