In this special “May the Fourth” article, NPD Scope and Standards, 4th edition contributor Pamela S. Dickerson, PhD, RN, NPDA-BC®, FAAN, guides us through a deep dive into Standard 4: Planning. When working within Standard 4, “the nursing professional development practitioner establishes a collaborative plan encompassing strategies to achieve expected outcomes” (Harper & Maloney, 2022, p. 74). Read on for tips on applying this standard for professional development strategies, measuring program effectiveness, and more.

In your work on the Scope & Standards of Practice, 4th ed., what were your goals in outlining Standard 4? Are there any key takeaways you would like to stress?

One of the first things you will note in comparing Standard 4 in the 4th edition of the NPD Scope and Standards with the 3rd edition (Harper & Maloney, 2016) is there are now 19 planning competencies for NPD practitioners in the 4th edition compared to nine in the 3rd edition. That in itself speaks to the importance of planning!

The Scope and Standards Work Group felt it was critically important to be inclusive of factors such as diversity, interprofessional collaboration, and the use of NPD practice judgment in the planning process. Another consideration was linking the planning process to other elements in Standards 1-6 in order to provide a comprehensive framework for thoughtful deliberation as NPD practitioners move from Standard 1 (Assessment) to Standard 6 (Evaluation).

How does effective planning enhance the professional development of healthcare team members?

Every phase of the activity design process is important. Regardless of whether you are planning a 1-hour webinar or a 12-month nurse residency program, effective planning is critical. This ensures that the educational intervention is based on a thorough understanding of the needs of the target audience, awareness of the expected outcome and how it will be measured, and incorporation of best available evidence and resources to promote learning. Knowing learner characteristics and unique needs helps you customize an activity to achieve maximum value for learners, resulting in improved knowledge, skill acquisition, and integration of knowledge and skills into practice.

Thoughtful planning also considers how the activity will support the organization in achieving its strategic goals. Incorporating factors such as anticipated cost of the activity and return on investment helps the planner justify the value of the education in supporting professional development of nurses and other members of the healthcare team. 

Can you speak to the importance of collaborating across teams for effective professional development planning?

Several competencies in Standard 4 address collaboration in the planning process. The importance of collaboration is also emphasized in Standard 11. During the planning process, collaboration may occur across nursing teams. For example, there might be an activity in which the educational need is relevant for the unit coordinator, patient care assistants, licensed practical nurses (LPNs), and registered nurses (RNs). Including representatives of the target audience in the planning process and incorporating their unique needs into the design of the activity helps ensure educational quality and a higher likelihood of achieving the desired outcome.

Healthcare requires a team effort, so in many cases it is important to interface with other professions such as medicine, pharmacy, respiratory therapy, and social work to address an identified gap in team care. Planning active learning strategies that encourage networking and collaboration among learners helps facilitate positive change in practice as well as increased awareness of the contributions of each team member in achieving desired results.

What strategies can NPDs implement to monitor the effectiveness of educational programs and adjust based on feedback and evaluation data? How can NPDs plan for gathering and utilizing feedback and evaluation data?

This is an important question, because too often evaluation is not considered during the planning process. This can result in collection of random data that may or may not reflect      the root that underlies the professional practice gap or opportunity for improvement that the activity intends to address, and potentially not provide useful information to NPD practitioners. First and foremost, Standards 1-3 need to be implemented before planning how the effectiveness of the activity will be monitored. If you don’t know where you’re going, how will you know if you get there? A thorough assessment of learner needs and identification of a clearly defined gap with supportive evidence sets the stage for determination of the desired outcome for the activity. Collaboration with learners, decision makers, impacted/interested parties, and interprofessional colleagues helps ensure the activity plan includes formative and summative evaluation methods.

During an activity, you can plan to incorporate various types of feedback strategies resulting in just-in-time modification of the plan, or implementation revisions as appropriate to meet learner needs and facilitate outcome achievement. Development of the end-of-activity evaluation method should occur with Standard 3, so the planning process then considers how and when data are collected.

While Standards 3 and 6 speak to outcomes determination and evaluation processes, integration of evaluation in the planning process is crucial. Certainly, you need to collect data to show that the identified gap for the activity has been narrowed or closed. This can be done in various ways in alignment with the expected outcome(s), including report-out by learners, verbal sharing, post-tests, skills demonstrations, and—at a point in the future—observation of actual change in practice. You can consider additional useful data, perhaps asking learners to evaluate the quality of the learning resources, the use of learner engagement strategies, and the likelihood of implementing what was learned, given potential barriers that might exist in the practice environment. After an activity, you then summarize data from learners to develop a concise analysis of the effectiveness of the activity and opportunities to either improve the current activity if it is offered again or apply what was learned to other activities in the future.  

Can you share any examples of effectively implementing Standard 4 from your experience?

I was asked to plan an activity for RNs on medical-surgical units in one hospital to help them better understand and use delegation rules as required by our state Board of Nursing. In analyzing the issue, I learned that the primary concern of nurse managers was that RNs and patient care assistants (PCAs) were not communicating effectively, resulting in confusion about patient care and potential violation of Board of Nursing rules. In evaluating the evidence to support the need for the activity, I talked with RNs and PCAs in the involved units. I learned that neither group clearly understood delegation rules: RNs felt like they needed to “tell the PCAs what to do,” and the PCAs felt they didn’t have any input into decisions being made—they just had to “do stuff.” My planning process therefore focused on the need for collaboration, communication, and developing mutual respect and trust, as well as increasing knowledge of both RNs and PCAs about the rules for delegation. I coordinated with another NPD practitioner to change the target audience for the activity from RNs to both RNs and PCAs and convened a focus group of the new target audience to discuss areas of concern and opportunities for improvement. Potential barriers were identified so the activity could be planned to address those barriers. We planned the activity to address a knowledge gap about delegation shared by both groups as well as a skill gap in effective and respectful communication about delegation in implementing plans of care. Shifting the focus from the initial request to a more comprehensive plan to address the problem was significant to achieve the desired outcome.

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The NPD Scope and Standards, 4th Ed. is available for purchase on the ANPD store.

References:

Harper, M.G. & Maloney, P. (2022). Nursing professional development: Scope and Standards of Practice. 4th ed. Association for Nursing Professional Development.

Harper, M.G. & Maloney, P. (2016). Nursing professional development: Scope and Standards of Practice. 3rd ed. Association for Nursing Professional Development.