The University of Texas at Arlington's Path to Competency-Based Education

Speaker: Meagan Rogers, PhD, RN, MSN, NPD-BC, Associate Chair, Undergraduate Nursing, University of Texas at Arlington CON

Meagan Rogers, PhD, RN, MSN, NPD-BC: Here at the University of Texas at Arlington, We map our didactic course blueprints to the Essentials every year. However, we've never done this with the clinical component of our courses. So, we saw a major opportunity at participating in this project to redevelop our clinical evaluation tools using consistent verbiage across the program in clear, objective, longitudinal skill and activity scaffolding. Our faculty have now participated in three days of workshop activities to date associated with redesigning our clinical evaluation tools. In addition to the work on our clinical evaluation tools that we've been doing, we completed mapping our didactic courses to the new Essentials, and identified gaps and redundancies that we're currently working to address with curricular changes that will go into effect soon. We're also working very closely with our practice partner on a number of strategic projects related to a more seamless transition to professional practice among our graduates.

Meagan Rogers, PhD, RN, MSN, NPD-BC: We recognized early on in this project that the Essentials competencies are currently written in a way that's measurable and objective enough to be used as clinical outcomes measures on our clinical evaluation tools. So we decided to adopt the Creighton tool as a validated measure of clinical performance. Instead of using the Essentials to measure observable performance. We also knew that our faculty needed to know the "why" behind the move to CBE. So we brought in a CBE expert at the beginning of the project to talk with them about CBE, and help us identify major issues with our own status quo. As we began working on our tool, we also recognize the need to build on some of the innovative work that we had already done to develop learning activities associated with population health and informatics and health care technologies that really could be used as toolkit submissions through AACN. So we wanted to recognize as an early lesson learned that we had already done much of the work associated with learning activities around these do Essentials domains. So we built on that, and started where we were. That was one of the most important lessons learned for us that we noticed early on that's really helped us to keep moving forward, because it's easy to want to recreate the wheel. But as educators, we know that we have to start where we are, and work from there.

Meagan Rogers, PhD, RN, MSN, NPD-BC: We selected domain eight: informatics and health care technologies has our implementation focus because UTA and the College of Nursing and Health Innovation have a cadre of new and innovative resources to support this work in this domain. In 2020, we established UTA's Multi-Interprofessionals Center for Health Informatics along with world-renowned nursing informatics researchers with the goal of creating a synergistic environment to contribute to the science of health informatics. Also in January of this year, we opened our brand new state of the art 33,000 square foot simulation facility that's fully equipped with both virtual reality and informatic-specific suites to provide learning experiences for our nursing students. We're currently developing learning activities and assessment tools to focus on these various health, telehealth, and informatics technologies used by nurses while also emphasizing the importance of this technology and enhancing the quality of care delivery for our students. Another emphasis for this domain is the use of decision support and precision health tools to support patient care with an emphasis on interoperability and the ethics of health care data sharing. We currently use precision health tools to support patient care and informatics related learning experiences threaded throughout our curriculum. And we're continuing to develop robust experiences to measure outcomes in this domain. For example, in our psychiatric nursing course, students currently complete simulated telehealth interviews with patients with a variety of psychiatric diagnoses. We also use telepresence robots currently to conduct clinical learning experiences in specialty care areas across the state of Texas. In our medical surgical nursing course, our students participate virtually in care conferences at an inpatient Alzheimer's care facility and observe care delivery and coordination using that telepresence robot. We've also used telehealth as part of a global initiative in pairing our nursing students in rural Texas health care facilities with students in rural Canada to share clinical experiences between differing health care systems and differing approaches to practicing nursing. This has really been a huge success for us. It's an area that we invested in years ago, and we believe we're well suited to contribute to both the tool kit and the development of this competency domain associated with informatics and health care technologies for AACN.

Meagan Rogers, PhD, RN, MSN, NPD-BC: Our practice partner in this project, Baylor Scott & White Health is currently working with us to develop domain eight submissions for a AACN's tool kit. They're also working collaboratively with us on a project to measure new graduate practice outcomes with a faculty that carries a joint appointment as a faculty at UTA, and a clinical educator in one of the Baylor facilities. We're also working on milestones to be used in our capstone course, and identifying opportunities to use the students capstone experience to truly begin the new graduate residency onboarding process for students with an early commitment to their postgraduate employer. We hope that working together with our practice partner to identify opportunities to improve the new graduate transition to practice and increase the operational efficiency of orienting new grads can help us move the needle and understanding the issues associated with new graduates and the challenges they're facing once they get to practice.

Meagan Rogers, PhD, RN, MSN, NPD-BC: If we can work together with our crediting agency and our practice partners to develop standardized, measurable clinical performance outcomes for the new graduate nurse, I believe we can foster a shared agreement among all stakeholders about the end product that we're producing in schools of nursing.

Meagan Rogers, PhD, RN, MSN, NPD-BC: Our faculty are most excited about doing the work to develop clinical evaluation tools that are measurable while also adopting this longitudinal performance dashboard technology that we're working on to evaluate students across the program. We believe that showing students their own performance data and how they've progressed through the program will also help the students understanding of graduate competence, and their own transition and readiness for graduate practice. We also ensure that our students clinical experience starts and ends where they left off the prior semester. So using the same competency verbiage with scaffolded observable performance measures across our program will place us in line with the evidence associated with the transition to competency-based education in medical education and pharmacy education as well.