6/13/2008
Background
Competency Assessment
for Population-focused
Public Health Practice
z
z
Susan J. Zahner, DrPH, RN
Jeffrey B. Henriques, PhD
Paul M. Schwartz, MS, RN
z
z
Public Health Systems Research
Washington, DC
June 7, 2008
z
Statutes emphasize core functions and
essential services
Changes in practice require new
knowledge,
g , skills and attitudes
Core competencies for public health
professionals published/adapted
No standard competency assessment
method
No prior competency assessment of
PHN in Wisconsin
Funded by US DHHS/PHS/HRSA, Division of Nursing #
D11HP07731-01
Linking Education and Practice
for Excellence in Public Health
Nursing
z
z
Study methods
•
Statewide academic-practice
partnership
Improve competency for populationf
focused
d PHN practice
ti
•
2006)
•
• Improved education for students
• Improved orientation
• Continuing education
z
UW-Madison IRB approval
Self-reported competency assessment
instrument (Issel, Baldwin, Lyons, & Madamala,
•
•
•
•
Baseline assessment
ACHNE/Essential Services (2000)
Reliability/validity
Length
Web-delivered (Websurvey@UW)
Cross-sectional baseline survey
Funded by US DHHS/PHS/HRSA, Division of
Nursing # D11HP07731-01
Competency assessment
instrument
Stem:
“How competent do
you feel with your
knowledge or skills
in each of the
following areas?”
•9 domains
•65 items
Response:
1 = I need to be
taught about this
2 = I do or can do this
ith help
h l
with
3 = I do or can do this
4 = I do this with ease
5 = I do this and teach
it to others
Competency assessment
instrument domains (item #)
•
•
•
•
•
•
•
•
•
Issel, Baldwin, Lyons, & Madamala, 2006
Monitoring community health status (13 items)
Informing, educating, and empowering
populations at risk (4 items)
Mobilizing community partnerships (13 items)
Policy and planning skills (6 items)
Enforcement of laws and regulations (4 items)
Linking people to services (4 items)
Ensuring a competent workforce (12 items)
Evaluating health services (9 items)
Researching innovative solutions (6 items)
Issel, Baldwin, Lyons, & Madamala, 2006
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6/13/2008
Participant demographics
Survey administration
•
• Wisconsin Health Alert Network
Mean age
• PHN Group email list
• Removed state-level PHN addresses
• N=471
•
•
•
40.0
45.0
• Email invitation to participate
• Reminder emails at 2 and 3 weeks
• April-September 2007
50.0
Managers
55.0 Full-time staff
Years Part-time staff
•
•
Response rate = 63.5%
(299/471)
Female (97.8%)
White, non-Hispanic (97%)
Part-time staff ((n=76))
Full-time staff (n=153)
Managers (n=42)
Years in public health
Highest degree earned
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Managers
Full-time staff
Part-time staff
0.0
10.0
20.0
Years
30.0
Graduate degree
Baccalaureate
degree
Part-time
staf f
Full-time
staf f
Managers
Mean responses by domain
Scale reliability
6
Research
Linking
3.59 (0.78)
Informing
2.83 (0.83)
Mobilizing
2.78 (0.73)
Ensuring
2.78 ((0.72))
Enforcing
2.70 (0.89)
Researching
2.47 (0.72)
Monitoring
2.44 (0.76)
Planning
2.31 (0.78)
Evaluating
2.24 (0.77)
9
Evaluate
12
Workforce
Link
4
Enforce
4
6
Policy
13
Partner
4
Inform
13
Monitor
0.8
0.85
0.9
0.95
1
Cronbach's Alpha
n= 296-299
Mean responses by domain and type of
respondent
^
Linking
*^
Ensuring
*
Enforcing
*^
Researching
*^
Monitoring
*^
Planning
2
3
4
5
Limitations-sample
Group email list incomplete and
voluntary
z Under-representation of PHN by
region of state
z Limited generalizability
z
Informing
Mobilizing
1
Part-time staff
Full-time staff
Managers
*
Evaluating
*^
1
2
3
4
5
Significance at alpha <.05 via one-tailed Tukey B post-hoc comparison:
* = Managers/full-time ^ = Full-time/part-time
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6/13/2008
Limitations-instrument
Discussion
Self-assessed perceptions versus
observed competency
z Response category “5” may not
reflect
fl t the
th same conceptt as “1 – 4”
responses
z “doing with help”
WI PHN workforce is:
Discussion
Discussion
z
Competency low in most domains
Higher perceived competency in
traditional areas of practice
z Higher perceived competency in
managers compared to staff
z Higher competency in full-time
compared to part-time staff
z
z
Conclusion
Change in practice for staff PHN
toward more systems-level activity
based on essential services will
require additional training and support
to achieve perception of competency
•
•
•
Well educated
Experienced
Aging
Competency assessment instrument:
Reliable
Length
g
z Compare with other competency
assessment tools
z Use by other public health
professionals
z
z
Next steps
• LEAP Project activities
• Academia/practice regional learning
collaboratives
• Orientation program
• Continuing education
• Follow-up survey
• Comparison with Illinois
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6/13/2008
References
Issel, L. M., Baldwin, K. A., Lyons, R. L., & Madamala, K. (2006).
Self-reported competency of public health nurses and faculty
in Illinois. Public Health Nursing, 23(2), 168-177.
Public Health Functions Steering Committee. (1994). The public
health workforce: An agenda for the 21st century. Full report
of the Public Health Functions Project. Washington, DC: U.S.
D
Department
t
t off H
Health
lth and
d Human
H
Services,
S
i
Public
P bli Health
H lth
Service.
Quad Council of Public Health Nursing Organizations. (2004).
Public health nursing competencies. Public Health Nursing.,
21(5), 443-452.
Wisconsin Department of Health & Family Services. (2005).
Public Health Profiles for Wisconsin. Retrieved October 22,
2007, from
http://dhfs.wisconsin.gov/localdata/pubhlthprofiles.htm
Questions?
Contact:
Susan Zahner, DrPH, RN
Associate Professor
UW-Madison
H6/246 CSC
600 Highland Avenue
Madison, WI 53792-2455
608-263-5282
sjzahner@wisc.edu
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