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Jo-Anne McShane

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    Portfolios thesis Portfolios thesis Document Transcript

    • i Professional Portfolios Jo-Anne McShaneThesis submitted in fulfilment for the requirement of the Award of Masters of Clinical NursingSchool of Nursing, Midwifery and Postgraduate Medicine Edith Cowen University Western Australia 2010
    • iiDeclarationI certify that this work does not, to the best of my knowledge and belief;(i) Incorporate without acknowledgement any material previously submitted for a degree or diploma in any institution of higher education.(ii) Contain any material previously published or written by another person except where due reference is made in the text; or(iii) Contain any defamatory materialSignature………J McShane………………..Date: October 2010………….
    • iiiTable of ContentsDECLARATION……………………………………………………………………………...iiABSTRACT…………………………………………………………………………………..vACKNOWLEDGEMENTS……………………………………….…………………………viTERMS USED………………………………………………………………………………viiLIST OF APPENDICES…………………………………………………………………...viiiLIST OF FIGURES………………………………………………………………………….ixChapter 1…………………………………………………………………………………...1INTRODUCTION…………………………..………………………………………………..1 Background to the Study…………..……………………………………………….1 Purpose of the Study…………………………………………………..……………3 Research Question……………………………………………………………….....3 Significance of the Study…………………………..………………….……………3 Theoretical Framework…………………………………………...………………...3Chapter 2…………………………………………………………………………………...5REVIEW OF THE LITERATURE…………………………………………………………..5What is a Portfolio?......................................................................................................5 Presentation Portfolios……………………………………………………………...5 Learning Portfolios…………………………………………………………………..6 Assessment Portfolios………………………………………………………………7E-Portfolios……………………………………………………………….……..…………...8Paper versus Electronic………………………………………………..…………….……..9Chapter 3………………………………………………………………………………….11Competence………………………………………………………………………………..11Competency Standards……………………………………………………………..…….11Competency Frameworks………………………………………………………………...12Demonstrating Competence………………………………………………………………13 Self Declaration…………………………………………………………………….14 Continuing Professional Development…………………………………………..14 Recency of Practice……………………………………………………………….15 Learning Plans……………………………………………………………………..15Challenges for the Australian Competency Framework……………………………….17 Learning Plans……………………………………………………………………..17 CPD Standards……………………………………………………………….……18
    • ivPortfolios and Competence…………………………….………………………………....18Chapter 4…………………………………………….………………………...........…...20Is teaching about portfolios a worthwhile experience for the participants?................20Chapter 5………………………………………………………………………………….22METHOD…………………………………………………...……………………………….22 Design, Setting and Sample……………………………………...………………22 Analysis………………………………………………………………………….….23Chapter 6…………………………………………………….…………………………...24RESULTS………..…………………………………………………………………………24 Introduction and National Registration…………………………………………..24 Continuing Professional Development…………………………………………..25 Portfolios………………………………………………………………………….…26 E-portfolios………………………………………………………………………….27 Learning Plans……………………………………………………………………..28 Reflection…………………………………………………………………………...29 Have you used a portfolio before?..................................................................30 Would you be interested in maintaining a e-portfolio over a paper portfolio?.30 Did you find the handouts helpful?..................................................................31 What was good about the workshop?.............................................................31 What could have been improved?..................................................................32 Additional comments……………………………………………..………………..32 Overall satisfaction…………………………………………………………………33Chapter 7………………………………………………………………………………….34DISCUSSION…………………………..…………………………………………………..34 Competence………………………………………………………………………..34 Workshop…………………………………………………………………………...34 Recommendations…………………………………………………………………35 Conclusion………………………………………………………………………….36REFERENCES………………………………………………..……………………………37
    • vAbstractThis report was written to detail the findings found during an extensive literaturereview on professional portfolios in nursing practice and the feedback received on aworkshop designed to educate nurses on the benefits of maintaining a professionalportfolio.Professional portfolios in nursing are well established within the academic arena,particularly since the advent of e-portfolios as an assessment tool. Despite anoverwhelming amount of articles promoting portfolios as a standard of practice, thereis a distinct lack of evidence suggesting portfolios are beneficial when applying foremployment or promotions. One of the emerging uses of portfolios in the literature isthe use of portfolios to demonstrate competence to practice.Australia is entering a new era of nursing with the introduction of NationalRegistration. The Continuing Competence Framework developed by the ANMCpromoted the use of the portfolio to provide evidence of ongoing competence topractice nursing. However, APHRA has chosen to endorse only the CPD andRecency of Practice elements of the framework. Nurses have been given very littleto guidance and support in the new expectations, which may leave nurses feelingslightly confused. Despite this, portfolios can still be used as a tool to document thestandards and showcase the nurse’s experience and best work.A workshop was developed to educate, innovate and motivate nurses to documenttheir achievements in a professional portfolio. The interactive workshop covered thefollowing topics:  National Registration  Continuing Professional Development  Portfolios  E-portfolios  Competency Standards  ReflectionThe feedback received showed that a majority of participants rated the workshop aseither ‘very helpful’ or ‘excellent’. Despite the workshop being a success, it is evidentthat further research is needed to validate portfolios in professional practice.
    • vi Acknowledgements Thank you to my friends and colleagues at Robina Emergency Department, Gold Coast, who encouraged me to take my nursing career one step further. Thank you to my supervisor Christopher Churchouse steering me in the right direction. The librarians and nurse researcher Dr Julia Crilly from the Gold Coast Hospital were very helpful in assisting me to understand research. Thank you to Sarah Stewart for introducing me to e-portfolios and to Richard fortaking an interest in what we could do as an emergency department to help nurses meet their registration expectations.Also, thank you to my Manager Jo Timms and educator David Corkill for letting me ‘do what I needed to do’, and Lyn Armit and Sarah Burston from the NursingEducation and Research Unit who allowed me to develop and present the workshop within the district. Finally, thanks to my son for helping mummy to colour in the articles- I did the straight lines, he did the squiggly ones.
