The current and projected nursing shortage makes it imperative for healthcare organizations to examine factors that promote staff retention. Previous studies identify nursing leadership as a key component influencing staff retention and turnover. This study supplements these studies by identifying key behaviors and attitudes of frontline nursing leaders that influence staff retention. Using a grounded theory qualitative approach, the researcher interviewed 19 frontline nursing leaders in an acute care community hospital. The researcher also explored the extent to which nursing leaders felt current leadership education and training programs support their practices that promote staff retention. The goal of the study was to create a theory or model of nursing leadership and staff retention grounded in the data. Five major themes emerged from the interview data analysis process using grounded theory strategies. These themes include organizational culture and policies, nursing leaders training and development, behaviors and attitudes, employee factors, and turnover. The researcher interpreted the data within a systems theory conceptual framework. Using this framework aided the researcher in creating a model of frontline nursing leaders and staff retention. This model illustrates the inter-relationship of the five major themes from a systems perspective. The usefulness of the data collected in this study is predicated on three major domains: competency identification; human resource management and development; and education. Competencies form the foundation for the education and practice of frontline nursing leaders (Barker et al., 2006). These role-specific, evidenced-based expectations should be clearly delineated in competency-based job descriptions, which in turn merge into performance evaluations. Explicitly defined competencies provide a conceptual framework for collegiate and hospital-based education and training programs to train current and future frontline nursing leaders.

M.Phil. (Economics) / Please refer to full text to view abstract

M.Sc. (Med.), Epidemiology and Biostatistics, Faculty of Health Sciences, University of the Witwatersrand, 2009

Digitized by Kansas Correctional Industries

Spirituality has been associated with wholeness, inner peace, and key elements of well-being or quality of life. Spirituality support is particularly important for patients with chronic illness and patients who view spirituality as a way of coping with suffering. Evidence-based education is lacking in schools of nursing and in places of nursing employment on spirituality interventions that nurses can use to improve patient quality of life. The purpose of this project was to determine whether an educational intervention would increase knowledge of spiritual care in a small sample of clinic nurses (n = 37). This project used Watson's caring theory, which is an explanatory, middle-range theory focused on human caring. Watson's caring theory supports the relationship between spirituality and quality of life in patients with a chronic illness. Staff nurses completed the Spirituality Care Competence Scale as a pretest evaluation of spirituality knowledge. Spirituality training, which included evidence-based handouts, articles, and assessments, was followed by a second completion of the Spirituality Care Competence Scale as a posttest evaluation of the training effectiveness. The pretest to posttest knowledge of spiritual care significantly increased (p < .0001) on the 10 questions as measured by a t test statistic. These findings may contribute to social change by guiding training strategies to meet organizational goals for increased nurses' knowledge of and skills in spiritual care delivery for chronically ill patients. Nurses will have increased competency to provide patients with quality holistic care that includes support of spirituality.

Competence and competency assessment in nursing are promoted as necessary to ensure the quality of health care services. The dominant discourse in the international nursing community suggests that competence should be assured through some form of competency assessment, however competence is a controversial concept, with many different definitions. There are significant concerns about the validity and reliability of currently available assessment technologies. Rather than continue the debate about definitions and measurement, I take as my research aim the discovery of how what has come to count as competence became settled. The data for this study was drawn from textbooks, journal articles, meeting minutes, government reports, interviews with senior nurse leaders who were active in the development of the ANRAC Competencies and the ANCI Competency Standards 3e and RN preceptors who assess competence, group interviews with Clinical Development Nurses who assess competence, and observations of newly qualified nurses being assessed by Clinical Development Nurses. Newly qualified nurses were chosen as the focus for this study as they are formally assessed as part of Transition to Practice programs offered by health agencies around Australia. The study focuses on the period 1985 to 2005. Theories from the science, technology and social (STS) discipline informed the analysis. I found that rather than existing as a singular definable reality, competence exists in an undecided set of potentials and is momentarily reified in daily nursing practices in the form of competency standards assemblages. Combined, the semiotic (competence) - material (competency standard) assemblages are created by inventive assessors who work allegorically with multiple competences. This is not the work of assessing competence; rather it is the work of producing competence. The findings of this thesis offer new insight into competence and assessment technologies that can inform further research and development into the practices of competence assessment.

