Question

Research at least two different applications or platforms to use to create own e-portfolio as nurse practitioner

Two pros and two cons for each methods.

• Statement of career goals as Nurse practitioner
  • Special interests
• Current competencies and skills
• Awards, honors, and distinctions earned
• Continuing education as Nurse practitioner

Answer 1

INTRODUCTION

In the Nurse Practitioner Standards Project,

competence and capability were proposed as key

criteria to assess candidates in nurse practitioner

educational courses. Portfolios have traditionally

been used to demonstrate competence in nursing

and are integral to nursing education as well. The

current evidence on nurse practitioner education,

competence, capability and e‑portfolios points to the

integration of the use of an e‑portfolio into current

nurse practitioner curriculum models to meet the

unique needs of nurse practitioner candidates.

Three outcomes for nurse practitioner (NP) policy and

practice in Australia were achieved in a landmark

2004 report from the ANMC Nurse Practitioner

Standards Project. Firstly, a consensus was reached

on core role and practice competencies for nurse

practitioners. Secondly, standards for NP education

and program accreditation based on an audit of

Australian and New Zealand university courses were

identified. Lastly, standards for nurse practitioner

authorisation were developed. However, Gardner et

al (2004) noted the inherent complexity and depth

of the NP role indicated that competence was not

sufficient criteria for the education and evaluation

of NPs and suggested the construct of capability to

complement competence.

The demonstration of both competence and

capability in NP introduces complexity into the

assessment of NP education, as capability in addition

to competence is required to be evaluated (Gardner et

al 2006). A useful tool towards this end is a portfolio,

which has been used in nursing to document and

showcase education and competence (Andre and

Heartfield 2007). Byrne et al(2007) suggested the

use of portfolios to facilitate continuous assessable

learning in response to changes and complexities

in nursing practice and to foster personal qualities

such as critical thinking and individual assessment

and accountability. The purpose of this paper is

to integrate the nurse practitioner literature on

competence and capability with post graduate

and nursing literature on e‑portfolios in order to

demonstrate the potential merits of e‑portfolios in

nurse practitioner education for competence and

capability development.

COMPETENCE AND CAPABILITY IN NURSE

PRACTITIONER EDUCATION

Nurse practitioner education in Australia and New

Zealand

Gardner et al (2004) conducted a qualitative study,

which trialled nurse practitioner education in practice.

The four participants were advanced practice nurses

who had completed a post graduate qualification in

their specialty with at least three years experience and

support from their employer and a clinical specialist

team in their area. The educational program involved

the nurse practitioners undertaking clinical practice,

with support and education provided by mentors in

their clinical support team. In addition, the nurse

practitioners participated in action learning, which

involved experiential learning and reflective practice

and clinical research facilitated by clinical and

academic mentors and experts. Group discussions

on learning needs and issues and associated

themes including contributions to the nurse

practitioner, generic elements and specific learning

activities provided a forum for data generation.

These discussions were supported by clinical logs

maintained by participants, who recorded learning

needs and issues experienced during the previous

week leading up to the clinical research day.

An ideal model of nurse practitioner education was

proposed at the Masters level, following on from

postgraduate specialist and advanced practice

education and clinical experience. Gardner et al

(2004a) suggested the incorporation of a specialist

field of study in clinical practice within a nurse

practitioner education course. This component

would be undertaken as fieldwork using experiential

learning and learning contracts, supported by a

clinical team and academic staff. Assessment

goals for clinical practice would include clinical

decision making and clinical performance. Generic

nurse practitioner education would be developed

to both enhance knowledge and scope and expan

the candidate’s current role. This generalist

education would be categorised as clinical sciences,

covering clinical decision making, assessment and

diagnosis and pharmacology; and nursing studies,

incorporating evidence based practice and models

of practice. Learning for these components would

involve action and self directed forms of learning,

to meet the objectives of knowledge acquisition and

application in complex situations and development

of a model specific scope of practice respectively.

The above model of nurse practitioner education

represents a research informed curriculum and an

audit of the 14 NP educational courses in Australia

and New Zealand conducted by Gardner et al

(2004a) revealed some commonalities in courses

that concurred with Gardner et al (2006a), while

other areas of course content were fragmented. Nine

courses had a portfolio element, which was mostly

an assessment piece.