    • viiTerms UsedANF: Australian Nursing FederationANMC: Australian Nursing and Midwifery CouncilAPHRA: Australian Health Practitioners Regulation Agency.CCF: Continuing Competence FrameworkCOAG: Council of Australian GovernmentsCPD: Continuing Professional DevelopmentNMBA: Nursing and Midwifery Board of AustraliaNMC-UK: Nursing and Midwifery Council United KingdomQNC: Queensland Nursing CouncilQUT: Queensland University of Technology
    • viiiList of AppendicesAppendix A- Portfolio and CPD Requirements…………………………………… 42Appendix B- Professional Portfolios Workshop Objectives and Learning Plans 43Appendix C- Professional Portfolios Flyer………………………………………… 50Appendix D- Certificate of Attendance………………….………..……………….. 51Appendix E- Feedback Form………………………………………………………. 52Appendix F- Preparation Checklist………………………………….………….… 53Appendix G-Agenda…………………………………….…………………………. 54Appendix H- PowerPoint Presentation…………………….…………………….. 55Appendix I- Optional Survey Results…………………………………………….. 56Appendix J- Conference Abstract and Autobiography………..……………….. 57
    • ixList of FiguresFigure 1- Continuing Competence Frameworks World-Wide…………… 12Figure 2- ANMC Continuing Competence Framework………………….. 13Figure 3- Introduction and National Registration………………………… 24Figure 4- Continuing Professional Development…………………………. 25Figure 5- Portfolios…………………………………………………………... 26Figure 6- E-portfolios………………………………………………………… 27Figure 7-Learning Plans……………………………………………………. 28Figure 8-Reflection………………………………………………………….. 29Figure 9- Previous Portfolio Use…………………………………………… 30Figure 10- E-portfolios………………………………………………………. 30Figure 11- Handouts…………………………………………………………. 31Figure 12-Overall satisfaction………………………………………………. 33
    • 1Chapter 1IntroductionBackground to the StudyIn 2005 the Commonwealth Government (COAG) asked the ProductivityCommission1 to research the issues impacting the health workforce and makerecommendations that would ensure the continued quality of health care in anenvironment of rising health costs, an aging population and advancing technologies.National Registration and accreditation was just one of the many recommendationsthe Productivity Commission proposed. The purpose of implementing NationalRegistration across Australia was to improve patient safety by ensuring that theeducation and training standards of nurses are consistent. A safe competent andmobile body of nurses therefore will be registered to look after patients in Australia(Carrigan, 2008).Prior to July 2010, nurses have been required to register state-wide with theirrespective Nursing Councils. Each state was governed by their own NursingCouncils and Nursing Acts, which subsequently had different expectations forregistration and competency. National Registration will eliminate the need formultiple state registrations which will affect at least 11,783 nurses (2005 data: AIHW,2009).In July 2006, COAG decided to establish a national registration of healthcareworkers including Physiotherapists, Podiatrist, Optometrists, Chiropractors,Pharmacists, Dentists, Psychologists, Osteopaths, Nurses, Midwives and Doctors ofMedicine. In March 2008, the Intergovernmental Agreement for a NationalRegistration and Accreditation Scheme for the Health Professions policy was signedby the Premiers and Chief Ministers of each state, as well as the former PrimeMinister of Australia, Kevin Rudd. This agreement outlined the ‘objectives, scopeand governance, legislative, administrative and financial arrangements for the1 ‘The Productivity Commission is the Australian Governments independent research and advisorybody on a range of economic, social and environmental issues affecting the welfare of Australians...help governments make better policies in the long term interest of the Australian community’(ProductivityCommission, n.d.)
    • 2scheme’ (COAG, 2008 p2) of National Registration by July 2010. However, it shouldbe noted at the time of writing that the state of Western Australia’s LegislativeCouncil has not passed the National Law Act. It is anticipated that Western Australiawill adopt the National Law Act by the 19th, October 2010 (NMBWA, 2010).The new Health Practitioner Regulation National Law Act (Australian Government,2009) was implemented in July 2010, and will cover all nurses registered in Australia(except WA at time of submission). Nurses who are registered in each state will nowbe registered with the new Nursing and Midwifery Board of Australia. Individualstates have had in the past different registration requirements in regards tocontinuing professional development (Appendix A), competence, auditing, andrecency of practice. The new National Mandatory Registration standards will includea criminal history check, English language skills competence, professional indemnityinsurance, recency of practice and continuing professional development (CPD)standards (NMBA, 2010a).The Australian Nursing and Midwifery Council (ANMC) was established in 1992 todevelop a national approach to nursing and midwifery regulation. The role of theANMC has changed with the advent of National Registration; now being the nationalaccrediting authority for nursing and midwifery (ANMC, 2010). The ContinuingCompetency Framework (CCF) was previously developed to provide nurses andmidwives a national process for the demonstration of ongoing competence topractice.The components of the framework included assessment, CPD and recencyof practice which would be contained in a professional portfolio (ANMC, 2009). Atthis stage, APHRA has chosen not to endorse the CCF, therefore maintaining aportfolio is an option for nurses rather than a mandate. A possible reason to thisdecision maybe the ongoing disagreement by the ANF that the CCF was a suitablemethod of assessing ongoing competence, however the use of a portfolio wassupported (ANF, 2008a, 2008b). It was an assumption by the author and manyAustralian writers (Masson & Williams, 2008; Mills, 2009), that the ANMC- CCFwould be implemented as part of the National Registration standards, therefore theoriginal project was based on the idea that portfolios would be mandatory. Therefore,a change in focus for the project was made; to educate nurses on the benefits ofportfolios for a wide range of usages.
    • 3Purpose of the StudyThe purpose of the study was to identify a current issue in nursing practice anddesign a quality assurance activity and report. It was decided to write about portfoliosas it is a relevant and contemporary issue in nursing practice. A workshop wasdesigned and implemented, with feedback from participants analysed to establish if itis a worthwhile project to continue.Research QuestionThe primary hypothesis for the report was to confirm that portfolios are beneficial tonurses, and that teaching nurses about portfolios is a worthwhile experience.Significance of the StudyThe project is significant as many nurses are not familiar with portfolios or the newNational Registration expectations. A workshop was developed to educate nursesabout portfolios and the new competence standards implemented with NationalRegistration. The NMBA has outlined that 20 hours of CPD must be completed by allnurses registered in Australia. Portfolios are an ideal method/tool to document CPDhours, learning plans and evaluation of learning.Theoretical FrameworkThe theoretical framework behind portfolio use is based on Knowles theory of adultlearning, whilst developing competence as a nurse is outlined in Benners theory ofnovice to expert nursing practice.Knowles theory of adult learning is based on the assumption that adult learners areself-directed, ready to learn, curious and self motivated (McMullan et al., 2003).Portfolios users recognise that learning is self-directed and problem focused, withrelevant and realistic goals that encourage life-long learning (Cangelosi, 2008).Patricia Benner outlines how nurses develop competence in her novice to expertmodel of nursing practice. Nurses move through each stage of development –novice, advanced beginner, competent, proficient to expert through experience andeducation. Benner asserts that through each stage, nurses have differenteducational needs and respond to strategies differently, which should be taken intoconsideration when suggesting CPD activities. For example nurses who are
    • 4proficient and expert would benefit from CPD that is based on case studies, or giventhe opportunity to conduct research on clinical problems (Benner, 2001). Otherconsiderations include the span of generations that nurses cover, from babyboomers to Gen-Y, and their perceptions of learning and technologies (Weingarten,2009). This is potentially a reason why suggestions for CPD activities are broad andcater to a variety of methodologies.
    • 5Chapter 2Review of the literatureWhat is a Portfolio?Portfolios have traditionally been used by the visual arts community to showcasebest work; however portfolios are now widely promoted within the nursing arena todemonstrate competence and promote nursing achievements. A Professional Portfolio is: ‘a structured collection of different types of evidence that show the individual’s professional goals, competencies, career achievements and continuing professional development activities and experiences’ (Andre & Heartfield, 2007 p2).Professional portfolios usually fall into three different categories; presentation andlearning and assessment (Mills, 2009). Presentation portfolios are generally used bynurses for job applications and promotions. Learning portfolios can be used forregistration purposes and performance appraisals. Assessment portfolios arecommonly used at undergraduate/postgraduate level. Portfolios can beelectronic/web based; also known as e-portfolios, or paper-based.Whilst many authors refer to assessment portfolios as learning portfolios, for thepurpose of this literature review, assessment portfolios will be referred to in theUniversity setting, whilst learning portfolios will be referred to from a post registrationperspective.Presentation PortfoliosPresentation portfolios are usually offered at job interviews, performance appraisalsand for audit purposes. Whilst portfolios ‘promote critical thinking, self assessmentand individual accountability’ (Byrne et al., 2007 p24), careful consideration of whatgoes into a portfolio is essential to prevent overwhelming the audience. Portfoliosmust be well planned, organised and presentable. There is limited researchevaluating the effectiveness of presentation portfolios, despite the overwhelmingpromotion of portfolios in health literature as a standard of practice (Billings, 2008;Dion, 2006; Johnson, 2002; Meister, Heath, Andrews, & Tingen, 2002; Shirey, 2009) .
