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

Performance Based Development System (PBDS)

Performance-Based Development System (PBDS) is the creation of Dorothy del Bueno, the founder of performance management services. PBDS is a commercial competency exam that can be individually tailored to evaluate hospital personnel. In practice, it is almost exclusively used to test the competency of nurses. At least 500 hospitals nationwide currently use the PBDS system.

The test can address one of four nursing specialty areas: medical-surgical, critical care, neonatal ICU, and OB.

Within the designated specialty, a variety of methods are used to assess competency in three key areas: critical thinking, interpersonal relations, and technical skills.

The vast majority of the assessment addresses critical thinking skills. Short video clips ("vignettes") are used to portray abnormal clinical situations (such as a case of digoxin toxicity or a blood transfusion reaction). The nurse examinee is expected to deduce the probable medical diagnosis and then decide what nursing interventions should be immediately performed.

del Bueno defines four components for interpersonal skills: conflict resolution, customer relations, team building, and issue versus content. The nurse is asked to write responses to such problems as: (1) a patient says to you, "I don't want that nurse to take care of me" (customer relations); and (2) the physician tells you, "add 80meq of potassium chloride to present IV bag" (conflict resolution).

The PBDS is used mainly for two purposes: to facilitate orientation of new nurse hires by pinpointing areas of weakness for remediation and to "weed out" suspect travel nurses. For travelers who score less than satisfactory on the PBDS examination, participating facilities generally do not give a chance at remediation. Travel nursing contracts will then be canceled, which can be very costly financially and emotionally devastating for the agency nurse.

del Bueno's method of assessing "critical thinking" in nurses has never been satisfactorily shown to be valid and reliable. The PBDS website makes frequent mention of "research," but fails to offer documentation for critical appraisal of the PBDS method.

These few "research" references are:

Whelan, l. (2006). Competency assessment of nursing staff. Orthopaedic nursing, 25(3), 198-202.

del Bueno, d. (2001). Buyer beware: the cost of competence. Nursing economic$, 19(6), 250-257.

del Bueno, d. (2005). A crisis in critical thinking. Nursing education perspectives, 26(5), 278-282.

The need to critically appraise a nurse's critical thinking ability and competency (as discussed in these articles) is indisputable. However, I know of no research that backs up del Bueno's method as an accurate appraisal of the above.

There are many nurses with years of experience and otherwise stellar work records who score poorly on this test. Until adequate validation by research is provided, there will always be controversy and a big question mark surrounding PBDS. Also, the use of the "medical model" and requiring nurses to make "medical diagnoses" is troubling.

Here are some valuable resources concerning the PBDS assessment

PBDS corporate website

Cross-country staffing guide to PBDS

Freedom healthcare PBDS test & study guide information

HRN performance based development system study guide

PBDS sample exam

Clinical one resource on PBDS

PBDS information (need to register to receive this one, but registration is free)

Reference

Tong, V., & Henry, D. (2005). Performance-Based Development System for Nursing Students. Journal of Nursing Education, 44 (2), 95-96.

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VickyRN

About VickyRN, MSN, DNP, RN

VickyRN, PhD, RN, is a certified nurse educator (NLN) and certified gerontology nurse (ANCC). Her research interests include: the special health and social needs of the vulnerable older adult population; registered nurse staffing and resident outcomes in intermediate care nursing facilities; and, innovations in avoiding institutionalization of frail elderly clients by providing long-term care services and supports in the community. She is a Professor in a large baccalaureate nursing program in North Carolina.

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del bueno's method of assessing "critical thinking" in nurses has never been satisfactorily shown to be valid and reliable. the pbds website makes frequent mention of "research," but fails to offer documentation for critical appraisal of the pbds method.

there are many nurses with years of experience and otherwise stellar work records who score poorly on this test. until adequate documentation is provided, there will always be controversy and a big question mark surrounding pbds. also, the use of the "medical model" and requiring nurses to make "medical diagnoses" is troubling.

yes, yes , yes!!!

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Specializes in Cath Lab, OR, CPHN/SN, ER.

*Mental note to remember to reference this when people ask about it in the NC forum!*

I've been talking to my husband about it, since we're moving back and we'll both have to take it. It'll be his first time, and my second time!

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Specializes in Gerontological, cardiac, med-surg, peds.
*Mental note to remember to reference this when people ask about it in the NC forum!*

I've been talking to my husband about it, since we're moving back and we'll both have to take it. It'll be his first time, and my second time!

Glad this has been helpful to you. Please let us know your experiences with this exam. Hope you both do well.

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Specializes in Medical Surgical, Telemetry, Psych.

VickyRN,

Thanks for an informative article on PBDS. They have competition in the hospital market, and we have been asking to see their data (to back up their claims), or at least show it to their clients, so they know the methodology on how the content/assessment was created.

Best regards,

Ron

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Specializes in Gerontological, cardiac, med-surg, peds.
VickyRN,

Thanks for an informative article on PBDS. They have competition in the hospital market, and we have been asking to see their data (to back up their claims), or at least show it to their clients, so they know the methodology on how the content/assessment was created.

Best regards,

Ron

Thank you for your comment, Ron. Such a dearth of research exists concerning the PBDS method of assessing competency. It seems shrouded in secrecy. Like you, I would like to see further proof.

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Specializes in psychiatric, UR analyst, fraud, DME,MedB.
Thank you for your comment, Ron. Such a dearth of research exists concerning the PBDS method of assessing competency. It seems shrouded in secrecy. Like you, I would like to see further proof.

It makes sense when you introduce a model system , we need to know as to the back ground of the product, what was used, theoretically and actuality. Is it practical in it's application etc. Makes sense to me. why the secrecy? this is not a good sign. they need to back up their "product" w/ research and lots of footnotes to be earn credibility.:specs:

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Are there any other tests out there currently?

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Specializes in Gerontological, cardiac, med-surg, peds.
Are there any other tests out there currently?

I'm aware of these alternatives to PBDS:

NurseTesting

Situational Testing

Prophecy

There are probably others.

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Specializes in Gerontological, cardiac, med-surg, peds.

Interesting read from the US Dept of Labor: 41 CFR 60-3.10 - Employment agencies and employment services.

Especially this part:

The use of an employment agency does not relieve an employer or labor organization or other user of its responsibilities under Federal law to provide equal employment opportunity or its obligations as a user under these guidelines.

How does this apply to facilities using PBDS one way for their internal staff and differently for agency/travel nurses? Just a thought....

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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.

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The other "oddity" with PBDS is that it was designed by a Dr!

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