PRIOR LEARNING ASSESSMENT RESEARCH PROJECT IN NURSING Mount Royal College, Calgary, Alberta 2003- 2006

1. PRIOR LEARNING ASSESSMENTRESEARCH PROJECTIN NURSINGMount Royal College, Calgary, Alberta2003- 2006 Purpose of the Research: To assess the impact of PLAR on the advancement of internationally educated nurses into educational programs and employment in nursing

2. OVERVIEW • Development of the PLAR process • Challenges • Lessons learned

3. GENESIS OF THE PROJECT • Response to the shortage of nurses (predicted need of 211,000 by 2016) • Intent to advance internationally educated nurses (IEN’s) into professional nursing education and employment • Build on previously acquired knowledge and skills of the IEN

4. PROJECT STAGES: 2003-2006 • Stage One: Study and Development • Stage Two: Implementation • Stage Three: Evaluation

5. YEAR 1: Study & Development • Survey of RN licensure processes & challenges • Survey of PLAR in nursing education programs • Interviews with nurse employers and managers • Interviews with IEN program managers • Literature reviews • “Barriers and Challenges” summary

6. CHALLENGES for IENs Complex credentialing processes Challenge of language fluency Knowledge and practice deficits Examination preparation Lack of socialization and mentoring opportunities Financial barriers BN entry Need for employment readiness skills

7. PLAR ASSESSMENT • Establish level of English fluency (use of variety of language tests) • Preliminary Diagnostic Exam • Competency Assessments • assessment of “RN Entry to Practice” competencies • Clinical assessment

8. Preliminary Diagnostic Exam Assessment of general nursing knowledge: • Pharmacology • Canadian standards of practice • Legal and ethical standards • General nursing skills and knowledge Analysis, interview and plan

9. Competency Testing Assessment of • General nursing theory and nursing interventions • Pharmacology and drug administration • Communications and interactional skills • Health assessment including physical assessment • Nursing standards of practice in Canada • Legal, ethical and professional practice decision-making • Technology and common clinical skills • Teaching and health promotion • Clinical judgment, problem-solving and critical thinking • Health care systems in Canada Analysis, interview and plan

10. Assessment Strategies • Modified OSCE’s • Triple Jump • Clinical Judgement Scenarios • Self Assessment of Standards of practice

11. STANDARDS USED for thePLAR ASSESSMENT • Comprehensiveness • Validity • Currency • Reliability • Authenticity • Sufficiency

12. COMPREHENSIVENESS Survey of Nursing Registrars across Canada • Language fluency • “Culture” of Canadian nursing, nurse roles • Educational opportunities & post-assessment • Accessibility and affordability • Essentials of entry to practice • Consistent standards and processes

13. VALIDITY Determining a “Benchmark” Canadian RN Entry to Practice competencies 2005 – 2009 • Clear, specific language • “Currency” and longevity • Thorough development process • Established validity • Used with all entry level nurses

14. RELIABILITY Assessed reliability of tests and elements of tests with 4th year graduating students from BN classes at MRC • Test-retest consistency • Item analysis (item difficulty; item discrimination; equivalence; etc) • Marking guides & scoring checklists; standardized tasks and performance standards

15. AUTHENTICITY Context-specific measures of assessment • Complex, integrated, typical nursing “case management” situations developed as basis for modified OSCE testing and modified “Triple Jump” assessment. • OSCE: nurse-client interaction; ethical judgment; medication administration; problem-solving; health assessment • Triple Jump: complex performance evaluation of critical thinking

16. Addressing the Challenges SUFFICIENCY When do we have enough information? • Variety of assessment measures • “Triangulation” • Benchmark competencies; performance standards • Assessment experience

17. Addressing the Challenges GAPS AND DEFICITS • Specialized language training • Upgrading and orientation • Meeting the standards of safe practice • Adequate, timely, targeted programs

18. LESSONS LEARNED • Comprehensive assessment • Nursing-specific language preparation • Competency benchmarks • Educational opportunities to “fill gaps” • Personal support measures • Self – knowledge; “Assessment as intervention”

19. Bridge to Canadian Nursing Program Level One: • Professional English for Nurses • 4 courses, 3 hours per week of nursing • specific language training Level Two: • Nursing Theory & Canadian Practice • 3 courses, 9 hours of classes per week that address • Expectations of nursing practice in Canada Level Three: • Preparation for Competencies • Assessment • Workshops and practice sessions on guided • assessment and case-management scenarios • * Nursing Clinical Review – 360 hours supervised • clinical practice

20. KEY INNOVATIONS IN THIS PROJECT • Case management situations to assess experiential learning and performance (practice-theory integration) • Dissemination of findings (January 2006) – web based in both official languages

21. English as a Second LanguageAssessment/Study Processes • English for Nurses: a nursing-specific approach to language training • Pre-post testing: showed increase of over 1 “benchmark” point over 12 weeks of English as a Second LanguageAssessment/Study Processes study