Portfolios thesis

i

Professional Portfolios

Jo-Anne McShane

Thesis submitted in fulfilment for the requirement of the

Award of Masters of Clinical Nursing

School of Nursing, Midwifery and Postgraduate Medicine

Edith Cowen University

Western Australia

2010

ii

Declaration

I 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 material

Signature………J McShane………………..Date: October 2010…………

.

iii

Table of Contents

DECLARATION……………………………………………………………………………...ii ABSTRACT…………………………………………………………………………………..v

ACKNOWLEDGEMENTS……………………………………….…………………………vi

TERMS USED………………………………………………………………………………vii

LIST OF APPENDICES…………………………………………………………………...viii

LIST OF FIGURES………………………………………………………………………….ix

Chapter 1…………………………………………………………………………………...1

INTRODUCTION…………………………..………………………………………………..1

Background to the Study…………..……………………………………………….1

Purpose of the Study…………………………………………………..……………3

Research Question……………………………………………………………….....3

Significance of the Study…………………………..………………….……………3

Theoretical Framework…………………………………………...………………...3

Chapter 2…………………………………………………………………………………...5

REVIEW OF THE LITERATURE…………………………………………………………..5

What is a Portfolio?......................................................................................................5

Presentation Portfolios……………………………………………………………...5

Learning Portfolios…………………………………………………………………..6

Assessment Portfolios………………………………………………………………7

E-Portfolios……………………………………………………………….……..…………...8

Paper versus Electronic………………………………………………..…………….……..9

Chapter 3………………………………………………………………………………….11

Competence………………………………………………………………………………..11

Competency Standards……………………………………………………………..…….11

Competency Frameworks………………………………………………………………...12

Demonstrating Competence………………………………………………………………13

Self Declaration…………………………………………………………………….14

Continuing Professional Development…………………………………………..14

Recency of Practice……………………………………………………………….15

Learning Plans……………………………………………………………………..15

Challenges for the Australian Competency Framework……………………………….17

Learning Plans……………………………………………………………………..17

CPD Standards……………………………………………………………….……18

iv

Portfolios and Competence…………………………….………………………………....18

Chapter 4…………………………………………….………………………...........…...20

Is teaching about portfolios a worthwhile experience for the participants?................20

Chapter 5………………………………………………………………………………….22

METHOD…………………………………………………...……………………………….22

Design, Setting and Sample……………………………………...………………22

Analysis………………………………………………………………………….….23

Chapter 6…………………………………………………….…………………………...24

RESULTS………..…………………………………………………………………………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…………………………………………………………………33

Chapter 7………………………………………………………………………………….34

DISCUSSION…………………………..…………………………………………………..34

Competence………………………………………………………………………..34

Workshop…………………………………………………………………………...34

Recommendations…………………………………………………………………35

Conclusion………………………………………………………………………….36

REFERENCES………………………………………………..……………………………37

v

Abstract

This report was written to detail the findings found during an extensive literature

review on professional portfolios in nursing practice and the feedback received on a

workshop designed to educate nurses on the benefits of maintaining a professional

portfolio.

Professional portfolios in nursing are well established within the academic arena,

particularly since the advent of e-portfolios as an assessment tool. Despite an

overwhelming amount of articles promoting portfolios as a standard of practice, there

is a distinct lack of evidence suggesting portfolios are beneficial when applying for

employment or promotions. One of the emerging uses of portfolios in the literature is

the use of portfolios to demonstrate competence to practice.

Australia is entering a new era of nursing with the introduction of National

Registration. The Continuing Competence Framework developed by the ANMC

promoted the use of the portfolio to provide evidence of ongoing competence to

practice nursing. However, APHRA has chosen to endorse only the CPD and

Recency of Practice elements of the framework. Nurses have been given very little

to guidance and support in the new expectations, which may leave nurses feeling

slightly confused. Despite this, portfolios can still be used as a tool to document the

standards and showcase the nurse’s experience and best work.

A workshop was developed to educate, innovate and motivate nurses to document

their achievements in a professional portfolio. The interactive workshop covered the

following topics:

National Registration

Continuing Professional Development

Portfolios

E-portfolios

Competency Standards

Reflection

The feedback received showed that a majority of participants rated the workshop as

either ‘very helpful’ or ‘excellent’. Despite the workshop being a success, it is evident

that 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 for

taking 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 Nursing

Education 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.

vii

Terms Used

ANF: Australian Nursing Federation

ANMC: Australian Nursing and Midwifery Council

APHRA: Australian Health Practitioners Regulation Agency.

CCF: Continuing Competence Framework

COAG: Council of Australian Governments

CPD: Continuing Professional Development

NMBA: Nursing and Midwifery Board of Australia

NMC-UK: Nursing and Midwifery Council United Kingdom

QNC: Queensland Nursing Council

QUT: Queensland University of Technology

viii

List of Appendices

Appendix A- Portfolio and CPD Requirements…………………………………… 42

Appendix B- Professional Portfolios Workshop Objectives and Learning Plans 43

Appendix C- Professional Portfolios Flyer………………………………………… 50

Appendix D- Certificate of Attendance………………….………..……………….. 51

Appendix E- Feedback Form………………………………………………………. 52

Appendix F- Preparation Checklist………………………………….………….… 53

Appendix G-Agenda…………………………………….…………………………. 54

Appendix H- PowerPoint Presentation…………………….…………………….. 55

Appendix I- Optional Survey Results…………………………………………….. 56

Appendix J- Conference Abstract and Autobiography………..……………….. 57

ix

List of Figures

Figure 1- Continuing Competence Frameworks World-Wide…………… 12

Figure 2- ANMC Continuing Competence Framework………………….. 13

Figure 3- Introduction and National Registration………………………… 24

Figure 4- Continuing Professional Development…………………………. 25

Figure 5- Portfolios…………………………………………………………... 26

Figure 6- E-portfolios………………………………………………………… 27

Figure 7-Learning Plans……………………………………………………. 28

Figure 8-Reflection………………………………………………………….. 29

Figure 9- Previous Portfolio Use…………………………………………… 30

Figure 10- E-portfolios………………………………………………………. 30

Figure 11- Handouts…………………………………………………………. 31

Figure 12-Overall satisfaction………………………………………………. 33

1

Chapter 1

Introduction

Background to the Study

In 2005 the Commonwealth Government (COAG) asked the Productivity

Commission1 to research the issues impacting the health workforce and make

recommendations that would ensure the continued quality of health care in an

environment of rising health costs, an aging population and advancing technologies.

