volume 45 | may 2010 - ncsbn · 2014. 10. 14. · volume 45 | may 2010 2009 tuning analysis: a...
Post on 23-Mar-2021
1 Views
Preview:
TRANSCRIPT
NCSBN reSearCh Brief
Volume 45 | May 2010
2009 TUNING Analysis:
A Comparison of
U.S. and International
Nursing Educational
Competencies
Report of Findings from the
2009 TUNING Analysis: A Comparison of U.S. and International Nursing Educational Competencies
National Council of State Boards of Nursing, Inc. (NCSBN®)
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
ii
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
ii 2009 TUNING ANALYSIS
Mission Statement
The National Council of State Boards of Nursing, composed of member boards, provides leadership to advance regulatory excellence for public protection.
Copyright ©2010 National Council of State Boards of Nursing, Inc. (NCSBN®)
All rights reserved. NCSBN®, NCLEX®, NCLEX-RN®, NCLEX-PN®, Nursys® and TERCAP® are registered trademarks of NCSBN and this document may not be used, reproduced or disseminated to any third party without written permission from NCSBN.
Permission is granted to boards of nursing to use or reproduce all or parts of this document for licensure related purposes only. Nonprofit education programs have permission to use or reproduce all or parts of this document for educational purposes only. Use or reproduction of this document for commercial or for-profit use is strictly prohibited. Any authorized reproduction of this document shall display the notice: “Copyright by the National Council of State Boards of Nursing, Inc. All rights reserved.” Or, if a portion of the document is reproduced or incorporated in other materials, such written materials shall include the following credit: “Portions copyrighted by the National Council of State Boards of Nursing, Inc. All rights reserved.”
Address inquiries in writing to NCSBN Permissions, 111 E. Wacker Drive, Suite 2900, Chicago, IL 60601-4277. Suggested Citation: National Council of State Boards of Nursing. (2010). Report of Findings from the 2009 TUNING Analysis: A Comparison of U.S. and International Nursing Educational Competencies. Chicago: Author.
Printed in the United States of America
ISBN# 978-0-9826465-0-2
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
iiiTABLE OF CONTENTS
TABLE OF CONTENTS
List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ivList of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vAcknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viiExecutive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1I. Background of Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7II. Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Methodology Reviewers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Survey Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Survey Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Sample Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Mailing Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Confidentiality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Return Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
III. Demographics, Experiences and Practice Environments of Participants . . . . . . . . . . . . . . . . . . . . 11Demographics/Past Experiences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Race/Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Educational Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Employment Setting/Specialty Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
IV. Competency Statement Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Overview of Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Competency Statement Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Reliability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Competency Averages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14E .U . and U .S . Rating Comparisons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Correlation Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25TUNING Analysis Survey Nonresponder Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
V. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27VI. References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28Appendix A: 2009 TUNING Analyses Methodology Reviewers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Appendix B: 2009 U.S. Surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30Appendix C: 2009 TUNING Analysis Survey Nonresponder Study . . . . . . . . . . . . . . . . . . . . . . . . . . . 47Appendix D: U.S. Educational Comparison . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
iv LIST OF TABLES
LIST OF TABLES
Table 1. Adjusted Return Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Table 2. Descriptive Age Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Table 3. Reliability Estimates (U.S. Study). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Table 4. Competency Averages (U.S. Study) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Table 5. Competency Averages (U.S. and E.U. Studies) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Table 6. Average Importance Differences (U.S. and E.U). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Table 7. Correlation Between Competency Averages (U.S. and E.U.) . . . . . . . . . . . . . . . . . . . . . . . . . 26
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
vLIST OF FIGURES
LIST OF FIGURES
Figure 1. Gender of TUNING Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Figure 2. Race/Ethnicity of TUNING Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Figure 3. Highest Nursing Degree . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Figure 4. Employment Facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Figure 5. Average Ratings (U.S. and E.U.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
vi
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
vi 2009 TUNING ANALYSIS
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
viiACKNOWLEDGMENTS
ACKNOWLEDGMENTSThis study would not have been possible without support from a large number of entry-level nurses, nurs-ing educators and supervisors from all parts of the U .S . The time and attention they gave to completing the survey is greatly appreciated and the information they provided has increased our understanding of the core nursing educational competencies . The authors also gratefully acknowledge Dr . Mary Gobbi for her support and assistance with the European Union (E .U .) data, and the staff of NCSBN in the preparation of this document, which was essential for the completion of this study .
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
viii
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
viii 2009 TUNING ANALYSIS
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
1EXECUTIVE SUMMARY
A new initiative seeks to understand the role of nurses and nursing education from an international perspective . The goal of this study was to evaluate the consistency of nursing educational competen-cies globally . This study was conducted to evaluate the importance of nursing education competen-cies in the U .S . In addition, results from the current study were compared to the results of a similiar study, called TUNING, conducted in the following European Union (E .U .) countries: Denmark, Finland, Flanders, France, Germany, Hungary, Ireland, Italy, Lithuania, Malta, Norway, Netherlands, Portugal, Slovakia, Spain, Ukraine and the United Kingdom .
Survey DevelopmentA previous study was conducted in the E .U . to eval-uate education competencies that are important to the nursing profession; 17 E .U . countries took part in the study . The E .U . survey was used as the basis for creating the U .S . version . For this U .S . study, the 47 nursing education competency statements in the E .U . study were used . To stay congruent with previ-ous nursing surveys conducted by NCSBN, the U .S . survey also included questions about nurses’ prac-tice settings, past experiences and demographics .
The survey contained four sections . In the first section, the questions were related to nurse edu-cation . The second section contained the actual competencies, which were rated by an importance rating scale . The third section focused on work environments, including type and age of clients, employment setting and type of facility . The fourth section asked basic demographic information .
Survey Process
Sample Selection
Remaining congruent with the sampling method of the E .U . surveys and the methodology of previous NCSBN survey studies, respondents of this study were drawn from four samples . The first sample was drawn from recent NCLEX® registrants from nurs-ing programs who registered for the NCLEX-RN®
in May 2009 . The majority of these candidates
were scheduled to take the examination in June or July 2009 . The second sample was drawn from NCLEX-RN candidates who passed the examina-tion between May and August 2008 . By the time the current study was in progress, the majority of indi-viduals in this group had been working as registered nurses (RNs) for approximately one year . This group represents first-year RNs . Surveys for the recent NCLEX registrants and first-year RNs were admin-istered electronically . The second two samples, who were mailed paper surveys, were nursing educators and supervisors of nurses .
Mailing Procedure
A five-stage mailing process was used to engage participants in the study . A presurvey letter was sent to each participant through regular mail, except for the recent NCLEX registrants’ cohort . For the recent NCLEX registrants’ cohort, the sample was split in half randomly; one-half was sent the presurvey letter by regular mail and the other half by e-mail . A week later, an e-mail invitation with a login address and a unique access code was sent to the recent NCLEX registrants and first-year RNs; the paper survey, with a cover letter and postage-paid return envelope, was mailed to educators and supervisors . One week later, reminder e-mails were sent to the electronic survey nonresponders and reminder postcards were sent to paper survey nonresponders, reiterating the importance of the study and urging participation . Reminder e-mails and postcards were sent three times . The first two reminder communications were sent one week apart, starting from the initial invita-tion . The final notification was sent two weeks after the second reminder notification .
Return Rates
Of the 6,000 total Web surveys sent to recent NCLEX registrants, a total of 2,857 were completed and returned . There were 76 that were undeliver-able due to incorrect e-mail addresses, resulting in an adjusted return rate of 48 .23% .
EXECUTIVE SUMMARY
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
2 EXECUTIVE SUMMARY
Of the 2,500 total Web surveys sent to first-year RNs, a total of 590 were completed and returned . There were 175 that were undeliverable due to incorrect e-mail addresses, resulting in an adjusted return rate of 25 .38% .
Of the 2,751 surveys sent to RN educators, a total of 1,380 were completed and returned . There were four that were undeliverable due to incorrect addresses, resulting in an adjusted return rate of 50 .24% .
Of the 2,750 surveys sent to RN supervisors, a total of 657 were completed and returned . There were 166 that were undeliverable due to incorrect addresses, resulting in an adjusted return rate of 25 .43% .
Demographics, Experiences and Practice Environments of Participants
Demographics/Past Experiences
Demographic information, including gender, age, racial and ethnic backgrounds, and educational preparation are presented next, followed by a description of responders’ work environments .
Gender
The majority of survey responders reported being female . Educators had the highest percentage of females responding (96%) and first-year RNs had the lowest percentage (89%) .
Age
Participants in the study varied in reported age . The recent NCLEX registrant cohort was the young-est with an average age of 26 .87 . The first-year RN group had an average age of 32 .03 . The educator and supervisor group had an average age of 51 .48 and 50 .58, respectively .
Race/Ethnicity
Participants in the current study were consistent with the general ethnic distribution of nurses in the U .S . with 71% to 90% reporting being White across the four respondent groups . The second largest racial group represented was African-American (3% to 8%) .
Educational Background
Recent NCLEX registrants in the current sample listed RN baccalaureate degree in the U .S . most frequently (80%) as their highest nursing degree . For first-year RNs, 88% of the respondents selected either RN associate or RN baccalaureate degree . Nurse supervisors and nurse educators held higher degrees when compared to recent NCLEX regis-trants and first-year RNs .
Employment Setting/Specialty Area
Overall, the majority of respondents, regardless of survey group type, reported working in hospitals (ranging from 49% to 82%) . A large group of nurse supervisors reported working in long-term care (40%) . Approximately 36% of the recent NCLEX registrant sample was not working as an RN, which is likely reflective of the sample’s new graduation status . For the other three categories (first-year RN, educator and supervisor), more than 97% were working as an RN .
Competency Statement Characteristics
Reliability
Reliability indices were calculated to evaluate the internal consistency of the survey instruments . The survey ratings exhibited high reliability estimates .
Competency Averages
Descriptive statistics were calculated for each competency . Data were compared by the four respondent groups . The average competency rat-ings ranged from 2 .82 to 3 .73 for recent NCLEX registrants, from 2 .52 to 3 .70 for first-year RNs, from 2 .29 to 3 .86 for educators and from 2 .05 to 3 .75 for supervisors .
E.U. and U.S. Rating Comparisons
Data for the four U .S . respondent groups were com-pared to the four E .U . cohorts . Similar to the U .S . results, Competency 17 - Using nursing skills, medi-cal devices and interventions/activities to provide optimum care, demonstrates the ability to safely administer medicines and other therapies was rated
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
3EXECUTIVE SUMMARY
most important by E .U . respondents . Competency 27 - Demonstrates current and relevant knowledge of international and national policies that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty was rated least important by all groups, except E .U . employers .
Nonresponder SurveyIn order to ensure validity of the results, a survey of nonresponders was conducted to determine if the individuals in the U .S cohort sampling frame not responding would have rated the educational competency statements comparably . Based on the nonresponder data, the ratings for nonresponders were similar to the ratings of responders, which pro-vides support for the validity of the survey results .
ConclusionThere is evidence to suggest that the basic nurs-ing education competencies are equally important, regardless of nursing role or geographic setting . Average importance ratings were very similar for the 47 competencies . Correlations for the 47 com-petencies were high and statistically significant . A limitation of the study may be the construction of the competencies . Some of the education compe-tency statements were long and contained multiple concepts . The researchers of this study recommend that the education competency statements be revised to increase ease of use and interpretation prior to inclusion in future research studies .
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
4
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
4 2009 TUNING ANALYSIS
Report of Findings from the
2009 TUNING Analysis: A Comparison of U.S. and International Nursing Educational Competencies
National Council of State Boards of Nursing, Inc. (NCSBN®)
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
6
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
6 2009 TUNING ANALYSIS
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
7BACKGROUND OF STUDY
BACKGROUND OF STUDY
A new initiative seeks to understand the role of nurses and nursing education from an international perspective . The goal of this study was to evaluate the consistency of nursing educational competen-cies globally, as well as evaluate the importance of nursing competencies in the U .S . Results from the current study were compared to the results of a similiar study called TUNING, which was conducted in the following European Union (E .U .) countries: Denmark, Finland, Flanders, France, Germany, Hungary, Ireland, Italy, Lithuania, Malta, Norway, Netherlands, Portugal, Slovakia, Spain, Ukraine and the United Kingdom .
To better understand the initial E .U . research, below is a quote from Competencies in Education and Cross-Border Recognition: Evaluation of the Useful-ness of Learning Outcomes and Competences for International Recognition, published in 2007 .
The TUNING project was launched in 2000, in order to support universities across Europe in the implementation of the Bolo-gna Process at university level . TUNING proposes and promotes the redefinition of educational programs in an outcomes-oriented manner . Learning outcomes are expressed in terms of generic and subject-specific competences as well as ECTS [European Credit Transfer and Accumu-lation System] credits that are based on workload . Currently, universities from about 35 countries in Europe work together in the TUNING process . Since 2005, the TUNING project has also been extended to the Latin American continent, from which institutions in a further 18 countries also joined the process . The focus of the TUNING project is not on the various educational systems of countries, but on the educational struc-tures and content of educational programs . Across all the participating countries, the project aims at identifying reference points for generic and subject-specific competences for both first (Bachelor) and second (Master) cycle graduates in a series of subject areas . In order to be able to
understand individual curricula and make them comparable, a methodology has been designed according to which com-mon reference points could be identified . Within this methodology, the following five lines of approach were distinguished (González, J ., & Wagenaar, R ., 2005):
1 . definition of generic (general academic) competences;
2 . definition of subject-specific competences;
3 . the role of ECTS as an accumulation system;
4 . approaches to learning, teaching and assessment;
5 . the role of quality enhancement in the educational process .
These five lines of approach will allow universities to tune their curricula without losing their autonomy and at the same time stimulate their capacity to innovate (CoRe Project, 2007) .
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
8 METHODOLOGY
A number of steps are necessary to perform an analysis of the core nursing education competencies .