    • 6A study of nurse recruiters (n=34) from Jackson, USA showed that, 26.5% ofrespondents believed that professional portfolios were not useful for promotions and50.2% believed that professional portfolios were not useful in their organisation(Patrick-Williams & Bennett, 2010). Nurses are encouraged to keep a portfolio forpresentation purposes such as interviews; however there is a distinct lack ofevidence suggesting portfolios are beneficial when applying for employment orpromotion.Learning PortfoliosA learning portfolio’s purpose is to ‘reflect on practice, with the aim of self-assessment and planning for continuing professional development’ (Mills, 2009p207). Some Canadian states and the UK (See Figure 1) have implemented learningportfolios to demonstrate ongoing competence to practice, whilst some hospitalsrequest a portfolio be presented at their annual performance review (Picton, 2009;Thomas, 2005; Twaddell & Johnson, 2007). Learning portfolios can include annualgoals and career plans (Oermann , 2002; Shirey , 2009).Careful selection of evidence for inclusion in the portfolio is advised to ensure thatthe piece reflects ongoing competency to the nurse. It is suggested to provide a briefrationale for why a piece has been included, which competency standard it relatesto, and a reflective component to link a change in practice (Andre & Heartfield,2007; Billings, 2008; Mills, 2009). Evidence can be collected or reflected upon inrelation to the competency standards, and the identification of strengths and areas inneed of improvement can be highlighted (Masson & Williams, 2008). Cangelosi(2008, p125) explains that learning portfolios should reflect the ‘acquisiton ofknowedge and the development critical thinking’. Learning portfolios rely on theprocess of reflection to implement a change in practice.The Texas Children’s Hospital in the USA implemented portfolios as it was ‘seen asa tool to help provide a structure for identifying the strengths and learning needs ofstaff’ (Williams & Jordan, 2007 p126). Seven purposes for the portfolio were outlined: 1. Establish career goals. 2. Showcase professional accomplishments. 3. Illustrate specific areas of expertise.
    • 7 4. Enhance knowledge and skills. 5. Plan for additional career opportunities. 6. Help gain admission to school in order to advance academic preparation. 7. Apply to participate in the hospitals clinical ladder program.In addition, the portfolio was also introduced to the performance managementprocess. Managers felt that the portfolio was a valuable tool to outline professionalactivities and development.The University of North Carolina Hospital in the USA introduced portfolios as amethod of documenting learning experiences and competencies as part of theirleadership classes. There is an emphasis that the portfolio is a learning tool whichcan assist in identifying strengths, weakness and encourage reflection. Theparticipant is encouraged to write a personal statement about the portfolio whichdemonstrates integration of knowledge and practice, therefore giving meaning to theportfolio (Lannon, 2007).A literature review by Kostrzewski , Dhillon, Goodsman and Taylor (2008) on theimpact portfolios have on a health professionals practice, concluded that theevidence that a portfolio contribute to practice is limited. More research wasrecommended to assess the impact portfolios have on professional practice.Assessment PortfoliosThe concept of portfolio use in the literature is focuses mainly on the use of portfoliosto be used from an academic angle. The use of portfolios has been used inUniversity education since the early 1970’s (Parboosingh, 1996), however there hasbeen a renewed interest in the use of portfolios particularly with ongoingtechnological advancements and the emergence of e-portfolios. Behind the push forusing portfolios as an assessment based method is the movement from facultycentred teaching to student learning focussed curricula. Instead of the teacher beingat the podium lecturing, students are now being encouraged to participate in thelearning process (Allen, 2010; Jantzi & Austin, 2002), which correlates with theprinciples of adult learning.
    • 8A review of the literature of portfolios and the assessment of competence in nursingeducation in the UK from 1989-2001, showed the use of portfolios to demonstratecompetency was evolving, that reflection was a integral aspect of learning and thatassessment should be qualitative (McMullan et al., 2003). A literature review ofportfolio use in undergraduate portfolio assessment (from all disciplines) showed thattime-consuming portfolios can detract from learning, despite showing improvementsin reflection. They suggest that comparative studies should be considered ‘whichobserve changes in student knowledge and abilities directly, rather than reporting ontheir perceptions once a portfolio has been completed’ (Buckley et al.,2009 p283).Whilst portfolios are a useful assessment tool, it must be remembered that ‘aportfolio is not transparent text through which to see clinical practice. The best placeto see clinical practice is in the practice itself’ (Shakespeare, 2002 p32).E-portfoliosE-portfolios are at the forefront of innovative nursing education at present with manyUniversities taking up this pedological experience. E-portfolios have been a recentagenda for nursing acedamia and the broader education environment and theAustralian Government. There have been a number of reports and recommendationsin the recent years looking at the use of e-portfolios in the broader context ofuniversities and education, with much of the background work undertaken by theAustralian Government. They recognise that e-portfolios contain personalinformation which may be compromised, therefore the Australian Flexible LearningFramework was developed to provide national guidelines, functional specificationsand strategies to implement the use of e-portfolios by vocational education andtraining networks (AFLF, 2009). Privacy impact statement reports have beenpublished to assist service providers in being aware of their obligations to the learner(AFLF, 2010).In 2007, the Australian Learning and Teaching Council (ALTC) commissioned aresearch project to examine the use of e-portfolios by university students. TheAustralian E-portfolio Project consisted of four universities; Queensland University ofTechnology, The University of Melbourne, The University of New England and theUniversity of Wollongong. The results of this study highlighted a number of
    • 9recommendations which focus on encouraging the government sector to promote theuse of e-portfolios to articulate employability skills, encourage life-long learning andenhance the learning experience (Hallam, Harper, Hauville, Creagh, & McAllister,2009).The Queensland University of Technology (QUT) has successfully integratedportfolios across all faculties with at least 23,000 e-portfolios in use (Harper,McCowan, Hauville, Moody, & Chorazyczewski, 2007). Also, undergraduate nursingstudents from QUT have trialled in the clinical setting, the use of handheld personalcomputers to document in their e-portfolios with success, however there wereconcerns about the security of the devices (Bogossian, Kellett, & Mason, 2009).Although many universities are now using e-portfolios as part of their assessmentand learning, access to their e-portfolio may be terminated when the student ceasestheir studies. The strategic ICT Advisory Service looked at extending the use of e-portfolio from study to career by recommending an e-portfolio site which istransferable. E-portfolios are relatively new and the ‘development of an Australian e-portfolio in the current environment could only be undertaken on the basis of anunderstanding that this is the way of the future’ (Leeson & Williams, 2009 p44).Paper versus Electronic The benefits of using an e-portfolio over a paper portfolio are:  Templates can be set out for ease of use (Jantzi & Austin, 2002) i.e. reflection hyperlink to competencies.  Multiple portfolios can be created depending on the nature of the portfolio and its audience (Dion, 2006).  Eliminate the need to carry around large folders (Jantzi & Austin, 2002).  Important documents can be uploaded and saved in the event of a fire or flood (Dion & Smolenski, 2008; OMalley, 2008).Portfolios are well established within the academic arena, particularly since theevolvement of e-portfolios and their technological advantages. Presentation
    • 10portfolios have received wide input and notice in the literature, however there is alack of research supporting the theory that portfolios are useful for promotion andemployment. Learning portfolios are a method that many hospitals and registrationauthorities are taking up to assist nurses in demonstrating ongoing competence topractice. Whichever type of portfolio is used, the principles of adult learning can beapplied as the use of a portfolio encourages reflection, and the responsibility forlearning lies with the individual.