National Registration and accreditation was just one of the many recommendations

the Productivity Commission proposed. The purpose of implementing National

Registration across Australia was to improve patient safety by ensuring that the

education and training standards of nurses are consistent. A safe competent and

mobile 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 their

respective Nursing Councils. Each state was governed by their own Nursing

Councils and Nursing Acts, which subsequently had different expectations for

registration and competency. National Registration will eliminate the need for

multiple 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 healthcare

workers including Physiotherapists, Podiatrist, Optometrists, Chiropractors,

Pharmacists, Dentists, Psychologists, Osteopaths, Nurses, Midwives and Doctors of

Medicine. In March 2008, the Intergovernmental Agreement for a National

Registration and Accreditation Scheme for the Health Professions policy was signed

by the Premiers and Chief Ministers of each state, as well as the former Prime

Minister of Australia, Kevin Rudd. This agreement outlined the ‘objectives, scope

and governance, legislative, administrative and financial arrangements for the

1 ‘The Productivity Commission is the Australian Government's independent research and advisory

body 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.)

2

scheme’ (COAG, 2008 p2) of National Registration by July 2010. However, it should

be noted at the time of writing that the state of Western Australia’s Legislative

Council has not passed the National Law Act. It is anticipated that Western Australia

will 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 now

be registered with the new Nursing and Midwifery Board of Australia. Individual

states have had in the past different registration requirements in regards to

continuing professional development (Appendix A), competence, auditing, and

recency of practice. The new National Mandatory Registration standards will include

a criminal history check, English language skills competence, professional indemnity

insurance, recency of practice and continuing professional development (CPD)

standards (NMBA, 2010a).

The Australian Nursing and Midwifery Council (ANMC) was established in 1992 to

develop a national approach to nursing and midwifery regulation. The role of the

ANMC has changed with the advent of National Registration; now being the national

accrediting authority for nursing and midwifery (ANMC, 2010). The Continuing

Competency Framework (CCF) was previously developed to provide nurses and

midwives a national process for the demonstration of ongoing competence to

practice.The components of the framework included assessment, CPD and recency

of practice which would be contained in a professional portfolio (ANMC, 2009). At

this stage, APHRA has chosen not to endorse the CCF, therefore maintaining a

portfolio is an option for nurses rather than a mandate. A possible reason to this

decision maybe the ongoing disagreement by the ANF that the CCF was a suitable

method of assessing ongoing competence, however the use of a portfolio was

supported (ANF, 2008a, 2008b). It was an assumption by the author and many

Australian writers (Masson & Williams, 2008; Mills, 2009), that the ANMC- CCF

would be implemented as part of the National Registration standards, therefore the

original 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 of

portfolios for a wide range of usages.

3

Purpose of the Study

The purpose of the study was to identify a current issue in nursing practice and

design a quality assurance activity and report. It was decided to write about portfolios

as it is a relevant and contemporary issue in nursing practice. A workshop was

designed and implemented, with feedback from participants analysed to establish if it

is a worthwhile project to continue.

Research Question

The primary hypothesis for the report was to confirm that portfolios are beneficial to

nurses, and that teaching nurses about portfolios is a worthwhile experience.

Significance of the Study

The project is significant as many nurses are not familiar with portfolios or the new

National Registration expectations. A workshop was developed to educate nurses

about portfolios and the new competence standards implemented with National

Registration. The NMBA has outlined that 20 hours of CPD must be completed by all

nurses registered in Australia. Portfolios are an ideal method/tool to document CPD

hours, learning plans and evaluation of learning.

Theoretical Framework

The theoretical framework behind portfolio use is based on Knowles theory of adult

learning, whilst developing competence as a nurse is outlined in Benners theory of

novice to expert nursing practice.

Knowles theory of adult learning is based on the assumption that adult learners are

self-directed, ready to learn, curious and self motivated (McMullan et al., 2003).

Portfolios users recognise that learning is self-directed and problem focused, with

relevant and realistic goals that encourage life-long learning (Cangelosi, 2008).

Patricia Benner outlines how nurses develop competence in her novice to expert

model of nursing practice. Nurses move through each stage of development –

novice, advanced beginner, competent, proficient to expert through experience and

education. Benner asserts that through each stage, nurses have different

educational needs and respond to strategies differently, which should be taken into

consideration when suggesting CPD activities. For example nurses who are

4

proficient and expert would benefit from CPD that is based on case studies, or given

the opportunity to conduct research on clinical problems (Benner, 2001). Other

considerations include the span of generations that nurses cover, from baby

boomers to Gen-Y, and their perceptions of learning and technologies (Weingarten,

2009). This is potentially a reason why suggestions for CPD activities are broad and

cater to a variety of methodologies.

5

Chapter 2

Review of the literature

What is a Portfolio?

Portfolios have traditionally been used by the visual arts community to showcase

best work; however portfolios are now widely promoted within the nursing arena to

demonstrate 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 and

learning and assessment (Mills, 2009). Presentation portfolios are generally used by

nurses for job applications and promotions. Learning portfolios can be used for

registration purposes and performance appraisals. Assessment portfolios are

commonly used at undergraduate/postgraduate level. Portfolios can be

electronic/web based; also known as e-portfolios, or paper-based.

Whilst many authors refer to assessment portfolios as learning portfolios, for the

purpose of this literature review, assessment portfolios will be referred to in the

University setting, whilst learning portfolios will be referred to from a post registration

perspective.