The thesis that emerges from the publications nominated for examination, is that a holistic or integrated competency based approach to vocational education and training (VET) and professional education (both initial and continuing) has many advantages over traditional approaches: * It provides a curriculum framework which links practice to theory in more coherent ways than currently exist; * It potentially provides a way of breaking the old dichotomy between 'knowing that' and 'knowing how' which has characterised Anglo-Saxon education and which has resulted in the belief that education which is practical is both different from and inferior to that which is abstract; * It provides the basis for teaching and learning approaches which could enhance students' adaptability and flexibility over their lives; * It has the potential for developing in occupational education more valid assessment strategies than those traditionally used and also for reducing the deleterious effects on learning of measurement-based assessment approaches. In summary, it is argued that the integrated approach to competency-based education provides a conceptual base for the competency movement and a promising direction for educational reform for all levels of occupational education. It is further argued that competency standards developed through an integrated approach can facilitate the implementation of a number of other areas of social and economic policy, such as the recognition of qualifications of overseas professionals in Australia, and the internationalisation of professional services. Overview of the publications The publications span a six-year period from 1990 to 1996. The first of them was written at a time when there was very little literature in the area (and virtually none in Australia) and when there was a great deal of confusion about the nature of competency, how to develop competency standards and the implications of the competency approach for education and training. What literature did exist, was mostly twenty years old and was largely a reaction against educational curricula which, it was felt, had failed to adequately prepare students for occupations or for life more generally. In place of a curriculum based on the acquisition of knowledge most of the critics suggested that curriculum should be based on an analysis of what people needed to do. Conceptually, as Wolf (1995) and others have pointed out, it was based on a niave reductionism arising out of behaviourist approaches to education. This approach was quite powerful for a brief period in the 1970s in teacher education programs in the United States. However the challenge to behaviourism from cognitive and humanist approaches to learning seemed to undermine the conceptual basis of the competency movement and very little was written about competency approaches until the late 1980s. As Raven (1996) has recently pointed out, the literature on competency-based education which has appeared recently is also a reaction against 'something that is sensed to be wrong' (p.74). But what this is, what needs to be achieved and how this could be done is not clear. He suggests that the contemporary competency literature lacks a conceptual and analytical base and that there is little recognition of the need for a research program which develops a better understanding of the nature of competence, how it might be developed in individuals, how it might be assessed and what impact this would have on individuals, organisations and society generally. It is these issues that the publications submitted for examination have addressed. They have attempted to provide a conceptual base for competency-based education and a framework for how competency might be developed and assessed. Much of the recent literature in Australia has built on the approach which the publications originated. The publications can be divided into those dealing with the nature of competency, particularly the integrated model, (a, b, d, e) those dealing with curriculum and teaching issues (b, j) and those dealing with assessment of competence (c, f, h, i, k). The theme which unites them, is the integrated approach to competency and its capacity to provide a coherent framework for improved educational practices in all occupational education. Another possible way of categorising the publications would be by educational level. For reasons associated with the traditional division of labour in our workforces we tend to think about the differences between educational levels rather than the similarities. It is usual to think about higher education for example, even when it prepares people for occupations, as substantially different from other occupational education. This is underlined by the fact that there is no term, in common usage, to encompass both what is currently referred to as middle level or vocational education, and education for the professions. Despite its specific nature, professional education is often identified with academic and general education, while vocational education is identified with practical education and is assumed to be devoid of substantial theoretical content. In fact much of higher education for the professions is practical and much vocational education is grounded in theory, even if it is not always made explicit. A conclusion which I believe can be drawn from these publications as a whole is that the difference between higher education for the professions and vocational education for middle level occupations is one of degree rather than one of kind. Obviously most professional work is more complex than work at, say, trades level. But it is better to conceptualise these levels on a continuum rather than to see them as essentially different. There will be many instances when professionals need to do things which are routine where simple competencies are used. Conversely many tradespeople will need to use complex combinations of competencies to solve challenging problems. Hence, it is not useful to divide the publications into those dealing specifically with the professions (of which there are six- a, b, c, d, g, i) and those dealing with issues relevant to all sectors of education (of which there are five- e, f, h, j, k). What the publications have to say about the nature of competency, how to develop competency through curricula and teaching and how to assess it, is broadly applicable to all occupational education irrespective of the context in which it is discussed.

