Performance Based Development System (PBDS)

Few subjects have stirred up as much controversy within the nursing community as the Performance Based Development System (PBDS) nursing "competency" assessment. What exactly is this test and why is it so controversial? Specialties Educators Article

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VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
The other "oddity" with PBDS is that it was designed by a Dr!

Del Bueno is a doctor - she has a PhD in nursing. She is not a physician, but a doctorally-prepared nurse.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
I had to take this for my first (so far only) travel assignment. I did not do well (I flunked) I have A.D.D. and was given special testing considerations in nursing school (timed tests are given differently) as well as on the nursing boards. I was an A student in school and passed the NCLEX with the minimum number of questions. As a traveller, I was given no recourse and my agency discouraged me from claiming discrimination (I told them before the test I was worried about the testing format). I did get another assignment (worked per diem and finageled a contract) but will never be tempted to try the PBDS ever again. It is a dysfunctional test that only certain people will pass and it has nothing to do with competency. If someone passes the NCLEX in the last year or so but fails the PBDS, what does that say about the NCLEX? Which test is more valid? As for the question about the staff nurses taking the PBDS, I've heard if they fail, they have to take "remedial nursing" (orient until they pass; they may stay on orientation for six months or more!) and frequently, the person orienting them still doesnt' know how to help them or even address it! The people who grade these tests can be anything from HR (not a nurse at all!) to someone who grades these, but hasn't done floor work in years. I went to a university nursing program instead of online because I was afraid of being graded by someone who didn't know me and who I didn't know.

Thank you for sharing about this test. Sounds like a very humiliating experience.

TechieRN

9 Posts

Specializes in CVICU.

FYI ...... :nurse: :twocents: :banghead: B/4 I get my two cents out ...please be aware that I'm an older "newer" nurse with a background in IT and business who went back to school (BSN) at a major university to go ALL the way through a traditional program b/c I value my education and it's results in my practice in the clinical setting. I am an older individual (life's experience should rate for something right??) ..... so please be informative and kind when responding :nurse: b/c this nurse cratchit WANTS to know what she did wrong - why and how I can do it better for the individual(s) I'm caring for..... (what WAS I thinking when I invested that 50 grand???)............

Ok - I've got 2 years experience in cvicu with great background in cardiology. Now I'm called by an agency to interview ....three interviews later they make me go through REPEAT ACLS classes (my certification was good) AND they make me take myriad tests online from nursetesting.com. I was not notified of the "time" element in the exams and was in a hurry to get ....yet another exam out of the way to get some work in (some of us need to work to support our hips - ok, that was sarcastic - I have basic rent to cover as a single mother).

So I hit the test, take it and then it shuts down on me. I am told that they will "put it up again" it must have been a malfunction. So I take it and pass it (ccu) at over a 90% scoring.

Next day I take the cvicu test and pass it at 75% and am told after doing everything necessary for the "agency" (Jacho certified) that I failed the 2nd test .....even after passing the previous 5 tests that they've given me: Core mandatories for 2009 and 2010....then other "specialties". They then inform me that they will "go over the missed questions with me"; and everything will be "ok" to work for them.

Then - I get a call from them and THAT person tells me that she doesn't "know anything" and will have to have someone from the testing agency call me to discuss the "missed questions" with me. The questions were ambiguous and frankly I was so disturbed by some of the obvious mistaken questions that I reached out to two other icu nurses, a 25 year cvicu nurse still in practice and our "go to" person ....and a physician (trauma doc who teaches for the major university's medical school and is still in practice) to go over the "missed questions" with me. WOW .... scary was the over-riding response.

Scary for me b/c I value my learning b/c of the level of compassionate skilled care that I provide (and want to continue) and scary b/c I felt the 2nd person at the agency was putting me off.... particularly when I read on the website that they do not "remediate". YIKES ..... what in the world is up with these "competency exams" - Really???