Presentation Portfolios

Presentation portfolios are usually offered at job interviews, performance appraisals

and for audit purposes. Whilst portfolios ‘promote critical thinking, self assessment

and individual accountability’ (Byrne et al., 2007 p24), careful consideration of what

goes into a portfolio is essential to prevent overwhelming the audience. Portfolios

must be well planned, organised and presentable. There is limited research

evaluating the effectiveness of presentation portfolios, despite the overwhelming

promotion of portfolios in health literature as a standard of practice (Billings, 2008;

Dion, 2006; Johnson, 2002; Meister, Heath, Andrews, & Tingen, 2002; Shirey, 2009) .

6

A study of nurse recruiters (n=34) from Jackson, USA showed that, 26.5% of

respondents believed that professional portfolios were not useful for promotions and

50.2% believed that professional portfolios were not useful in their organisation

(Patrick-Williams & Bennett, 2010). Nurses are encouraged to keep a portfolio for

presentation purposes such as interviews; however there is a distinct lack of

evidence suggesting portfolios are beneficial when applying for employment or

promotion.

Learning Portfolios A learning portfolio’s purpose is to ‘reflect on practice, with the aim of self-

assessment and planning for continuing professional development’ (Mills, 2009

p207). Some Canadian states and the UK (See Figure 1) have implemented learning

portfolios to demonstrate ongoing competence to practice, whilst some hospitals

request a portfolio be presented at their annual performance review (Picton, 2009;

Thomas, 2005; Twaddell & Johnson, 2007). Learning portfolios can include annual

goals and career plans (Oermann , 2002; Shirey , 2009).

Careful selection of evidence for inclusion in the portfolio is advised to ensure that

the piece reflects ongoing competency to the nurse. It is suggested to provide a brief

rationale for why a piece has been included, which competency standard it relates

to, and a reflective component to link a change in practice (Andre & Heartfield,

2007; Billings, 2008; Mills, 2009). Evidence can be collected or reflected upon in

relation to the competency standards, and the identification of strengths and areas in

need of improvement can be highlighted (Masson & Williams, 2008). Cangelosi

(2008, p125) explains that learning portfolios should reflect the ‘acquisiton of

knowedge and the development critical thinking’. Learning portfolios rely on the

process of reflection to implement a change in practice.

The Texas Children’s Hospital in the USA implemented portfolios as it was ‘seen as

a tool to help provide a structure for identifying the strengths and learning needs of

staff’ (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 management

process. Managers felt that the portfolio was a valuable tool to outline professional

activities and development.

The University of North Carolina Hospital in the USA introduced portfolios as a

method of documenting learning experiences and competencies as part of their

leadership classes. There is an emphasis that the portfolio is a learning tool which

can assist in identifying strengths, weakness and encourage reflection. The

participant is encouraged to write a personal statement about the portfolio which

demonstrates integration of knowledge and practice, therefore giving meaning to the

portfolio (Lannon, 2007).

A literature review by Kostrzewski , Dhillon, Goodsman and Taylor (2008) on the

impact portfolios have on a health professionals practice, concluded that the

evidence that a portfolio contribute to practice is limited. More research was

recommended to assess the impact portfolios have on professional practice.

Assessment Portfolios

The concept of portfolio use in the literature is focuses mainly on the use of portfolios

to be used from an academic angle. The use of portfolios has been used in

University education since the early 1970’s (Parboosingh, 1996), however there has

been a renewed interest in the use of portfolios particularly with ongoing

technological advancements and the emergence of e-portfolios. Behind the push for

using portfolios as an assessment based method is the movement from faculty

centred teaching to student learning focussed curricula. Instead of the teacher being

at the podium lecturing, students are now being encouraged to participate in the

learning process (Allen, 2010; Jantzi & Austin, 2002), which correlates with the

principles of adult learning.

8

A review of the literature of portfolios and the assessment of competence in nursing

education in the UK from 1989-2001, showed the use of portfolios to demonstrate

competency was evolving, that reflection was a integral aspect of learning and that

assessment should be qualitative (McMullan et al., 2003). A literature review of

portfolio use in undergraduate portfolio assessment (from all disciplines) showed that

time-consuming portfolios can detract from learning, despite showing improvements

in reflection. They suggest that comparative studies should be considered ‘which

observe changes in student knowledge and abilities directly, rather than reporting on

their perceptions once a portfolio has been completed’ (Buckley et al.,2009 p283).

Whilst portfolios are a useful assessment tool, it must be remembered that ‘a

portfolio is not transparent text through which to see clinical practice. The best place

to see clinical practice is in the practice itself’ (Shakespeare, 2002 p32).

E-portfolios

E-portfolios are at the forefront of innovative nursing education at present with many

Universities taking up this pedological experience. E-portfolios have been a recent

agenda for nursing acedamia and the broader education environment and the

Australian Government. There have been a number of reports and recommendations

in the recent years looking at the use of e-portfolios in the broader context of

universities and education, with much of the background work undertaken by the

Australian Government. They recognise that e-portfolios contain personal

information which may be compromised, therefore the Australian Flexible Learning

Framework was developed to provide national guidelines, functional specifications

and strategies to implement the use of e-portfolios by vocational education and

training networks (AFLF, 2009). Privacy impact statement reports have been

published 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 a

research project to examine the use of e-portfolios by university students. The

Australian E-portfolio Project consisted of four universities; Queensland University of

Technology, The University of Melbourne, The University of New England and the

University of Wollongong. The results of this study highlighted a number of

9

recommendations which focus on encouraging the government sector to promote the

use of e-portfolios to articulate employability skills, encourage life-long learning and

enhance the learning experience (Hallam, Harper, Hauville, Creagh, & McAllister,

2009).

The Queensland University of Technology (QUT) has successfully integrated

portfolios across all faculties with at least 23,000 e-portfolios in use (Harper,

McCowan, Hauville, Moody, & Chorazyczewski, 2007). Also, undergraduate nursing

students from QUT have trialled in the clinical setting, the use of handheld personal

computers to document in their e-portfolios with success, however there were

concerns about the security of the devices (Bogossian, Kellett, & Mason, 2009).

Although many universities are now using e-portfolios as part of their assessment

and learning, access to their e-portfolio may be terminated when the student ceases

their 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 is

transferable. 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 an

understanding 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; O'Malley, 2008).

