Comparing validated healthcare competency tests to unvalidated ones, is like comparing apples to oranges – once you understand the difference, there really is no comparison.

But, do you find yourself wondering why only results from validated healthcare competency exams should be used to  influence hiring decisions?  Well, we hope the answers to two questions asked over and over again will help settle the dust surrounding this important topic.

Validated Nurse Competency Exams

How are the assessments validated to be applicable across all organizations and populations?

Prophecy use a software package called “TVAP” (Test Validation and Analysis Program) that calculates many different statistical metrics for each of our assessments.  Several of these metrics include:

• Individual Item Analyses
• Item Difficulty
• Differential Item Functioning
• Mean Score of the Sample
• Cronbach Alpha (reliability metric)
• Standard Deviation, and several others.

Two items above that may not be familiar to you are

1. The Differential Item Functioning which specifically looks at how different populations are answering certain items. (for example, Hispanics vs. Native Americans vs. Asians), and
2. The Cronbach Alpha which is a reliability metric – not a a statistical test, but a measure of internal consistency, that shows how closely related a set of items are as a group.

At a minimum, we review these metrics on each assessment annually.  During this review, we look for updates that need to be done on each assessment.  When items are not functioning well, or not contributing to the overall reliability of the assessment, they are either updated or removed.

As with any test, when you change the “DNA” or structure of an exam, it normally means that the Angoff score will require a minor adjustment as well.

Using Healthcare Competency Test Cutoff Scores

Do most organizations use the recommended pass/fail cutoff score, or do they set their own passing score?

Yes, most organizations follow and use the recommended Angoff score for each of Prophecy’s assessments.  This scoring methodology is the same as used by the NCSBN for the NCLEX-RN, NCLEX-PN, the AACN for the CCRN exam, etc.

The Angoff scoring methodology, used by Prophecy, is endorsed by the courts and follows the Federal Uniform Guidelines on Employee Selection Procedures.

What does this mean for you?  Should your organization ever be audited by the Department of Labor, EEOC, or OFCCP, our assessments have technical reports and documentation that describe how each of one of our exams were created under these guidelines and meet all requirements for use as a selection tool in the pre-hire setting.

These are both great questions asked by most clients doing their research before selecting a competency testing provider.  Check out our comparison guide to Prophecy’s Assessments to see how they stack up against others in the industry.

Prophecy Healthcare Inc ®, the leading provider of healthcare pre-employment assessment and employee selection technology announced strong financial results for year ending 2011, as the launch and adoption of its core product, Prophecy® Assessments, is introduced into the acute care space.

As Founder and CEO, Ron Gonzalez explained, “2011 was a turnaround year for us. As many companies were negatively affected by the economic downturn, we took 2009 and 2010 as restructuring years, focusing on streamlining our workforce and completing the important research that drives our products. That focus paid off big in 2011 with record growth in Gross Revenue and Net Operating Income.”

Ron continued by explaining that a highlight of the year was a major hospital system in the west using the Prophecy system to enhance their hiring policies and practices.  Given the size of the facility, Prophecy now has been shown to integrate well with small and enterprise level facilities.

A special congratulations is due to both Eric Gonzalez, Chief Operating Officer appointed as President, and Christine Carrington, Chief Professional Services Officer of Prophecy Professional Services promoted to Chief Clinical Officer.   Both expressed their excitement and anticipation for great things coming in Prophecy’s future.

Eric commented, “Our team’s hard work is starting to be realized in many ways and I couldn’t be more excited about the future for Prophecy Healthcare.  We are now offering a service proven to positively affect a hospital’s bottom line while increasing the level of safe, effective patient care provided. Two goals that make up the core of Prophecy’s corporate mission.”

Check out the full press release for the rest of the story!

When you see the words “Magnet® – designated facility” what things come to mind?  It might be “quality nursing care, satisfied nurses, employee engagement, outcomes and evidenced-based,” to name a few.

Less than 8% of hospitals across the United States hold this prestigious title.

