Skills Testing

Updated:   Published

  1. IS skills testing a waste of time?

    • 6
      yes
    • 16
      no
    • 4
      depends

26 members have participated

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Is skills testing a waste of time?

Specializes in oncology.
On 1/10/2022 at 6:29 PM, summertx said:

better idea is to familiarize yourself with the devices, setting up O2, pumps, suction, needles, etc. This is all what is going to be needed when taking care of a patient.

How can I get a job limited to these skills and etc? 

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Specializes in oncology.
On 1/9/2022 at 9:12 PM, FiremedicMike said:

if you do or don’t do specific actions, it is an immediate failure.

Yes, there are certain  critical actions/lack of actions that will terminate the testing session.

On 1/9/2022 at 9:12 PM, FiremedicMike said:

Nursing skills on the other hand are subjective.  Sure they have these “checklists”, but they are very long and about 75% fluff and not even utilized while the instructor is checking you off.  I tried in two different classes to establish “what exactly do I need to do or avoid to pass this skill” and have never been given an actual answer

(what exactly do I need to do or avoid to pass this skill”) was on the check off.  There was your answer.

On 1/9/2022 at 9:12 PM, FiremedicMike said:

For EMS, there are specific check sheets with measurable objectives, and most importantly “critical criteria” - if you do or don’t do specific actions, it is an immediate failure.  There is zero subjectivity to EMT and paramedic skills testing and everyone knows upfront exactly what is expected of them in order to pass a skill.

Are these criteria framed in situation where the EMS have no control over any conditions where performing the skill? Such as setting up a sterile field, inserting an NG, trach care? Yes, it is so important for the EMS to address wounds, a trach etc. No time to provide the environment that is best for these skills. But you're not in EMS (Kansas) anymore in a nursing program. 

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Specializes in CEN, Firefighter/Paramedic.
51 minutes ago, londonflo said:

Yes, there are certain  critical actions/lack of actions that will terminate the testing session.

(what exactly do I need to do or avoid to pass this skill”) was on the check off.  There was your answer.

Are these criteria framed in situation where the EMS have no control over any conditions where performing the skill? Such as setting up a sterile field, inserting an NG, trach care? Yes, it is so important for the EMS to address wounds, a trach etc. No time to provide the environment that is best for these skills. But you're not in EMS (Kansas) anymore in a nursing program. 

Not sure why you're just now responding to this.. 

Google NREMT psychomotor skill sheets, you'll understand what I mean.  There is no fluff in there, everything that needs to be done gets a point value, you must achieve a % of points to pass, and the "critical criteria" are listed at the bottom, which will immediately fail the students.  Everything is laid out and the expectations are clear.

This is not the case with nursing skills testing, where skills sheets are filled with fluff, critical criteria are not specifically listed, and not even utilized during testing.

My point stands, there is a more efficient means for skills testing that allows for students to have more confidence coming into each station as to what they'll be evaluated on.

 

Thanks for reminding me that I'm "not in EMS anymore".. I'm weeks from being done with my ADN.. 

 

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Specializes in oncology.
1 hour ago, FiremedicMike said:

Not sure why you're just now responding to this.. 

Not sure why you think there is a time limit on comments/responses

1 hour ago, FiremedicMike said:

Google NREMT psychomotor skill sheets, you'll understand what I mean. 

I don't structure EMS skill check offs. The check offs I have developed deal with nursing skills and nursing science.

 

2 hours ago, FiremedicMike said:

This is not the case with nursing skills testing, where skills sheets are filled with fluff,

If by "fluff" you mean a) washing your hands. b) with IM skills, drawing up the ordered volume, given the order and labeled vials c) maintaining asepsis d) identifying the patient etc., etc ...I am guilty. I am not asking a student to do more than an RN.

2 hours ago, FiremedicMike said:

My point stands, there is a more efficient means for skills testing that allows for students to have more confidence coming into each station as to what they'll be evaluated on.

We give out the checklists and a DVD demonstrating every skill following the checklist (made by the faculty who teach/evaluate them) at the beginning of the semester, each week the lab professional demonstrates a skill as the students follow on their checklist, they have an hour to practice (12 students/2 faculty), each week there are open lab times and multiple  other lab times to practice with a lab professional. 

Yes, skills testing is extremely stressful...all high stakes tests are. Students who fail the first time (usually for breaking sterile technique on the dressing change) meet with the lab professional and for retest we have 2 faculty there so there is a consensus. (This increases the stress but eliminates bias). 

Congrats on your coming graduation. Nursing school is so very stressful and everyone who has endured it, has an opinion on it. Every program is different and if you come up with a way to deliver an  comprehensive effective nursing program that everyone agrees with, count me in! We can both retire tomorrow with unlimited $$$ -- like the woman who developed the HESI test! She is living on some lush island!

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Specializes in CEN, Firefighter/Paramedic.
12 minutes ago, londonflo said:

Not sure why you think there is a time limit on comments/responses

I don't structure EMS skill check offs. The check offs I have developed deal with nursing skills and nursing science.

If by "fluff" you mean a) washing your hands. b) with IM skills, drawing up the ordered volume, given the order and labeled vials c) maintaining asepsis d) identifying the patient etc., etc ...I am guilty. I am not asking a student to do more than an RN.

We give out the checklists and a DVD demonstrating every skill following the checklist (made by the faculty who teach/evaluate them) at the beginning of the semester, each week the lab professional demonstrates a skill as the students follow on their checklist, they have an hour to practice (12 students/2 faculty), each week there are open lab times and multiple  other lab times to practice with a lab professional. 

Yes, skills testing is extremely stressful...all high stakes tests are. Students who fail the first time (usually for breaking sterile technique on the dressing change) meet with the lab professional and for retest we have 2 faculty there so there is a consensus. (This increases the stress but eliminates bias). 