Portfolios are well established within the academic arena, particularly since the

evolvement of e-portfolios and their technological advantages. Presentation

10

portfolios have received wide input and notice in the literature, however there is a

lack of research supporting the theory that portfolios are useful for promotion and

employment. Learning portfolios are a method that many hospitals and registration

authorities are taking up to assist nurses in demonstrating ongoing competence to

practice. Whichever type of portfolio is used, the principles of adult learning can be

applied as the use of a portfolio encourages reflection, and the responsibility for

learning lies with the individual.

11

Chapter 3

Competence

Competence is a ‘combination of skills, knowledge, attitudes, values and abilities that

underpin effective performance in the nursing role’ (ANF , 2005 p5). Maintaining

competence to practice includes ‘communication…clinical reasoning, problem

solving skills and the ability to have the psychological and social temperament to

adapt to changing environments and conditions’ (Burns, 2009 p222). Whilst many

articles address competence and what it is, in reality it is difficult to assess

competency due to differing skill levels, experience and expectations.

Competency Standards

The issue of competence in nursing has evolved since the 1980’s with the

introduction of entry to practice competency standards (ANF , 2005). The Australian

Nursing and Midwifery Council (ANMC) was established in 1992 to develop a

national approach to nursing and midwifery regulation. The ANMC competency

standards were developed by nurses for nurses to describe the expectations of a

nurse on entry to practice. Competency standards have been developed for

Registered Nurses, Enrolled Nurses, Midwives and Nurse Practitioners (NMBA,

2010b). At least thirty different specialities have developed competency standards in

addition to the accepted ANMC standard, as specific to their practice (Chiarella,

Thoms, Lau, & McInnes, 2008). This idea is based on the idea that the ANMC

competency guidelines are expected by all nurses; however the specialist

competencies can be used in addition to the ANMC competencies (Bryce , 2007).

12

Competence Frameworks

Continuing Competence Frameworks have been developed as a quality assurance

mechanism to protect the public from unsafe and incompetent practitioners (ANMC,

2007). A review of Continuing Competence Frameworks in Australia, Canada, New

Zealand and the United Kingdom, showed a variety of methods of demonstrating

ongoing competence to practice (Figure 1). World-wide in nursing, there are many

CCF’s that are based on self-declaration, CPD and recency of practice. Many of the

models promote a holistic approach, recognising that not one single method

demonstrates nursing competence.

Australia Canada New Zealand

United Kingdom

Recency of Practice

CPD

(AHPRA, 2010)

Self Assessment

Learning Plan

Ontario (CNO, 2010) Alberta (CARNA, 2010b)

Above plus: Recency of practice British Columbia (CRNBC, 2010) Saskatchewan (SRNA, 2010)

Recency of Practice

CPD

Self Assessment

(NCNZ, 2008)

Personal Professional Profile (Portfolio)

Learning Plan

CPD

Recency of Practice

(NMC-UK, 2010)

Figure 1: Continuing Competence Frameworks World-Wide

13

The ANMC developed the CCF (Figure 2) to assist nurses in demonstrating

ongoing competence to practice with the anticipation the framework would ‘become

part of the national suite of professional standards’ (ANMC , 2009 p3). The

components of the framework included assessment, CPD and recency of practice,

all to be documented in a professional portfolio (ANMC, 2009). National Registration

for all health professionals commenced in July 2010, and the role of the ANMC

moved from developing a national approach to nursing and midwifery regulation to

accreditation of nursing education. The CCF was handed over to APHRA; however

the recency of practice and CPD standards only were endorsed.

Component Requirement

Professional Portfolio Electronic or hard copy format to record evidence of each component

Assessment • Annual self assessment of performance

in current role, against relevant ANMC

competency standards

• Annual professional review (PAD)

• Annual self declaration of competence

CPD Annual completion of 20hrs

Recency of Practice

3 months equivalent full time work within the last 5 years

Figure 2: ANMC Continuing Competence Framework

(ANMC, 2009; NMBA , 2010b)

Demonstrating Competence

Self declaration, CPD, recency of practice and learning plans are several methods of

demonstrating competence. This section will highlight some current arguments that

each method has in demonstrating competency, in reference to the competence

model that the NMBA was offered (ANMC-CCF), and the model that was chosen

(CPD and recency of practice).

14

Self Declaration

A study by Pearson & FitzGerald (2001) commissioned by the Australian Nursing

Council Inc. (now known as the ANMC) surveyed nurses opinions on demonstrating

nursing competence. The randomised study was conducted in 1997/1998 were 1005

nurses around Australia responded to a questionnaire surveying nurse’s views on

competency and how nurses should demonstrate competency to regulating bodies.

The study showed that most nurses believed that signing a declaration of

competence (against the ANMC standards) was the preferred method of providing

evidence of continuing competence, followed closely by verifying recency of practice.

The ANF supports this method by asserting that the self declaration of competence

is the most appropriate mechanism to renew their registration. The mandatory model

of competence suggested by the ANMC by linking CPD, minimum hours of practice

and peer review was opposed (Bryce , 2008).

Walker and Godfrey (2008) highlighted the difficulties using the ANMC competencies

to demonstrate competency, due to a lack of knowledge nurses have about the

competency standards. The study of 11 community nurses from Longreach,

Queensland looked at their perceptions of evidence needed to demonstrate their

clinical practice meets the competency standards. The data was collected by

interview and questionnaire and analysed through percentages and content analysis.

Of the 11 nurses studied, three nurses did not know what the competency standards

were. The study identified that and only one participant knew that the competencies

for their particular area were based on the ANMC competencies. The remainder

were aware there were competency standards; however they were unable to identify

how many domains there were or the content of the competencies. This study

shows the self declaration of competence is limited as many nurses struggle to

define how the ANMC competencies relate to their clinical practice, or indeed are

even aware of what they are (Walker & Godfrey, 2008).

Continuing Professional Development Although competence to practice has previously concentrated on entry to practice

nurses, there has been the assumption that nurses would perform CPD activities to

maintain competence; however this has been largely unregulated (ANMC, 2007).

