Updating the core competencies document
Review of the core competencies document had to
take into consideration the major strategic shifts
in the NHS. While clinical governance existed at
the beginning of the project (DH1999b)it was
not as integral and well defined as it is now. The
new competencies needed to reflect the language
of governance in terms of risk and effectiveness,
but also patient involvement, research and
development. Public health components needed
to be reflected in terms of the specialist knowledge
domain. Most importantly, the ICN's role as a
leader in influencing practice needed to be
distinguished from the role of manager (Table 3).
One criticism of the first editions of the core
competencies and self-assessment tool was that
the documents were separate, making
completion complicated. Therefore, it was
NURSING STANDARD
necessary to combine the core competencies and
self-assessment tool into one document. There
was also concern that using the competencies as a
basis for professional portfolio made the process
paper intensive. To demonstrate competence
through curriculum vitae, a summary of
compliance was perceived to be useful.
It was clear that a scoring system would need
to be applied to compliance in relation to each key
criteria. Despite collaboration with information
analysts, it was difficult to devise a suitable system
because of the large number of criteria for
achievement. A review of the literature identified
a system used by the College of Nurses of Ontario
(1996), which described compliance in terms of
individual strengths and learning opportunities.
This seemed a useful way to identify compliance
in relation to competence and development and
learning. However, this system required a level
descriptor different to that used in the first edition
which operationally was more user friendly
(Table 4). The 'not applicable' box was perceived
as important given the varying nature of some
individuals' job descriptions.
Having assessed performance against key
criteria, it is possible to calculate a strengthsversus-opportunities
ratio that can be used to
define competence or identify opportunities for
development by totalling the number of ticks at
each level. These ratios can be better used in
portfolio documentation. An example of a
completed summary is shown in Figure 1.
It was emphasised that there is no such thing
as a good or a bad ratio. The greater number in
the ratio indicates either greater strength, with
less need for development, or a learning
opportunity, with further development indicated
(Figure 1). Identifying areas with greater ratio
differences allows individuals to prioritise areas
for development in times when resources are
scarce, both in terms of funding training and
release from the workplace. The result should
Level descriptors
Descriptor
Expert
Highly developed
Refining
Developing
Not applicable