Congrats on your coming graduation. Nursing school is so very stressful and everyone who has endured it, has an opinion on it. Every program is different and if you come up with a way to deliver an  comprehensive effective nursing program that everyone agrees with, count me in! We can both retire tomorrow with unlimited $$$ -- like the woman who developed the HESI test! She is living on some lush island!

You're deliberately missing my point.  YOU do those skill check offs for YOUR program and make the objectives clear to  YOUR students.  In my program, I asked, and was told to reference our elsevier nursing skills online textbook.  IM injection has over 43 steps to it with no point value for each step and no critical criteria and includes items such as "held a gauze pad between the third and fourth fingers of the nondominant hand" and "held the syringe between the thumb and forefinger of the dominant hand" - useless fluff.  Oh and by the way, as I actually look through this skill check off sheet, we did nearly none of this on skill checkoff day.

In the EMS world, they are standardized across the country.  A paramedic in California can take a psychomotor skills test in Ohio and know exactly what steps will be graded, how much each step is worth and which of those steps is critical to passing.

Nursing curriculum is standardized with extensive input from national accrediting bodies.  There is no reason they can't come  up with a nationally standardized skill checkoff so that the grading scheme is clear to everyone.  This is and has been my point from the start.  Any additional side-mouth jabs of expecting nurses to do/know more than medics is unnecessary. 

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Specializes in oncology.
12 minutes ago, FiremedicMike said:

 Any additional side-mouth jabs of expecting nurses to do/know more than medics is unnecessary. 

Never intended a jab (I don't know what a "side-mouth" jab is so if I did it I am sorry.) Each profession has it's own knowledge base and educational foundation. None is better than the other. I have always appreciated your comments on AN but I somehow hit a nerve on this subject. 

After graduation, you will (should get) a 6 month questionnaire which is anonymous. Here you can make your criticisms known. Items raised MUST be addressed by the faculty per accreditation. Return rate is usually poor, I know life goes on but you can have an impact there. 

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Specializes in oncology.
On 3/23/2022 at 4:30 PM, FiremedicMike said:

IM injection has over 43 steps to it with no point value for each step and no critical criteria and includes items such as "held a gauze pad between the third and fourth fingers of the nondominant hand" and "held the syringe between the thumb and forefinger of the dominant hand" - useless fluff. 

May be you learned from these checkoffs" How would YOU hold a syringe besides  your thumb and forefinger of the dominate hand? Please clue me in what you feel are actions that are not part of the process... Perhaps take the cap off the syringe off with your teeth? 

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Specializes in oncology.
On 3/23/2022 at 4:30 PM, FiremedicMike said:

Nursing curriculum is standardized with extensive input from national accrediting bodies. 

Nursing curriculum is NOT standardized. The programmatic accrediting bodies look through the content syllabi for basic nursing education.....They cannot dictate what a school teaches. On the other hand they do look at NCLEX scores to make sure a student knows the basic educational foundation. 

You need  to get a grip on the differences between nursing and EMS education. Nursing is not the frosting on the cup cake. 

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Specializes in Maternal-Child, Women's Health.
2 hours ago, londonflo said:

Nursing curriculum is NOT standardized. The programmatic accrediting bodies look through the content syllabi for basic nursing education.....They cannot dictate what a school teaches. On the other hand they do look at NCLEX scores to make sure a student knows the basic educational foundation. 

You need  to get a grip on the differences between nursing and EMS education. Nursing is not the frosting on the cup cake. 

Accrediting bodies have guidelines, more recently known as "competencies" for nursing education. Nursing schools have to show that their students have attained these competencies by the time they graduate. So, yes, accrediting bodies kinda do "dictate" what is taught, so that competencies can be met. 

Example: American Association of Colleges of Nursing (AACN) Essentials (including entry level and graduate education) : https://www.aacnnursing.org/Portals/42/AcademicNursing/pdf/Essentials-2021.pdf

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Specializes in oncology.
45 minutes ago, Sue Demonas said:

Accrediting bodies have guidelines, more recently known as "competencies" for nursing education. Nursing schools have to show that their students have attained these competencies by the time they graduate

Competencies are not content specific. The OP wanted skills testing requirements (testing criteria with points assigned)  to be universal, such as he had in an EMS program. 

Guidelines are generalized for accreditation. When an  accrediting team visits, syllabi are available but the measurable criteria are the graduation rate, NCLEX rate etc.  For example, an evaluator cannot insist more time be spent on orthopedics or cardiac. The course outcomes are weighed if they culminate in the graduation outcomes and mission statement. 

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Specializes in Maternal-Child, Women's Health.
Just now, londonflo said:

Competencies are not content specific. 

Clearly you did not read the 75 page document file that was attached to my post. Competencies are pretty specific to content. However, schools can teach/present/cover this content how they wish, as long as students achieve the competency outcome. IMHO, the competencies are pretty darn "specific".

In the post of yours that I responded to you wrote that "Nursing curriculum is NOT standardized." I gave evidence to show that indeed it is. Other arguments you bring to this post dilute the original intent of my response. 

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Specializes in oncology.
1 minute ago, Sue Demonas said:

Clearly you did not read the 75 page document file that was attached to my post.

You're right. I did not read the AACN competencies. But after 40 plus years of ACEN (NLN) visits and Higher Learning Commission criteria and visits I stand by my comments. If AACN really dictated content, why would we have so many 'bad offender' schools like the for-profits, persisting?

5 minutes ago, Sue Demonas said:

Competencies are pretty specific to content.

They are not. Competencies are much more general and subject to interpretation. I think there is one state in the US that requires all their state schools to follow the same curriculum. Perhaps you are thinking of that state?

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