Teaching patients and validating competency
Objective To describe the development and clinimetric validation of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) through several evidence sources about reliability and validity in the Spanish context.
Design and setting APNCAI development was based on a multisequential and systematic process: literature review, instrument content consensus through qualitative Delphi method approach (a panel of 51 Advanced Practice in Nursing –APN– experts was selected) and the clinimetric validation process based on a sample of 600 nurses from the Balearic Islands public healthcare setting.
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Validation of competence can have a direct impact on positive outcomes for patients and reduced costs for the healthcare organizations.
Methods for implementing a competency-based curriculum and lessons learned during the process are discussed. In the public marketplace, the theme of "let the buyer beware" has been replaced with the philosophy of "excellence is defined by the customer." This perspective has general application across all types of industries.
When the "public good" relates to education or health care, standards of acceptable performance are clearly defined by regulatory and professional bodies and society holds practitioners fully accountable when performance is unacceptable or questionable.
Many of these efforts focus on measuring the nurse's capability to perform a particular skill, not on the nurse's overall ability to perform in a practice setting (Koncaba, 2007).
This approach reinforces an archaic belief that professional nursing practice is about doing and not about thinking.
The concept of competence has been defined and explored in healthcare literature in a variety of ways.