Walla Walla University's Path to Competency-Based Education

Speaker: Drs. Karen Tetz and Michaelynn Paul, Professor & Dean of Nursing and Professor of Nursing, Walla Walla University SON

Drs. Karen Tetz and Michaelynn Paul: education? So, we have mapped two of the domains throughout our curriculum. And we chose two courses to start implementing the full competency-based education. Our senior chronic illness class and our senior community health class. And we're hoping to implement CBE in both of those classes in the fall of 2023. However, during the spring of 2023, I started to implement some CBE in the nursing and the chronically ill class with my senior students. So, a couple of the things I did was one, we talk a lot about person-centered care, which is one of the domains that we are implementing. We talk a lot about that throughout our curriculum, and especially in the chronic illness class, because we talk about transitions in care, and making sure that we are addressing each patient's needs as they transition from acute care to the community and to chronic illness care settings. And so in the past, I just had students talk about person-centered care, what it is, how they've seen it implemented, but this time, instead of just addressing it, generally, I asked each student to describe a situation from clinical in which they had implemented person-centered care with a patient they were working with. So that's one of the things I implemented in the spring of 2023. The other thing is that at the end of the quarter, we had a used a standardized patient, and had a home health care scenario in which each student individually interacted with the patient. And in the past, we'd done case studies with groups. We'd also done some simulations with groups, but we had never had each student go through and implement person-centered care with a standardized patient. And so that's one of the things we did differently in the spring, and it was exciting to see how the students responded in that situation. So, additionally, we're now going to be looking at continuing to implement CBE and other courses throughout our curriculum. In addition, three faculty attended the Essentials workshop last year and another six will attend in September. And we're excited to implement CBE throughout our entire curriculum.

Drs. Karen Tetz and Michaelynn Paul: Well, our first lesson learned was that our excitement got the best of us. We were so excited at the beginning. That we probably worked through things a little bit faster than we should have, and we were not as thorough. Also taking into consideration the fact that we're a small school - we only had six full-time faculty at the time, and we were also working short staff. We quickly learned that we really don't need to rush, but we need to take the time to fully understand the domains and actually work through our content. We also discovered that we are for the most part covering the content of the new Essentials, however, we're not measuring competence in a meaningful way. So we're currently working on that process of how we will measure competence. We've not chosen a specific tool yet to use. So that will be part of our work for the coming year. And then, we will also add in how we're going to begin scaffolding how we measure that competence throughout our curriculum.

Drs. Karen Tetz and Michaelynn Paul: In addition to population health, the domain that we focused on is person-centered care. We feel like it really is the basis of patient care, treating each person as an individual and being attentive to what their needs are, and what their goals are. We already have a lot of information about person-centered care in our curriculum. And so this seemed like a natural one to focus on, because now we can move beyond just talking about the information or discussing it in class - but actually, learning how to measure our students' competence in implementing person-centered care. And we also feel like it's essential for nurses as they interact with patients in any setting. And that's why it worked so well across the entire curriculum. No matter what setting our students are practicing in, our nurses are practicing in, they need to be aware of and implement person-centered care skillfully and with confidence.

Drs. Karen Tetz and Michaelynn Paul: Well, we've started conversations with Adventist Health Portland. Our plan is to integrate DEUs first for our med surg students in order to provide a consistent clinical for each student, and then to more easily assess competence. Once we get med surg done, then we'll move on to critical care and to family, which is OBM pediatrics and our other clinical classes that are of the hospital nature. We're also beginning conversations with some of our community and outpatient practice partners again to enhance consistent clinical goals and be able to measure competence across our curriculum.

Drs. Karen Tetz and Michaelynn Paul: Our students will be more competent, and have greater confidence to know that they are ready to practice if we have incorporated CBE throughout our nursing curriculum. While trialing the person-centered care, simulation in the chronic illness course using a standardized patient, we had set up a home health simulation, and students commented that they felt like they were with a real patient, an actual patient. This was somebody they didn't know. So it wasn't a faculty member, it wasn't another student, this was somebody they had not met before. And so they felt like they were interacting with an actual patient. And so they felt like they were really able to demonstrate what they did know. It made them a little more nervous, but they expressed afterwards that they felt like they had been able to see that they could actually take the information that we had talked about during the quarter and implement it with somebody who could be a real patient of theirs. So that's our goal - is that they will really be able to demonstrate competence in a more meaningful way than if we're just discussing information in the classroom.

Drs. Karen Tetz and Michaelynn Paul: for your faculty? You know, we teach because we want to empower a new generation of nurses. While our current pass rate is high, it's about more than passing scores on the NCLEX, or any individual class or exam, or quiz. We want to develop nurses who share a deep passion for caring for their patients, and who can do that in a competent and confident way. It's difficult out there for the new grad, and we want to provide ways that will allow them to be the best that they can possibly be. The other thing that's exciting for faculty is, we just, we're kind of different, we really like change, and we're excited about implementing a change that will allow our students to have better outcomes. And with our students getting better outcomes, then their patients are gonna have better outcomes.