    • 11Chapter 3CompetenceCompetence is a ‘combination of skills, knowledge, attitudes, values and abilities thatunderpin effective performance in the nursing role’ (ANF , 2005 p5). Maintainingcompetence to practice includes ‘communication…clinical reasoning, problemsolving skills and the ability to have the psychological and social temperament toadapt to changing environments and conditions’ (Burns, 2009 p222). Whilst manyarticles address competence and what it is, in reality it is difficult to assesscompetency due to differing skill levels, experience and expectations.Competency StandardsThe issue of competence in nursing has evolved since the 1980’s with theintroduction of entry to practice competency standards (ANF , 2005). The AustralianNursing and Midwifery Council (ANMC) was established in 1992 to develop anational approach to nursing and midwifery regulation. The ANMC competencystandards were developed by nurses for nurses to describe the expectations of anurse on entry to practice. Competency standards have been developed forRegistered Nurses, Enrolled Nurses, Midwives and Nurse Practitioners (NMBA,2010b). At least thirty different specialities have developed competency standards inaddition to the accepted ANMC standard, as specific to their practice (Chiarella,Thoms, Lau, & McInnes, 2008). This idea is based on the idea that the ANMCcompetency guidelines are expected by all nurses; however the specialistcompetencies can be used in addition to the ANMC competencies (Bryce , 2007).
    • 12Competence FrameworksContinuing Competence Frameworks have been developed as a quality assurancemechanism to protect the public from unsafe and incompetent practitioners (ANMC,2007). A review of Continuing Competence Frameworks in Australia, Canada, NewZealand and the United Kingdom, showed a variety of methods of demonstratingongoing competence to practice (Figure 1). World-wide in nursing, there are manyCCF’s that are based on self-declaration, CPD and recency of practice. Many of themodels promote a holistic approach, recognising that not one single methoddemonstrates nursing competence.Australia Canada New United Zealand KingdomRecency of Self Assessment Recency of PersonalPractice Practice Professional Learning Plan Profile (Portfolio)CPD CPD Ontario (CNO, 2010) Learning Plan(AHPRA, 2010) Alberta (CARNA, Self Assessment 2010b) CPD (NCNZ, 2008) Above plus: Recency of Practice Recency of practice (NMC-UK, 2010) British Columbia (CRNBC, 2010) Saskatchewan (SRNA, 2010)Figure 1: Continuing Competence Frameworks World-Wide
    • 13 The ANMC developed the CCF (Figure 2) to assist nurses in demonstratingongoing competence to practice with the anticipation the framework would ‘becomepart of the national suite of professional standards’ (ANMC , 2009 p3). Thecomponents of the framework included assessment, CPD and recency of practice,all to be documented in a professional portfolio (ANMC, 2009). National Registrationfor all health professionals commenced in July 2010, and the role of the ANMCmoved from developing a national approach to nursing and midwifery regulation toaccreditation of nursing education. The CCF was handed over to APHRA; howeverthe recency of practice and CPD standards only were endorsed.Component Requirement Assessment • Annual self assessment of performanceProfessional in current role, against relevant ANMCPortfolio competency standardsElectronic or hard • Annual professional review (PAD)copy format to recordevidence of each • Annual self declaration of competencecomponent CPD Annual completion of 20hrs Recency of 3 months equivalent full time work within Practice the last 5 yearsFigure 2: ANMC Continuing Competence Framework (ANMC, 2009; NMBA , 2010b)Demonstrating CompetenceSelf declaration, CPD, recency of practice and learning plans are several methods ofdemonstrating competence. This section will highlight some current arguments thateach method has in demonstrating competency, in reference to the competencemodel that the NMBA was offered (ANMC-CCF), and the model that was chosen(CPD and recency of practice).
    • 14Self DeclarationA study by Pearson & FitzGerald (2001) commissioned by the Australian NursingCouncil Inc. (now known as the ANMC) surveyed nurses opinions on demonstratingnursing competence. The randomised study was conducted in 1997/1998 were 1005nurses around Australia responded to a questionnaire surveying nurse’s views oncompetency and how nurses should demonstrate competency to regulating bodies.The study showed that most nurses believed that signing a declaration ofcompetence (against the ANMC standards) was the preferred method of providingevidence of continuing competence, followed closely by verifying recency of practice.The ANF supports this method by asserting that the self declaration of competenceis the most appropriate mechanism to renew their registration. The mandatory modelof competence suggested by the ANMC by linking CPD, minimum hours of practiceand peer review was opposed (Bryce , 2008).Walker and Godfrey (2008) highlighted the difficulties using the ANMC competenciesto demonstrate competency, due to a lack of knowledge nurses have about thecompetency standards. The study of 11 community nurses from Longreach,Queensland looked at their perceptions of evidence needed to demonstrate theirclinical practice meets the competency standards. The data was collected byinterview and questionnaire and analysed through percentages and content analysis.Of the 11 nurses studied, three nurses did not know what the competency standardswere. The study identified that and only one participant knew that the competenciesfor their particular area were based on the ANMC competencies. The remainderwere aware there were competency standards; however they were unable to identifyhow many domains there were or the content of the competencies. This studyshows the self declaration of competence is limited as many nurses struggle todefine how the ANMC competencies relate to their clinical practice, or indeed areeven aware of what they are (Walker & Godfrey, 2008).Continuing Professional DevelopmentAlthough competence to practice has previously concentrated on entry to practicenurses, there has been the assumption that nurses would perform CPD activities tomaintain competence; however this has been largely unregulated (ANMC, 2007).
    • 15The ANMC developed a CPD standard within the CCF, whilst APHRA has endorsed20hrs per year as the minimum number of hours that nurses must spend on CPDactivities with the advent of National Registration.The ANF was in staunch opposition of the CPD requirements during thedevelopment of the CCF due to a lack of evidence connecting CPD withcompetence. Feedback from the ANF highlighted that some nurses lack access toCPD activities and that the workforce may suffer if nurses cannot re-register if theyare unable to meet the CPD requirements (ANF , 2008a, 2008b). Yoder-Wise (2006in Lannon 2007) agree that CPD may not be the most appropriate method ingauging competence, however it shows that nurses are intent in staying up to datewith nursing knowledge.Recency of PracticeRecency of practice was a common thread of all states in Australia to demonstratecompetency, except NSW prior to National Registration. Although recency ofpractice is one indicator of competency, it does not recognise that nurses in currentpractice may not be competent to practice. It is recommended that other indicatorsare used in combination with recency of practice to monitor competence (Pearson,Fitzgerald, Walsh, & Borbasi, 2002).Learning PlansA method of identifying learning needs that has been embraced by Canada, theUnited Kingdom and Australia (although not clearly defined as a method ofidentifying learning needs for self-directed study), is the learning plan and reflectionon activities. This concept is based on linking competency standards with learningneeds and outcomes.The use of learning plans and reflection has been criticised by authors Nelson andPurkis (2004) in an analysis of the mandatory reflection requirements of Canadiannurses. They argue that the reflective component of the framework ‘radically fails asa tool for auditing quality and assessing competency’ (Nelson & Purkis, 2004 p247).Namely because for auditing purposes a plan is only required, with no requirementsof demonstration of that activity. The paper asserts the process of reflection causesa nurse to ‘routinely scrutinises her skill set, and works to remedy deficits’ as a
    • 16‘confessional’ (Nelson & Purkis, 2004 p255). On reviewing the College andAssociation of Registered Nurses of Alberta’s Continuing Competence Programaudit requirements, nurses are required to submit a questionnaire answeringquestions about their participation in the program, learning plans and outcomes-inthe form of a tick box answer (CARNA , 2010). The form however, resembles aresearch questionnaire rather than an audit of competency.The United Kingdom however has a contrasting attitude towards learning plans withthe belief that learning plans help a nurse ‘keep up with new developments inpractice, think and reflect for yourself, demonstrate that you are keeping up to dateand developing your practice and provide a high standards of practice andcare’(NMC -UK, 2010 p3). Examples of learning plans are given to the participant togain an understanding of the expectations of the standards.The end point of a learning plan includes reflecting or evaluating what you havelearnt from that activity. Refection on practice has become a popular method ofdemonstrating competence (Byrne, Delarose, King, Leske, Sapnas, et al., 2007;Byrne, Schroeter, Carter, & Mower, 2009; Cangelosi, 2008; Masson & Williams,2008), whilst others believe that developing clinical competence and leadershipthrough reflection shows emotional intelligence (Horton-Deutsch & Sherwood, 2008)Maintaining competence to practice as a nurse is an issue at the forefront of nursingregulation around the world. Various competency frameworks have been developedin many countries that is centred around recency of practice. A variety of methodssuch as portfolio use, learning plans, self-assessment and CPD requirements havelead to much controversy and discussion; however it is recognised that acombination of methods is required to demonstrate ongoing competence to practice.
