Institute of Medicine Core Competencies as a Foundation for Nursing Program Evaluation

Article excerpt

ABSTRACT

Aim. The purpose of this case study was to explore one institution's experience integrating the Institute of Medicine (IOM) competencies into a pre-licensure baccalaureate nursing curriculum.

Background. In response to a growing number of errors in the health care system and efforts to increase patient safety and quality of care, the IOM proposed that students in health care professions learn to implement five core competencies.

Method. The program evaluation encompassed a mixed-method, stakeholder-focused methodology using a curriculum matrix triangulated with Student and Faculty Core Competency surveys.

Results, Results of the study indicate that all competencies were evident in the curriculum. Students often cited barriers to implementation of the competencies while faculty cited opportunities.

Conclusion, Findings suggest that faculty need to raise student awareness of performing the competencies and be deliberate in the design of experiences to facilitate competency implementation.

Key Words Institute of Medicine--Nursing Education--Outcomes Core Competencies--Program Evaluation

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MITIGATION OF ERRORS IN THE DELIVERY OF CARE BEGINS WITH THE EDUCATION OF HEALTH CARE PROVIDERS. In Health Professions Education: A Bridge to Quality, the Institute of Medicine (IOM) established core competencies so that "all health professionals [are] educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics" (IOM, 2003, p. 45). This article reports on the evaluation of core competency integration into a baccalaureate nursing program.

Background The IOM competencies became the framework for the Quality and Safety Education for Nurses (QSEN) initiative, which has permeated nursing accreditation, education, and practice standards. Implementation of the competencies transforms the task-oriented student to one who can "demonstrate an integrative view of clinical performance" (Benner, Sutphen, Leonard, & Day, 2010, p. 84). Emphasizing the importance of teaching the IOM competencies, Finkelman and Kenner (2009) stressed that the "education of health professionals is ... a bridge to quality care" (p. 24).

The primary IOM competency is to implement patient-centered care. In 2002, Lauver et al. found that patient-centered care and its implementation were not well defined in the literature. Droege, Anderson-Worts, Litwin, Rosenthal, and Garcia (2007) surveyed administrators involved in curriculum development for medicine, nursing, pharmacy, and allied health academic programs. They found that patient-centered care was addressed in 86.4 percent of nursing curricula, compared to 46.4 percent for all disciplines.

The ability to work in interdisciplinary teams was identified as a second core competency. In a study of 280 nursing programs conducted on behalf of the National Council of State Boards of Nursing, Li and Kenward (2006) found that more than half (58.6 percent) scheduled clinical activities with other health care professionals, while fewer than 25 percent scheduled didactic coursework with other health care professionals; one third had no scheduled interdisciplinary learning activities. In the Droege et al. (2007) study, a third of nurse faculty said that working in interdisciplinary teams was integrated into their curricula, compared to an overall integration rate of 16 percent across participating disciplines. Droege et al. also found that 47.6 percent of nurse faculty integrated evidence-based practice into their curricula, compared to an overall integration of 42 percent in medical, pharmacy, and physical therapy education. More than 50 percent of respondents in the Li and Kenward study reported the integration of evidence-based practice in their curricula, but 11.7 percent said they did not teach evidence-based practice. …