Methodology ReviewersThere were three methodology reviewers, chosen for their expertise in survey studies and certifica-tion examination development, who reviewed the methodologies and procedures utilized in this study . All three reviewers indicated this methodol-ogy was psychometrically sound and in compliance with professional standards for survey studies . See Appendix A for a listing of methodology reviewers.
Survey DevelopmentA previous study was conducted in the E .U . to eval-uate education competencies that are important to the nursing profession; 17 E .U . countries took part in the study . The E .U . survey was used as the basis for creating the U .S . version . For this U .S . study, the 47 nursing education competency statements in the E .U . study were used . To stay congruent with previous nursing surveys conducted by NCSBN, the U .S . survey also included questions about the nurses’ practice settings, past experiences and demographics .
Following the sampling method of E .U . surveys, respondents of the present study were drawn from four samples . The first sample was drawn from senior nursing students or recent NCLEX® regis-trants from nursing programs who registered for the NCLEX-RN® in May 2009 . The majority of these can-didates were scheduled to sit for the examination in June or July 2009 . The second sample consisted of individuals who graduated from a nursing program within the past year . This sample was drawn among NCLEX-RN candidates who passed the examina-tion between May and August 2008 . By the time the current study was in progress, the majority of indi-viduals in this group had been working as registered nurses (RNs) for approximately one year . This group represents first-year RNs . Surveys for the recent NCLEX registrants and first-year RNs were admin-istered electronically . The second two samples, who
were mailed paper surveys, were nursing educators and supervisors of nurses .
The survey contained four sections . In the first sec-tion the questions were related to nurse education . The second section contained the actual education competency statements, which were rated by an importance rating scale . The third section focused on work environments, including type and age of clients, employment setting and type of facility . The fourth section asked basic demographic informa-tion . The Web and paper versions of the survey may be found in Appendix B.
Survey Process
Sample Selection
The E .U . TUNING survey for core nursing competen-cies was administered to four groups of individuals: supervisors of nurses, newly licensed nurses, recent nursing school graduates and other individuals who completed the survey, which includes professional association members, physicians and nursing edu-cators . This study primarily followed the respondent groups sampled in the E .U . TUNING survey . To stay congruent with other NCSBN survey studies, reg-istered nurse educators were also sampled for the present study .
Recent NCLEX registrants: This cohort consisted of a random sample of 6,000 candidates who were first-time NCLEX-RN test-takers who registered for the NCLEX-RN Examination between May 1 and May 30, 2009 . Please note that the E .U . study only sampled baccalaureate level nurses . To replicate the design of the E .U . study as much as possible, the researchers purposefully over-sampled bacca-laureate-level registrants in this group . The resulting responses show that this over-sampling strategy was successful, as 84% of the sample was at the bac-calaureate level and 16% held an associate degree .
First-year RNs: A random sample of 2,500 NCLEX-RN candidates were selected among those who had passed the NCLEX-RN between May 1 and August 31, 2008, and had provided valid e-mail addresses during registration . This sample
METHODOLOGY
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
9METHODOLOGY
included all graduates, regardless of degree level . The NCLEX-RN candidate pool includes nurses who hold an associate degree to those with doc-toral degrees, with the majority graduating at the baccalaureate level . There were 10 NCSBN member boards that opted out of this project; thus, candi-dates from those jurisdictions were not sampled .
Registered nurse educators (nursing school faculty): Finally, surveys were sent to 2,751 deans or directors of 917 RN nursing programs across all levels . Each dean/director sampled received three surveys . They were asked to distribute the surveys to a medical/surgical nursing instructor, an obstetrics/gynecol-ogy (OB-GYN)/pediatric nursing instructor and a mental health or community health nursing instruc-tor in their institution . All programs in the sample graduated at least nine NCLEX-RN candidates in 2008 .
Supervisors of newly licensed RNs (supervisors of nurses): In addition to nurses new to the profes-sion, 2,750 supervisors of newly licensed RNs were surveyed . This list came from a substantially larger mailing list of medical facilities, but the selection of the supervisors was based upon the number of RN employees . This criterion was applied to maximize the likelihood that supervisors sampled worked with newly licensed RNs .
Mailing Procedure
A five-stage mailing process was used to engage participants in the study . A presurvey letter was sent to each participant through regular mail, except for the recent NCLEX registrant cohort . The recent NCLEX registrant cohort sample was split in half randomly; one-half was sent the presurvey letter by regular mail and the other half was sent the presur-vey letter by e-mail . A week later, an e-mail invitation with a login address and a unique access code was sent to recent NCLEX registrants and first-year RNs; the paper survey, with a cover letter and postage-paid return envelope, was mailed to educators and supervisors . One week later, reminder e-mails were sent to the electronic survey nonresponders, and reminder postcards were sent to paper survey nonresponders, reiterating the importance of the study and urging participation . Reminder e-mails and postcards were sent three times . The first two
reminder communications were sent one week apart, starting with the initial invitation . The final notification was sent two weeks after the second reminder notification .
Confidentiality
All nurses surveyed were promised confidential-ity with regard to their participation and their responses . Files containing mailing information were kept separate from the data files . Preassigned code numbers were used to facilitate cost-effective follow-up mailings . The study protocol was reviewed and approved by NCSBN’s CEO for compliance with organizational and industry guidelines for research studies involving human subjects .
Return Rates
Of the 6,000 total Web surveys sent to recent NCLEX registrants, a total of 2,857 were completed and returned . There were 76 that were undeliver-able due to incorrect e-mail addresses, resulting in an adjusted return rate of 48 .23% .
Of the 2,500 total Web surveys sent to first-year RNs, a total of 590 were completed and returned . There were 175 that were undeliverable due to incorrect e-mail addresses, resulting in an adjusted return rate of 25 .38% .
Of the 2,751 surveys sent to RN educators, a total of 1,380 were completed and returned . There were four that were undeliverable due to incorrect addresses, resulting in an adjusted return rate of 50 .24% .
Of the 2,750 surveys sent to RN supervisors, a total of 657 were completed and returned . There were 166 that were undeliverable due to incor-rect addresses, resulting in an adjusted return rate of 25 .43% . Adjusted return rates are presented in Table 1.
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
10 METHODOLOGY
Figure 1. Gender of TUNING Respondents
0
10
20
30
40
50
60
70
80
90
100
Recent NCLEX Reg. 1st-year RN Educator Supervisor
Group
Female Male
Perc
enta
ge
91%
9%
89%
11%
96%
4%
93%
7%
Table 1. Adjusted Return Rates
Survey Format Sample Bad Addresses
Adjusted Sample
Adjusted Responses
Adjusted Return Rate
Recent NCLEX Reg . 6,000 76 5,924 2,857 48 .23%
First-Year RN 2,500 175 2,325 590 25 .38%
Educators 2,751 4 2,747 1,380 50 .24%
Supervisors 2,750 166 2,584 657 25 .43%
Total 14,001 421 13,580 5,484 40 .38%
Table 2. Descriptive Age Information
Survey N Average Standard Deviation
Recent NCLEX Reg . 2,853 26 .87 7 .61
First-Year RN 585 32 .03 9 .27
Educators 1,137 51 .48 8 .77
Supervisors 633 50 .58 8 .1
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
11DEMOGRAPHICS, EXPERIENCES AND PRACTICE ENVIRONMENTS OF PARTICIPANTS
and supervisor group had an average age of 51 .48 and 50 .58, respectively . Descriptive respondent age statistics are presented in Table 2.
Race/Ethnicity
Participants in the current study were consistent with the general ethnic distribution of nurses in the U .S ., with 71% to 90% reporting being White across the four respondent groups . The second largest racial group represented was African-American (3% to 8%) . See Figure 2 for racial/ethnic backgrounds compared among the four respondent groups.
Educational Background
As anticipated, based on the sampling method described earlier, the recent NCLEX registrants in the current sample listed RN baccalaureate degree
Demographics/Past ExperiencesDemographic information, including gender, age, racial and ethnic backgrounds, and educational preparation are presented next, followed by a description of responders’ work environments .
Gender
The majority of survey responders reported being female . Educators had the highest percentage of females responding (96%) and first-year RNs had the lowest percentage (89%) .
Age
Participants in the study varied in reported age . The recent NCLEX registrant cohort was the young-est, with an average age of 26 .87 . The first-year RN group had an average age of 32 .03 . The educator
DEMOGRAPHICS, EXPERIENCES AND PRACTICE ENVIRONMENTS OF PARTICIPANTS
Figure 2. Race/Ethnicity of TUNING Respondents
8% 8%
5% 3%1% 1% 0% 0%
4%
9%
1% 3%5% 5%
2% 1%0% 1% 0% 1%3% 3%
1% 1%1% 1% 0% 1%
78%
71%
90% 89%
0
10
20
30
40
50
60
70
80
90
100
Recent NCLEX Reg. 1st-year RN Educator Supervisor
Group
African-American Asian Indian Asian other
Hispanic Native American Other
Pacific Islander White – not of Hispanic origin
Percen
tage
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
12 DEMOGRAPHICS, EXPERIENCES AND PRACTICE ENVIRONMENTS OF PARTICIPANTSFi
gur
e 3.
Hig
hest
Nur
sing
Deg
ree
0%3%
0%2%
1%3%
10%
6%17
%
49%
0%
23%
80%
39%
6%
32%
1%4%
0%10
%0%
0%
13%
2%1%
0%
32%
18%
0%0%
5%0%
1%2%
Rece
nt N
CLEX
Reg
.1s
t-ye
ar R
NEd
ucat
orSu
perv
isor
Gro
up
Any
nurs
ing
prog
ram
NO
T lo
cate
d in
the
U.S
.O
ther
(ple
ase
spec
ify)
RN -
Asso
ciat
e D
egre
e in
U.S
.
RN -
Bacc
alau
reat
e D
egre
e in
U.S
.RN
- D
iplo
ma
in U
.S.
RN -
Gen
eric
Doc
tora
te in
U.S
.
RN -
Gen
eric
Mas
ter'
s D
egre
e in
U.S
.RN
- M
aste
r's
(Cli
nica
l Nur
se S
peci
alis
t)RN
- M
aste
r's
(Nur
se P
rac�
�one
r)
020406080100
Percentage
24% 15
%
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
13DEMOGRAPHICS, EXPERIENCES AND PRACTICE ENVIRONMENTS OF PARTICIPANTS
in the U .S . most frequently (80%) as their high-est nursing degree . For first-year RNs, 88% of the respondents selected either RN associate or RN baccalaureate degree . Nurse supervisors and nurse educators held higher degrees when compared to the recent NCLEX registrants and first-year RNs . See Figure 3 .
Employment Setting/Specialty Area
Overall, the majority of respondents, regardless of survey group type, reported working in hospitals (ranging from 49% to 82%) . A large group of nurse supervisors reported working in long-term care (40%) . Approximately 36% of the recent NCLEX registrant sample was not working as an RN, which is likely reflective of the sample’s new graduation
status . For the other three categories (first-year RN, educator and supervisor), almost all were working as an RN . See Figure 4 .
Figure 4. Employment Facility
3%8% 11% 8%
56%
82%
68%
49%
3% 6%2%
40%36%
2% 0% 0%2% 2%
20%
2%
0
10
20
30
40
50
60
70
80
90
100
Recent NCLEX Reg. 1st-year RN Educator Supervisor
Group
Perc
enta
ge
Community-based or ambulatory care facil ity/organiza�onHospitalLong-term careNot working as an RNOther
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
14 COMPETENCY STATEMENT FINDINGS
COMPETENCY STATEMENT FINDINGS
Findings relative to the competency statements are presented in this section . The methods used to col-lect and analyze the statements will be discussed . In addition, the U .S . findings are compared to the E .U . findings to see if there is consistency . A validation of survey findings with estimates provided by the subject matter expert panel will also be provided .
Overview of MethodsThe current study replicated the methodology of the E .U . TUNING survey whenever applicable . The present TUNING survey asked responders to answer one question about each competency statement . They were asked to rate the overall importance of the competency on a scale of 1 to 4, with 1 being not important to 4 being vital .
Staying congruent with the design of the E .U . study, only data from the baccalaureate-level recent reg-istrants sample were analyzed for competencies . Additional analyses were conducted to ascertain whether diploma, associate and baccalaureate- level recent registrants rated the competencies comparably (Appendix D) . There were essentially no differences in the average importance ratings between the U .S . associate and baccalaureate- prepared nurses . Because of the low prevalence of recent NCLEX registrants reporting graduation from RN diploma programs, any results comparing educational competency statement data to either associate or baccalaureate-prepared nurses should be interpreted cautiously .
The responder ratings were analyzed in two parts . First, average importance ratings were com-pared within the U .S . and the E .U . Next, average importance ratings were correlated to see if the
importance ratings for each of the 47 competencies were related across the cohorts . The correlation analysis used both U .S . data and E .U . data .
Competency Statement Characteristics
Reliability
Reliability indices were calculated to evaluate the internal consistency of the survey instruments . Cronbach’s alpha coefficients were calculated for the importance ratings (Cronbach, 1951) . As seen in Table 3, the survey ratings exhibited high reliability estimates.
Competency Averages
There were four groups of U .S . respondents who completed the surveys . The groups were recent NCLEX registrants, first-year RNs, educators and supervisors . Descriptive statistics were calculated for each competency . Data were compared by the four respondent groups .
Competency 17 - Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to safely administer medicines and other therapies was rated most important by all groups . In the E .U . survey, students and graduates also rated Competency 17 as the most important . Recent U .S . NCLEX registrants rated Competency 9 - Demonstrates the ability to recognize and inter-pret signs of normal and changing health/ill health, distress, or disability in the person (assessment/diagnosis) equally as important as Competency 17 .
Competency 27 - Demonstrates current and relevant knowledge of international and national policies that can be appropriately applied to nursing prac-tice, patient/client care and situations of uncertainty was rated least important by all four U .S . groups . In addition, four E .U . groups rated Competency 27 least important as well . The range of average rat-ings was 3 .86 to 2 .05 across the four respondent cohorts . Table 4 presents the U.S. competency rat-ings in survey order.