15

The ANMC developed a CPD standard within the CCF, whilst APHRA has endorsed

20hrs per year as the minimum number of hours that nurses must spend on CPD

activities with the advent of National Registration.

The ANF was in staunch opposition of the CPD requirements during the

development of the CCF due to a lack of evidence connecting CPD with

competence. Feedback from the ANF highlighted that some nurses lack access to

CPD activities and that the workforce may suffer if nurses cannot re-register if they

are unable to meet the CPD requirements (ANF , 2008a, 2008b). Yoder-Wise (2006

in Lannon 2007) agree that CPD may not be the most appropriate method in

gauging competence, however it shows that nurses are intent in staying up to date

with nursing knowledge.

Recency of Practice Recency of practice was a common thread of all states in Australia to demonstrate

competency, except NSW prior to National Registration. Although recency of

practice is one indicator of competency, it does not recognise that nurses in current

practice may not be competent to practice. It is recommended that other indicators

are used in combination with recency of practice to monitor competence (Pearson,

Fitzgerald, Walsh, & Borbasi, 2002).

Learning Plans A method of identifying learning needs that has been embraced by Canada, the

United Kingdom and Australia (although not clearly defined as a method of

identifying learning needs for self-directed study), is the learning plan and reflection

on activities. This concept is based on linking competency standards with learning

needs and outcomes.

The use of learning plans and reflection has been criticised by authors Nelson and

Purkis (2004) in an analysis of the mandatory reflection requirements of Canadian

nurses. They argue that the reflective component of the framework ‘radically fails as

a tool for auditing quality and assessing competency’ (Nelson & Purkis, 2004 p247).

Namely because for auditing purposes a plan is only required, with no requirements

of demonstration of that activity. The paper asserts the process of reflection causes

a nurse to ‘routinely scrutinises her skill set, and works to remedy deficits’ as a

16

‘confessional’ (Nelson & Purkis, 2004 p255). On reviewing the College and

Association of Registered Nurses of Alberta’s Continuing Competence Program

audit requirements, nurses are required to submit a questionnaire answering

questions about their participation in the program, learning plans and outcomes-in

the form of a tick box answer (CARNA , 2010). The form however, resembles a

research questionnaire rather than an audit of competency.

The United Kingdom however has a contrasting attitude towards learning plans with

the belief that learning plans help a nurse ‘keep up with new developments in

practice, think and reflect for yourself, demonstrate that you are keeping up to date

and developing your practice and provide a high standards of practice and

care’(NMC -UK, 2010 p3). Examples of learning plans are given to the participant to

gain an understanding of the expectations of the standards.

The end point of a learning plan includes reflecting or evaluating what you have

learnt from that activity. Refection on practice has become a popular method of

demonstrating 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 leadership

through reflection shows emotional intelligence (Horton-Deutsch & Sherwood, 2008)

Maintaining competence to practice as a nurse is an issue at the forefront of nursing

regulation around the world. Various competency frameworks have been developed

in many countries that is centred around recency of practice. A variety of methods

such as portfolio use, learning plans, self-assessment and CPD requirements have

lead to much controversy and discussion; however it is recognised that a

combination of methods is required to demonstrate ongoing competence to practice.

17

Challenges for the Australian Competency Framework

Learning Plans

Nurses in Australia are expected to identify and prioritise their learning needs based

on:

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 are

given as to how a learning plan should be developed or the quality or depth of

reflection that is required. Indeed, one can wonder if the ‘relevant’ competency

standards are referring to the ANMC competency standards or from other relevant

competency standards available to nurses.

A paper written by Campbell and Mackay (2001) from the Professional Practice

Department of the College of Nurses of Ontario, Canada asserts that an effective

professional development program must contain tools and resources to help nurses

maintain 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 plan

on their own’, sums up the experience the NMBA has left to Australian nurses. It will

be interesting to see the quality of learning plans, if nurses feel that the 20hrs of CPD

must be related to the learning plans, and indeed if the learning plans will be

required in the event of auditing at all. o process for audit has been posted on the

website making it difficult for nurses to identify audit requirements and expectations.

18

CPD standards

Whilst the NMBA is attempting to keep the CPD broad and non prescriptive, further

explanation of the CPD standard document may be required. The statement

‘Documentation of self-directed CPD must include dates, a brief description of the

outcomes, and the number of hours spent in each activity’ (NMBA, 2010a), has lead

to confusion and frequent questioning. Exactly ‘what is self-directed learning’ the

author asks? Some colleagues have taken this explanation to mean, that if an

activity was held by an outside source, because it is not self-directed, a learning plan

is not required. To get around this, many nurses will therefore attempt to ‘rack’ up

their 20hrs of CPD requirement by attending in-services and workshops, with little

planning in advance for their learning needs and no reflection.

Portfolios and Competence

Behind the phenomena of portfolio use to demonstrate competence is the notion that

competence can be demonstrated through the collection of evidence and documents

that show ongoing competence to practice. Therefore portfolios are a tool, rather

than a method to demonstrate competence. Some states have previously asked

nurses to keep portfolios to demonstrate ongoing competence to practice (See

Appendix A), whilst others have required recency of practice and self review. The

new NMBA has adopted the CPD and Recency of Practice standards only.

The ANMC (2007) developed the CCF based on the results of a literature review

focusing on ‘Trends in Continuing Competence’. The literature review looked at

current competence requirements in each state from nursing and other professions

such as medicine, law engineering etc. International nursing requirements were also

reviewed focussing on Canada, New Zealand and the USA. It was generally agreed

by many authors that the portfolio was the most ‘effective and appropriate means of

recording the maintenance of competence’ (ANMC, 2007 p30). Some articles have

linked the maintenance of portfolios with the new Australian nursing legislative

requirements, emphasizing the use of the competency standards and reflection

(Masson , 2008; Mills, 2009).

