The Carnegie Foundation for the Advancement of Teaching was established in 1905. Its founder, Andrew Carnegie, created it to act as a general pension fund for universities in the United States, Canada and Newfoundland. Carnegie quickly realized there needed to be a way to determine which schools qualified as legitimate institutions of higher education, and thus which faculty members qualified for pensions.
This was how the “Carnegie Unit” was born. It measures students’ progress in a course based on credit hours. In other words, time spent in class. More than a century later, this is still how almost all colleges and universities assess aptitude.
New data suggests that this method of assessment leaves a great deal to be desired. Today, the Carnegie Foundation is leading the effort to transform the way we instruct and assess students. One option is a competency-based education (CBE) teaching model.
In a field like allied healthcare that relies so heavily on the fusion of theoretical knowledge and practical skills application, the model holds significant promise, especially as employers face a preparation-to-practice skills gap affecting as much as 40% of newly graduated professionals.
In part one of this two-part blog series, we discussed what competency-based education means, its benefits and how to implement your own CBE program. Part two will focus on best practices for assessing learner progress using the teaching model to make the most of this transformative strategy. But first a brief recap…
How Competency-Based Education Addresses the Skills Gap
Whereas traditional education focuses on imparting theoretical knowledge through lectures, textbooks and exams, competency-based education places a greater emphasis on skills proficiency. In this format, learners are encouraged to put theoretical knowledge to use in real-world scenarios and settings. This way, they also gain practical knowledge and the confidence that they can perform the roles they aspire to. Benefits include:
- Flexibility by allowing learners to spend more time on areas where they struggle and less on those they’ve mastered.
- Opportunity for continuous feedback as learners grow and develop, rather than relying solely on high stakes testing.
- Opportunity for experiential learning by aligning theoretical knowledge with practical skills application through professional observations, performance evaluations and more.
- Supports diverse learning strategies with an emphasis on proven competence rather than attendance hours.
- Promotes multi-competency and stacked credentialling as learners gain proficiency in skills that apply across healthcare specialties.
- A more confident and resilient workforce since learners only progress once they’ve proven skill mastery and their ability to perform in real-world scenarios.
To fully realize such benefits, instructors must properly assess learner progress, which requires a different approach from traditional methods.
How Learners Have Been Assessed Historically and Why It Doesn’t Necessarily Work
Traditionally, health science learners have been required to pass theoretical exams after completing a certain number of credit hours to prove they’re ready to graduate or earn certification. But experts have come to realize that these kinds of high-stakes assessments do little to prepare individuals for the realities they will face day in and day out as professionals.
Time spent in a controlled classroom environment and standardized tests do not push learners to think critically about how they’d react to and work through the kinds of novel situations that arise regularly in healthcare.
As Amit Sevak, CEO of Educational Testing Service (ETS) and Timothy Knowles, President of the Carnegie Foundation explained, these traditional methods have several shortcomings:
- They limit the curriculum to a narrow set of skills that can conveniently be taught in a classroom.
- They sideline a range of essential skills, from communication to creativity, that require a more nuanced approach.
- They disregard learning that takes place outside the classroom.
- They ignore diversity, both in students’ backgrounds and in the different ways they learn.
There is a wealth of data that supports their theory. For instance, between July 2010 and 2015, more than 5,000 newly graduated nurses were assessed. Just 23% demonstrated entry-level competencies and practice readiness. The authors of the study, Joan M. Kavanagh, MSN, RN, NEA-BC and Christine Szweda, MS, BSN, RN, labeled their findings as a “crisis in competence.”
Their study is just one of many that supports the growing belief that traditional instructional methods and assessments pose the risk of “painting a false or incomplete picture of practice readiness.” And the consequences can be dire. From driving alarming burnout and turnover rates to threatening patient safety and countless other concerns, the failure to adequately prepare learners and assess their ability to perform in high-stress situations needs to be addressed.
Competency-based education holds much promise to this end, so long as instructors rethink how they track progress and qualify success by committing to:
- Providing regular feedback to help learners practice and refine knowledge and skills application.
- Providing timely, targeted remediation solutions to address weaknesses.
- Constantly gathering, analyzing and leveraging learner data for continuous improvement.
In addition to helping learners master essential clinical skills, the competency-based education model also emphasizes the development of those intangible ones that make the best allied healthcare professionals—things like communication, empathy and adaptability. This is because it forces learners to think more creatively and interact with others to problem solve and achieve their desired objectives.