Table 3. Reliability Estimates (U.S. Study)
Importance
N Items N Cases Scale Reliability
Recent NCLEX Reg .
47 2,624 0 .98
First-year RN 47 532 0 .97
Educators 47 1,084 0 .96
Supervisors 47 521 0 .96
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
15COMPETENCY STATEMENT FINDINGSTa
ble
4. C
om
pet
ency
Ave
rag
es (U
.S. S
tud
y)
Comp #
Co
mp
eten
cy
Rec
ent
NC
LEX
Reg
.Fi
rst-
year
RN
Ed
ucat
ors
Sup
ervi
sors
NA
vg.
Std
. Err
.N
Avg
.St
d. E
rr.
NA
vg.
Std
. Err
.N
Avg
.St
d. E
rr.
1D
emo
nstr
ates
the
ab
ility
to
pra
ctic
e w
ithin
the
co
ntex
t o
f pro
fess
iona
l, et
hica
l, re
gul
ato
ry a
nd le
gal
co
des
, re
cog
nizi
ng a
nd re
spo
ndin
g t
o m
ora
l/et
hica
l dile
mm
as a
nd
issu
es in
day
to
day
pra
ctic
e .
2879
3 .60
0 .01
600
3 .50
0 .03
1362
3 .80
0 .01
644
3 .59
0 .02
2D
emo
nstr
ates
the
ab
ility
to
pra
ctic
e in
a h
olis
tic, t
ole
rant
, no
n ju
dg
men
tal,
carin
g a
nd s
ensi
tive
man
ner,
ensu
ring
tha
t th
e rig
hts,
bel
iefs
and
wis
hes
of d
iffer
ent
ind
ivid
uals
and
g
roup
s ar
e no
t co
mp
rom
ised
.
2879
3 .56
0 .01
599
3 .38
0 .03
1363
3 .68
0 .01
645
3 .50
0 .02
3D
emo
nstr
ates
the
ab
ility
to
ed
ucat
e, fa
cilit
ate,
pro
mo
te,
sup
po
rt a
nd e
nco
urag
e th
e he
alth
, wel
l-bei
ng a
nd c
om
fort
o
f po
pul
atio
ns, c
om
mun
ities
, gro
ups
and
ind
ivid
uals
who
se
lives
are
affe
cted
by,
illn
ess,
dis
tres
s, d
isea
se, d
isab
ility
or
dea
th .
2875
3 .56
0 .01
598
3 .32
0 .03
1362
3 .46
0 .02
642
3 .15
0 .03
4W
ithin
the
sco
pe
of h
is/h
er p
rofe
ssio
nal p
ract
ice
and
ac
coun
tab
ility
, dem
ons
trat
es a
war
enes
s o
f the
diff
eren
t ro
les,
resp
ons
ibili
ties
and
func
tions
of a
nur
se .
2872
3 .43
0 .01
598
3 .33
0 .03
1363
3 .44
0 .02
641
3 .36
0 .03
5W
ithin
the
sco
pe
of h
is/h
er p
rofe
ssio
nal p
ract
ice
and
ac
coun
tab
ility
, dem
ons
trat
es t
he a
bili
ty t
o a
dju
st t
heir
role
to
resp
ond
effe
ctiv
ely
to p
op
ulat
ion/
pat
ient
nee
ds .
Whe
re
nece
ssar
y an
d a
pp
rop
riate
is a
ble
to
cha
lleng
e cu
rren
t sy
stem
s to
mee
t p
op
ulat
ion/
pat
ient
nee
ds .
2871
3 .38
0 .01
594
3 .20
0 .03
1361
3 .20
0 .02
643
3 .10
0 .03
6D
emo
nstr
ates
the
ab
ility
to
acc
ept
resp
ons
ibili
ty fo
r hi
s/he
r o
wn
pro
fess
iona
l dev
elo
pm
ent
and
lear
ning
, usi
ng
eval
uatio
n as
a w
ay t
o re
flect
and
imp
rove
up
on
his/
her
per
form
ance
so
as
to e
nhan
ce t
he q
ualit
y o
f ser
vice
d
eliv
ery .
2868
3 .48
0 .01
595
3 .34
0 .03
1356
3 .51
0 .02
641
3 .39
0 .03
7D
emo
nstr
ates
the
ab
ility
to
und
erta
ke c
om
pre
hens
ive
and
sys
tem
atic
ass
essm
ents
usi
ng t
he t
oo
ls/f
ram
ewo
rks
app
rop
riate
to
the
pat
ient
/clie
nt t
akin
g in
to a
cco
unt
rele
vant
phy
sica
l, so
cial
, cul
tura
l, p
sych
olo
gic
al, s
piri
tual
an
d e
nviro
nmen
tal f
acto
rs .
2861
3 .51
0 .01
595
3 .34
0 .03
1361
3 .65
0 .01
641
3 .52
0 .02
8D
emo
nstr
ates
the
ab
ility
to
per
form
an
effe
ctiv
e ris
k as
sess
men
t an
d t
ake
app
rop
riate
act
ions
.28
573 .
490 .
0159
63 .
390 .
0313
583 .
460 .
0264
13 .
430 .
03
9D
emo
nstr
ates
the
ab
ility
to
reco
gni
ze a
nd in
terp
ret
sig
ns o
f no
rmal
and
cha
ngin
g h
ealth
/illn
ess,
dis
tres
s, o
r d
isab
ility
in
the
per
son
(ass
essm
ent/
dia
gno
sis)
.28
353 .
730 .
0158
93 .
670 .
0213
603 .
760 .
0164
23 .
740 .
02
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
16 COMPETENCY STATEMENT FINDINGSTa
ble
4. C
om
pet
ency
Ave
rag
es (U
.S. S
tud
y)
Comp #
Co
mp
eten
cy
Rec
ent
NC
LEX
Reg
.Fi
rst-
year
RN
Ed
ucat
ors
Sup
ervi
sors
NA
vg.
Std
. Err
.N
Avg
.St
d. E
rr.
NA
vg.
Std
. Err
.N
Avg
.St
d. E
rr.
10D
emo
nstr
ates
the
ab
ility
to
resp
ond
to
pat
ient
/clie
nt
need
s b
y p
lann
ing
, del
iver
ing
and
eva
luat
ing
ap
pro
pria
te
and
ind
ivid
ualiz
ed p
rog
ram
s o
f car
e w
hile
wo
rkin
g in
p
artn
ersh
ip w
ith t
he p
atie
nt/c
lient
, the
ir ca
reg
iver
s, fa
mili
es
and
oth
er h
ealth
care
wo
rker
s .
2860
3 .47
0 .01
593
3 .25
0 .03
1359
3 .57
0 .02
643
3 .40
0 .02
11D
emo
nstr
ates
the
ab
ility
to
crit
ical
ly q
uest
ion,
eva
luat
e,
inte
rpre
t an
d s
ynth
esiz
e a
rang
e o
f inf
orm
atio
n an
d d
ata
sour
ces
to fa
cilit
ate
pat
ient
cho
ice .
2862
3 .45
0 .01
593
3 .24
0 .03
1368
3 .38
0 .02
643
3 .18
0 .03
12D
emo
nstr
ates
the
ab
ility
to
mak
e so
und
clin
ical
jud
gm
ents
to
ens
ure
qua
lity
stan
dar
ds
are
met
and
pra
ctic
e is
ev
iden
ce b
ased
.28
533 .
550 .
0159
33 .
380 .
0313
683 .
600 .
0264
33 .
530 .
02
13D
emo
nstr
ates
the
ab
ility
to
use
mo
der
n te
chno
log
ies
to
asse
ss a
nd re
spo
nd a
pp
rop
riate
ly t
o p
atie
nt/c
lient
nee
d
(for
exam
ple
thr
oug
h te
lehe
alth
, mul
timed
ia a
nd w
eb
reso
urce
s) .
2848
3 .01
0 .01
590
2 .81
0 .03
1363
2 .79
0 .02
645
2 .61
0 .03
14D
emo
nstr
ates
the
ab
ility
to
ap
pro
pria
tely
use
a r
ang
e o
f nu
rsin
g s
kills
, med
ical
dev
ices
and
inte
rven
tions
/act
iviti
es
to p
rovi
de
op
timum
car
e .28
563 .
410 .
0159
23 .
310 .
0313
643 .
290 .
0264
43 .
230 .
03
15U
sing
nur
sing
ski
lls, m
edic
al d
evic
es a
nd in
terv
entio
ns/
activ
ities
to
pro
vid
e o
ptim
um c
are,
dem
ons
trat
es t
he
abili
ty t
o m
aint
ain
pat
ient
/clie
nt d
igni
ty, a
dvo
cacy
and
co
nfid
entia
lity .
2855
3 .55
0 .01
592
3 .44
0 .03
1364
3 .59
0 .02
644
3 .41
0 .03
16U
sing
nur
sing
ski
lls, m
edic
al d
evic
es a
nd in
terv
entio
ns/
activ
ities
to
pro
vid
e o
ptim
um c
are,
dem
ons
trat
es t
he a
bili
ty
to p
ract
ice
prin
cip
les
of h
ealth
and
saf
ety,
incl
udin
g m
ovi
ng
and
han
dlin
g, i
nfec
tion
cont
rol,
esse
ntia
l firs
t ai
d a
nd
emer
gen
cy p
roce
dur
es .
2848
3 .63
0 .01
591
3 .57
0 .02
1368
3 .65
0 .02
645
3 .54
0 .02
17U
sing
nur
sing
ski
lls, m
edic
al d
evic
es a
nd in
terv
entio
ns/
activ
ities
to
pro
vid
e o
ptim
um c
are,
dem
ons
trat
es t
he a
bili
ty
to s
afel
y ad
min
iste
r m
edic
atio
ns a
nd o
ther
the
rap
ies .
2851
3 .73
0 .01
592
3 .70
0 .02
1366
3 .86
0 .01
644
3 .75
0 .02
18U
sing
nur
sing
ski
lls, m
edic
al d
evic
es a
nd in
terv
entio
ns/
activ
ities
to
pro
vid
e o
ptim
um c
are,
dem
ons
trat
es t
he a
bili
ty
to c
ons
ider
em
otio
nal,
phy
sica
l and
per
sona
l car
e ne
eds,
in
clud
ing
mee
ting
the
nee
d fo
r co
mfo
rt, n
utrit
ion,
per
sona
l hy
gie
ne a
nd e
nab
ling
the
per
son
to m
aint
ain
the
activ
ities
ne
cess
ary
for
dai
ly li
fe .
2849
3 .47
0 .01
589
3 .31
0 .03
1368
3 .54
0 .02
646
3 .41
0 .02
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
17COMPETENCY STATEMENT FINDINGSTa
ble
4. C
om
pet
ency
Ave
rag
es (U
.S. S
tud
y)
Comp #
Co
mp
eten
cy
Rec
ent
NC
LEX
Reg
.Fi
rst-
year
RN
Ed
ucat
ors
Sup
ervi
sors
NA
vg.
Std
. Err
.N
Avg
.St
d. E
rr.
NA
vg.
Std
. Err
.N
Avg
.St
d. E
rr.
19U
sing
nur
sing
ski
lls, m
edic
al d
evic
es a
nd in
terv
entio
ns/
activ
ities
to
pro
vid
e o
ptim
um c
are,
dem
ons
trat
es t
he
abili
ty t
o re
spo
nd t
o a
per
son’
s ne
eds
thro
ugho
ut t
he li
fe
span
and
hea
lth/i
llnes
s ex
per
ienc
e e .
g . p
ain,
life
cho
ices
, re
valid
atio
n, d
isab
ility
or
whe
n d
ying
.
2850
3 .41
0 .01
590
3 .24
0 .03
1360
3 .37
0 .02
641
3 .19
0 .03
20D
emo
nstr
ates
the
ab
ility
to
info
rm, e
duc
ate
and
sup
ervi
se
pat
ient
/car
egiv
ers
and
the
ir fa
mili
es .
2838
3 .37
0 .01
587
3 .20
0 .03
1339
3 .24
0 .02
632
3 .13
0 .03
21D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
th
eorie
s o
f nur
sing
and
nur
sing
pra
ctic
e th
at c
an b
e ap
pro
pria
tely
ap
plie
d t
o n
ursi
ng p
ract
ice,
pat
ient
/clie
nt
care
and
situ
atio
ns o
f unc
erta
inty
.
2827
3 .06
0 .02
583
2 .88
0 .04
1364
2 .78
0 .02
642
2 .91
0 .03
22D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
orie
s co
ncer
ning
the
nat
ure
and
cha
lleng
e o
f pro
fess
iona
l p
ract
ice
that
can
be
app
rop
riate
ly a
pp
lied
to
nur
sing
p
ract
ice,
pat
ient
/clie
nt c
are
and
situ
atio
ns o
f unc
erta
inty
.
2827
2 .98
0 .02
582
2 .78
0 .03
1361
2 .70
0 .02
640
2 .70
0 .03
23D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
na
tura
l and
life
sci
ence
s th
at c
an b
e ap
pro
pria
tely
ap
plie
d
to n
ursi
ng p
ract
ice,
pat
ient
/clie
nt c
are
and
situ
atio
ns o
f un
cert
aint
y .
2831
3 .09
0 .01
583
2 .86
0 .03
1364
3 .00
0 .02
641
2 .79
0 .03
24D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
so
cial
, he
alth
and
beh
avio
ral s
cien
ces
that
can
be
app
rop
riate
ly
app
lied
to
nur
sing
pra
ctic
e, p
atie
nt/c
lient
car
e an
d
situ
atio
ns o
f unc
erta
inty
.
2827
3 .10
0 .01
582
2 .87
0 .03
1359
3 .00
0 .02
640
2 .80
0 .03
25D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f eth
ical
th
eory
, law
and
hum
aniti
es t
hat
can
be
app
rop
riate
ly
app
lied
to
nur
sing
pra
ctic
e, p
atie
nt/c
lient
car
e an
d
situ
atio
ns o
f unc
erta
inty
.