Pearson and FitzGerald (2001 p23) survey of 1005 nurses showed that portfolios

was the preferred method of a nurses ‘ability to provide evidence of professional

19

development’ followed by the combination of a portfolio and a self assessment based

on a competency questionnaire .This is in contrast to the belief that self assessment

is the preferred method of providing evidence of continuing competency as

mentioned earlier.

Much controversy surrounds determining the best method of demonstrating

competence to practice from nursing regulatory bodies around the world. Despite

significant research by the ANMC into to best method of determining competence to

practice, the new NMBA has chosen to endorse the CPD and recency of practice

standards only. Without clear guidelines for nurses to refer to such as the auditing

procedures, nurses may fail in their attempt to meet the new standards as expected

by the NMBA.

20

Chapter 4

Is teaching about portfolios a worthwhile experience for the participants?

As keeping a portfolio is a new concept for many nurses, literature on teaching

portfolios development classes was looked at to ascertain if nurses need assistance

in developing portfolios. Feedback given by participants who had attended classes

on portfolio development and by employer’s feedback was evaluated.

A workshop by Lannon (2007) provided professional development classes for nurses

working at the University of North Carolina Hospital in America, with workshops on

presenting, poster development, portfolios, interview skills and resume writing. The

most popular workshop was the portfolio development workshop which was

designed to prepare nurses for leadership roles beyond clinical expertise. Feedback

by assessors of the portfolios commented ‘there was a definite difference between

the 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 nursing

students in Pennsylvania, America. Feedback by participants included ‘that the

professional portfolio gave them the edge over other candidates’ (Serembus, 2000

p286) which supports the assumption that portfolio development may assist nurses

in gaining employment, however was not backed up with solid research to support

this theory.

Whyalla Hospital in South Australia, introduced portfolios to assist nurses in the

development of nursing skills. Ten senior nursing staff piloted the project with the

challenge ‘to define the purpose of the portfolio, determining what was appropriate

and reasonable to expect of nurses and ensuring the whole process did not become

so burdensome it was rendered insignificant' (Emden , Hutt, & Bruce, 2003 p126).

For the project to work, the nurses decided the journey of self-development was

more important than demonstrating competency. The participants were provided with

a book about portfolios and had a clear objective of relating the portfolio building

experience to their clinical practice.

On implementing portfolios at the Texas Children’s Hospital in the US, feedback from

staff concluded that the long-term benefits were recognised, however compiling the

portfolio was ‘overwhelming for many nurse’s’ (Williams & Jordan, 2007 p129).

21

These types on comments are thematic in many portfolio articles, supporting the

possibility 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 not

confident in preparing or presenting their portfolios despite guidelines being

available. Bower and Jinks (2004) suggest nurses could be mentored through the

process of developing their portfolio. Clearly and Freeman (2005) believe

appropriate resources should be made available to nurses when developing a

portfolio. Workbooks were developed to support life-long learning in clinical practice

which gave guidance to nurses when developing clinical skills. Whilst the onus of

portfolio development is ultimately the nurse’s responsibility, a workbook can assist

in helping nurses develop learning objectives in accordance with departmental goals.

22

Chapter 5

Method

Design, Setting and Sample

The research was a descriptive study to ascertain if it was beneficial to educate

nurses on the benefits of portfolio use. A workshop was designed and implemented

to see if the workshop was a viable project to continue.

Invitations to participant in the workshop were sent to Emergency Department

nurses across two campuses however there was a poor response rate, partially

attributed to previous in-services already held by the author on the same topic. With

the assistance and support of the Nursing Education and Research Unit of the Gold

Coast Hospital, the workshop was opened to all nurses across the district. Requests

to attend the workshop were overwhelming; however participation was limited to 25

nurses.

The workshop was held in the Nurse Education building with 27 participants

attending. 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 and

officiated by the author. Two participants (who had not booked in), came in for the

first two sessions only, and 21 participants completed the feedback form.

The morning covered the following topics:

National Registration

CPD

Portfolios

E-portfolios

Learning Plans

Reflection

Participants were asked to fill out the feedback form honestly and were verbally

advised the results would be used for research purposes.

23

Analysis

The feedback form was the data collection tool used to assess the workshop by

participants. The results were graphed on a ‘helpfulness’ scale, giving participants

five levels to select as well as allowing for comments.

0- Not helpful at all

1- Mildly helpful

2- Helpful

3- Very helpful

4- Excellent

Each session was graphed on a pie chart to show an overall impression if they found

the session helpful in percentage, whilst column graphs were used to show yes/no

answers.

Whilst no cross analysis was undertaken comparing if participants usually gave a

particular 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 overall

rated as mildly helpful.

24

Chapter 6

Results

Introduction and National Registration

This session focussed on introducing the workshop and highlighting the changes that

National Registration will bring to nurses in Australia. General housekeeping issues

were 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 brief

background of how and why National Registration was brought about and the five

new registration standards were discussed.

Results

Figure 3: Introduction and National Registration

Comments 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.

5%19%

43%

33%

Introduction and National Registration

1-mildly helpful 2- helpful 3- very helpful 4- excellent

25


This section discussed the CDP requirements of National Registration and the

documentation required in the event a nurse is audited. Examples were given of

different types of CPD and documentation templates.

Results

Figure 4: Continuing Professional Development


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.

5% 5%

38%52%



26

Portfolios

This session looked at different types of portfolios and how to compile one

depending on the audience looking at the portfolio. In preparation, several portfolios

where designed to show different types of portfolios, and participants were

encouraged to look at these during morning tea. A teacher kindly let me show her

portfolio to the group.

Results

Figure 5: Portfolios


Hearing about types of portfolios and their uses.

Having the opportunity to look through portfolios was very useful.

Provided info, examples +broke it down.

5%14%

33%

48%

Portfolios


27

E-portfolios

This session discussed the potentials for storing portfolios online. Examples of

several e-portfolios were given and the benefits/problems were discussed.

Results

Figure 6: E-portfolios


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.