    • 17Challenges for the Australian Competency FrameworkLearning PlansNurses in Australia are expected to identify and prioritise their learning needs basedon:  Evaluation of their practice against the relevant competency or professional practice standards.  Developed a learning plan based on identified learning needs.  Participated in effective learning activities relevant to their learning needs.  Reflected on the value of the learning activities or the effect that will have on their practice (NMBA, 2010a).However, this is the extent of the explanation of the requirement. No examples aregiven as to how a learning plan should be developed or the quality or depth ofreflection that is required. Indeed, one can wonder if the ‘relevant’ competencystandards are referring to the ANMC competency standards or from other relevantcompetency standards available to nurses.A paper written by Campbell and Mackay (2001) from the Professional PracticeDepartment of the College of Nurses of Ontario, Canada asserts that an effectiveprofessional development program must contain tools and resources to help nursesmaintain their competence to practice. A statement made by Campbell and Mackay(2001 p24)- ‘Many times professional are left to develop an effective learning plan,identify tools, and acquire the appropriate resources to effectively implement the planon their own’, sums up the experience the NMBA has left to Australian nurses. It willbe interesting to see the quality of learning plans, if nurses feel that the 20hrs of CPDmust be related to the learning plans, and indeed if the learning plans will berequired in the event of auditing at all. o process for audit has been posted on thewebsite making it difficult for nurses to identify audit requirements and expectations.
    • 18CPD standardsWhilst the NMBA is attempting to keep the CPD broad and non prescriptive, furtherexplanation of the CPD standard document may be required. The statement‘Documentation of self-directed CPD must include dates, a brief description of theoutcomes, and the number of hours spent in each activity’ (NMBA, 2010a), has leadto confusion and frequent questioning. Exactly ‘what is self-directed learning’ theauthor asks? Some colleagues have taken this explanation to mean, that if anactivity was held by an outside source, because it is not self-directed, a learning planis not required. To get around this, many nurses will therefore attempt to ‘rack’ uptheir 20hrs of CPD requirement by attending in-services and workshops, with littleplanning in advance for their learning needs and no reflection.Portfolios and CompetenceBehind the phenomena of portfolio use to demonstrate competence is the notion thatcompetence can be demonstrated through the collection of evidence and documentsthat show ongoing competence to practice. Therefore portfolios are a tool, ratherthan a method to demonstrate competence. Some states have previously askednurses to keep portfolios to demonstrate ongoing competence to practice (SeeAppendix A), whilst others have required recency of practice and self review. Thenew NMBA has adopted the CPD and Recency of Practice standards only.The ANMC (2007) developed the CCF based on the results of a literature reviewfocusing on ‘Trends in Continuing Competence’. The literature review looked atcurrent competence requirements in each state from nursing and other professionssuch as medicine, law engineering etc. International nursing requirements were alsoreviewed focussing on Canada, New Zealand and the USA. It was generally agreedby many authors that the portfolio was the most ‘effective and appropriate means ofrecording the maintenance of competence’ (ANMC, 2007 p30). Some articles havelinked the maintenance of portfolios with the new Australian nursing legislativerequirements, emphasizing the use of the competency standards and reflection(Masson , 2008; Mills, 2009).Pearson and FitzGerald (2001 p23) survey of 1005 nurses showed that portfolioswas the preferred method of a nurses ‘ability to provide evidence of professional
    • 19development’ followed by the combination of a portfolio and a self assessment basedon a competency questionnaire .This is in contrast to the belief that self assessmentis the preferred method of providing evidence of continuing competency asmentioned earlier.Much controversy surrounds determining the best method of demonstratingcompetence to practice from nursing regulatory bodies around the world. Despitesignificant research by the ANMC into to best method of determining competence topractice, the new NMBA has chosen to endorse the CPD and recency of practicestandards only. Without clear guidelines for nurses to refer to such as the auditingprocedures, nurses may fail in their attempt to meet the new standards as expectedby the NMBA.
    • 20Chapter 4Is teaching about portfolios a worthwhile experience for the participants?As keeping a portfolio is a new concept for many nurses, literature on teachingportfolios development classes was looked at to ascertain if nurses need assistancein developing portfolios. Feedback given by participants who had attended classeson portfolio development and by employer’s feedback was evaluated.A workshop by Lannon (2007) provided professional development classes for nursesworking at the University of North Carolina Hospital in America, with workshops onpresenting, poster development, portfolios, interview skills and resume writing. Themost popular workshop was the portfolio development workshop which wasdesigned to prepare nurses for leadership roles beyond clinical expertise. Feedbackby assessors of the portfolios commented ‘there was a definite difference betweenthe applicants who attended the portfolio development class and those who had not’(Lannon, 2007 p21).Serembus (2000) reported on a workshop series aimed at undergraduate nursingstudents in Pennsylvania, America. Feedback by participants included ‘that theprofessional portfolio gave them the edge over other candidates’ (Serembus, 2000p286) which supports the assumption that portfolio development may assist nursesin gaining employment, however was not backed up with solid research to supportthis theory.Whyalla Hospital in South Australia, introduced portfolios to assist nurses in thedevelopment of nursing skills. Ten senior nursing staff piloted the project with thechallenge ‘to define the purpose of the portfolio, determining what was appropriateand reasonable to expect of nurses and ensuring the whole process did not becomeso burdensome it was rendered insignificant (Emden , Hutt, & Bruce, 2003 p126).For the project to work, the nurses decided the journey of self-development wasmore important than demonstrating competency. The participants were provided witha book about portfolios and had a clear objective of relating the portfolio buildingexperience to their clinical practice.On implementing portfolios at the Texas Children’s Hospital in the US, feedback fromstaff concluded that the long-term benefits were recognised, however compiling theportfolio was ‘overwhelming for many nurse’s’ (Williams & Jordan, 2007 p129).
    • 21These types on comments are thematic in many portfolio articles, supporting thepossibility of offering educational sessions on how to develop a nursing portfolio.Whilst nurses in the UK have been using portfolios for years now, some are still notconfident in preparing or presenting their portfolios despite guidelines beingavailable. Bower and Jinks (2004) suggest nurses could be mentored through theprocess of developing their portfolio. Clearly and Freeman (2005) believeappropriate resources should be made available to nurses when developing aportfolio. Workbooks were developed to support life-long learning in clinical practicewhich gave guidance to nurses when developing clinical skills. Whilst the onus ofportfolio development is ultimately the nurse’s responsibility, a workbook can assistin helping nurses develop learning objectives in accordance with departmental goals.