Competency standards for nurse practitioners

The Australian national competency standards

emerged of a synthesis of data, including in‑depth

interviews with current practicing NPs in Australia and

New Zealand, literature review of nurse practitioner

reports and submissions from national nursing

bodies such as the Australian Nursing Federation Content of the competency  

standards is similar to the proposed content of nurse

practitioner education, as identified in Gardner

et al (2006b) research based the model of nurse

practitioner education (p. 100):

The three competency standards are supported by

competencies and indicators of competences, which

are intended to guide curriculum development for

NP education, as well as other NP issues such as

practice and authorisation. The second NP education

and program accreditation standard pertains to

coverage of competency standards. It stipulates that

curriculum content must demonstrate the indicators

which relate to each competency and that specialty

components are to be developed in consultation with

appropriate specialty organisations.

Capability in NP Education

Thefinaltwostandards forNPeducationandprogram

accreditation relate to capability: its teaching and

learning processes and assessment respectively.

Capability was described by Hase (2000) as a

holistic trait comprised of creativity, high self efficacy,

appropriate social and communication skills to work

well in a team, knowledge of how to learn and the

ability to apply competencies in common and novel

situations. Learning strategies conducive to capability

learning reported by et al (2006) include

learning contracts, problem‑based learning, situated

learning, experiential learning, clinical learning

environment, flexible and responsive learning

pathways and traditional approaches to supporting

skills acquisition

Gardner et al (2008) conducted a deductive analysis

of interview content of the NP sample from the NP

standards project to determine evidence of capability

in their practice. The use of a capability construct to

inform NP education was supported by the salience

of capability in practice. Knowledge of how to learn

was exemplified by participant comments pertaining

to knowing when and how to apply knowledge,

understanding of deficits in knowledge and how to

source and evaluate potential knowledge resources

such as research literature. The respondents

emphasised social and communication skills in

several ways. These included personal empowerment

to remain autonomous in multidisciplinary teams

in order to contribute to teamwork, inclusion of all

team members and the patient in clinical decisions

and the ability to impart and share knowledge as an

educator. Respondents articulated self efficacy from

their autonomy, exercised through feeling confident

and taking responsibility for their decisions. Creativity

was reported to factor into the NP role in terms of

obtaining evidence for diagnostic decisions and

arranging additional support for patients. In a similar

fashion, the NPs also recounted incidents whereby

novel usage of knowledge and skills were needed,

for example, in scenarios where standard procedures

were unable to be performed.

ELECTRONIC PORTFOLIOS FOR NP

COMPETENCE AND CAPABILITY

In the previous section, portfolios were identified

as a general assessment tool in nurse practitioner

education, which could be refined for competence

and capability learning. Until recently, portfolios

were also a requirement for nurse practitioner

authorisation ). While

successful completion of a Masters level course is

now considered sufficient for authorisation by state

and territory accreditation by portfolios may be helpful for  

nurse practitioners for employment purposes and

documenting lifelong learning

Electronic portfolios have two main uses: formative, as

a tool to document a process of learning or individual

learning journey; or showcasing to present evidence

of competence for employment or professional

registration

The e‑portfolio was initially used as a showcasing

tool to guide professional development planning

(PDP) and lifelong learning. With the advent of

online learning, e‑portfolios also became popular

in educational settings. Learning e‑portfolios differ

from showcase portfolios in thatreflection is involved

(Hartnell‑Young 2006; Marcoul‑Bulinson 2006).

While reflection has been defined in many different

ways, most authors refer to1933, cited in

Moon 1999) definition as a starting point:

The e‑portfolio is intended to stimulate learning

processes or outcomes in which reflection plays a

role. For example, educational frameworks used in

conjunction with e‑portfolios, such as constructivism

and deep learning et al 2006) rely heavily on

reflection to generate desired learning outcomes. In

nurse practitioner education adult and constructivist

learning, or variations on these themes, are central to

teaching and learning, which suggests an e‑portfolio

for learning and assessment would capitalise on

current andragogical methods in NP education.

A UK based study identified four different types

of portfolio structure used in educational courses

(Endacott et al 2004), although it was not stated

whether the portfolios were electronic. The simplest

structure was called the shopping trolley, which

was essentially a disorganised showcase portfolio.