To savvy hospital executives, the Magnet® designation means excellence, second to none.  It also means meeting and adhering to the 5 Model Components of the Magnet Recognition Program®, which include the 14 forces of Magnetism.  They are:

1. Transformational Leadership (demonstrating that leaders are moving to meet future demands)
2. Structural Empowerment (containing structure and processes which allow for high quality professional practice, meeting the needs of both patients and the community)
3. Exemplary Professional Practice (promoting a comprehensive understanding and application of nursing practice, including new knowledge and evidence based practice)
4. New Knowledge, Innovation, & Improvements (maintaining a focus of quality improvement, whereby existing and new evidence is applied)
5. Empirical Quality Results (utilizing outcomes data to demonstrate positive differences made in nursing, workforce, patient experience, etc.)

There are many parts of a hospital system, that, when working collaboratively as they should, create positive outcomes, for both internal staff and the patients receiving care.  The core of a Magnet® organization is not about establishing strong nursing practice – it is about the potential of what nursing practice can achieve. In addition, Magnet® organizations must create a dynamic, positive work environment consisting of leadership, collaboration, and professional development.

Nurses must not only demonstrate clinical competency, but must also work in collaboration with interdisciplinary partners “to ensure that care is comprehensive, coordinated, and effective” (Luzinski, 2012).

Hiring “Magnet” Qualified Nurse

The Journey to Magnet is certainly a rewarding process, but comes with great work and focus on the 5 model components.  Magnet hospitals must select nurses that:

• fit the hospital’s culture,
• engage in multidisciplinary collaboration, and
• understand the importance and application of evidence based practice.

Research has shown that nurses are attracted to hospital working environments the promote autonomy and foster good nurse-physician relationships.  Furthermore, it has shown that hospitals with these characteristics have better patient outcomes, including lower mortality rates(Laschinger, 2003).

Create a Journey to Magnet Work Environment

So, how do facilities on the Journey to Magnet® begin to create this environment?

With the upcoming nursing shortage due to baby boomer retirement and conversely lower numbers of nursing school applicants, hospitals must be more diligent than ever, in their search for nurses who possess the right clinical knowledge, cognitive skills, attitude, and communication skills to fill core vacancies.

The cost of nursing turnover has been reported to be between $22,000 and $64,000 per nurse (OJIN, 2007).

Magnet® hospital employees report higher job satisfaction, meaning less burnout, and at least 1.7% less turnover than the industry average (Drenkard, 2010).

Selecting the Top Nurse Applicants

If hospitals had the ability to assess these important characteristics of nurse applicants, before they’re actually hired, wouldn’t it make sense to do so?

Of course it does!  The philosophy of the Magnet program is that nurses function at peak performance when a Magnet environment is embedded throughout the health care organization (Hughes, 2008).   For organizations currently or considering the Journey to Magnet, Prophecy® Healthcare can help you improve the working environment for nurses, which leads to peak performance.

Prophecy offers hospitals the ability to look at each nurse holistically, by combining three tools – Clinical, Behavioral, and Situational assessments.  The combination of these will predict how well the nurse will fit into your organization and perform on the job.  Prophecy’s ability to predict such characteristics is supported by criterion evidence-based validity, from a two-year study, with over 880 RN’s from across the country.

Spend 8 minutes reviewing the ROI video, and understand how your organization can put measures into place that will improve the nurse work environment, create employee engagement and facilitate your Journey to Magnet®, while saving money at the same time!!

References:

Drenkard, K. (2010).  Going for the gold:  The value of attaining Magnet recognition.  American Nurse Today, 5(3).   

Hughes, R.G. (Ed). 2008.  Patient safety and quality:  An evidence-based handbook for nurses.  AHRQ Publication No. 08-0043.  Rockville, MD:  Agency for Healthcare Research and Quality.

Laschinger, H. (2003).  Workplace empowerment and Magnet hospital characteristics.  Journal of Nursing Administration, 33(7/8).  

Luzinksi, Craig (2012). Exemplary Professional Practice.  The Journal of Nursing Administration, 42(2), pp 72-73.

The Online Journal of Issues in Nursing (2007). 12(3).