    • 22Chapter 5MethodDesign, Setting and SampleThe research was a descriptive study to ascertain if it was beneficial to educatenurses on the benefits of portfolio use. A workshop was designed and implementedto see if the workshop was a viable project to continue.Invitations to participant in the workshop were sent to Emergency Departmentnurses across two campuses however there was a poor response rate, partiallyattributed to previous in-services already held by the author on the same topic. Withthe assistance and support of the Nursing Education and Research Unit of the GoldCoast Hospital, the workshop was opened to all nurses across the district. Requeststo attend the workshop were overwhelming; however participation was limited to 25nurses.The workshop was held in the Nurse Education building with 27 participantsattending. Several people did not show up and others attended without a booking.There was a variety of participants from all nursing areas including educators,midwives, mental health and community nurses. The workshop was designed andofficiated by the author. Two participants (who had not booked in), came in for thefirst two sessions only, and 21 participants completed the feedback form.The morning covered the following topics:  National Registration  CPD  Portfolios  E-portfolios  Learning Plans  ReflectionParticipants were asked to fill out the feedback form honestly and were verballyadvised the results would be used for research purposes.
    • 23AnalysisThe feedback form was the data collection tool used to assess the workshop byparticipants. The results were graphed on a ‘helpfulness’ scale, giving participantsfive levels to select as well as allowing for comments. 0- Not helpful at all 1- Mildly helpful 2- Helpful 3- Very helpful 4- ExcellentEach session was graphed on a pie chart to show an overall impression if they foundthe session helpful in percentage, whilst column graphs were used to show yes/noanswers.Whilst no cross analysis was undertaken comparing if participants usually gave aparticular score, it was noted that one participant scored a one for all six sessions;however no written feedback was given to ascertain why the workshop was overallrated as mildly helpful.
    • 24Chapter 6ResultsIntroduction and National RegistrationThis session focussed on introducing the workshop and highlighting the changes thatNational Registration will bring to nurses in Australia. General housekeeping issueswere brought up such as turning off phones, emergency exits and plan for the day.All participants were given handouts, a CD and outline for the day. A briefbackground of how and why National Registration was brought about and the fivenew registration standards were discussed.Results Introduction and National Registration 1-mildly helpful 2- helpful 3- very helpful 4- excellent 5% 33% 19% 43% Figure 3: Introduction and National RegistrationComments from the session: Increased awareness of changes. This information should be shared with all nursing staff, perhaps make it part of mandatory skills (included CPD session). A good introduction to the workshops learning objectives. Very helpful information revising updates in National registration requirements and changes.
    • 25Continuing Professional DevelopmentThis section discussed the CDP requirements of National Registration and thedocumentation required in the event a nurse is audited. Examples were given ofdifferent types of CPD and documentation templates.Results Continuing Professional Development 1-mildly helpful 2- helpful 3- very helpful 4- excellent 5% 5% 52% 38% Figure 4: Continuing Professional DevelopmentComments from the session: Helped understand how this is calculated better. I learnt there is much more you can do to reach your CPD points. Excellent info -clear explanation.
    • 26PortfoliosThis session looked at different types of portfolios and how to compile onedepending on the audience looking at the portfolio. In preparation, several portfolioswhere designed to show different types of portfolios, and participants wereencouraged to look at these during morning tea. A teacher kindly let me show herportfolio to the group.Results Portfolios 1-mildly helpful 2- helpful 3- very helpful 4- excellent 5% 14% 48% 33% Figure 5: PortfoliosComments from the session: Hearing about types of portfolios and their uses. Having the opportunity to look through portfolios was very useful. Provided info, examples +broke it down.
    • 27E-portfoliosThis session discussed the potentials for storing portfolios online. Examples ofseveral e-portfolios were given and the benefits/problems were discussed.Results E-portfolios 1-mildly helpful 2- helpful 3- very helpful 4- excellent 0- not helpful 5% 9% 38% 38% 10% Figure 6: E-portfoliosComments from the session: Food for thought. Not personally techno savvy at all hence not a lot gained personally, but interesting to know.Further exploration will make this a valuable tool for employer to access, previously unaware thank u. I had never heard of e-portfolios- will want to give this a go. Inspiring- demystified this for me.
    • 28Learning PlansThis interactive session dived participants into groups after showing them how towrite a learning plan. Although mostly rated as excellent, most participants hadproblems grasping the concept of linking the ANMC competencies with learningplans; however most participants had a good understanding of how thecompetencies related to their work. Example of learning plans from Canada and theUK were given out in the handouts and referred to. Learning Plans 1-mildly helpful 2- helpful 3- very helpful 4- excellent 5% 43% 33% 19% Figure 7: Learning PlansComments from the session: Felt re-capping previously learnt information. Difficult to relate to ANMC.Group activity not clearly explained, needs further explanation prior to discussion in separate groups. I felt this part difficult as when you don’t know something you automatically see resources. Hard to put on paper. Requires better explanation. Great group activity.
    • 29 ReflectionThis session talked about reflection in five steps. Participants were then encouragedto discuss in groups reflection situations. Whilst participants were advised not todiscuss emotionally disturbing situations that may upset them, most concentrated onpositive outcomes, rather than negative.Results Reflection 1-mildly helpful 2- helpful 3- very helpful 4- excellent 5% 33% 29% 33% Figure 8: ReflectionComments from the session: Re-capped prior learning. Good until exercise. Good exercise. Good group activities and examples.
    • 30Have you used a portfolio (as opposed to a CV or resume) previously?When discussing who had used portfolios in the past, nurses who had worked in NZor the UK have had previous portfolio use. Previous portfolio use n=16 n=3 n=2 yes no no answerFigure 9-Previous portfolio useWould you be interested in maintaining an e-portfolio over a paper portfolio?This graph shows that most of the participants would be interested in setting up an e-portfolio. Of those who answered yes (n=14), 11 said they would need help settingone up. 16 14 12 10 interested in e- 8 portfolios? 6 need help setting one up? 4 2 0 yes no maybe no answerFigure 10- E-portfolios
    • 31Did you find the handouts helpful? Did you find the handouts helpful? 20 1 yes noFigure 11- HandoutsComments: However have not read all- would have been nice to have been presented in a folder. Could have been assembled and stapled- very confusing.What was good about the workshop? Prior to the workshop I was fearful of portfolios and had no idea. Now I am much more comfortable and feel I have some understanding. Will definitely recommend this workshop to others. Engaging presenter who walks the talk. Clarified the obligations that we have to adhere to and a practical way to achieve that. Everything was relevant to the day. Give me idea on how to start my portfolio folder. Presented well and with easy, simple language.
    • 32What could have been improved?Several participants suggested more visual examples of portfolios and learningplans. Some of it confusing in short space of time.Lengthen course to have staff commence with help some completion of templates to add to portfolio. The session could be shortened. Not all of it was relevant to what we need to provide. Spending more time on the development of a portfolio from the start. The learning plan section.Additional comments: Highly recommend other staff to attend, very helpful and informative- especially for those who portfolios are new to. To learn more about writing a CV +resume- what is the difference. Well presented by a facilitator with clear understanding of portfolio development. Competency standards- discussion was informative- encouraged us to critically analyse competencies and learning plans. Needed more breaks- it was a very long session. Thankyou Jo-Anne for a brilliant in-service where I learnt loads. Cheers. Great to network with other staff from other departments. Highly recommended. Thank you for researching this topic and sharing this information which is so useful and valuable for my professional life.