2827
3 .07
0 .01
582
2 .86
0 .03
1366
2 .96
0 .02
642
2 .72
0 .03
26D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f te
chno
log
y an
d h
ealth
care
info
rmat
ics
that
can
be
app
rop
riate
ly a
pp
lied
to
nur
sing
pra
ctic
e, p
atie
nt/c
lient
ca
re a
nd s
ituat
ions
of u
ncer
tain
ty .
2826
3 .01
0 .02
583
2 .79
0 .03
1365
2 .87
0 .02
641
2 .71
0 .03
27D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f in
tern
atio
nal a
nd n
atio
nal p
olic
ies
that
can
be
app
rop
riate
ly
app
lied
to
nur
sing
pra
ctic
e, p
atie
nt/c
lient
car
e an
d
situ
atio
ns o
f unc
erta
inty
.
2828
2 .82
0 .02
583
2 .52
0 .04
1337
2 .29
0 .02
631
2 .05
0 .03
28D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f pro
ble
m
solv
ing
, dec
isio
n m
akin
g a
nd c
onfl
ict
theo
ries
that
can
be
app
rop
riate
ly a
pp
lied
to
nur
sing
pra
ctic
e, p
atie
nt/c
lient
ca
re a
nd s
ituat
ions
of u
ncer
tain
ty .
2827
3 .25
0 .01
582
3 .08
0 .03
1335
3 .08
0 .02
638
3 .04
0 .03
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
18 COMPETENCY STATEMENT FINDINGSTa
ble
4. C
om
pet
ency
Ave
rag
es (U
.S. S
tud
y)
Comp #
Co
mp
eten
cy
Rec
ent
NC
LEX
Reg
.Fi
rst-
year
RN
Ed
ucat
ors
Sup
ervi
sors
NA
vg.
Std
. Err
.N
Avg
.St
d. E
rr.
NA
vg.
Std
. Err
.N
Avg
.St
d. E
rr.
29D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
orie
s re
late
d t
o p
erso
nal a
nd p
rofe
ssio
nal d
evel
op
men
t so
as
to
enha
nce
pro
fess
iona
l pra
ctic
e .28
252 .
970 .
0258
22 .
780 .
0313
382 .
670 .
0263
42 .
600 .
03
30D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
re
sear
ch p
roce
ss a
nd c
urre
nt n
ursi
ng re
sear
ch t
hat
can
be
app
rop
riate
ly a
pp
lied
to
nur
sing
act
ions
/act
iviti
es t
o
pro
vid
e nu
rsin
g c
are
that
is r
igo
rous
and
evi
den
ce b
ased
.
2821
3 .08
0 .01
582
2 .80
0 .03
1345
2 .82
0 .02
636
2 .46
0 .03
31D
emo
nstr
ates
the
ab
ility
to
co
mm
unic
ate
effe
ctiv
ely
(incl
udin
g t
he u
se o
f new
tec
hno
log
ies)
: with
pat
ient
s,
fam
ilies
and
so
cial
gro
ups,
incl
udin
g t
hose
with
co
mm
unic
atio
n d
ifficu
lties
.
2833
3 .49
0 .01
584
3 .40
0 .03
1340
3 .56
0 .02
632
3 .38
0 .03
32D
emo
nstr
ates
the
ab
ility
to
ena
ble
pat
ient
s an
d t
heir
care
giv
ers
to e
xpre
ss t
heir
conc
erns
and
can
resp
ond
ap
pro
pria
tely
e .g
. em
otio
nal,
soci
al, p
sych
olo
gic
al, s
piri
tual
o
r p
hysi
cal c
onc
erns
.
2832
3 .41
0 .01
585
3 .24
0 .03
1342
3 .49
0 .02
633
3 .35
0 .03
33D
emo
nstr
ates
the
ab
ility
to
ap
pro
pria
tely
rep
rese
nt t
he
pat
ient
/clie
nt's
per
spec
tive
and
act
to
pre
vent
ab
use .
2833
3 .53
0 .01
585
3 .39
0 .03
1340
3 .55
0 .02
634
3 .50
0 .03
34D
emo
nstr
ates
the
ab
ility
to
ap
pro
pria
tely
use
co
unse
ling
sk
ills
to p
rom
ote
pat
ient
wel
l-bei
ng .
2824
3 .21
0 .01
580
2 .97
0 .03
1345
2 .96
0 .02
636
2 .82
0 .03
35D
emo
nstr
ates
the
ab
ility
to
iden
tify
and
man
age
chal
leng
ing
beh
avio
r (u
sing
co
mm
unic
atio
n te
chni
que
s to
p
rom
ote
pat
ient
wel
l-bei
ng) .
2828
3 .22
0 .01
584
3 .07
0 .03
1338
3 .18
0 .02
630
3 .05
0 .03
36D
emo
nstr
ates
the
ab
ility
to
reco
gni
ze a
nxie
ty, s
tres
s an
d
dep
ress
ion
(usi
ng c
om
mun
icat
ion
tech
niq
ues
to p
rom
ote
p
atie
nt w
ell-b
eing
) .28
323 .
290 .
0158
43 .
090 .
0313
243 .
290 .
0263
03 .
120 .
03
37D
emo
nstr
ates
the
ab
ility
to
giv
e em
otio
nal s
upp
ort
and
id
entif
y w
hen
coun
selin
g o
r o
ther
inte
rven
tions
are
nee
ded
.28
343 .
290 .
0158
43 .
100 .
0313
413 .
300 .
0263
43 .
060 .
03
38D
emo
nstr
ates
the
ab
ility
to
iden
tify
and
use
op
po
rtun
ities
fo
r he
alth
pro
mo
tion
and
hea
lth e
duc
atio
n ac
tiviti
es .
2831
3 .24
0 .01
585
3 .00
0 .03
1330
3 .20
0 .02
632
2 .78
0 .03
39D
emo
nstr
ates
the
ab
ility
to
acc
urat
ely
rep
ort
, rec
ord
, d
ocu
men
t an
d re
fer
care
usi
ng a
pp
rop
riate
tec
hno
log
ies .
2829
3 .47
0 .01
586
3 .33
0 .03
1327
3 .55
0 .02
635
3 .45
0 .03
40D
emo
nstr
ates
the
ab
ility
to
real
ize
that
pat
ient
/clie
nt
wel
l-bei
ng is
ach
ieve
d t
hro
ugh
the
com
bin
ed re
sour
ces
and
ac
tions
of a
ll m
emb
ers
of t
he h
ealth
care
tea
m .
2840
3 .37
0 .01
586
3 .23
0 .03
1341
3 .29
0 .02
632
3 .28
0 .03
41D
emo
nstr
ates
the
ab
ility
to
lead
and
co
ord
inat
e a
team
, d
eleg
atin
g c
are
app
rop
riate
ly a
nd m
eani
ngfu
lly .
2836
3 .25
0 .01
587
3 .04
0 .03
1337
3 .04
0 .02
632
3 .09
0 .03
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
19COMPETENCY STATEMENT FINDINGSTa
ble
4. C
om
pet
ency
Ave
rag
es (U
.S. S
tud
y)
Comp #
Co
mp
eten
cy
Rec
ent
NC
LEX
Reg
.Fi
rst-
year
RN
Ed
ucat
ors
Sup
ervi
sors
NA
vg.
Std
. Err
.N
Avg
.St
d. E
rr.
NA
vg.
Std
. Err
.N
Avg
.St
d. E
rr.
42D
emo
nstr
ates
the
ab
ility
to
wo
rk a
nd c
om
mun
icat
e co
llab
ora
tivel
y an
d e
ffect
ivel
y w
ith o
ther
nur
ses
in t
he b
est
inte
rest
of t
he p
atie
nt/c
lient
.28
333 .
510 .
0158
73 .
370 .
0313
383 .
560 .
0263
33 .
480 .
02
43D
emo
nstr
ates
the
ab
ility
to
wo
rk a
nd c
om
mun
icat
e co
llab
ora
tivel
y an
d e
ffect
ivel
y w
ith a
ll su
pp
ort
sta
ff to
p
riorit
ize
and
man
age
time
effe
ctiv
ely
whi
le q
ualit
y st
and
ard
s ar
e m
et .
2840
3 .44
0 .01
588
3 .27
0 .03
1334
3 .41
0 .02
633
3 .41
0 .03
44D
emo
nstr
ates
the
ab
ility
to
ass
ess
risk
and
act
ivel
y p
rom
ote
th
e w
ell-b
eing
, sec
urity
and
saf
ety
of a
ll p
eop
le in
the
w
ork
ing
env
ironm
ent
(incl
udin
g t
hem
selv
es) .
2839
3 .45
0 .01
588
3 .29
0 .03
1365
3 .37
0 .02
647
3 .22
0 .03
45D
emo
nstr
ates
the
ab
ility
to
crit
ical
ly u
se t
oo
ls t
o e
valu
ate
and
aud
it ca
re a
cco
rdin
g t
o re
leva
nt q
ualit
y st
and
ard
s .28
363 .
130 .
0158
82 .
900 .
0313
582 .
720 .
0264
82 .
820 .
03
46W
ithin
the
clin
ical
co
ntex
t, d
emo
nstr
ates
the
ab
ility
to
ed
ucat
e, fa
cilit
ate,
sup
ervi
se a
nd s
upp
ort
nur
sing
stu
den
ts
and
oth
er h
ealth
care
stu
den
ts o
r w
ork
ers .
2839
3 .25
0 .01
588
3 .00
0 .03
1359
2 .86
0 .02
643
2 .66
0 .03
47D
emo
nstr
ates
an
awar
enes
s o
f the
prin
cip
les
of h
ealth
care
fu
ndin
g a
nd u
ses
reso
urce
s ef
fect
ivel
y .28
333 .
030 .
0158
72 .
730 .
0313
532 .
590 .
0264
82 .
480 .
03
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
20 COMPETENCY STATEMENT FINDINGS
E.U. and U.S. Rating Comparisons
The U .S . groups (recent NCLEX registrants, first-year RNs, educators and supervisors) were compared to results from the E .U . TUNING survey . Table 5 and Figure 5 present these results.
Table 5. Competency Averages (U.S. and E.U. Studies)
Co
mp
#
Competency
Recent NCLEX
Reg. U.S.
First-year RN U.S.
Educators U.S.
Supervisors U.S.
Students E.U.
Graduates E.U.
Employers E.U.
Others E.U.*
Avg. Avg. Avg. Avg. Avg. Avg. Avg. Avg.
1 Demonstrates the ability to practice within the context of professional, ethical, regulatory and legal codes, recognizing and responding to moral/ethical dilemmas and issues in day to day practice .
3 .60 3 .50 3 .80 3 .59 3 .40 3 .38 3 .46 3 .26
2 Demonstrates the ability to practice in a holistic, tolerant, non judgmental, caring and sensitive manner, ensuring that the rights, beliefs and wishes of different individuals and groups are not compromised .
3 .56 3 .38 3 .68 3 .50 3 .42 3 .46 3 .22 3 .49
3 Demonstrates the ability to educate, facilitate, promote, support and encourage the health, well-being and comfort of populations, communities, groups and individuals whose lives are affected by, illness, distress, disease, disability or death .
3 .56 3 .32 3 .46 3 .15 3 .41 3 .43 3 .37 3 .38
4 Within the scope of his/her professional practice and accountability, demonstrates awareness of the different roles, responsibilities and functions of a nurse .
3 .43 3 .33 3 .44 3 .36 3 .35 3 .41 3 .47 3 .16
5 Within the scope of his/her professional practice and accountability, demonstrates the ability to adjust their role to respond effectively to population/patient needs . Where necessary and appropriate is able to challenge current systems to meet population/patient needs .
3 .38 3 .20 3 .20 3 .10 3 .00 3 .15 3 .04 3 .15
6 Demonstrates the ability to accept responsibility for his/her own professional development and learning, using evaluation as a way to reflect and improve upon his/her performance so as to enhance the quality of service delivery .
3 .48 3 .34 3 .51 3 .39 3 .33 3 .39 3 .36 3 .23
7 Demonstrates the ability to undertake comprehensive and systematic assessments using the tools/frameworks appropriate to the patient/client taking into account relevant physical, social, cultural, psychological, spiritual and environmental factors .
3 .51 3 .34 3 .65 3 .52 3 .23 3 .28 3 .19 3 .30
8 Demonstrates the ability to perform an effective risk assessment and take appropriate actions .
3 .49 3 .39 3 .46 3 .43 3 .37 3 .35 3 .26 3 .23
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
21COMPETENCY STATEMENT FINDINGS
Table 5. Competency Averages (U.S. and E.U. Studies)
Co
mp
#
Competency
Recent NCLEX
Reg. U.S.
First-year RN U.S.
Educators U.S.
Supervisors U.S.
Students E.U.
Graduates E.U.
Employers E.U.
Others E.U.*
Avg. Avg. Avg. Avg. Avg. Avg. Avg. Avg.
9 Demonstrates the ability to recognize and interpret signs of normal and changing health/illness, distress, or disability in the person (assessment/diagnosis) .
3 .73 3 .67 3 .76 3 .74 3 .49 3 .42 3 .53 3 .60
10 Demonstrates the ability to respond to patient/client needs by planning, delivering and evaluating appropriate and individualized programs of care while working in partnership with the patient/client, their caregivers, families and other healthcare workers .
3 .47 3 .25 3 .57 3 .40 3 .24 3 .35 3 .26 3 .57
11 Demonstrates the ability to critically question, evaluate, interpret and synthesize a range of information and data sources to facilitate patient choice .
3 .45 3 .24 3 .38 3 .18 3 .12 3 .18 3 .02 3 .22
12 Demonstrates the ability to make sound clinical judgments to ensure quality standards are met and practice is evidence based .
3 .55 3 .38 3 .60 3 .53 3 .26 3 .30 3 .32 3 .24
13 Demonstrates the ability to use modern technologies to assess and respond appropriately to patient/client need (for example through telehealth, multimedia and web resources) .
