Measuring Post-Licensure Competence with Simulation: The Nursing Performance Profile

A valid, reliable practice assessment is needed to support intervention on the public's behalf when the pattern of a nurse's performance results in or is likely to result in patient harm. A collaborative multiagency research team developed and tested a criterion-referenced competency assessment process, using high-fidelity clinical simulation based on the Taxonomy of Error Root Cause Analysis and Practice Responsibility and the Clinical Competency Assessment of Newly Licensed Nurses. The 41-item instrument includes nine competency categories essential for safe practice. Registered nurses volunteered to be tested three times in the simulation laboratory (N = 21). Experienced nurses made significantly fewer errors (M = − 0.86, S = 0.50) than inexperienced nurses (M = − 1.52, S = 0.91, p < 0.001), indicating that the instrument could be used to distinguish levels of competence. The instrument used with high-fidelity simulation testing shows promise as a reliable, valid method for identifying unsafe nursing practice.