    • 33Overall satisfactionAll scores were graphed to show an overall satisfaction rating. Most participants(40%) gave the workshop an ‘excellent’ rating. Overall satisfaction 52 38 28 7 1 0 1 2 3 4 0- Not helpful at all, 1- Mildly helpful,2- Helpful,3- Very helpful, 4-ExcellentFigure 12- Overall satisfaction
    • 34Chapter 7DiscussionCompetenceThe hypothesis of the study was to identify if teaching about portfolios was beneficialto nurses. The initial idea to develop the workshop was based on the idea that theANMC CCF would be implemented with the advent of National Registration;therefore maintaining a portfolio would be mandatory. However, as only the recencyof practice and CPD standards were endorsed, there was a change in focus. Thislead to the author asking what is competence and how is it demonstrated?, whichwas explored in the literature review.Much of the literature review focuses on competence in nursing with reference toCCF’s around the world. Some of the issues highlighted by Nelson & Purkis (2004)in their review of Canada’s use of learning plans has relevance to the Australiannursing community. Due to a lack of explanation and direction it is anticipated by theauthor that nurses will have difficulties in developing a learning plan as expected bythe NMBA. Even though the concept of learning plans was explained and examplesgiven, nurses still found it difficult to write a learning plan in relation to the ANMCcompetencies during the workshop. Perhaps it would be wise of the NMBA to reviewthe UK model- PREP handbook (NMC-UK, 2010) to assist in developing guidelinesfor developing learning plans.WorkshopMuch of the interest in the workshop was centred on learning what was expected forregistration purposes. This is why it was decided to open with the background ofNational Registration and the mandatory standards. One participant believed that‘this information should be shared with all nursing staff, perhaps make it part ofmandatory skills’. The most successful session of the workshop was the CPDsession which 52% of participants giving it an excellent rating. E-portfolios generatedattention with 76% (n=16) of participants interested in starting an e-portfolio.Most nurses in Queensland have not had exposure to portfolios unless advocated bytheir hospitals or from living in states or countries that require one for registrationusage. This was confirmed by the response rate that only three participants had
    • 35used portfolios in the past. Overall, it was found that 40% of participants rated theworkshop as excellent, which confirms the hypothesis that teaching about portfoliosis beneficial to nurses.Whilst no literature was found specifically reporting feedback from a workshop onportfolios, a paper from Lannon (2007) reported that the portfolios workshop was themost popular class of five leadership classes, with assessors noting the benefits ofportfolio development. The results of the feedback on the portfolio workshop showthat whilst portfolio development is a worthwhile topic to explore, research is lackingin the experience of being taught portfolios. There is a large amount of literaturerelating the student’s experience of assessment portfolios; however no feedback onthe actual learning experience (i.e. learning about portfolios) was noted.RecommendationsThe impact of nurses using e-portfolios as an option supported by APHRA would beuseful to nurses and the Nursing and Midwifery board alike. APHRA could outlineclear and concise expectations by providing templates within an e-portfolio site.Nurses could submit their portfolio for audit at the press of a button, and portfolioscould be transferable between employment as the system would be Australia wide,rather than hospital or university dependent. The use of an e-portfolio could beabsorbed by registration costs or an additional optional fee. Privacy andconfidentiality notices could be set into the templates, as well as assuring nurses thataccess to their site by APHRA would not be undertaken unless permission given.Whilst portfolios are recommended for nurses to use, there is very little researchbacking up many of the claims made. Research looking at the following questionswould be beneficial in establishing the usefulness of portfolios and assist thecompetency movement that is still evolving within Australia. 1. Do employers look at portfolios when hiring new staff? Do portfolios improve the chances of gaining employment?
    • 36 2. If the ANMC CCF was implemented in Australia, what would be the ‘marking guide’ and would the resources be available to review portfolios in the event of auditing? 3. Since the advent of National Registration, how many nurses are developing learning plans and partaking of 20hours of CPD? 4. What sort of CPD activities are Australian nurses undertaking and how is this being documented?ConclusionNurses can choose to maintain a portfolio for a variety of purposes such asdemonstrating ongoing competence to practice, evidence for job promotions or forassessment purposes. There is a lack of evidence to suggest that portfolios arebeneficial when applying for employment or promotion despite a overwhelmingamount of literature stating it is advantageous. Assessment portfolios are wellingrained in the academic arena to show ongoing learning and reflection. As portfoliouse may be new for many nurses, and potentially overwhelming the literaturesuggests that a workshop to teach nurses about portfolios may be appropriate andhelpful.Countries such as Australia, Canada, New Zealand and the United Kingdom havedefined various competency frameworks which are based on recency of practice.These countries have adapted their competency frameworks to include either CPD,portfolios, self assessment and learning plans, which has generated a great deal ofdiscussion and controversy. Some hospitals around the world are now asking nursesto maintain portfolios to demonstrate nursing competency, and to provide evidencein performance reviews. The new legislative requirements as expected by the NMBAof CPD and learning plans may need further clarification to avoid confusion and non-compliance. This may cause problems in the near future as audit requirements haveyet to be made public.
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    • 41Appendix
    • 42Appendix A: Portfolio and CPD requirementsAustralian States Portfolios requirement CPD requirementsACT (ACTNMB) Yes 10 hours per yearNT (NBT) No NoWA (NMBWA) Yes 20 hours per yearQLD (QNC) No NoSA (NBSA) No NoTAS (NBT) Yes Yes (?hours)NSW (NMB) No NoVIC (NBV) No Yes (?hours)National Registration No 20 hours per year(ANMC, 2007)
    • 43 Appendix B: Workshop Objectives and Learning PlanTime Learning Objectives Teaching Method Outcome and Evaluation0800-0830 Topic: Welcome and Introduction to National PowerPoint Student will be able to identify and Registration presentation compare changes by being able to answer the following questions: Housekeeping i.e. toilets, fire escapes, outline of Interaction: Asking the morning and importance of feedback. questions to ascertain  What were the previous Nursing Act participant’s level of and the new Nursing Law? Students to demonstrate an understanding of knowledge throughout  What governing body were QLD recent changes that will affect their nursing the presentation. nurses under, and what governing registration. body are all Australian nurses under now?  Health Practitioner Regulation National Law  What are the new national Act 2009 registration standards?  Australian Health Practitioner Regulation Agency. Score and comments from feedback  Nursing and Midwifery Board of Australia form  National Registration Standards Rationale: Introducing the national registration expectations will provide the background evidence to why developing a portfolio is desirable.
    • 44Time Learning Objectives Teaching Method Outcome and Evaluation0830-0900 Topic: PowerPoint presentation Continuing Professional Development (CPD) The participant will be able to discuss Interaction: Participant to what types of activities constitute CPD. list different CPD The participant will be able to outline activities on white board The participant will be able to state expectations of CPD and be able to discuss the how many hours of CPD are required each year. different types of CPD that can be undertaken. Score and comments from feedback Rationale: form. Outlining the CPD requirements will support the use of portfolios as a portal to document hours
    • 45Time Learning Objectives Teaching Method Outcome and Evaluation0900-1000 Topic: Portfolios PowerPoint The participant will be able to discuss presentation the differences between a resume and Different types of portfolios will be discussed and a portfolio. typical content. The participant will engage in the Interaction: The compilation of their portfolio. participant will bring The participant will be able to outline their portfolio and the components of portfolios. Rationale: documents to the class Bringing the portfolio to class will encourage and receive assistance The participant will be able to describe nurses to commence the compiling of the portfolio. with construction and the different applications of portfolios. feedback Score and comments from feedback form
    • 46Time Learning Objectives Teaching Method Outcome and Evaluation1020-1035 Topic: Eportfolios PowerPoint presentation Participant will be able to locate resources on the internet that could The participant will explore the options of an Interaction: Participant assist them in developing an eportfolio. internet based portfolio. will be shown an e- portfolio of a nurse and be able to navigate Score and comments from feedback Rationale: through the site. form. Nurses can document their CPD hours in any form (not specified by the NWBA).