3 .01 2 .81 2 .79 2 .61 2 .72 2 .99 2 .99 2 .79
14 Demonstrates the ability to appropriately use a range of nursing skills, medical devices and interventions/activities to provide optimum care .
3 .41 3 .31 3 .29 3 .23 3 .42 3 .39 3 .52 3 .14
15 Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to maintain patient/client dignity, advocacy and confidentiality .
3 .55 3 .44 3 .59 3 .41 3 .55 3 .43 3 .49 3 .43
16 Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to practice principles of health and safety, including moving and handling, infection control, essential first aid and emergency procedures .
3 .63 3 .57 3 .65 3 .54 3 .54 3 .46 3 .58 3 .54
17 Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to safely administer medications and other therapies .
3 .73 3 .70 3 .86 3 .75 3 .63 3 .57 3 .49 3 .60
18 Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to consider emotional, physical and personal care needs, including meeting the need for comfort, nutrition, personal hygiene and enabling the person to maintain the activities necessary for daily life .
3 .47 3 .31 3 .54 3 .41 3 .33 3 .43 3 .43 3 .54
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
22 COMPETENCY STATEMENT FINDINGS
Table 5. Competency Averages (U.S. and E.U. Studies)
Co
mp
#
Competency
Recent NCLEX
Reg. U.S.
First-year RN U.S.
Educators U.S.
Supervisors U.S.
Students E.U.
Graduates E.U.
Employers E.U.
Others E.U.*
Avg. Avg. Avg. Avg. Avg. Avg. Avg. Avg.
19 Using nursing skills, medical devices and interventions/activities to provide optimum care, demonstrates the ability to respond to a person’s needs throughout the life span and health/illness experience e .g . pain, life choices, revalidation, disability or when dying .
3 .41 3 .24 3 .37 3 .19 3 .41 3 .41 3 .58 3 .47
20 Demonstrates the ability to inform, educate and supervise patient/caregivers and their families .
3 .37 3 .20 3 .24 3 .13 3 .23 3 .23 3 .37 3 .27
21 Demonstrates current and relevant knowledge of the theories of nursing and nursing practice that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .
3 .06 2 .88 2 .78 2 .91 3 .17 3 .20 3 .23 2 .99
22 Demonstrates current and relevant knowledge of theories concerning the nature and challenge of professional practice that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .
2 .98 2 .78 2 .70 2 .70 3 .07 3 .11 3 .14 2 .97
23 Demonstrates current and relevant knowledge of the natural and life sciences that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .
3 .09 2 .86 3 .00 2 .79 2 .87 2 .99 3 .07 2 .93
24 Demonstrates current and relevant knowledge of the social, health and behavioral sciences that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .
3 .10 2 .87 3 .00 2 .80 2 .96 3 .04 3 .09 2 .99
25 Demonstrates current and relevant knowledge of ethical theory, law and humanities that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .
3 .07 2 .86 2 .96 2 .72 3 .02 3 .21 3 .03 3 .10
26 Demonstrates current and relevant knowledge of technology and healthcare informatics that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .
3 .01 2 .79 2 .87 2 .71 2 .76 2 .96 2 .96 2 .98
27 Demonstrates current and relevant knowledge of international and national policies that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .
2 .82 2 .52 2 .29 2 .05 2 .61 2 .81 2 .91 2 .77
28 Demonstrates current and relevant knowledge of problem solving, decision making and conflict theories that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .
3 .25 3 .08 3 .08 3 .04 3 .14 3 .28 3 .24 3 .35
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
23COMPETENCY STATEMENT FINDINGS
Table 5. Competency Averages (U.S. and E.U. Studies)
Co
mp
#
Competency
Recent NCLEX
Reg. U.S.
First-year RN U.S.
Educators U.S.
Supervisors U.S.
Students E.U.
Graduates E.U.
Employers E.U.
Others E.U.*
Avg. Avg. Avg. Avg. Avg. Avg. Avg. Avg.
29 Demonstrates current and relevant knowledge of theories related to personal and professional development so as to enhance professional practice .
2 .97 2 .78 2 .67 2 .60 3 .12 3 .25 3 .31 3 .18
30 Demonstrates current and relevant knowledge of the research process and current nursing research that can be appropriately applied to nursing actions/activities to provide nursing care that is rigorous and evidence based .
3 .08 2 .80 2 .82 2 .46 2 .98 3 .13 3 .13 2 .95
31 Demonstrates the ability to communicate effectively (including the use of new technologies): with patients, families and social groups, including those with communication difficulties .
3 .49 3 .40 3 .56 3 .38 3 .33 3 .36 3 .36 3 .20
32 Demonstrates the ability to enable patients and their caregivers to express their concerns and can respond appropriately e .g . emotional, social, psychological, spiritual or physical concerns .
3 .41 3 .24 3 .49 3 .35 3 .30 3 .30 3 .25 3 .36
33 Demonstrates the ability to appropriately represent the patient/client's perspective and act to prevent abuse .
3 .53 3 .39 3 .55 3 .50 3 .24 3 .28 3 .17 3 .20
34 Demonstrates the ability to appropriately use counseling skills to promote patient well-being .
3 .21 2 .97 2 .96 2 .82 3 .18 3 .24 3 .29 3 .22
35 Demonstrates the ability to identify and manage challenging behavior (using communication techniques to promote patient well-being) .
3 .22 3 .07 3 .18 3 .05 3 .08 3 .22 3 .24 3 .12
36 Demonstrates the ability to recognize anxiety, stress and depression (using communication techniques to promote patient well-being) .
3 .29 3 .09 3 .29 3 .12 3 .24 3 .39 3 .32 3 .47
37 Demonstrates the ability to give emotional support and identify when counseling or other interventions are needed .
3 .29 3 .10 3 .30 3 .06 3 .29 3 .34 3 .23 3 .23
38 Demonstrates the ability to identify and use opportunities for health promotion and health education activities .
3 .24 3 .00 3 .20 2 .78 3 .20 3 .19 3 .19 3 .12
39 Demonstrates the ability to accurately report, record, document and refer care using appropriate technologies .
3 .47 3 .33 3 .55 3 .45 3 .24 3 .34 3 .31 3 .50
40 Demonstrates the ability to realize that patient/client well-being is achieved through the combined resources and actions of all members of the healthcare team .
3 .37 3 .23 3 .29 3 .28 3 .30 3 .34 3 .10 3 .28
41 Demonstrates the ability to lead and coordinate a team, delegating care appropriately and meaningfully .
3 .25 3 .04 3 .04 3 .09 3 .20 3 .08 3 .16 2 .94
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
24 COMPETENCY STATEMENT FINDINGS
Table 5. Competency Averages (U.S. and E.U. Studies)
Co
mp
#
Competency
Recent NCLEX
Reg. U.S.
First-year RN U.S.
Educators U.S.
Supervisors U.S.
Students E.U.
Graduates E.U.
Employers E.U.
Others E.U.*
Avg. Avg. Avg. Avg. Avg. Avg. Avg. Avg.
42 Demonstrates the ability to work and communicate collaboratively and effectively with other nurses in the best interest of the patient/client .
3 .51 3 .37 3 .56 3 .48 3 .44 3 .38 3 .35 3 .49
43 Demonstrates the ability to work and communicate collaboratively and effectively with all support staff to prioritize and manage time effectively while quality standards are met .
3 .44 3 .27 3 .41 3 .41 3 .39 3 .23 3 .23 3 .19
44 Demonstrates the ability to assess risk and actively promote the well-being, security and safety of all people in the working environment (including themselves) .
3 .45 3 .29 3 .37 3 .22 3 .30 3 .29 3 .43 3 .15
45 Demonstrates the ability to critically use tools to evaluate and audit care according to relevant quality standards .
3 .13 2 .90 2 .72 2 .82 3 .07 3 .15 3 .19 2 .83
46 Within the clinical context, demonstrates the ability to educate, facilitate, supervise and support nursing students and other healthcare students or workers .
3 .25 3 .00 2 .86 2 .66 3 .24 3 .18 3 .23 2 .93
47 Demonstrates an awareness of the principles of healthcare funding and uses resources effectively .
3 .03 2 .73 2 .59 2 .48 3 .07 3 .07 3 .22 2 .88
*This group of respondents includes professional association members, physicians and nursing educators .
Figure 5. Average Ratings (U.S. and E.U.)
.00
.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47
Competency
Ave
rage
Ra�
ng
Recent NCLEX Reg. U.S. Mean Educators U.S. Mean
Supervisors U.S. Mean Graduates E.U. Mean
Employers E.U. Mean
First-year RN U.S. Mean
Students E.U. Mean
Others E.U. Mean
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
25COMPETENCY STATEMENT FINDINGS
Ratings for the 47 competency statements appear to be consistent . Recent U .S . NCLEX registrants, first-year RNs, educators and supervisors appear to have rated the competency statement similarly . Fig-ure 5 shows how similar the importance ratings were across the 47 competency statements with each line representing one of the eight U .S . and E .U . cohorts .
An unweighted average was calculated for each competency by averaging each mean within the U .S . and E .U . categories . The goal was to identify which competencies were most disparate . Table 6 shows the five most disparate average ratings when comparing all U.S. groups to all E.U. groups. No difference in this comparison was greater than .50 points . In the difference column, negative values represent a higher E .U . rating .
Correlation Analysis
To evaluate the relationship among the U .S . respon-dent cohorts and the E .U . cohorts, a correlation study was conducted using the 47 average impor-tance values . All correlations were positively related and statistically significant . The relationship among all groups, except Employers-E .U ., had correlations above .76 . Table 7 presents this data .
TUNING Analysis Survey Nonresponder Study
In order to ensure the validity of the results, NCSBN conducted a telephone survey of nonresponders to determine if the nurses not responding would have rated the nursing competency statements differently than the survey responders . If there are no system-atic differences in responders versus nonresponders, it would seem that the results are not biased and the nonresponder study provided evidence to support the validity of survey results . A stratified random sample of recent NCLEX registrants, first-year RNs, educators and nursing supervisors who did not participate in the survey were contacted via telephone . Of the potential contacts, a telephone interview was obtained from a total of 121 nurses: 30 recent NCLEX registrants, 30 first-year RNs, 30 edu-cators and 31 nursing supervisors . The study found that the majority of nonresponders either did not receive the initial survey invitation or were too busy to respond . More importantly, the study found that the nonresponders rated the competency state-ments similarly to how responders rated them; this similarity supports validity of the results of the study . See Appendix C for the results of the nonresponder study.
Table 6. Average Importance Differences (U.S. and E.U.)
Comp # CompetencyU.S.
AverageE.U.
Average Difference
29 Demonstrates current and relevant knowledge of theories related to personal and professional development so as to enhance professional practice .
2 .76 3 .22 -0 .46
27 Demonstrates current and relevant knowledge of international and national policies that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .
2 .42 2 .77 -0 .35
47 Demonstrates an awareness of the principles of healthcare funding and uses resources effectively .
2 .71 3 .06 -0 .35
22 Demonstrates current and relevant knowledge of theories concerning the nature and challenge of professional practice that can be appropriately applied to nursing practice, patient/client care and situations of uncertainty .
2 .79 3 .07 -0 .28
33 Demonstrates the ability to appropriately represent the patient/client's perspective and act to prevent abuse .
3 .49 3 .22 0 .27
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
26 COMPETENCY STATEMENT FINDINGS
Table 7. Correlation Between Competency Averages (U.S. and E.U.)
Measure
Recent NCLEX
Reg.-U.S.First-year RN-U.S.
Educators- U.S.
Supervisors-U.S.
Students- E.U.
Graduates- E.U.
Employers- E.U.
Others- E.U.*
Recent NCLEX Reg .-U .S .
.988** .962** .947** .856** .838** .675** .798**
First-year RN-U .S . .959** .962** .864** .853** .706** .793**
Educators-U .S . .961** .801** .826** .619** .823**
Supervisors-U .S . .821** .820** .633** .793**
Students-E .U . .926** .842** .765**
Graduates-E .U . .816** .858**
Employers-E .U . .655**
Others-E .U .
* This group of respondents includes professional association members, physicians and nursing educators .** Correlation is significant at the 0 .01 level (2-tailed) .
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
27CONCLUSION
There is evidence to suggest that basic nursing education competencies are equally important, regardless of nursing role or geographic setting . Average importance ratings were very similar for the 47 competencies . Correlations for the 47 com-petencies were high and statistically significant .
A limitation of the study may be the construction of the education competency statements . Some of the competencies were long and contained multiple concepts . The researchers of the present study recommend that the education competency statements be revised to increase ease of use and interpretation prior to inclusion in future research studies .
While the competencies are similar, organizations should consider undertaking an international study on the role of the RN . Specifically, organizations representing different countries should identify basic nursing roles or activities and evaluate them across geographies .
CONCLUSION
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
28 REFERENCES
REFERENCES
CoRe Project . (2007) . Competencies in education and cross-border recognition: Evaluation of the useful- ness of learning outcomes and competencies for international recognition final report . Retrieved January 6, 2010, from http://www .dashe .nl/publications/documents/CoRe20Final20Report .pdf
Cronbach, L .J . (1951) . Coefficient alpha and the internal structure of tests . Psychometrika, 16, 297-334 .
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
29APPENDIX A
APPENDIX A: 2009 TUNING ANALYSES METHODOLOGY REVIEWERS
Ira Bernstein, PhD, is a professor in the department of clinical sciences at the University of Texas South-western Medical Center . He also holds joint appointments at the University of Texas School of Health Professions and at the University of Texas at Arlington . For the last 10 years, Bernstein has served as con-sulting editor for a number of peer review journals, such as Behavior Research Methods and Educational and Psychological Measurements . Bernstein is an expert in the field of measurement and psychometrics . He was one of the researchers funded by the NCSBN Joint Research Committee (JRC) in 2009 .