Doctor of Philosophy (PhD) / Ensuring that speech pathology students are sufficiently competent to practise their profession is of critical importance to the speech pathology profession, students, their future employers, and clients/patients. This thesis describes the development and validation of a competency based assessment of speech pathology students’ performance in the workplace and their readiness to enter the profession. Development involved an extensive literature review regarding the nature of competency and its relationship to professional practice, the purpose and nature of assessment, and the validation of performance assessments. An online and hard copy assessment tool (paper) was designed through integrating multiple sources of information regarding speech pathology and assessment of workplace performance. Sources included research, theory, expert opinion, current practice, and focus group consultations with clinical educators and speech pathology students. The resulting assessment tool and resource material included four generic components of competency (clinical reasoning, professional communication, lifelong learning, and professional role) and seven occupational competencies previously developed by the speech pathology profession. The tool comprised an assessment format, either in a booklet or online, for clinical educators to rate students’ performances on the competencies at mid and end placement using a visual analogue scale. Behavioural descriptors and an assessment resource booklet informed and supported clinical educators’ judgement. The validity of the assessment tool was evaluated through a national field trial and using Messick’s six interrelated validity criteria which address content, substantive, structural, generalisability, external, and consequential aspects of validity (Messick, 1996). The validity of the assessment tool and its use with speech pathology students was evaluated through Rasch analysis, parametric statistical evaluation of relationships existing between information yielded by the Rasch analysis and other factors, and student and clinical educator feedback. The assessment tool was found to have strong validity characteristics across all validity components. Item Fit statistics generated through Rasch analysis ranged from .81 to 1.17 strongly upholding that the assessment items sampled a unidimensional construct of workplace competency for speech pathology students and confirming that generic and occupational competencies are both necessary for competent practice of speech pathology. High Item and Person Reliabilities (analogous to Cronbach’s alpha) were found (.98 and .97 respectively) and a wide range of person measures (-14.2 to 13.1) were generated. This indicated that a large spread of ability and a clear hierarchy of development on the construct was identified and that the assessment tool was highly reliable. This was further confirmed by high Intra Class Correlation coefficients for a small group of paired clinical educators rating the same student in the same workplace (.87) or in different workplaces concurrently (.82). Rasch analysis of the visual analogue scale used to rate student performance on 11 items of competence identified that clinical educators were able to reliably discriminate 7 categories or levels of student performance. This, in combination with careful calibration procedures, has resulted in an assessment tool that Australian Speech Pathology pre-professional preparation programs can use with confidence to place their students’ level of workplace competence into 7 zones of competency, with the seventh representing sufficient competence to enter the profession. The assessment tool also showed strong potential for identifying marginal students and for future use in promoting quality teaching and learning of professional competence. Limitations to the research and the tool validity were discussed, and recommendations made regarding future research. First, the clinical educator, who has dual and possibly conflicting roles as facilitator and assessor of student learning, made the assessment. Second, situating the assessment in the real workplace limits the students’ opportunities to demonstrate competence to those that naturally arise in the workplace. Paradoxically, both these factors also contributed to the validity of the assessment tool. It was recommended that the assessment tool be revised on the basis of the information gathered from the field trial, that further data be collected to ensure a broader proportional representation of speech pathology programs, to investigate possible threats to validity as well as those areas for which the tool showed promise. This research developed the first prototype of a validated assessment of entry level speech pathology competence that is grounded in a unified theoretical conception of entry level competence to the profession of speech pathology and the developmental progression required to reach this competence. This research will assist the profession of speech pathology by ensuring that speech pathologists enter the workplace well equipped to provide quality care to their future clients, the ultimate goal of any professional preparation program. Messick, S. (1996). Validity of performance assessments. In G. W. Phillips (Ed.), Technical Issues in Large-Scale Performance Assessment (pp. 1-18). Washington: National Centre for Education Statistics.