    • 47Time Learning Objectives Teaching Method Outcome and Evaluation1035-1115 Topic: -: Competency Standards PowerPoint presentation The participant will be able to The competencies which make up the ANMC write a learning plan for the Interaction: The class will be year which pertains to the Competency Standards for Registered Nurses are divided into four groups and organized into 4 domains: ANMC competencies. discuss how each of the domains pertains to their own Score and comments from Professional Practice practice. The groups will then feedback form. Critical Thinking and Analysis present which types of CPD will assist them in meeting their Provision and Coordination of Care learning goals. Collaborative and Therapeutic Practice The aim of this session is to encourage participants to link their nursing practice with the ANMC competencies and think of evidence they could provide which shows this. Rationale: Understanding the way the competencies relate to practice is fundamental in providing appropriate evidence.
    • 48Time Learning Objectives Teaching Method Outcome and Evaluation1115-1155 Topic: Reflection PowerPoint presentation The participant will be able to write a reflective piece of writing linking The participant will be able to explore and Interaction: Participants are to how the ANMC competencies affect apply the principles of reflection to clinical anonymously state on two the situation. situations. different pieces of paper, a strength and a weakness in their The participant will be able to Participants will be able to link the ANMC identify learning needs for the year nursing practice. The facilitator standards to everyday nursing practice. by reflecting on their own practice. will then encourage group discussion to apply the principles Score and comments from of reflection to each situation. Rationale: feedback form. Reflection links theory to practice which leads to an improvement in practice. Reflection will also help identify learning needs.
    • 49Time Learning Objectives Teaching Method Outcome and Evaluation1155-1200 Topic: Summery and Feedback PowerPoint Score and comments from feedback presentation form This session will summarise the content of the workshop, highlighting the key points and essential elements that the NMBA will expect of nurses. (a) identified and prioritised their learning needs, based on an evaluation of their practice against the relevant competency standards. (b) developed a learning plan based on identified learning needs. (c) participated in effective learning activities relevant to their learning needs (CPD) (d) reflected on the value of the learning activities or the effect that participation will have on their practice. Final words: Work through your learning plan, document your hours and evaluation/reflection as you go. Start now! Rationale: Summarising the content of the workshop will reinforce the objectives of the workshop.
    • Appendix C: Professional Portfolios Flyer 50 Gold Coast Health Service District Nursing Professional Development Professional Portfolios 25th August 2010 Time: 08:00 – 12:00 Education Centre Southport Target Audience: All nurses For Bookings: Contact Admin Officer NERU on 5519 8493 Contact Jo-Anne MsShane for further information email joanne_mcshane@health.qld.gov.au Programme Overview: • Expectations of National Registration. • What is a portfolio? Types of portfolios. • How to develop a learning plan. • ANMC competencies • What types of learning constitutes Continuing Professional Development (CPD). • How many hours of CPD you will need to do, and how to demonstrate ‘effective learning’.
    • Appendix D- Certificate of Attendance 51 Statement of Attendance Name Attended the Professional Portfolios Workshop 25 August 2010 Southport Campus Gold Coast Hospital Subjects included: • Expectations of National Registration • What is a portfolio? Types of portfolios. • Continuing professional development • Developing a learning plan • Reflection 8am-1200hrs Facilitated by Jo-Anne McShane Clinical Nurse 7 CNE Gold Coast Health Service District Points
    • 52 Appendix E: Feedback National Registration and Portfolios Scores 0 -not helpful at all 1 -mildly helpful, 2 –helpful, 3- very helpful, 4- excellent Time Topic Presenter Score Comments 0800-0830 Introduction and National Registration 0830-0900 CPD 0900-1000 Portfolios 1000-1015 Morning Tea 1015-1030 E-portfolios 1030-1115 Learning Plans 1115-1155 Reflection 1155-1200 Summery and FeedbackHave you used a portfolio (as opposed to a CV or resume) previously? YES/NO (please circle)What was good about this workshop?__________________________________________________________________________________________________________________________What could be improved? ___________________________________________________________________________________________________________________________________Would you be interested in maintaining an e-portfolio over a paper portfolio? YES/NOIf so, do you think you would need help setting one up? YES/NODid you find the handouts helpful? YES/NOAny additional comments would be appreciated______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
    • 53Appendix F: Preparation checklist  Book room, work out seating arrangements  Make sure PowerPoint presentation works on computer with correct font.  Create sign in sheet with list of participants  Name labels, stickers  Provide morning tea  Handouts and CD burned  Print feedback sheets  Develop agenda  Compile own portfolios- 3 paper and 2 e-portfolio  Create certificate template- have certificates printed off during the break
    • Appendix G: Agenda 54 Professional Portfolios Workshop 25th August 2010 Programme Outline 0800 Welcome and Introduction to National Registration 0830 Continuing Professional Development 0900 Portfolios 1000 Morning Tea 1020 Eportfolios 1035 Learning Plans 1115 Reflection 1155 Summery and Feedback 1200 Close
    • 55Appendix H: PowerPoint PresentationPresentation will be attached to the thesis submission. Photos taken during the workshop. Below: Identifying learning opportunities in relation to the ANMC standards.
    • 56Appendix I: Optional SurveyAn optional survey was developed to gain insight into potential topics of interest if theworkshop was to run over a day. Forteen particpants choose to complete theaddditonal optional survey. Optional Survey 14 12 10 Participants 8 6 4 2 0 1 2 3 4 5 6 7 8 9 10 11 Questions 1. Portfolio preparation? 2. National registration? 3. How to write a learning plan? 4. Writing for publication? 5. Interviewing skills? 6. PAD process- how to get a good review? 7. Presenting at conferences? 8. How to do a poster presentation? 9. How to develop a presentation (i.e. PowerPoint) 10. How to write a resume? 11. How to organise a journal club?The most popular request was for learning plans, followed by portfolio preparation,the PAD (performance appraisals) and how to develop a presentation.
    • 57Appendix J: Conference Abstract and AutobiographyConference Presenter:E-portfolios Australia Conference 2010 (EAC2010)3-4th November, Melbourne AustraliaAbstractJo-Anne McShaneClinical NurseEmergency DepartmentGold Coast Hospital, QueenslandNursing and e-portfolios: 2 steps forward, 1 step backThe Australian Nursing and Midwifery Council recommended that all nurses shouldmaintain a professional portfolio, which many states mandated as part of registration.National Registration for nurses commenced this year; however the new registrationstandards do not include the maintenance of a portfolio. This is potentially abackwoods step in the demonstration of competence for nurses, which had alreadybeen implemented in some states.The use of a portfolio is a valid tool to assist nurses in meeting their CPD standards,assist in life-long learning and showcase a nurse’s work for employment andpromotion purposes. This presentation will highlight the mission of one nurse tointroduce e-portfolios to the Emergency Department and if it was a success orfailure.Recommendations will be made that may assist the e-portfolio community inunderstanding and developing strategies to help the everyday nurse embrace e-portfolios as ‘the way of the future’, remembering that learning does not stop once aperson leaves the classroom.Autobiography:Jo-Anne works at the Emergency Department at the Gold Coast Hospital and hasbeen a nurse for 13yrs. Passionate about nursing excellence, Jo-Anne has beenteaching about portfolios and is writing her Master’s thesis on ‘developing aworkshop to educate nurses about portfolios’.Jo-Anne’s work place is already using the internet to store continuing professionaldevelopment details, however she believes there is room to improve by creating apersonalised e-portfolio account within the system.