Could anyone help? The testing site states that I passed the CVICU exam but the agency has told me that they need an even higher score to put you in the field - even after they "hired" me and made me go through a not-necessary ACLS class. I'm frustrated - menopausal and confused :scrying: Can anyone help?? :bow: I'm headed for the quart of ice cream looming in my freezer as I'm told that they will get back with me "sometime soon".............:hug:

Specializes in criticalcare, nursing administration.

I was extremely unimpressed with the use of PBDS at my last hospital worked. Staff identified outdated content and questioned it's value. In addition, orientees on several occasions had difficulty with PBDS despite performing extremely well during orientation. Others doing poorly in orientation sailed through PBDS. I agree with the comments above requestion validation of this 'dated' method of assessment....

TechieRN

9 Posts

Specializes in CVICU.

One of the questions was as simple as:

After extubation, your pt is assessed for s/s of upper airway obstruction. This is a concern b/c the narrowest part of the airway is the:

a. trachea

b. larynx

c. esophagus

d. bronchii

Anyone care to answer that question? .....

MaritesaRN

427 Posts

Specializes in psychiatric, UR analyst, fraud, DME,MedB.

I am not a cardio nurse , but the narrowest part shoud be the :confused:larynx?

Specializes in criticalcare, nursing administration.

Scary, isn't it? Also cardiac scenarios where you were supposed to request lidocaine for dysrhythmias.......

nursetime

1 Post

The test you took is from nurse testing and is not PBDS. So why not take your complaints with the right company

TechieRN

9 Posts

Specializes in CVICU.

I was "seeing" them as an overview nursetime - as in "competency exams" which are various exams (similar formats). I wasn't addressing them from a company based perspective ... is there some reason why you feel it

should be addressed somewhere else ...and why that might be? I didn't do a search under testing companies or nursetesting.com and I take no issue with them as a company. As I understand it (and I'm always open for correction) they are simply another company that uses competency testing in an online/computer-based format.

lamazeteacher

2,170 Posts

Specializes in OB, HH, ADMIN, IC, ED, QI.

After 50 years in nursing, I want to share with y'all, that things come and go in the medical worl, except for the needy constantly excreting patients.....

This month's competency tests are tomorrows deletions..... However in the interest of having the most competent nurses in the world, we lose many nurses whose skills aren't measurable but bedside competence is appreciated beyond belief, by patients.

As soon as anyone graduates from a master's program, their brainchildren that took up reems of paper and countless trees, are put to the reality test and (almost always) found wanting...... :smackingf

The tried ands true test of competence is time, within which the most important nursing measures are done reasonably correctly, in a timely manner without offending anyone's "sensibilities" too much (which most of those tools do), or making too many errors, especially the lethal ones. :thankya:

Newreturn

2 Posts

Hello, the posts are helpful and I'm hoping the study guide for the PBDS is going to help. I'm a re-entry nurse and have been out of the hospital for almost 13 years. The re-entry review was completed in 08 and it's taken a while to find a job. I don't test well and am very nervous and anxious about this PBDS as it takes 6 hours? I'm reviewing like crazy and my experience is 13 years old too. Any advice? Am I to diagnosis and write a care plan? I've read where I'm to prioritize interventions with rationale behind for what I am to do first, within my shift and then later on. I've also read where nurses with much more experience than me fail it. Oh my....any suggestions on what else to study? review? Thanks so much!

dwrobleski

3 Posts

I am studying to take the PBDS test. I've read where I'm to prioritize interventions with rationale behind for what I am to do first, within my shift and then later on. I have practiced what I would type if I was to diagnose a problem. I have practiced typing what assessment I would do, listing nursing interventions, call the doctor, antisipate orders and treatments. It is taking about 9 minutes on average to type this information for a given diagnosis. I don't see how I would have time to also type the rationale for nursing assessment or interventions. For example: confusion, anxiety and restlessness could be a sign of hypoxia. If I have to give the rationale for everything that I assess for, I want have enough time to type everything. I would appreciate any help that you have to offer. Thank You