9%

38%

10%

38%

5%

E-portfolios

1-mildly helpful 2- helpful 3- very helpful 4- excellent 0- not helpful

28

Learning Plans

This interactive session dived participants into groups after showing them how to

write a learning plan. Although mostly rated as excellent, most participants had

problems grasping the concept of linking the ANMC competencies with learning

plans; however most participants had a good understanding of how the

competencies related to their work. Example of learning plans from Canada and the

UK were given out in the handouts and referred to.

Figure 7: Learning Plans


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.

5%

33%

19%

43%

Learning Plans


29

Reflection

This session talked about reflection in five steps. Participants were then encouraged

to discuss in groups reflection situations. Whilst participants were advised not to

discuss emotionally disturbing situations that may upset them, most concentrated on

positive outcomes, rather than negative.

Results

Figure 8: Reflection


Re-capped prior learning.

Good until exercise.

Good exercise.

Good group activities and examples.

5%

29%

33%

33%

Reflection


30

Have 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 NZ

or the UK have had previous portfolio use.

Figure 9-Previous portfolio use

Would 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 setting

one up.

Figure 10- E-portfolios

n=3

n=16

n=2

yes no no answer

Previous portfolio use

0

2

4

6

8

10

12

14

16

yes no maybe no answer

interested in e-portfolios?

need help setting one up?

31

Did you find the handouts helpful?

Figure 11- Handouts

Comments:

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.

20

1

yes no

Did you find the handouts helpful?

32

What could have been improved?

Several participants suggested more visual examples of portfolios and learning

plans.

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.

33

Overall satisfaction

All scores were graphed to show an overall satisfaction rating. Most participants

(40%) gave the workshop an ‘excellent’ rating.

Figure 12- Overall satisfaction

17

28

38

52

0 1 2 3 4

0- Not helpful at all, 1- Mildly helpful,2- Helpful,3- Very helpful, 4-Excellent

Overall satisfaction

34

Chapter 7

Discussion

Competence

The hypothesis of the study was to identify if teaching about portfolios was beneficial

to nurses. The initial idea to develop the workshop was based on the idea that the

ANMC CCF would be implemented with the advent of National Registration;

therefore maintaining a portfolio would be mandatory. However, as only the recency

of practice and CPD standards were endorsed, there was a change in focus. This

lead to the author asking what is competence and how is it demonstrated?, which

was explored in the literature review.

Much of the literature review focuses on competence in nursing with reference to

CCF’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 Australian

nursing community. Due to a lack of explanation and direction it is anticipated by the

author that nurses will have difficulties in developing a learning plan as expected by

the NMBA. Even though the concept of learning plans was explained and examples

given, nurses still found it difficult to write a learning plan in relation to the ANMC

competencies during the workshop. Perhaps it would be wise of the NMBA to review

the UK model- PREP handbook (NMC-UK, 2010) to assist in developing guidelines

for developing learning plans.

Workshop

Much of the interest in the workshop was centred on learning what was expected for

registration purposes. This is why it was decided to open with the background of

National Registration and the mandatory standards. One participant believed that

‘this information should be shared with all nursing staff, perhaps make it part of

mandatory skills’. The most successful session of the workshop was the CPD

session which 52% of participants giving it an excellent rating. E-portfolios generated

attention with 76% (n=16) of participants interested in starting an e-portfolio.

Most nurses in Queensland have not had exposure to portfolios unless advocated by

their hospitals or from living in states or countries that require one for registration

usage. This was confirmed by the response rate that only three participants had

35

used portfolios in the past. Overall, it was found that 40% of participants rated the

workshop as excellent, which confirms the hypothesis that teaching about portfolios

is beneficial to nurses.

Whilst no literature was found specifically reporting feedback from a workshop on

portfolios, a paper from Lannon (2007) reported that the portfolios workshop was the

most popular class of five leadership classes, with assessors noting the benefits of

portfolio development. The results of the feedback on the portfolio workshop show

that whilst portfolio development is a worthwhile topic to explore, research is lacking

in the experience of being taught portfolios. There is a large amount of literature

relating the student’s experience of assessment portfolios; however no feedback on

the actual learning experience (i.e. learning about portfolios) was noted.

Recommendations

The impact of nurses using e-portfolios as an option supported by APHRA would be

useful to nurses and the Nursing and Midwifery board alike. APHRA could outline

clear 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 portfolios

could be transferable between employment as the system would be Australia wide,

rather than hospital or university dependent. The use of an e-portfolio could be

absorbed by registration costs or an additional optional fee. Privacy and

confidentiality notices could be set into the templates, as well as assuring nurses that

access to their site by APHRA would not be undertaken unless permission given.

Whilst portfolios are recommended for nurses to use, there is very little research

backing up many of the claims made. Research looking at the following questions

would be beneficial in establishing the usefulness of portfolios and assist the

competency 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?

Conclusion

Nurses can choose to maintain a portfolio for a variety of purposes such as

demonstrating ongoing competence to practice, evidence for job promotions or for

assessment purposes. There is a lack of evidence to suggest that portfolios are

beneficial when applying for employment or promotion despite a overwhelming

amount of literature stating it is advantageous. Assessment portfolios are well

ingrained in the academic arena to show ongoing learning and reflection. As portfolio

use may be new for many nurses, and potentially overwhelming the literature

suggests that a workshop to teach nurses about portfolios may be appropriate and

helpful.

Countries such as Australia, Canada, New Zealand and the United Kingdom have

defined 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 of

discussion and controversy. Some hospitals around the world are now asking nurses

to maintain portfolios to demonstrate nursing competency, and to provide evidence

in performance reviews. The new legislative requirements as expected by the NMBA

of 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 have

yet to be made public.

37

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41

Appendix

42

Appendix A: Portfolio and CPD requirements

Australian States Portfolios requirement CPD requirements

ACT (ACTNMB) Yes 10 hours per year

NT (NBT) No No

WA (NMBWA) Yes 20 hours per year

QLD (QNC) No No

SA (NBSA) No No

TAS (NBT) Yes Yes (?hours)

NSW (NMB) No No

VIC (NBV) No Yes (?hours)

National Registration No 20 hours per year

(ANMC, 2007)

43

Appendix B: Workshop Objectives and Learning Plan

Time Learning Objectives

Teaching Method Outcome and Evaluation

0800-0830

Topic: Welcome and Introduction to National Registration Housekeeping i.e. toilets, fire escapes, outline of the morning and importance of feedback. Students to demonstrate an understanding of recent changes that will affect their nursing registration.