How CBE and the Right Method of Assessment Can Eliminate Healthcare’s “Crisis in Competence”
To be sure, today’s learners must still be provided with adequate foundational knowledge. The key is striking the right balance between academics and skill development—and encouraging learners to harness both through hands-on, experiential lessons, like simulations, practice assessments and internships or externships.
Rather than focusing on how long a learner engages in these experiences, instructors should instead consistently assess their development and provide guidance for continued growth. Sevak and Knowles explained how this form of assessment differs from traditional ones:
- Instead of measuring time, the new paradigm measures skills.
- Instead of being relegated to the classroom, the new paradigm captures learning wherever it takes place.
- Instead of offering one data point—pass or fail—the new paradigm generates insights throughout the learning process.
It’s worth noting that this approach mimics the way in which professionals continue to grow and hone their skills over their careers. It is a constant refinement and layering of competencies rather than learning something once and replicating the same action over and over. Instilling this growth mindset early on will serve learners (and their patients) for a lifetime.
The ability to capture, track, analyze and leverage key learner metrics along the way can create more powerful outcomes, both for individuals and instructors by shedding light on the effectiveness of different techniques. Yet, this is often easier said than done.
More than ever, health sciences instructors are strapped for time and resources. Dr. Tamara Willis is concerned that even if schools and employers manage to gather data, they’ll struggle to make sense of it.
“The data is only as good as your capacity to interpret it,” Willis said. “Schools will need staff to make sure the skills-based experiences are rigorous, evidence-based, meaningful, and not another faddish flyby, of which there are so many in education.”
Rather than placing the burden on their staff, leaders can engage with a partner like NHA both to implement an effective competency-based education program, and furnish instructors with the tools to easily access and analyze valuable learner metrics.
Leverage Powerful NHA Insights for Learning Success
Meaningfully assessing learners in the competency-based education model requires giving less weight to high-stakes, standardized tests focused on theoretical knowledge, and instead consistently measuring a learner’s ability to demonstrate their understanding of material and proficiency through skills application.
NHA tools make it easy for both learners and instructors to regularly capture data that tracks progress and facilitates individualized, targeted learning. They include:
- Practice Assessments: Over the course of an NHA program, learners can complete 6 practice assessments, helping them become familiar with job-relevant competencies. After each, learners receive a personalized report through NHA’s Focused Review®.
- Focused Review: Individual reports highlight outcomes in each area of the NHA practice assessment. Learners are not told which questions they missed, but instead, which competencies to work on to ensure they focus on areas of weakness rather than memorizing specific facts. “We don’t want learners to shy away from their mistakes,” said Laura Roose, MAEd, Sales & Client Enablement and Training Manager. Instead, the report directs them to where they should spend more time in the NHA study guide to proactively address issues holistically.
- Performance Analytics: NHA’s reporting tools provide on-demand access to and real-time analysis of each learner’s performance data across products, giving instructors the opportunity to assess exam readiness and target group or individual remediation needs as soon as they arise.
- Suggested Review: This automated feature, available to both learners and instructors, analyzes performance to determine where an individual is struggling before offering tailored study recommendations.
(Check out our “Boosting Exam Readiness” webinar for more tips on how to use NHA tools and analytics.)
“This Change Opens a World of Possibilities”
Delivering meaningful learning experiences and facilitating skills mastery hinge on an instructor’s ability to provide learners with a rich experience that extends beyond textbooks and even the classroom, as discussed part 1 of this series. But that’s not all.
Instructors also need to be able to consistently track learner progress and leverage findings to create more powerful experiences and combat the current “crisis in competency,” which is not limited to any one allied healthcare specialty. Luckily, neither is the solution.
“The monumental shift from seat time to competency-based learning puts the spotlight on real-world job skills, whether they’re attained through prior learning, work experiences, internships or apprenticeships,” said NHA Product Integration Specialist Kelly Cobb, BSN, RN.
“This change opens a world of possibilities, including fostering academic-work partnerships. Rather than learning in silos, imagine a system where academia and industry enrich learners through collaborative partnerships. And by focusing on competencies, we can significantly address educational gaps across disciplines.
“The proof of learning becomes the skills you’ve mastered, not just the hours you’ve logged in a classroom.”
NHA solutions and analytics can help drive this transformation for you and your learners. Contact us today for more information.