Under the impact of double cards in the past two years, domestic banks have tightened the business of the double cards and been stricter on the examination of credit terms such as house loans with guarantees. The focus of credit business has been switched to corporate finance from consumer finance. The credit to small/medium enterprises is the main goal. In the long past, economic policies of the government have aimed at helping small/medium enterprises in sustainable development. From the data of White Paper on Small/medium Enterprises, close to 97.8 (over 1.16 million) companies in 2005 in Taiwan were small/medium enterprises, which have been the cornerstone of macroeconomic development in Taiwan. It is an urgent job to foster professional credit personnel to meet the needs of government¡¦s policies or in the overall financial environment. The purpose of this study is establish and develop the required knowledge, skills and qualities at work of credit personnel at banks to small/medium enterprises in order to help banks¡¦ recruitment, screening/training development, and improving/ehnahcing job performance to have the personnel make contribution to the banks. The process is literature exploration, job analysis and behaviorial interviews to establish competency structure and competency scale. Formal interviews are made with middle/high ranking supervisors at banks of different nature with over 10 years of experiences in lending to small/medium enterprises. Questionnaires are collected for statistics and analysis to develop the competency model of credit personnel. The conclusions are: 1. The required competency of credit personnel to small/medium enterprises includes product knowledge, market information,judgment,communication, activeness/aggresiveness, mofive of acheivment and establiment of relations. Banks of different nature have slightly views on the competency, which is resulted from the corporte culture, organization structure or other factors. Future researchers can focus on this. 2.For a successful credit staffer to small/medium enterprises, the most important is qualities in the competency, followed by professional knowledge. Skills are relatively less important. Judement is the most significant in the skill aspect, which is apparently different from that of common sales representatives. Future resarchers can focus on whether it has anything to do with the nature of the products sold. Keywords : competency, credit, credit personnel, small/medium enterprises

The key point of the successful business unit is the human resource. It depends on man who starts from R&D, sales, to the process of service departments. Therefore, the level of the whole management team determines the consequences of the business, and that is why we pay more attention on core abilities. It is easy to be copied on techniques, products, or even service in the organization, but the one and the only asset that is irreplaceable is the employee. The outputs of the superior employees will benefit the organization and lead the unit to the most competitive situation. This research will realize the effect of the business competitive power and the results of the organization when the business unit conducts the competency pattern. By qualitative research, we could find out the relationship between the competency pattern and the results along with competitive power inside the business units and dig in the five cases which conducted the competency pattern for the business competitive power also with organization results by interviewing the management teams of these candidates, collecting the related dissertations, data in the meanwhile. We had the conclusions by this research, 1.Generally, our cases contained three frames of the competency pattern, including core , profession, and management. They all focused on the behaviors through physical description or observation, and based on these aspects to check the performance level. 2.There are some key points including the entire involved, supports from the high level management team and also helped by the external experts or consultants which affected building the competency pattern and pushed a new management system or the value change of the organization revolution process into practice. 3.The research found out that the competency pattern could promote or encourage the function when human resource strategy transformed to the physical human resource development activities. The competency pattern could not only integrate with human resource development activities and lead to the synergy, but make the results upgraded. It also clarified the human resource development strategy and practiced into the reality, upgraded the whole efficiency in the meanwhile. 4.We could tell from this research that all the competency patterns were all based on the perspective, strategy and the goal, and we also focused on the performance of the business predicted value behavior. It not only made it more delicate and effective of the circulation under the human resource function, but let the human resource development activities connected to the strategy and running results of the business unit much closely. 5.The researchers told us the need and motivation to build the competency pattern what was made for organization transformation could help reconstruct the whole human resource system and lead to the better source integration, efficiency, and flexibility. Meanwhile, due to the change of this environment or the demand of the organization development, we could integrate the original value system and core competition inside the business unit, also we could construct or plan the suitable human resource development strategy, go through with the business long term development at the same time, then develop, prolong and improve the core competition. Finally, we perform this advantage on upgrading the human resource quality. 6.In this research we could find the ability of our employee get developed and reached the expectation of the organization. It is just the consequences of conducting the competency pattern, and so, we could prove conducting the competency is positive to the whole business results.