Reflective pieces were rarely included in shopping

trolley portfolios and artefacts were not connected

to competency standards or learning goals. Better

structured was the toast rack portfolio, which was

still essentially a showcase portfolio, although

artefacts were organised under categories such

as competencies or reflective accounts. The spinal

column portfolio involved a series of competencies or

learning goals, which served as the vertebrae in the

metaphor. Artefacts were tied to each competency

and candidates were required to demonstrate

learning and competence via reflective writing

pieces. As such the spinal column represents a

learning portfolio, rather than simply showcasing

competence. Lastly, the cake mix portfolio involved

an underpinning reflective narrative written by the

student that linked all of the artefacts together. This

model was most frequently used in postgraduate or

advanced practice courses.

Use of electronic portfolios in developing

competence and personal qualities in postgraduate

nurse education

The existing literature on e‑portfolios in postgraduate

nursing settings demonstrates the value of this tool

in learning and showcasing competence. Capability

was not explicitly researched in the e‑portfolio and

postgraduate nursing literature; however some

studies mentioned personal qualities that alluded

to capability traits.

Anderson et al (2008) reviewed the use of an

e‑portfolio designed b2007) for use with

nurse practitioner students at Queensland University

of Technology. The portfolio followed the spinal

column structure and used the national competency

standards as anchors for reflective narrative and

evidence. Student experiences of the e‑portfolio were

solicited via interview and survey. Thematic analysis

of responses indicated the competency standards

were of benefit to NP candidates in shaping learning

and reflection, understanding the expanded scope

of the NP role and planning future professional

development. Students identified additional uses

of the e‑portfolio including lifelong learning, an

educational tool for subsequent cohorts of NPs

and identifying research needs. While the sample

size was small with only four participants, the study

demonstrated the use of national competency

standards for NPs was of value to students in their

learning and professional development. The next

study suggests an increased focus on personal

qualities may raise awareness of and possibly

develop capability.

A study (2004) at Curtain

University, Western Australia provided an analysis of

the e‑portfolio experience amongst 32 postgraduate

nursing students undertaking a Corporate Nursing

Leadership Development program. The portfolio

exercise included a student resume, an outline of

personal and professional goals pertaining to the

coursework and self assessment of coursework

specific core competencies. Self reflection via

activities such as evaluation of skills and setting

learning goals was thought to be the most valuable

aspect of the process, reported by 22 students.

Practical applications such as applying for jobs and

development of computer skills were also considered

to be beneficial by students. However, pre‑existent

information communication and technology skills

were limited amongst the cohort, which may have

influenced the perception of studentswho described

the task as time consuming and difficult.One student

referred to the possibility of using the e‑portfolio

to demonstrate competence for professional

registration. While Naude and Moynihan did not

require students to link self reflective narratives to

relevant competency standards for authorisation, the

e‑portfolio still represents a spinal column structure

as students were guided by coursework competencies

and self directed goals.

The focus on personal goals and qualities

may be beneficial to NP candidates in raising

awareness of capability traits and their subsequent

development. This was supported by student reports

of enhancement of characteristics describable as

capability including reflective thinking, confidence,

self directed learning, new ways of thinking and

team work). Similarly,

a case study described in Emden et al (2003/2004)

implied that portfolios may be used to facilitate

the development of capability in a professional

setting. Specifically, portfolios were introduced to

senior nursing staff at Whyalla Hospital and Health

Services to promote personal and organisational

development, which was also described as “personal

and professional attainment of wisdom”

While the initial focus of the portfolio was to provide

evidence of competence, the focus of the portfolio

was rapidly shifted to personal development, which

was deemed more meaningful by participants.

In international literature, there are two examples

of e‑portfolios in NP pre‑registration courses.

(2005) provides an example of a spinal column

portfolio in a NP education setting. Specific aims of

the portfolio were to create a bridge between theory

and practice, provide evidence of core concepts and

competencies stipulated by national standards and

to facilitate personal development planning (PDP)

amongst students. As a learning component of a

clinical practice subject, students were prompted

to recall and reflect on a clinical experience in

their writing and link it to the core concepts and

competencies.

The model of action learning and clinical practice has

been used in Australian NP eduction the above study demonstrates  

how e‑portfolios can be integrated into the existing

model. In addition, the portfolio framework used by

2005) students could be expanded upon to

includereflectivenarratives todemonstratecapability

in practice.

Hayes, Chandler, Merriam and King (2002) adopted

a different approach to portfolios in their study

and described the experience of one student who

completed a cake mix style portfolio. The student

was required to provide evidence of prior education

and development to stimulate reflection. By

beginning with employer references, educational

certificates and awards, the student engaged with.