Deirdre Knapp, PhD, is director of the Assessment, Training and Policy Studies Division at the Human Resources Research Organization (HumRRO) . She also serves as vice president of her organization . Knapp has more than 25 years of experience in conducting and managing personnel and testing related research . Her research emphasis is on designing and administering performance assessments . In that capacity, Knapp is a leader in the field of job analyses and practice analyses . Prior to her 20 years of service in HumRRO, she worked as a research psychologist at the U .S . Army Research Institute for the Behavioral and Social Sciences (ARI) .
Michael Rosenfeld, PhD, is president of Rosenfeld and Associates . His recent research focused on the development of job analysis procedures as a basis for designing assessment measures, documenting their validity and using the results of job analysis in curriculum design . Throughout his 30-plus years of experi-ence in the testing industry, he has worked on many important testing issues, such as the Americans with Disabilities Act (ADA) . Rosenfeld is a lead auditor for the American National Standards Institute in their program accrediting credentialing organizations . He also serves as co-editor of the CLEAR Exam Review, a professional testing journal . Prior to his work with Rosenfeld and Associates, Rosenfeld conducted and managed a wide variety of applied research projects for both the American Institutes for Research (AIR) and Educational Testing Service (ETS) .
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
30 APPENDIX B
APPENDIX B: 2009 U.S. SURVEYS
Page 1
National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First Year
This survey is part of an international research study on the importance of specific nursing competencies for Registered Nurses (RNs). The results of the survey will compare U.S. academic nursing competencies with European academic nursing competencies. This study is being conducted by NCSBN with permission from your board of nursing. Please complete this survey as soon as possible. This is your opportunity to contribute to international nursing knowledge.
Instructions:
Please read each question carefully and respond by selecting the option that most closely represents your answer. Choose the answer that best applies to your practice and select the appropriate response(s). A few questions ask you to enter information. Your answers will be kept confidential. Your individual responses to the questions will not be released.
Survey Progression:
To progress through the survey, please use the navigation buttons located at the bottom of each page:
Continue to the next page of the survey by clicking the Continue to the Next Page link.
Go back to the previous page in the survey by clicking on the Previous Page link. This will allow you to move back in the survey to look over the previous answers.
Finish the survey, by clicking the Submit the Survey link on the Thank You page.
Introduction
Section 1
Other
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
31APPENDIX B
Page 2
National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First Year1. What is the highest nursing degree you completed or are about to complete?
Indicate how important you think it is that a graduating nurse (you) should have acquired the following competencies in his/her educational program in order to practice as a professional registered nurse.
For each of the skills listed below rate the importance of the skill or competency using the following scale:
1 = not important, 2 = important, 3 = very important, 4 = vital
SPECIFIC COMPETENCIES – where possible these competencies should be demonstrated in both nursing practice and theoretical assessments.
2. What is the month and year you graduated? Please select from the dropdown menus.
Month Year
MM/YYYY
Section 2
RN - Diploma in U.S.
RN - Associate Degree in U.S.
RN - Baccalaureate Degree in U.S.
RN - Generic Masters Degree in U.S.
RN - Masters (Nurse Practitioner)
RN - Masters (Clinical Nurse Specialist)
RN - Generic Doctorate in U.S. (e.g., ND, PhD, DNP)
Any nursing program NOT located in the U.S.
Other (please specify)
Other
Other
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
32 APPENDIX B
Page 3
National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearA. Competencies: professional values and the role of the nurse
Importance
1. Demonstrates the ability to practice within the context of professional,
ethical, regulatory and legal codes, recognizing and responding to
moral/ethical dilemmas and issues in day to day practice.
2. Demonstrates the ability to practice in a holistic, tolerant, non
judgmental, caring and sensitive manner, ensuring that the rights, beliefs
and wishes of different individuals and groups are not compromised.
3. Demonstrates the ability to educate, facilitate, promote, support and
encourage the health, well-being and comfort of populations, communities,
groups and individuals whose lives are affected by, illness, distress,
disease, disability or death.
4. Within the scope of his/her professional practice and accountability,
demonstrates awareness of the different roles, responsibilities and
functions of a nurse.
5. Within the scope of his/her professional practice and accountability,
demonstrates the ability to adjust their role to respond effectively to
population/patient needs. Where necessary and appropriate is able to
challenge current systems to meet population/patient needs.
6. Demonstrates the ability to accept responsibility for his/her own
professional development and learning, using evaluation as a way to
reflect and improve upon his/her performance so as to enhance the quality
of service delivery.
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
33APPENDIX B
Page 4
National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearB. Competencies: nursing practice and clinical decision making
Importance
7. Demonstrates the ability to undertake comprehensive and systematic
assessments using the tools/frameworks appropriate to the patient/client
taking into account relevant physical, social, cultural, psychological,
spiritual and environmental factors.
8. Demonstrates the ability to perform an effective risk assessment and
take appropriate actions.
9. Demonstrates the ability to recognize and interpret signs of normal and
changing health/illness, distress, or disability in the person
(assessment/diagnosis).
10. Demonstrates the ability to respond to patient/client needs by
planning, delivering and evaluating appropriate and individualized
programs of care while working in partnership with the patient/client, their
caregivers, families and other healthcare workers.
11. Demonstrates the ability to critically question, evaluate, interpret and
synthesize a range of information and data sources to facilitate patient
choice.
12. Demonstrates the ability to make sound clinical judgments to ensure
quality standards are met and practice is evidence based.
13. Demonstrates the ability to use modern technologies to assess and
respond appropriately to patient/client need (for example through
telehealth, multimedia and web resources).
14. Demonstrates the ability to appropriately use a range of nursing skills,
medical devices and interventions/activities to provide optimum care.
15. Using nursing skills, medical devices and interventions/activities to
provide optimum care, demonstrates the ability to maintain patient/client
dignity, advocacy and confidentiality.
16. Using nursing skills, medical devices and interventions/activities to
provide optimum care, demonstrates the ability to practice principles of
health and safety, including moving and handling, infection control,
essential first aid and emergency procedures.
17. Using nursing skills, medical devices and interventions/activities to
provide optimum care, demonstrates the ability to safely administer
medications and other therapies.
18. Using nursing skills, medical devices and interventions/activities to
provide optimum care, demonstrates the ability to consider emotional,
physical and personal care needs, including meeting the need for comfort,
nutrition, personal hygiene and enabling the person to maintain the
activities necessary for daily life.
19. Using nursing skills, medical devices and interventions/activities to
provide optimum care, demonstrates the ability to respond to a person’s
needs throughout the life span and health/illness experience e.g. pain, life
choices, revalidation, disability or when dying.
20. Demonstrates the ability to inform, educate and supervise
patient/caregivers and their families.
Other
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
34 APPENDIX B
Page 5
National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearC. Knowledge and cognitive competencies
Importance
21. Demonstrates current and relevant knowledge of the theories of
nursing and nursing practice that can be appropriately applied to nursing
practice, patient/client care and situations of uncertainty.
22. Demonstrates current and relevant knowledge of theories concerning
the nature and challenge of professional practice that can be appropriately
applied to nursing practice, patient/client care and situations of
uncertainty.
23. Demonstrates current and relevant knowledge of the natural and life
sciences that can be appropriately applied to nursing practice,
patient/client care and situations of uncertainty.
24. Demonstrates current and relevant knowledge of the social, health and
behavioral sciences that can be appropriately applied to nursing practice,
patient/client care and situations of uncertainty.
25. Demonstrates current and relevant knowledge of ethical theory, law
and humanities that can be appropriately applied to nursing practice,
patient/client care and situations of uncertainty.
26. Demonstrates current and relevant knowledge of technology and
healthcare informatics that can be appropriately applied to nursing
practice, patient/client care and situations of uncertainty.
27. Demonstrates current and relevant knowledge of international and
national policies that can be appropriately applied to nursing practice,
patient/client care and situations of uncertainty.
28. Demonstrates current and relevant knowledge of problem solving,
decision making and conflict theories that can be appropriately applied to
nursing practice, patient/client care and situations of uncertainty.
29. Demonstrates current and relevant knowledge of theories related to
personal and professional development so as to enhance professional
practice.
30. Demonstrates current and relevant knowledge of the research process
and current nursing research that can be appropriately applied to nursing
actions/activities to provide nursing care that is rigorous and evidence
based.
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
35APPENDIX B
Page 6
National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearD. Communication and interpersonal competencies (including technology for communication)
E. Leadership, management and team competencies
Importance
31. Demonstrates the ability to communicate effectively (including the use
of new technologies): with patients, families and social groups, including
those with communication difficulties.
32. Demonstrates the ability to enable patients and their caregivers to
express their concerns and can respond appropriately e.g. emotional,
social, psychological, spiritual or physical concerns.
33. Demonstrates the ability to appropriately represent the patient/client’s
perspective and act to prevent abuse.
34. Demonstrates the ability to appropriately use counseling skills to
promote patient well-being.
35. Demonstrates the ability to identify and manage challenging behavior
(using communication techniques to promote patient well-being).
36. Demonstrates the ability to recognize anxiety, stress and depression
(using communication techniques to promote patient well-being).
37. Demonstrates the ability to give emotional support and identify when
counseling or other interventions are needed.
38. Demonstrates the ability to identify and use opportunities for health
promotion and health education activities.
39. Demonstrates the ability to accurately report, record, document and
refer care using appropriate technologies.
Importance
40. Demonstrates the ability to realize that patient/client well-being is
achieved through the combined resources and actions of all members of
the healthcare team.
41. Demonstrates the ability to lead and coordinate a team, delegating
care appropriately and meaningfully.
42. Demonstrates the ability to work and communicate collaboratively and
effectively with other nurses in the best interest of the patient/client.
43. Demonstrates the ability to work and communicate collaboratively and
effectively with all support staff to prioritize and manage time effectively
while quality standards are met.
44. Demonstrates the ability to assess risk and actively promote the well-
being, security and safety of all people in the working environment
(including themselves).
45. Demonstrates the ability to critically use tools to evaluate and audit
care according to relevant quality standards.
46. Within the clinical context, demonstrates the ability to educate,
facilitate, supervise and support nursing students and other healthcare
students or workers.
47. Demonstrates an awareness of the principles of healthcare funding and
uses resources effectively.
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
36 APPENDIX B
Page 7
National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First Year
1. Which of the following best describes most of your clients on the last day you worked? (Select all that apply.)
2. Which of the following best describes the ages of the majority of your clients? (Select all that apply.)
Section 3: Work Environment
Well clients, possibly with minor illnesses
OB (Maternity) clients
Clients with stabilized chronic conditions
Clients with unstabilized chronic conditions
Clients with acute conditions, including clients with medical, surgical or critical conditions
Clients at end of life
Clients with behavioral/emotional conditions
Not working as an RN
Other (please specify)
Newborns (less than 1 month)
Infants/children (1 month-12 years)
Adolescent (ages 13-18)
Young Adult (ages 19-30)
Adult (ages 31-64)
Older Adult (65-85)
Older Adult (over 85)
Not working as an RN
Other (please specify)
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
37APPENDIX B
Page 8
National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First Year3. Which of the following choices best describes your employment setting/specialty area on the last day you worked? If you work mainly in one setting, fill in the appropriate box for that one setting. If you worked in more than one setting, fill in the appropriate boxes for all settings where you spent at least one-half of your time. (Select no more than two answers.)
Critical care (e.g., ICU, CCU, step-down units, pediatric/neonatal intensive care, emergency department,
post-anesthesia recovery unit)
Medical-surgical unit or any of its sub-specialties (e.g., oncology, orthopedics, neurology)
Pediatrics
Nursery
Labor and delivery
Postpartum unit
Psychiatry or any of its sub-specialties (e.g., detox)
Operating room, including outpatient surgery and surgicenters
Nursing home, skilled or intermediate care
Assisted Living
Other long-term care (e.g., residential care, developmental disability)
Rehabilitation
Subacute unit
Transitional care unit
Physician/APRN/Dentist office
Occupational health
Outpatient clinic
Home health, including visiting nurses associations
Public health
Student/school health
Hospice care
Prison/correctional facilities/jails
Not working as an RN
Other (please specify)
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
38 APPENDIX B
Page 9
National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First Year
4. Which of the following best describes the type of facility/organization where your employment setting/specialty area is located?
1. What is your gender?
2. What is your age in years?
Section 4: Demographic Information
Hospital
Long-term care
Community-based or ambulatory care facility/organization (including public health department, visiting
nurses association, home health, physician/APRN/dentist’s office, clinic, school, prison, etc.)
Not working as an RN
Other (please specify)
Male
Female
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
39APPENDIX B
Page 10
National Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First YearNational Council of State Boards of Nursing (NCSBN®) First Year3. Which of the following is most descriptive of your racial/ethnic background? (Select one answer.)
4. What is your primary language?
We appreciate your participation in this important work.
To finalize your survey, please click the Submit button on this page.
If we need additional information in order to clarify the results of this study, we may call and/or e-mail some participants. If you would be willing to answer a few additional questions by phone or e-mail, please provide your contact information where you can be reached during the day or early evening.
Additional Information:
Thank you!
Name:
Email Address:
Phone Number:
African American
Asian Indian
Asian Other
Hispanic
Native American
Pacific Islander
White – not of Hispanic origin
Other (please specify)
English
English and another Language
Another Language
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
40 APPENDIX B
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
41APPENDIX B
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
42 APPENDIX B
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
43APPENDIX B
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
44 APPENDIX B
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
45APPENDIX B
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
46 APPENDIX B
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
47APPENDIX C
APPENDIX C: 2009 TUNING ANALYSIS SURVEY NONRESPONDER STUDY
IntroductionThe National Council of State Boards of Nurs-ing (NCSBN®) conducted a study to evaluate the importance of nursing competencies in the U .S . Respondents of the study were drawn from four samples: recent NCLEX registrants, registered nurses (RNs) obtaining their license within the last year (first-year RN), nursing educators and supervi-sors of nurses .
Out of the 6,000 recent NCLEX registrants who were invited to take the survey online, 2,857 surveys were submitted . In addition, 590 out of 2,500 first-year RNs, 1,380 out of 2,751 nursing educators and 657 out of 2,750 supervisors of nurses returned the sur-veys, separately .
