Speaker: Monica J. Hughes, DNP, RN, Clinical Assistant Professor, Texas State University St. David's SON
What steps is Texas State University taking to transition to competency-based education?
Monica J. Hughes, DNP, RN: We have created an approach to a thorough mapping of our curriculum. We've assigned one faculty to be domain champion for each of the domains. And then, the rest of the faculty have volunteered for which domain they wanted to work on. And then each team of about four faculty will provide an introduction to that domain over the course of the fall semester. We have it calendared out at curriculum committee meetings. So it's going to follow a certain calendar approach. And then that group, that team for each domain will provide assistance to the rest of the faculty in completing the course mapping on that specific domain. And they will also act as the subject matter experts on that domain, which we're excited about. Because as a team, they'll be able to really sort of delve deep into the meaning of that domain and what it should look like in practice in the educational setting. They're going to develop ideas for assessment and evaluating and teaching of the domain that they're working on. And then that, that will allow the grant faculty to sort of step back a little bit, and take a better look at the compiled results and put together an overall picture of the gaps and the strengths of our curriculum. Then we will be able to seek the, the input of the domain champions on additional methods of teaching and assessment and evaluation on competencies that appear to be weak in our curriculum once we've been able to view the whole thing. And we are also sharing this transition to competency-based education and the Essentials. We're starting this conversation with our clinical partners and letting them know so that they're all aware of the Essentials, and of our move to competency-based education, and how we will want them to be included in the process. And we are also just starting to think about what it will... what it will mean to us as a program to move from sort of a concept-based curriculum to a competency-based curriculum, just continuing to have that conversation with our faculty so that there's better understanding of what competency-based education is.
Texas State University's Early Lessons Learned
Monica J. Hughes, DNP, RN: We have learned some early lessons. Most of the faculty didn't know about the AACN changes in 2021. And of course, CBE competency-based education is, is mostly new to us as faculty. So didn't understand what CBE is, and they were also were unfamiliar with mapping courses in general, and didn't know how to do that with the new Essentials. When we asked for courses to be mapped, and to indicate how the sub-competency was assessed within a course, many were coming back indicating that it was assessed in their course just because it was, you know, mentioned once in a lecture or something like that. So that was a learning curve. It's a little bit challenging to get faculty to think in a new way about demonstration of competency, and to get away from that sort of traditional approach. So that's been a lesson that we learned. We've also learned our curriculum is sort of owned by the faculty and going through the process of mapping has provided a lot of insight and knowledge to all of the faculty in the program as we all learn more about our total curriculum. So we really had a very siloed approach. So even though the curriculum was owned by the faculty, we really were only experts in our own course and didn't have an idea of how our course fit within the whole program. So this is a lesson that we're learning. So for the first time, really starting to kind of have our eyes open to our, to our whole curriculum. And faculty carry very heavy workloads. So engaging faculty in this work is challenging - that has been a lesson. It's also been a lesson, an important lesson to learn how important it is that leadership really support and buy into the work that's being done so that we have an advocate at a higher level of authority who is repeating sort of the importance of the work that's being done, the importance of the timeline and sort of helping us as grant faculty hold the other faculty accountable for the assignments.
What domain of nursing practice is Texas State University focusing on in addition to population health?
Monica J. Hughes, DNP, RN: In addition to population health, domain three, we are focusing on domain 10: personal and professional leadership and development. We chose this domain because we have seen so many students struggle with developing and maintaining resilience and who become really overly frustrated by ambiguity and change. They have a very prescriptive approach and that is challenging for them to thrive in an environment in the education and in practice, right? So, we feel really strongly that we want to help our students develop in these areas. We want them to either maintain or reignite that curiosity, and that desire for learning about nursing and nursing practice that they had when they very first decided to go to nursing school. In all of the practice settings and within every context of nursing practice, we find that they kind of lose over the course of the program. So reigniting that and helping them to maintain that, we also chose this domain because as faculty, we need to do a better job of really intentionally demonstrating self-care and wellness behaviors and practicing more care in our own interpersonal skills, how conflict is managed between us as faculty, our own ability to self-reflect and redirect our behavior, and this is really essential for the sake of the well-being of the entire faculty as well as our ability to be better mentors and role models for students. And we really can't preach to them these behaviors if we aren't excellent in demonstrating that we do them as well.