Health Practitioner Regulation National Law

Act 2009

Australian Health Practitioner Regulation

Agency.

Nursing and Midwifery Board of Australia

National Registration Standards

Rationale:

Introducing the national registration expectations

will provide the background evidence to why

developing a portfolio is desirable.

PowerPoint presentation Interaction: Asking questions to ascertain participant’s level of knowledge throughout the presentation.

Student will be able to identify and compare changes by being able to answer the following questions:

What were the previous Nursing Act and the new Nursing Law?

What governing body were QLD nurses under, and what governing body are all Australian nurses under now?

What are the new national registration standards?

Score and comments from feedback

form

44



0830-0900

Topic: Continuing Professional Development (CPD)

The participant will be able to outline

expectations of CPD and be able to discuss the

different types of CPD that can be undertaken.

Rationale:

Outlining the CPD requirements will support the use of portfolios as a portal to document hours

PowerPoint presentation Interaction: Participant to list different CPD activities on white board

The participant will be able to discuss what types of activities constitute CPD. The participant will be able to state how many hours of CPD are required each year. Score and comments from feedback

form.

45



0900-1000

Topic: Portfolios

Different types of portfolios will be discussed and typical content. The participant will engage in the compilation of their portfolio. Rationale: Bringing the portfolio to class will encourage nurses to commence the compiling of the portfolio.

PowerPoint presentation Interaction: The participant will bring their portfolio and documents to the class and receive assistance with construction and feedback

The participant will be able to discuss the differences between a resume and a portfolio. The participant will be able to outline the components of portfolios. The participant will be able to describe the different applications of portfolios.

Score and comments from feedback form

46



1020-1035

Topic: Eportfolios

The participant will explore the options of an

internet based portfolio.

Rationale: Nurses can document their CPD hours in any form (not specified by the NWBA).

PowerPoint presentation Interaction: Participant will be shown an e-portfolio of a nurse and be able to navigate through the site.

Participant will be able to locate resources on the internet that could assist them in developing an eportfolio.

Score and comments from feedback

form.

47



1035-1115

Topic: -: Competency Standards

The competencies which make up the ANMC Competency Standards for Registered Nurses are organized into 4 domains:

Professional Practice

Critical Thinking and Analysis

Provision and Coordination of Care

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.

PowerPoint presentation Interaction: The class will be divided into four groups and discuss how each of the domains pertains to their own practice. The groups will then present which types of CPD will assist them in meeting their learning goals.

The participant will be able to

write a learning plan for the

year which pertains to the

ANMC competencies.

Score and comments from

feedback form.

48



1115-1155

Topic: Reflection

The participant will be able to explore and apply the principles of reflection to clinical situations. Participants will be able to link the ANMC standards to everyday nursing practice. Rationale: Reflection links theory to practice which leads to an improvement in practice. Reflection will also help identify learning needs.

PowerPoint presentation Interaction: Participants are to anonymously state on two different pieces of paper, a strength and a weakness in their nursing practice. The facilitator will then encourage group discussion to apply the principles of reflection to each situation.

The participant will be able to write a reflective piece of writing linking how the ANMC competencies affect the situation.

The participant will be able to identify learning needs for the year by reflecting on their own practice.

Score and comments from feedback form.

49



1155-1200

Topic: Summery and Feedback

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.

PowerPoint presentation

Score and comments from feedback form

50


25th August 2010Time: 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 [email protected]

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’.

Gold Coast Health Service District

Nursing Professional Development

Appendix C: Professional Portfolios Flyer

51

Gold Coast Health Service District

Statement of Attendance

Name

Attended the


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 McShaneClinical Nurse

7

CNE

Points

Appendix D- Certificate of Attendance

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 Feedback

Have 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/NO

If so, do you think you would need help setting one up? YES/NO

Did you find the handouts helpful? YES/NO

Any additional comments would be appreciated______________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

53

Appendix 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

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

Appendix G: Agenda

55

Appendix H: PowerPoint Presentation

Presentation will be attached to the thesis submission.

Photos taken during the workshop.

Below: Identifying learning

opportunities in relation to the

ANMC standards.

56

Appendix I: Optional Survey

An optional survey was developed to gain insight into potential topics of interest if the

workshop was to run over a day. Forteen particpants choose to complete the

addditonal optional survey.

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.

0

2

4

6

8

10

12

14

1 2 3 4 5 6 7 8 9 10 11

Part

icip

an

ts

Questions

Optional Survey

57

Appendix J: Conference Abstract and Autobiography

Conference Presenter:

E-portfolios Australia Conference 2010 (EAC2010)

3-4th November, Melbourne Australia

Abstract

Jo-Anne McShane Clinical Nurse Emergency Department Gold Coast Hospital, Queensland

Nursing and e-portfolios: 2 steps forward, 1 step back

The Australian Nursing and Midwifery Council recommended that all nurses should maintain a professional portfolio, which many states mandated as part of registration. National Registration for nurses commenced this year; however the new registration standards do not include the maintenance of a portfolio. This is potentially a backwoods step in the demonstration of competence for nurses, which had already been 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 and promotion purposes. This presentation will highlight the mission of one nurse to introduce e-portfolios to the Emergency Department and if it was a success or failure.

Recommendations will be made that may assist the e-portfolio community in understanding and developing strategies to help the everyday nurse embrace e-portfolios as ‘the way of the future’, remembering that learning does not stop once a person leaves the classroom.

Autobiography:

Jo-Anne works at the Emergency Department at the Gold Coast Hospital and has been a nurse for 13yrs. Passionate about nursing excellence, Jo-Anne has been teaching about portfolios and is writing her Master’s thesis on ‘developing a workshop to educate nurses about portfolios’.

Jo-Anne’s work place is already using the internet to store continuing professional development details, however she believes there is room to improve by creating a personalised e-portfolio account within the system.