Prophecy Healthcare wants to extend a special thanks to the lifesaving efforts of cardiovascular services professionals this week.  The fitting theme this year for Cardiovascular Appreciation Week is – Hands that serve, Hearts that care.  The high quality clinical skills and compassion of cardiovascular professionals should be congratulated this week and always.

As we discussed Cardiovascular Healthcare Professional Appreciation Week we realized how many different hospital departments are infused with cardiac “specialists.”  Given the variety of specialties responsible for caring for patients with cardiac challenges, it is essential to ensure that you are matching your clinicians to the actual knowledge, skills and abilities they will be required to perform in providing hands-on care.

One way this is accomplished is through competency assessments.  Therefore, it is essential to understand the patient population for which you are placing your clinicians and to understand the measurement tools provided by your competency testing service to facilitate safe and effective patient care.


  As an example, we will discuss a few of Prophecy’s assessments found in our comprehensive exam library that showcases the expansive reach of cardiac “experts”.

Cardiac Progressive Care

Sub-acute patient population inclusive of the progressive care or step-down phase.  This type of unit is sometimes called a “telemetry” unit.
The patient population that you might see in a progressive care unit would be patient’s with

• Congestive Heart Failure,
• Cardiac Catheterization patients or
• patients with cardiac arrhythmias.

General ICU

Measures clinician competency based on a critical patient population inclusive of all general disease pathologies familiar to the General ICU setting. This unit is sometimes referred to as a “Medical ICU”.  The patient population that is typically seen in a General ICU might consist of patients in:

• DKA(Diabetic Ketoacidosis),
• ARDS(Acute Respiratory Distress Syndrome),  or
• patients who are in Septic Shock.

CCU(Coronary Care Unit)

Measures clinician competency based on a critical patient population in area of the Coronary Care Unit.  This unit is sometimes called the “Cardiac Care Unit”.  The patient population that is typically seen in the CCU might consist of the

• MI(Myocardial Infarction),
• Congestive Heart Failure, or
• patients with cardiac arrhythmias.

CVICU(Cardiovascular Intensive Care Unit)

Measures clinician competency based on a critical patient population in area of the Cardiovascular Intensive Care Unit.  This unit cares for those patients who have had “open heart” surgery.  The patient population that is typically seen in the the CVICU would consist of patients who have had a:

• CABG(Coronary Artery Bypass Graft),
• Mitral Valve Repair, or
• Aortic Valve Repair.

ER (Emergency Room)

Measures clinician competency based on all of the components that are unique to the ER setting.  The department is called the Emergency Room or ER Department.  The patient population seen in this area consists of a broad range of diagnoses.

Dysrhythmia Interpretation Across Departments

Prophecy also offers a Dysrhythmia exam that contains basic rhythm strips for determining competency for rhythm recognition.   The Dysrhythmia exam is not limited to one particular specialty but should be utilized for any nurse who will caring for patients on a cardiac monitor.

We wanted to provide you with an sample of specialties where the Dysrhythmia exams would be appropriate:

• All Critical Care Units
• ER
• PACU
• Endoscopy/GI
• All Progressive Care Units with Telemetry capability
• Specialty labs such as Cardiac Cath Labs
• Interventional Radiology

As you can see, Cardiovascular Professionals Week may include more nursing professionals than you originally thought.  So, take a moment to thank those around you in any of the above specialties.  Truly their hands are serving, showing their hearts that care.

A recent article posted by Jason A. Wolf with Hospital Impact outlined 5 tactics for your patient experience strategy.  With the current, understandable focus on  the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, facilities are searching for the “golden ticket” to increase patient satisfaction.

Wolf summarized the importance on patient satisfaction by writing, “it is one of the most critical strategic opportunities you have at your disposal to engage your consumer, manage the bottomline and strive for quality outcomes.”

Healthcare Behavioral Assessment

While reading through the 5 tactics to take into consideration with patient experience strategies:

1. Noise Reduction
2. Discharge Process
3. Rounding
4. Responsiveness of Staff/Communication
5. Pain Management

…the attention placed in caregiver attentiveness can not be overlooked.  Vigilant bedside manner is no easy feat.  Not everyone is wired to be care – givers.  But, the people your patients come into contact with become the face of your facility.  Keeping those care – givers happy and positive can make a huge impact on overall satisfaction of your customers…their patients.