NCSBN wanted to contact a sample of the invitees who chose not to participate in the survey and com-pare a sample of competency statements, as well as demographic information, against the 2009 TUN-ING Analysis Survey responders .
Background of StudyA new initiative seeks to understand the role of nurses and nursing education from an international perspective . This study was conducted to evalu-ate the importance of nursing competencies in the U .S . In addition, results from the current study were compared to the results of a similiar study, called TUNING, conducted in the following European Union (E .U .) countries: Denmark, Finland, Flanders, France, Germany, Hungary, Ireland, Italy, Lithuania, Malta, Norway, Netherlands, Portugal, Slovakia, Spain, Ukraine and the United Kingdom .
MethodologySample Selection
A random sample of 30 invitees from the educator, recent NCLEX registrant and first-year RN groups, and 31 nursing supervisors who did not respond to
the 2009 TUNING Analysis Survey was contacted via telephone .
Survey Instrument and Process
There were a total of 121 nonresponders who were contacted via phone . First, nonresponders were asked about their reasons for not complet-ing the survey . In order to facilitate the gathering of data from nonresponders, NCSBN developed a list of possible reasons why invitees may not have responded to the survey based on prior research . Possible reasons included too busy, did not care, do not like/trust surveys, did not receive or other . Sec-ond, nonresponders were asked for demographic information in order to provide background, such as employment setting/specialty and length of time since they graduated with a nursing degree . In addition, nonresponders were asked to rate the importance of 10 competencies that were listed in the 2009 TUNING Analysis Survey . Nonresponders were thanked for their time and their data was recorded in a Microsoft Excel 2007 spreadsheet .
Nonresponder Results
Reasons for Not Responding
There were 63% (19/30) of recent NCLEX registrants, 60% (18/30) of first-year RNs, 97% (29/30) of educa-tors and 100% (31/31) of supervisors who did not receive the survey; 30% of recent NCLEX registrants and 37% of first-year RNs were too busy to return the survey . None of the nonresponders indicated
Table C-1. Reasons For Not Responding
Group Too Busy Did Not Care
Do Not Like/Trust Surveys
Did Not Receive It Total
Recent NCLEX
Reg .9 2 0 19 30
First-year RN
11 1 0 18 30
Educator 1 0 0 29 30
Supervisor 0 0 0 31 31
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
48 APPENDIX C
Table C-2. Average Importance Rating of Competencies
Competency
Responder Nonresponder
Recent NCLEX Reg.
First-year RN Educators Supervisors
Recent NCLEX Reg.
First-year RN Educators Supervisors
N Avg. N Avg. N Avg. N Avg. N Avg. N Avg. N Avg. N Avg.
Demonstrates the ability to practice in a holistic, tolerant, non judgmental, caring and sensitive manner, ensuring that the rights, beliefs and wishes of different individuals and groups are not compromised .
2879 3 .56 599 3 .38 1363 3 .68 645 3 .50 30 3 .63 30 3 .67 30 3 .80 31 3 .84
Within the scope of his/her professional practice and account-ability, demonstrates awareness of the different roles, responsibilities and functions of a nurse .
2872 3 .43 598 3 .33 1363 3 .44 641 3 .36 30 3 .43 30 3 .63 30 3 .73 31 3 .52
Demonstrates the ability to perform an effective risk assessment and take appropriate actions .
2857 3 .49 596 3 .39 1358 3 .46 641 3 .43 30 3 .93 30 3 .83 30 3 .73 31 3 .52
Demonstrates the ability to critically question, evaluate, interpret and syn-thesize a range of information and data sources to facilitate patient choice .
2862 3 .45 593 3 .24 1368 3 .38 643 3 .18 30 3 .63 30 3 .53 30 3 .73 31 3 .61
Demonstrates the ability to appro-priately use a range of nurse skills, medical devices and interventions/activities to provide optimum care .
2856 3 .41 592 3 .31 1364 3 .29 644 3 .23 30 3 .70 30 3 .47 30 3 .47 31 3 .55
Demonstrates the ability to inform, educate and supervise patient/ caregivers and their families .
2838 3 .37 587 3 .20 1339 3 .24 632 3 .13 30 3 .50 30 3 .27 30 3 .50 31 3 .32
Demonstrates current and relevant knowledge of the research process and current nursing research that can be appropriately applied to nursing actions/activities to provide nursing care that is rigorous and evidence based .
2821 3 .08 582 2 .80 1345 2 .82 636 2 .46 30 3 .23 30 3 .20 30 3 .07 31 2 .71
Demonstrates the ability to appropri-ately use counseling skills to promote patient well-being .
2824 3 .21 580 2 .97 1345 2 .96 636 2 .82 30 3 .37 30 3 .17 30 3 .13 31 3 .00
Demonstrates the ability to accurately report, record, document and refer care using appropriate technologies .
2829 3 .47 586 3 .33 1327 3 .55 635 3 .45 30 3 .60 30 3 .47 30 3 .73 31 3 .81
Demonstrates an awareness of the principles of healthcare funding and uses resources effectively .
2833 3 .03 587 2 .73 1353 2 .59 648 2 .48 30 3 .17 30 2 .97 30 3 .00 31 2 .68
that they do not like/trust surveys as a reason for not returning the survey . See Table C-1.
Employment Setting/Specialty
Nonresponders were asked to provide their set-ting/specialty area . The largest percentages, 43 .0% of recent NCLEX registrants and 33 .3% of first-year RNs, worked in the medical-surgical unit or any of its sub-specialties (e .g . oncology, orthopedics,
neurology), while 37% of the recent NCLEX reg-istrants, 37% of the first-year RNs and almost all nursing supervisors cited specialties other than those on the list . None of the educators contacted specified their specialties .
Importance Ratings
In general, the importance ratings between nonre-sponders and responders were very similar, with no
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
49APPENDIX C
competency importance rating differing by more than half a point . See Table C-2.
SummaryThe nonresponder study suggests that the main reasons individuals did not complete the study were they were either too busy or did not receive the survey . Overall, these results provide important information about why individuals do not complete surveys . More importantly, the ratings of the activ-ity statements were quite similar, which indicates that the results of the survey are not systematically biased . The nonresponder study provides support for the validity of the 2009 TUNING Analysis Survey results .
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
50 APPENDIX DA
pp
end
ix D
. U.S
. Ed
ucat
iona
l Co
mp
aris
on
Comp #D
iplo
ma
Ass
oci
ate
Bac
cala
urea
teA
sso
c-B
acc
Co
mp
eten
cyN
Avg
Std
. Err
.N
Avg
Std
. Err
.N
Avg
Std
. Err
.D
if.
1D
emo
nstr
ates
the
ab
ility
to
pra
ctic
e w
ithin
the
co
ntex
t o
f pro
fess
iona
l, et
hica
l, re
gul
ato
ry a
nd le
gal
co
des
, rec
og
nizi
ng a
nd re
spo
ndin
g t
o m
ora
l/et
hica
l dile
mm
as a
nd is
sues
in d
ay t
o d
ay p
ract
ice .
323 .
810 .
0849
03 .
580 .
0322
903 .
600 .
01-0
.02
2D
emo
nstr
ates
the
ab
ility
to
pra
ctic
e in
a h
olis
tic, t
ole
rant
, no
n ju
dg
men
tal,
carin
g a
nd s
ensi
tive
man
ner,
ensu
ring
tha
t th
e rig
hts,
bel
iefs
and
wis
hes
of
diff
eren
t in
div
idua
ls a
nd g
roup
s ar
e no
t co
mp
rom
ised
.32
3 .81
0 .08
490
3 .51
0 .03
2290
3 .57
0 .01
-0 .0
6
3D
emo
nstr
ates
the
ab
ility
to
ed
ucat
e, fa
cilit
ate,
pro
mo
te, s
upp
ort
an
d e
nco
urag
e th
e he
alth
, wel
l-bei
ng a
nd c
om
fort
of p
op
ulat
ions
, co
mm
uniti
es, g
roup
s an
d in
div
idua
ls w
hose
live
s ar
e af
fect
ed b
y, il
lnes
s,
dis
tres
s, d
isea
se, d
isab
ility
or
dea
th .
323 .
780 .
0749
03 .
540 .
0322
863 .
560 .
01-0
.01
4W
ithin
the
sco
pe
of h
is/h
er p
rofe
ssio
nal p
ract
ice
and
acc
oun
tab
ility
, d
emo
nstr
ates
aw
aren
ess
of t
he d
iffer
ent
role
s, re
spo
nsib
ilitie
s an
d
func
tions
of a
nur
se .
323 .
690 .
0948
83 .
440 .
0322
853 .
430 .
010 .
00
5W
ithin
the
sco
pe
of h
is/h
er p
rofe
ssio
nal p
ract
ice
and
acc
oun
tab
ility
, d
emo
nstr
ates
the
ab
ility
to
ad
just
the
ir ro
le t
o re
spo
nd e
ffect
ivel
y to
p
op
ulat
ion/
pat
ient
nee
ds .
Whe
re n
eces
sary
and
ap
pro
pria
te is
ab
le t
o
chal
leng
e cu
rren
t sy
stem
s to
mee
t p
op
ulat
ion/
pat
ient
nee
ds .
323 .
560 .
1348
93 .
370 .
0322
833 .
380 .
010 .
00
6D
emo
nstr
ates
the
ab
ility
to
acc
ept
resp
ons
ibili
ty fo
r hi
s/he
r o
wn
pro
fess
iona
l dev
elo
pm
ent
and
lear
ning
, usi
ng e
valu
atio
n as
a w
ay t
o
refle
ct a
nd im
pro
ve u
po
n hi
s/he
r p
erfo
rman
ce s
o a
s to
enh
ance
the
qua
lity
of s
ervi
ce d
eliv
ery .
323 .
660 .
1248
83 .
490 .
0322
813 .
480 .
010 .
01
7D
emo
nstr
ates
the
ab
ility
to
und
erta
ke c
om
pre
hens
ive
and
sys
tem
atic
as
sess
men
ts u
sing
the
to
ols
/fra
mew
ork
s ap
pro
pria
te t
o t
he p
atie
nt/
clie
nt t
akin
g in
to a
cco
unt
rele
vant
phy
sica
l, so
cial
, cul
tura
l, p
sych
olo
gic
al,
spiri
tual
and
env
ironm
enta
l fac
tors
.
323 .
660 .
1048
43 .
470 .
0322
793 .
510 .
01-0
.05
8D
emo
nstr
ates
the
ab
ility
to
per
form
an
effe
ctiv
e ris
k as
sess
men
t an
d t
ake
app
rop
riate
act
ions
.32
3 .63
0 .11
483
3 .49
0 .03
2276
3 .49
0 .01
0 .01
9D
emo
nstr
ates
the
ab
ility
to
reco
gni
ze a
nd in
terp
ret
sig
ns o
f no
rmal
and
ch
ang
ing
hea
lth/i
llnes
s, d
istr
ess,
or
dis
abili
ty in
the
per
son
(ass
essm
ent/
dia
gno
sis)
.31
3 .84
0 .07
480
3 .73
0 .02
2258
3 .73
0 .01
-0 .0
1
10D
emo
nstr
ates
the
ab
ility
to
resp
ond
to
pat
ient
/clie
nt n
eed
s b
y p
lann
ing
, d
eliv
erin
g a
nd e
valu
atin
g a
pp
rop
riate
and
ind
ivid
ualiz
ed p
rog
ram
s o
f ca
re w
hile
wo
rkin
g in
par
tner
ship
with
the
pat
ient
/clie
nt, t
heir
care
giv
ers,
fa
mili
es a
nd o
ther
hea
lthca
re w
ork
ers .
323 .
630 .
0948
43 .
440 .
0322
783 .
470 .
01-0
.03
11D
emo
nstr
ates
the
ab
ility
to
crit
ical
ly q
uest
ion,
eva
luat
e, in
terp
ret
and
sy
nthe
size
a r
ang
e o
f inf
orm
atio
n an
d d
ata
sour
ces
to fa
cilit
ate
pat
ient
ch
oic
e .32
3 .47
0 .10
485
3 .43
0 .03
2279
3 .47
0 .01
-0 .0
4
APPENDIX D: U.S. EDUCATIONAL COMPARISON
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
51APPENDIX DA
pp
end
ix D
. U.S
. Ed
ucat
iona
l Co
mp
aris
on
Comp #D
iplo
ma
Ass
oci
ate
Bac
cala
urea
teA
sso
c-B
acc
Co
mp
eten
cyN
Avg
Std
. Err
.N
Avg
Std
. Err
.N
Avg
Std
. Err
.D
if.
12D
emo
nstr
ates
the
ab
ility
to
mak
e so
und
clin
ical
jud
gm
ents
to
ens
ure
qua
lity
stan
dar
ds
are
met
and
pra
ctic
e is
evi
den
ce b
ased
.31
3 .65
0 .10
483
3 .51
0 .03
2274
3 .56
0 .01
-0 .0
5
13D
emo
nstr
ates
the
ab
ility
to
use
mo
der
n te
chno
log
ies
to a
sses
s an
d
resp
ond
ap
pro
pria
tely
to
pat
ient
/clie
nt n
eed
(fo
r ex
amp
le t
hro
ugh
tele
heal
th, m
ultim
edia
and
web
reso
urce
s) .
303 .
200 .
1348
33 .
060 .
0422
703 .
000 .
020 .
05
14D
emo
nstr
ates
the
ab
ility
to
ap
pro
pria
tely
use
a r
ang
e o
f nur
sing
ski
lls,
med
ical
dev
ices
and
inte
rven
tions
/act
iviti
es t
o p
rovi
de
op
timum
car
e .32
3 .59
0 .10
483
3 .45
0 .03
2275
3 .40
0 .01
0 .04
15U
sing
nur
sing
ski
lls, m
edic
al d
evic
es a
nd in
terv
entio
ns/a
ctiv
ities
to
pro
vid
e o
ptim
um c
are,
dem
ons
trat
es t
he a
bili
ty t
o m
aint
ain
pat
ient
/clie
nt d
igni
ty,
advo
cacy
and
co
nfid
entia
lity .
