Performance Based Development System (PBDS) - page 4
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... Read More
Feb 4, '11**** posted a thread about the PBDS she recently took. The posting is no longer available. I would appreciate hearing about your experience. Could you post it again so all of us who are preparing for the exam could learn from your experience. Thank You for taking the time to help the rest of us.Last edit by VickyRN on Feb 5, '11 : Reason: removed poster information
Feb 4, '11Quote from dwrobleskiIt is against copyright laws for the PBDS for anyone to give out information about this test after taking it. To request such information is also considered an illegal activity. Thank you for respecting the copyright laws concerning this test.***** posted a thread about the PBDS she recently took. The posting is no longer available. I would appreciate hearing about your experience. Could you post it again so all of us who are preparing for the exam could learn from your experience. Thank You for taking the time to help the rest of us.Last edit by VickyRN on Feb 5, '11
May 25, '11I took the PBDS test- the ICU one today and failed it. What I don't understand is why they gave me the ICU version instead of the med/surg version? Granted, my I would have been assigned to PCU for post op bariatric patients. But how could I possibly know whtat ICU does. I tried being very thorough, bt ICU and Med/surg are .different I talked to the recruiter to see if I can take the Med/surg one and she says they dont normaly do that. But I think at least try. Any comments or advice would be appreciated!!
May 26, '11i believe this is yet another example of the highly educated/degreed nurse who has been away from the bedside too long trying to tell bedside nurses how to do their jobs...and hospital administrators love this stuff. Without really examining the testing tools they jump on the bandwagon so they can promote how innovative they are in implementing new tools to keep nurses up to date and educated etc. etc.,, blah, blah blah.....in reality, having educators for departments and using experienced staff to train and evaluate nurses is really the best option. I can tell by having a conversation with a new traveler whether or not she/he is worth a flip...and i don't need to administer any test. Just by the content of conversation of a group of nurses you can tell who know what the heck they are doing and who doesn't. And most times everybody in a unit KNOWS the folks that need to be refreshed, updated, re-educated or whatever. And in a group with strong minded people like the ICU settings peers usually have no problem telling each other or going to management about an unsafe employee. I don't care what the traveler really scored on her assessment test. All I want to know is that when I'm in a sticky situation they will know what to do to help me out. Whether or not they have team building/player skills is one thing when you are sitting around chatting or need help changing a bed full of poop, but when it's crunch time, I don't know many true ICU nurses that will not jump in and help whether they like the team member or not. And if they can jump in and help out in critical situation that tells me the have critical thinking skills....some people are not test takers, especially the kind of tests that are trying to trip you up so the author can prove how great the program is by "weeding" out all these bad nurses. Its a shame actually that nurses feel the need to do that to others in their profession. After all we all started wearing little white uniforms and shoes and scared to death of our first clinical rotation. Just because some choose to become Masters and others prefer to stick with the heart of true nursing at the bedside doesn't mean the Masters prep nurse is a better nurse when it comes down to what nursing truly is. There are many nurses I've known over the years who were LVN's that I would prefer take care of my loved ones than if the MSN educator or manager came to the bedside and said I'm going to be working on the floor today and I'll be your nurse..!!!! AAhhhhhh!!!!
The point is that we have got to stop this nonsense of competition between the "classes" in our profession or we will continue to make less money, have less benefits and have less say in our daily work routine than other Professions. Let's just all play nicely in the sandbox and try to help other nurses rather than show off their flaws so we can look smarter...
May 26, '11I really appreciate your input on this issue. I understand exactly where you are coming from. As of today, 2 recruiters are contacting the hospital that did this and ask why I received the ICU "competency exam" instead of the med/surg which is my background. I spoke with a large agency today, and they had just had a meeting, in which they decided to no longer send their staff to this hospital because of the problems this "wonderful" test is causing. They also said, it is NOT an indicator for how well the nurse will do. All it does is prove they can take a test. If you fail that test, you are considered "unsafe"...well heck yea I would probably be "unsafe" in a way if I walked into an ICU to work without any training. And that is another issue. The hospitals dont want to "waste" their time educating a traveler, or agency nurse. They can't see the forest for the trees. They want improvedments in patient care, and yet they cut off their nose to spite their face!
That is something I complete don't understand. If you are in the profession for the right reasons, then I would think if you have a travel nurse that comes to work in a facility on a NEED basis, that the hospital would be more than eager to help this nurse if she wants or needs to learn some things. That is the type of action that makes nursing better for everyone.
So what this boils down to is the test results stated the obvious; I failed the test because I am not (as of yet) competent to work in an ICU ( and I wasnt applying for an ICU job Grrrr). well they could have saved 150.00 and just asked me! I am competent in Med surg/tele and that is all so far!
After this ordeal, I have made a decision to NOT even consider working at a facility that uses this test to hire and fire job candidates. And apparently, agencies are trending towards this as well as nurses!
Nov 16, '11Vicky RN,
This is the first time I heard of the PBDS. Some of my friends in NY usually take a pharmacology/med math exam. Then,Depending on the unit he or she is given a tailored competency test. I am not sure if that the PDBS, but I will find out additional information and let know. This article was very informative and shocking at the same time. We have become a society of evidences-based practice. If research doesn't back of Del Bruno PBDS---why is it still in use???