Assessing beyond job skills/competencies in caregiver placement is becoming an industry norm.  Interviewing alone in attempts to gauge a clinician’ s innate behavior leaves room for non-standardized and biased decision-making.    Objectively looking into a caregiver’s personality, attitude, cognitive abilities, and job engagement using a standardized test helps minimize these discrepancies.

As Donna Stubbs, Nurse Manager from UTMB Clinical Staffing Solutions explained, “We have used the Prophecy assessments … to weed out those that interviewed well but could have been a potential liability based on behavior or attitude. This is extremely important in these times as hospital reimbursement is limited based on HCAHPS scores. “

We recommend Wolf’s article to facilities looking to maximize their patient experience strategy.

And, for more information on Prophecy’s solution to placing the best fit candidates in your front line, contact Melissa Spangler @ 888-PRE-HIRE opt. 3.

It is a known fact that taking an online nurse competency exam can make one nervous, but this does not always have to be the case.  Taking the time to prepare can minimize the level of what is called “test anxiety”.  One widely accepted definition of test-anxiety is

“…an unpleasant feeling or emotional state that has both physiological and behavioral components and that is experienced in formal testing or other evaluative situations.”
(Dusek, 1980).

A competency assessment is testing those basic job knowledge skills a person should know.  However, this does not thwart general test anxiety that one may experience.  There are some things to remember that can help to minimize test anxiety. Prophecy would like to provide you with some helpful information in preparing to take an exam.

Helpful Online Nurse Competency Exam Taking Tips

1. Environment Conducive to Testing

Make sure you are in an environment that is conducive to testing.

Rationale
A testing environment that is quiet and free of distractions provides a test taker with an optimal environment to be successful.

2. Read Exam Instructions

Make sure you read all exam instructions prior to taking any exam.

Rationale
The exam instructions may contain vital information that can lead to successful completion of exams.

3. Review Study Guides

Exams that contain study guides allow the test taker the ability to study prior to taking an exam.  It is essential that a test taker review any study guides that are provided prior to an exam.

Rationale
Study guides are typically educational in nature and the intention is to achieve the learning objectives.

4. Use Content Outlines

Pay close attention to exams that contain content outlines.

Rationale
The exam content outline can help to minimize test anxiety while allowing the candidate to become familiar with what will be covered in the exam.  Exam Content Outlines can serve as useful tools to allow candidates exposure to topics covered within an exam.  It also allows the test taker an opportunity to “brush up” on any areas they feel is necessary.

5. Offer Proctored Testing Environment

A proctored testing environment is the optimal environment for testing.

Rationale
A proctored environment is the preferred method for exam administration.  There are many variables in a non-proctored environment that can negatively impact exam outcomes such as distractions, time constraints, and technological limitations.  A proctored environment allows for the ability to provide consistency with an optimal testing environment.

Test anxiety has affected most of us at least once in our lifetime.  With adequate time, preparation and adherence to instructions, test anxiety can be minimized so that an individual can be at their peak performance.  We hope you find these testing tips are helpful!

Happy Testing!

High Point, NC (PRWEB) January 17, 2012

Amistaff Healthcare Technology, recognized as industry leader for online, healthcare competency testing, announced its new company name, Prophecy Healthcare, Inc ®. With the expansion of competency assessments and solutions now provided, the company is changing its name from Amistaff HCT to Prophecy Healthcare to better reflect the company’s comprehensive portfolio of employment prediction assessments for the healthcare industry in a time where hospitals seek ways to raise patient satisfaction ratings.

Amistaff HCT’s flagship product, NurseTesting.com, was limited by the name in that it infers the company solely tested “nurses.” With the transition to Prophecy Healthcare, NurseTesting.com became Prophecy Clinical Assessments – one part of a suite of assessments including Behavioral and Situational Assessments that generate a holistic report incorporating interpersonal competencies typically missed in traditional testing.