How is Texas State University engaging with practice partners to transition to competency-based education?
Monica J. Hughes, DNP, RN: We are engaging with our practice partners in this transition by introducing them to the new Essentials, their role in contributing to our understanding of what competencies they need to see in a practice ready nurse. And we're working to come up with some new and interesting ways hopefully for them to contribute to this process. We are currently reaching out to them through our advisory councils first to get a better understanding of what practice-ready is to them. And then, we also want to educate them on what we expect our students to look like when they leave the program so that we can assure that these things, you know, are comprehensive and that they, it reflects accurately what each other's expectations are. One way that we have done this in a little bit more deliberate way is a new project we're developing with school nurses in the local school district through which the school nurses are going to help us assess student competencies in population health through precepting and mentoring student clinical groups through a community health improvement project that will be overseen by preceptor nurses in each school. So each school nurse will take a clinical group, and will really mentor them through the process of developing and assessing the needs of the community in the school and developing a project, and hopefully also, you know, actually implementing the project, two of the faculty members met with the school nurses at one of their professional development meetings over the summer and expose them for the first time to domain three to the sub-competencies to help them to better understand how important it is to us that we graduate students who actually have these population health competencies. And that in order to do that, well, we need the school nurses assistance and input. And as we develop the rubric for this assignment, which we have not done yet, but we will be doing that in preparation for next semester, we will be engaging the school nurses for their input on the ways that the sub-competencies relate to the project, and how those should be assessed and also for their input on whether we're capturing everything that they feel like should be captured in assessing the competencies of that assignment. And we're going to just continue sharing information about the competencies, and about how the efforts that we're taking to move to competency-based education with all of our clinical partner sites.
How will the move to competency-based education help to prepare more practice-ready nurses?
Monica J. Hughes, DNP, RN: The new intentionality with which we are approaching our revised curriculum is going to be tremendously helpful. We are going to level the competencies and their assessment across the curriculum, designing methods to provide students with more specific and meaningful feedback like in the moment in clinical and in didactic and making changes to our courses based on gaps that are becoming clear as we do this mapping. One change we are already making is providing additional faculty-led lab hours for new students as they practice this sort of basic assessment and clinical skills in their very first semester so that they can receive more immediate feedback and also begin to sort of understand and expect to be able to receive immediate feedback on how they are achieving competencies. We expect that using feedback from our practice partners and developing the assessment methods that we will use across the curriculum will also provide a way for the students who come out of the program to demonstrate what the practice partners indicated that they needed to be able to demonstrate before they joined the workforce.
What is most exciting in this work for your faculty?
Monica J. Hughes, DNP, RN: The most exciting aspect of the work for our faculty is the active involvement of everyone really being involved as a team, especially with this domain/champion kind of approach that we've taken for each particular domain, and everyone is involved, and they really feel the importance of their contribution. It's also exciting for them to have the opportunity to feel like they're developing expertise in a domain. So because of the way we've assigned them out each team, so every single faculty will be an expert in one of the domains and each team will have expertise in the specific domain they're assigned to. And that's exciting for them. It's also exciting to be able to see for the first time what is happening in the other courses across the curriculum. As I mentioned, we have been fairly siloed in our sort of course approach to the curriculum, and each faculty doesn't necessarily have an idea of what's happening in other courses and where certain concepts are being taught. And this is exciting, this is exciting for everyone to be able to get a better picture across the whole undergraduate curriculum of where things are taught, where they are touched on again, where the gaps are, and it's clearing up a lot of questions for faculty about our own curriculum. And I think although change is hard, I think we are all a little bit energized and excited about a remodel of our curriculum. I would say getting a good picture of overall where our curriculum stands and where gaps and strengths are, it's just an exciting prospect.