Nov 2, '12The only things we know (and read the specific language I use): PBDS- scoring well can possibly mean you are a good nurse, but I'm sure there are nurses with poor knowledge who pass. Scoring poorly does not necessarily mean you are a bad nurse.
I can understand about ADD making this test difficult.
Hospitals are giving this test to travelers before they can work. The hospitals that would send a nurse home for doing poorly are catching on to the bad press and dismissing them passive-aggressively. Some states have the legal right to dismiss anyone for any reason--except discrimination of women or minorities. These travelers came to their city at some personal expense and time expense. Read this, Hospitals: It is unethical to send someone home based on these criteria. I would not trust my loved one in a hospital that would do this to people. The PBDS test has to be given by the hospital and they do not have permission to proctor it out to different cities. If you are going to do this, find a way to do the "right" thing and test people in other cities before they travel. It is wrong to have them travel, then dismiss them based on a test. Even if you no longer fire nurses based on this test, you will judge the person based on the test. Great foot to start off on for a nurse. Do the right thing and find a way to test in other cities.
To anyone thinking of travel: hold these hospitals to a standard. Voice a concern with testing after a nurse travels. Even if one is a poor nurse with poor knowledge, they deserve the right not to be sent home after traveling to a hospital. Education departments: you can be as militant as you want to about flushing out bad nurses..or you can have a real nurse's attitude as one who builds other people up instead of tearing them down. Be someone who shares knowledge and helps the profession rather than damaging the profession. If this test is a reliable indicator of a quality nurse, the nurses should be drilled and trained in this exact method. Otherwise, you're puffing your chest out and being vindictive. This kind of bravado has got to end in nursing, or we will always be fighting for status.
Feb 22, '14I find it interesting that two of the three research references are by del Bueno. I'm curious as to her background. My institution consists of five hospitals in southwest Florida and subscribes to PBDS. I've known nurses, as you have stated, who are exceptional but have had difficulty with PBDS, thusly have had to jump through all manner of hoops to secure and maintain employment. Conversly, I also know of nurses who exhibit poor skills and nursing judgement that have sailed through PBDS. Until otherwise proven a reliable tool, I'm of the mind that PBDS is just another fad.
Feb 25, '14I just love it when a PBDS discussion surfaces... same arguments every time.
I work with a very large health care system. We have used PBDS for a Loooooonnnggg time. We have sufficient evidence to support continued use. It adds enormous value to our onboarding process. It enables us to identify performance gaps that need to be addressed - or to see that someone is "good to go" and only needs to become familiar with our P&P.
Dr. del Bueno is retired from day-to-day operations, but the company has stayed true to her model. Materials have been updated to please folks that don't realize that basic concepts are unchanged even though the 'look' may be dated. Since the assessments are rated by actual human beings, we are able to customize so that the 'satisfactory' responses are congruent with our organizational standards.
Our multifactorial data provides evidence (replicated this each time a hospital joins our organization) that PBDS is instrumental in reducing clinical error due to nursing practice problems. It also has an 'incidental' effect of reducing turnover that we see ~ 24-30 months after a facility begins to use PBDS.. the effects of improved onboarding & providing clear pathways for competency.
Competitors to PBDS have come and gone. They try to replace the human (highly trained) raters with software algorithms & it doesn't work. Participants are asked to view a 3-5 minute video of a clinical scenario and describe what it is, what they are going to do, why they are going to do those things, and what they should do first. Not very difficult - none of the scenarios are uncommon. The human raters base their ratings on the individual's background - for instance, a new grad is not expected to anticipate physician orders in the same way that an experienced nurse would.
BTW, there are NO multiple choice or any other forced selection items in a PBDS assessment. Everything is free text - 'downloaded' from the nurse's brain. This alone is a very scary thing for a lot of people.
The effectiveness of PBDS can be derailed by a lack of organizational commitment to the competency development process. If they do not provide adequate educational resources, sufficient numbers of trained preceptors, and attentive managers... it will likely become just a 'flavor of the month' that is quickly abandoned in favor of the next greatest thing.
Feb 25, '14I respectfully disagree with my houtx colleague above. I have also worked in facilities with PBDS and as a director often had to step in to " save" excellent staff who would have been terminated due to PBDS performance. I am a masters prepared nurse with published articles in decision-making. I have to wonder how cueing, past experience ( both as a nurse and in test- taking) come into play. I alsowonder if outdated scenarios create cognitive dissonance in answering situations. i have read, and respect, much of Delbueno's work....her testing program, no so much.
Oct 9, '14I was offered a job recently at a hospital where I had completed numerous travel contracts. I was tested by my agency using the Prophecy testing. As a new hire by the hospital directly, I was given the PBDS test. They did not like my results and want me to repeat it,
If they thought I was so "dumb" why were they always renewing me and asking for FT hours on my contracts? Registered Nurses need to smarten up and SUPPORT each other instead of stabbing each other in the back!
Del Bueno is just that. A woman with lots of alphabets behind her name, Why the PhD? She might as well just go to Medical School!
The sooner I can retire from nursing the better. I want peace. Costco pays well and has excellent benefits and incentives.