323 .
590 .
1148
53 .
530 .
0322
723 .
550 .
01-0
.02
16U
sing
nur
sing
ski
lls, m
edic
al d
evic
es a
nd in
terv
entio
ns/a
ctiv
ities
to
pro
vid
e o
ptim
um c
are,
dem
ons
trat
es th
e ab
ility
to p
ract
ice
prin
cip
les
of h
ealth
and
sa
fety
, inc
lud
ing
mo
ving
and
han
dlin
g, i
nfec
tion
cont
rol,
esse
ntia
l firs
t ai
d
and
em
erg
ency
pro
ced
ures
.
323 .
690 .
0948
33 .
580 .
0322
673 .
630 .
01-0
.05
17U
sing
nur
sing
ski
lls, m
edic
al d
evic
es a
nd in
terv
entio
ns/a
ctiv
ities
to
pro
vid
e o
ptim
um c
are,
dem
ons
trat
es t
he a
bili
ty t
o s
afel
y ad
min
iste
r m
edic
atio
ns
and
oth
er t
hera
pie
s .32
3 .81
0 .07
484
3 .71
0 .02
2269
3 .73
0 .01
-0 .0
2
18U
sing
nur
sing
ski
lls, m
edic
al d
evic
es a
nd in
terv
entio
ns/a
ctiv
ities
to
p
rovi
de
op
timum
car
e, d
emo
nstr
ates
the
ab
ility
to
co
nsid
er e
mo
tiona
l, p
hysi
cal a
nd p
erso
nal c
are
need
s, in
clud
ing
mee
ting
the
nee
d fo
r co
mfo
rt,
nutr
itio
n, p
erso
nal h
ygie
ne a
nd e
nab
ling
the
per
son
to m
aint
ain
the
activ
ities
nec
essa
ry fo
r d
aily
life
.
323 .
530 .
1148
33 .
480 .
0322
683 .
470 .
010 .
01
19U
sing
nur
sing
ski
lls, m
edic
al d
evic
es a
nd in
terv
entio
ns/a
ctiv
ities
to
pro
vid
e o
ptim
um c
are,
dem
ons
trat
es t
he a
bili
ty t
o re
spo
nd t
o a
per
son’
s ne
eds
thro
ugho
ut t
he li
fe s
pan
and
hea
lth/i
llnes
s ex
per
ienc
e e .
g . p
ain,
life
ch
oic
es, r
eval
idat
ion,
dis
abili
ty o
r w
hen
dyi
ng .
323 .
530 .
1148
43 .
400 .
0322
683 .
410 .
01-0
.01
20D
emo
nstr
ates
the
ab
ility
to
info
rm, e
duc
ate
and
sup
ervi
se p
atie
nt/
care
giv
ers
and
the
ir fa
mili
es .
323 .
410 .
1148
23 .
390 .
0322
583 .
360 .
010 .
03
21D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
the
orie
s o
f nur
sing
an
d n
ursi
ng p
ract
ice
that
can
be
app
rop
riate
ly a
pp
lied
to
nur
sing
pra
ctic
e,
pat
ient
/clie
nt c
are
and
situ
atio
ns o
f unc
erta
inty
.31
3 .26
0 .15
476
3 .09
0 .04
2254
3 .05
0 .02
0 .04
22D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
orie
s co
ncer
ning
the
na
ture
and
cha
lleng
e o
f pro
fess
iona
l pra
ctic
e th
at c
an b
e ap
pro
pria
tely
ap
plie
d t
o n
ursi
ng p
ract
ice,
pat
ient
/clie
nt c
are
and
situ
atio
ns o
f un
cert
aint
y .
323 .
220 .
1447
43 .
050 .
0422
552 .
970 .
020 .
08
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
52 APPENDIX DA
pp
end
ix D
. U.S
. Ed
ucat
iona
l Co
mp
aris
on
Comp #D
iplo
ma
Ass
oci
ate
Bac
cala
urea
teA
sso
c-B
acc
Co
mp
eten
cyN
Avg
Std
. Err
.N
Avg
Std
. Err
.N
Avg
Std
. Err
.D
if.
23D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
nat
ural
and
life
sc
ienc
es t
hat
can
be
app
rop
riate
ly a
pp
lied
to
nur
sing
pra
ctic
e, p
atie
nt/
clie
nt c
are
and
situ
atio
ns o
f unc
erta
inty
.32
3 .16
0 .16
476
3 .09
0 .04
2257
3 .08
0 .02
0 .00
24D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
so
cial
, hea
lth a
nd
beh
avio
ral s
cien
ces
that
can
be
app
rop
riate
ly a
pp
lied
to
nur
sing
pra
ctic
e,
pat
ient
/clie
nt c
are
and
situ
atio
ns o
f unc
erta
inty
.32
3 .22
0 .14
472
3 .10
0 .04
2257
3 .10
0 .02
-0 .0
1
25D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f eth
ical
the
ory
, law
and
hu
man
ities
tha
t ca
n b
e ap
pro
pria
tely
ap
plie
d t
o n
ursi
ng p
ract
ice,
pat
ient
/cl
ient
car
e an
d s
ituat
ions
of u
ncer
tain
ty .
323 .
090 .
1647
53 .
090 .
0422
543 .
070 .
020 .
02
26D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f tec
hno
log
y an
d
heal
thca
re in
form
atic
s th
at c
an b
e ap
pro
pria
tely
ap
plie
d t
o n
ursi
ng
pra
ctic
e, p
atie
nt/c
lient
car
e an
d s
ituat
ions
of u
ncer
tain
ty .
323 .
190 .
1547
43 .
060 .
0422
543 .
000 .
020 .
06
27D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f int
erna
tiona
l and
na
tiona
l po
licie
s th
at c
an b
e ap
pro
pria
tely
ap
plie
d t
o n
ursi
ng p
ract
ice,
p
atie
nt/c
lient
car
e an
d s
ituat
ions
of u
ncer
tain
ty .
322 .
810 .
1847
32 .
920 .
0422
572 .
810 .
020 .
11
28D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f pro
ble
m s
olv
ing
, d
ecis
ion
mak
ing
and
co
nflic
t th
eorie
s th
at c
an b
e ap
pro
pria
tely
ap
plie
d t
o
nurs
ing
pra
ctic
e, p
atie
nt/c
lient
car
e an
d s
ituat
ions
of u
ncer
tain
ty .
323 .
410 .
1447
43 .
300 .
0322
553 .
230 .
020 .
06
29D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
orie
s re
late
d t
o
per
sona
l and
pro
fess
iona
l dev
elo
pm
ent
so a
s to
enh
ance
pro
fess
iona
l p
ract
ice .
323 .
090 .
1647
43 .
010 .
0422
532 .
960 .
020 .
05
30D
emo
nstr
ates
cur
rent
and
rele
vant
kno
wle
dg
e o
f the
rese
arch
pro
cess
an
d c
urre
nt n
ursi
ng re
sear
ch t
hat
can
be
app
rop
riate
ly a
pp
lied
to
nur
sing
ac
tions
/act
iviti
es t
o p
rovi
de
nurs
ing
car
e th
at is
rig
oro
us a
nd e
vid
ence
b
ased
.
323 .
340 .
1447
03 .
130 .
0422
533 .
070 .
020 .
06
31D
emo
nstr
ates
the
ab
ility
to
co
mm
unic
ate
effe
ctiv
ely
(incl
udin
g t
he u
se
of n
ew t
echn
olo
gie
s): w
ith p
atie
nts,
fam
ilies
and
so
cial
gro
ups,
incl
udin
g
tho
se w
ith c
om
mun
icat
ion
diffi
culti
es .
323 .
690 .
0847
93 .
450 .
0322
563 .
490 .
01-0
.04
32D
emo
nstr
ates
the
ab
ility
to
ena
ble
pat
ient
s an
d t
heir
care
giv
ers
to e
xpre
ss
thei
r co
ncer
ns a
nd c
an re
spo
nd a
pp
rop
riate
ly e
.g . e
mo
tiona
l, so
cial
, p
sych
olo
gic
al, s
piri
tual
or
phy
sica
l co
ncer
ns .
323 .
630 .
1147
83 .
380 .
0322
563 .
410 .
01-0
.03
33D
emo
nstr
ates
the
ab
ility
to
ap
pro
pria
tely
rep
rese
nt t
he p
atie
nt/c
lient
's
per
spec
tive
and
act
to
pre
vent
ab
use .
323 .
630 .
1047
83 .
510 .
0322
573 .
530 .
01-0
.02
34D
emo
nstr
ates
the
ab
ility
to
ap
pro
pria
tely
use
co
unse
ling
ski
lls t
o p
rom
ote
p
atie
nt w
ell-b
eing
.32
3 .28
0 .12
475
3 .23
0 .03
2251
3 .21
0 .02
0 .02
35D
emo
nstr
ates
the
ab
ility
to
iden
tify
and
man
age
chal
leng
ing
beh
avio
r (u
sing
co
mm
unic
atio
n te
chni
que
s to
pro
mo
te p
atie
nt w
ell-b
eing
) .32
3 .41
0 .12
479
3 .25
0 .03
2251
3 .22
0 .01
0 .03
National Council of State Boards of Nursing, Inc. (NCSBN) | 2010
53APPENDIX DA
pp
end
ix D
. U.S
. Ed
ucat
iona
l Co
mp
aris
on
Comp #D
iplo
ma
Ass
oci
ate
Bac
cala
urea
teA
sso
c-B
acc
Co
mp
eten
cyN
Avg
Std
. Err
.N
Avg
Std
. Err
.N
Avg
Std
. Err
.D
if.
36D
emo
nstr
ates
the
ab
ility
to
reco
gni
ze a
nxie
ty, s
tres
s an
d d
epre
ssio
n (u
sing
co
mm
unic
atio
n te
chni
que
s to
pro
mo
te p
atie
nt w
ell-b
eing
) .32
3 .41
0 .12
478
3 .29
0 .03
2256
3 .30
0 .01
-0 .0
1
37D
emo
nstr
ates
the
ab
ility
to
giv
e em
otio
nal s
upp
ort
and
iden
tify
whe
n co
unse
ling
or
oth
er in
terv
entio
ns a
re n
eed
ed .
323 .
500 .
1148
03 .
290 .
0322
563 .
290 .
010 .
00
38D
emo
nstr
ates
the
ab
ility
to
iden
tify
and
use
op
po
rtun
ities
for
heal
th
pro
mo
tion
and
hea
lth e
duc
atio
n ac
tiviti
es .
323 .
380 .
1347
93 .
240 .
0322
543 .
250 .
020 .
00
39D
emo
nstr
ates
the
ab
ility
to
acc
urat
ely
rep
ort
, rec
ord
, do
cum
ent
and
refe
r ca
re u
sing
ap
pro
pria
te t
echn
olo
gie
s .32
3 .53
0 .13
478
3 .45
0 .03
2253
3 .48
0 .01
-0 .0
3
40D
emo
nstr
ates
the
ab
ility
to
real
ize
that
pat
ient
/clie
nt w
ell-b
eing
is
achi
eved
thr
oug
h th
e co
mb
ined
reso
urce
s an
d a
ctio
ns o
f all
mem
ber
s o
f th
e he
alth
care
tea
m .
323 .
440 .
1348
03 .
370 .
0322
623 .
370 .
010 .
00
41D
emo
nstr
ates
the
ab
ility
to
lead
and
co
ord
inat
e a
team
, del
egat
ing
car
e ap
pro
pria
tely
and
mea
ning
fully
.32
3 .47
0 .12
478
3 .28
0 .03
2260
3 .24
0 .02
0 .04
42D
emo
nstr
ates
the
ab
ility
to
wo
rk a
nd c
om
mun
icat
e co
llab
ora
tivel
y an
d
effe
ctiv
ely
with
oth
er n
urse
s in
the
bes
t in
tere
st o
f the
pat
ient
/clie
nt .
323 .
530 .
1147
83 .
490 .
0322
573 .
510 .
01-0
.02
43D
emo
nstr
ates
the
ab
ility
to
wo
rk a
nd c
om
mun
icat
e co
llab
ora
tivel
y an
d
effe
ctiv
ely
with
all
sup
po
rt s
taff
to p
riorit
ize
and
man
age
time
effe
ctiv
ely
whi
le q
ualit
y st
and
ard
s ar
e m
et .
323 .
410 .
1148
03 .
400 .
0322
623 .
440 .
01-0
.04
44D
emo
nstr
ates
the
ab
ility
to
ass
ess
risk
and
act
ivel
y p
rom
ote
the
wel
l-b
eing
, sec
urity
and
saf
ety
of a
ll p
eop
le in
the
wo
rkin
g e
nviro
nmen
t (in
clud
ing
the
mse
lves
) .32
3 .63
0 .10
481
3 .43
0 .03
2260
3 .46
0 .01
-0 .0
3
45D
emo
nstr
ates
the
ab
ility
to
crit
ical
ly u
se t
oo
ls t
o e
valu
ate
and
aud
it ca
re
acco
rdin
g t
o re
leva
nt q
ualit
y st
and
ard
s .32
3 .31
0 .12
477
3 .14
0 .03
2261
3 .13
0 .02
0 .01
46W
ithin
the
clin
ical
co
ntex
t, d
emo
nstr
ates
the
ab
ility
to
ed
ucat
e, fa
cilit
ate,
su
per
vise
and
sup
po
rt n
ursi
ng s
tud
ents
and
oth
er h
ealth
care
stu
den
ts o
r w
ork
ers .
323 .
470 .
1248
03 .
260 .
0322
613 .
250 .
020 .
02
47D
emo
nstr
ates
an
awar
enes
s o
f the
prin
cip
les
of h
ealth
care
fund
ing
and
us
es re
sour
ces
effe
ctiv
ely .
323 .
250 .
1347
93 .
080 .
0422
563 .
010 .
020 .
06
top related