“The unveiling of Prophecy Healthcare® marks a significant milestone for our company. Since we consolidated our business objective to focus on what we do best, testing and assessment, we were searching for something new. After 3 years of research and development on our “new” assessments, which resulted in us being able to predict the likelihood of success of candidates BEFORE they were hired, we were looking for branding and a name that focused on the predictive value of our new service,” explained Ronald Gonzalez, CEO/Founder of Prophecy Healthcare.

“Prophecy seemed like a natural fit since its definition is on mark with what we are attempting to do with our testing: ‘the foretelling or prediction of what is to come.’ We want to help both hiring managers select the best candidates for their organization and education coordinators evaluate and educate current staff members using the information generated from our Prophecy Assessments.”

In conjunction with the name change, the company also announced the availability of the two aforementioned assessments forming the following testing suite:

•     Prophecy Behavioral Assessments utilize personality and attitude tests to measure cognitive thinking. The results capture behavioral characteristics that predict high performance, such as integrity and conscientiousness.
•     Prophecy Clinical Assessments encompass the extensive exam library of the former NurseTesting.com. The comprehensive, nationally validated library include OSHA and Joint Commission mandatories, nursing and allied assessments, as well as clinical skills checklists.
•     Prophecy Situational Assessments identify caregivers with soft-skills directly correlated to successful nursing practice. Using Prophecy’s Situational Assessments, facilities are able to quantify which caregivers will make the most effective decisions in the workplace.

All of the assessments are web-based, with instant validated scoring, developing a scorecard that highlights each applicant’s strengths and areas for improvement.

Effective immediately, all future business activity will be conducted using the new name. There has been no change in the company’s management or ownership leaving clients with the same Prophecy Crew Members they have grown to know and trust.

About Prophecy Healthcare, Inc ®
Originally founded in 2004 as NurseTesting.com, Prophecy Healthcare® got its start as the first online Pre-Employment Testing Company exclusive to the Healthcare Industry. Initially focusing solely on clinical assessments measuring clinical competencies, efforts to exceed industry expectations led to isolating critical competencies missed in traditional testing initiatives, such as stress tolerance, critical thinking, and teamwork skills. The Prophecy approach offers the ability to find candidates with the clinical hard skills, personality attributes, and desired soft skills to match each organization. For more information about Prophecy, visit http://www.prophecyhealth.com or call 336.802.1070.

Our very own Director of Relationship Management, Meredith Juengel, MBA, was honored as keynote speaker for the University of North Carolina at Greensboro’s Bryan Graduate Programs Orientation and Welcome Reception on Saturday, January 7th.  She addressed the upcoming MBA, MSITM, MSA, MSN/MBA, Graduate Certificate, and Post Graduate Certificate students giving her top 5 tips on getting the most out of their graduate experience.

As a Beta Gamma Sigma inductee (graduating in the top 20% of her class), Meredith gave real testimony to thriving in a graduate program while balancing school, work, and family life.

1) Network with Classmates

She explained that classmates become a support family away from home while reminiscing about being reacquainted with now boss, Melissa Spangler, Prophecy’s Vice President of Client Experiences.  Networking with classmates directly led Meredith to advancing her career, becoming a Prophecy Crew member today.

2) Get to Know Administration

It never hurts to keep in mind that administrators have lives outside the confines of university buildings.  Reminding that professors make outstanding references, Meredith suggested students make it a point to be a positive contributor to each professor’s classroom – a small sacrifice that might open big doors in their future.

3) Keep a Positive Attitude

A huge believer in “you reap what you sow,” Meredith spoke on the effects of negative outlooks on classes.

“Keep from being the negative person waiting for class to begin.  For every class you consider trivial for your future, there will be classmates who value the information, looking forward to learning more on the subject.  A positive outlook can even make time feel like it goes by more quickly.”

4) Set Goals Along the Way

Always keep a big goal ahead of you, written down, within the next 12 calendar months. That way no matter how stressed life gets you can keep your eye on the prize and keep forging through.

