Professional Experience Placement

Gallagher, Smith and Ousey (2012) discussed the concept of competency assessment of student nurses. They indicate that demonstrating competence is a passive process and currently is designed to identify the incompetent minority rather than maintain the competency of the the majority of registrants. The authors argue that using competency standards is inappropriate for assessing undergraduate nursing students. They point out that the competency standards  are designed for assessing continuing competence rather than clinical readiness. Gallagher, Smith and Ousey (2012) argue that competence is holistic and a competent nurse has global qualities and capacities.  They denounce the view that assessing competence of students can be reduced to a few competency statements.

The authors discuss the notion ‘fit for practice’ rather than competency. They argue that fitness for practice requires familiarity with the context and opportunity to demonstrate competence over time. They raise the idea that competency based assessment needs to be re-orientated.  They suggest an internship be undertaken at the conclusion of the undergraduate degree rather than only short periods of professional experience or clinical practice attached to undergraduate units.

These authors raise interesting questions for clinical supervision of students. If students are not assessed against the competency standards there will need to be dialogue about what constitutes fitness for practice, clinical preparedness or work readiness. There will need to be a consistent approach to ensure there is a bench mark, gold standard or satisfactory level of readiness of students. Clinical supervisors will be required to demonstrate their assessment of students’ fitness to practice.  Much work will need to be done if “education is about the future not the present”. Clinical supervisors will continue to require guidance and support from faculty if they will be assessing students using a different point of reference than the well recognised standards currently used after registration as a nurse. At another level, depending on the models trialled, fitness to practice or work readiness could enable a proportion of nurses to complete their courses more rapidly, while others will require more time to meet the requirements.

If this notion is taken seriously and trialled, it will need to be rigorously evaluated.  Longitudinal study could provide insight into the lived experience of students and clinical supervisors when using a different set of tools to assess students in practice. Measuring outcomes may also be achallenge.

What is your reaction or response to the notion of fitness for practice rather than competency based assessment for work integrated learning of professional experience? Do you think that students need to undertake an internship prior to graduation? If you have any comments about competency assessment you are welcome to post them here.