Continuing Competence
Definition of Continuing Competence
Continuing Competence refers to the on-going acquisition and application of knowledge as well as the decision-making, psychomotor, and interpersonal skills expected of licensed nurses.
It results in nursing care that contributes to the health and welfare of clients served.
Importance of Continuing Competence to the Board of Nursing
The Board of Nursing is responsible for protecting the public by regulating safe and effective nursing care.
Nurses demonstrate initial competence by passing a licensure exam, but due to the rapid changes in nursing practice, initial knowledge can quickly become obsolete.
Hence, safe practice relies on the ongoing competence of nurses.
The Board is committed to ensuring that nurses maintain and develop their skills and competence.
Reflective Practice
Definition of Reflective Practice
Reflective Practice is defined as “a process for the assessment of one’s own practice to identify and seek learning opportunities to promote continued competence.”
It assists nurses in identifying their goals and progress from being a “novice” to an “expert” in their field (Benner, 1984).
This practice is not novel; rather, it is an approach to learning from experience and incorporating that knowledge into one's practice.
Steps in Reflective Practice
The process can be summarized as A, B, C, D:
Assess your practice - Evaluate based on established standards.
Use feedback - Collect verbal or written feedback from supervisors, patients, colleagues, and students.
Develop a learning plan - Use self-assessment and feedback to identify strengths and areas for improvement.
Implement your learning plan - Engage in activities that foster professional growth and competence.
Four Dimensions of Nursing Practice
When assessing competence, consider the following dimensions of nursing practice, applicable in any practice setting:
Professional Responsibility - Understanding the ethical and legal responsibilities of nursing practice.
Knowledge-Based Practice - Incorporating evidence-based knowledge into clinical practice.
Legal/Ethical Practice - Complying with laws and ethical standards governing nursing.
Collaboration - Working effectively within interdisciplinary teams.
Assessment of Competence
Tools for Assessment
The Board has developed worksheets and tools for using a reflective approach to assess nursing practice.
Employer evaluations can also be utilized to assist in the self-assessment process.
Feedback Collection
Seek feedback from available sources to help identify personal strengths and areas needing development.
Possible sources include supervisors, colleagues, and patients.
Developing a Learning Plan
Using Self-Assessment Data
Review data collected from self-assessment and feedback.
Identify personal strengths and areas that need improvement.
Setting Goals
Establish one or more personal goals for continued competence.
Select appropriate learning activities to assist in achieving these goals.
Required Learning Activities (Choose One)
National certification or re-certification by a credentialing body recognized by the Board.
30 contact hours of continued education.
Completion of a Board-approved refresher course.
Completion of two semester hours of post-licensure academic education related to nursing practice.
15 contact hours of continued education along with leading a nursing project as principal or co-investigator (include a problem statement, project objectives, methods, completion date, and summary of findings).
15 contact hours of continued education through authoring or co-authoring a nursing-related article, paper, book, or book chapter.
15 contact hours of continued education and conducting a nursing continuing education presentation(s) totaling at least five contact hours (requirements include a program brochure or course syllabi, objectives, presentation date, location, and estimated number of attendees).
15 contact hours of continued education combined with 640 hours of active practice within the preceding two years.
Definition of Contact Hour
A “contact hour” is defined as 60 minutes of an approved, organized learning experience.
The Board maintains a list of recognized providers of continued education courses.
Implementation of Learning Plan
As of July 1, 2006, nurses must complete the steps A-D: assessing practice, developing a learning plan, and selecting an acceptable learning activity. Implementation should occur prior to the next renewal period.
As of July 1, 2008, nurses must attest to completing the continuing competence requirements on their renewal application.
The Board will monitor compliance via random audits. If selected for audit, nurses will need to submit documentation such as certificates of continuing education or national certification, proof of hours worked, etc.
Acknowledgment
The North Carolina Board of Nursing expresses gratitude to the Council of the College of Nurses of Ontario, Canada, and the College and Association of Registered Nurses of Alberta, Canada, for their assistance in developing the Reflective Practice model and associated documentation.