5) No Excuses

As she started listing the major life events that could have caused her to push back graduation – changing careers, moving to a new city, two pregnancies, etc. -  Meredith encouraged the new students with her honesty.  Identifying with their fear of personal life being put on hold, she gave them confidence that life can continue to progress forward with attention placed on time management.

In closing, Meredith congratulated the students in taking this big step towards personal and professional development.  She noted that her MBA experience taught her far more than business management – it highlighted how she could maximize her strengths and improve her weaknesses leading her to be a better motivator, manager, mother, and wife.

An integral part to the Prophecy Crew, we commend Meredith’s success in this deserved recognition and expect her to be honored as keynote speaker for more engagements in the future.

Prophecy’s new Certified Surgical Technologist / Scrub Tech assessments made headlines!

Originally released on December 1, 2011, the CST assessments were developed using Prophecy’s extensive validation process.  Clients were pleased to see another one of their requested assessments delivered into their Prophecy accounts – just in time for the holiday season!

In other news, Prophecy’s Clinical Team projected an updated dysrhythmia interpretation exam to be released in early 2012.  The release of the new dysrhythmia interpretation assessment will include an assessment of the test taker’s ability to accurately measure the ECG tracings on the cardiac strips, in addition to assessing their ability to accurately interpret the cardiac rhythm.  The assessment will cover Sinus rhythms, Atrial rhythms, Ventricular rhythms, Paced rhythms, Junctional rhythms, and Heart blocks.

Based upon client feedback, Prophecy foresees these assessments being particularly helpful for nursing educators when developing educational plans for their nursing staff, based upon the test results of each individual.

Check out the full release here.

Prophecy’s Clinical Team has come through right on schedule! Clients now have access to the 2012 Core Mandatories and NPSG’s from the “Send Exams” screen.

So, here is a synopsis of the 2012 Core releases:

• 2012 Core Mandatory Part I: exams that are aligned to meet all Federal Regulatory Agency Requirements such as OSHA and CDC.
• 2012 Core Mandatory Part II: correlates with each discipline to meet all Joint Commission requirements.
• 2012 Core Mandatory Part III: for your convenience to meet any possible contractual or facility specific requirements.
• 2012 NPSG’s: for Nursing, Allied, & Non-licensed Personnel

Exams now available on the Mandatory section of the exam list:

2012 Core Mandatory Part I (for all disciplines) includes:

• Body Mechanics/Ergonomics
• Emergency Management Preparedness
• Environmental Safety
• Fire Safety
• Hazardous Chemicals
• HIPAA
• Infection Control/Blood Borne Pathogens

2012 Core Mandatory Part II (Nursing) includes:

• Age Specific
• Cultural Diversity
• Ethics for Healthcare
• 2012 National Patient Safety Goals (Nursing)
• Patient Rights

2012 Core Mandatory Part II (Allied) includes:

• Age Specific
• Cultural Diversity
• Ethics for Healthcare
• 2012 National Patient Safety Goals (Allied)
• Patient Rights

2012 Core Mandatory Part II (Non-Licensed Personnel) includes:

• Age Specific
• Cultural Diversity
• Ethics for Healthcare
• 2012 National Patient Safety Goals (Non-Licensed)
• Patient Rights

2012 Core Part III includes:

• Abuse
• Advanced Care Planning
• Domestic Violence
• Pain Management
• Patient Restraints
• Sexual Harassment
• Workplace Violence

To continue in assisting clients with their testing needs, we have released the 2012 NPSG exams specific for Nursing, Allied, and Non-Licensed Personnel. The following exams are now available and located in the Mandatory section of the exam list:

• 2012 NPSG (Nursing) – includes RN’s and LPN’s
• 2012 NPSG (Allied) – includes PT, OT, ORT, Radiology, Certified Medication Aides, CNA’s (licensed by state) and other Allied personnel that retain licensure.
• 2012 NPSG (Non-Licensed Personnel) – includes CNA’s (non-licensed by state), HHA’s, sitters and all other Non-Licensed Personnel.

We hope that these changes will assist our clients in their continued success for 2012!