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Competency based learning: a literature review
Inl. .I. Nurs. Stud.. Vol. 19, No. 3, Printed in Great Britain
pp.1 19-124.
1982
0020-7489/82/0301 I906 $03.00/O 0 1982 Pergamon Press Ltd.
Competency Based Learning: a literature review BEVERLEY
SCOTT,
R.N.,
B. App.
SC. (W.A.I.T.),
F.C.N.A.
Senior Tutor, School of Nursing, Western Australian Institute of Technology, Kent Street1 Bentley 6102. Western Australia.
Competency Based Learning is one of several approaches to learning which have developed over the past four decades. As with any educational development, Competency Based Learning has interesting facets which warrant examination by the Nurse Educator. This review covers the uses of Competency Based Learning (CBL) as a teaching/learning strategy, its applications and criticisms, and the relevance of this learning approach to nursing education.
Origins and definition
CBL models began to evolve during the 1960s as an approach to teacher education (Houston and Warner, 1977). A learning model may be described as a conceptual representation of an approach to the process of acquiring knowledge or skills. Since the 1960s the applications of CBL have spread to many educational fields, from secondary schools to University courses and continuing education programmes (Hanken, 1979). Specific examples to be found in the literature include courses preparing health professionals (Baris, 1978; Broski, 1977; de1 Bueno, Barker and Christmyer, 1980; Menne, 1975; Russell and Weinstein, 1978) and education in the liberal arts (Jarrett, 1977). CBL has been defined as: A data-based, adaptive, performance-oriented set of integrated processes that facilitate, measure, record and certify within the context of flexible time parameters the demonstration of known, explicitly stated, and agreed upon learning outcomes that reflect successful functioning in life roles. (Spady. 1977. p.10)
On examination, this complex definition contains the essential theoretical aspects of CBL, but it is possible that the scope of the definition mitigates against its “pure” application in many situations. Competence in relation to life roles was further clarified by Gale and Pol (1977): That which binds competence to a role are the abilities. skills, judgement. attitudes andvalues for successful functioning in that position. (p.24)
If competence
in a professional
role consists of the above characteristics, 119
required
and it seems
120
BE VERLE Y SCOTT
appropriate that it should, then professional education should help the student to attain that successful functioning (Strange. 1977). Being a relatively new approach to teaching/learning, the overall concept of CBL is possibly still evolving. Spady’s (1977) definition was mirrored by Jarrett (1977) in its essential features of learning objectives, flexible time parameters, criterion-referenced measurement and student performance-centred approach. As the applications of CBL grew outside the teacher education field (where it was called Competency Based Teacher Education - CBTE). so did the apparent modifications of the original model (Spady and Mitchell, 1977). It may be that the theoretical basis developed for teacher education was not easily applied to other fields of learning. as suggested by Chambliss (1976) and Reilly, Barclay and Culbertson (1977). Jarrett (1977) mentioned administrative and logistical difficulties, especially with voluminous record-keeping, scheduling and allocation of staff and learning resources.
Applications
of Competency
Based Learning
In general terms. viewing the essential theoretical features, CBL is usable in a variety of educational settings. To this end, several writers, for example, Davies (1973), Hall and Jones (1976) and Nagel and Richman (1972). have described the technology and management of CBL programmes in detail. The variation in application of CBL theoretical constructs was noted by Hall and Jones (1976. p.10): “variety is one characteristic that is most notable when examining different operational CBE programs”. (The term CBE refers to Competency Based Education, which appears to be used interchangeably with CBL in the literature.) It may be that the key to the variety in operationalized CBL is the evolving concept of the teacher-manager (Davies. 1973). The management of the learning environment is very important: individualized instruction. self-paced learning and remediation require careful planning and coordination (Nagel and Richman, 1972). The teacher-manager therefore brings to the learning situation an individual philosophy, management ability and teaching-style preference. The decisions made in relation to CBL application may be as varied as are the individuals making those decisions (Davies, 1973). The management decisions in CBL relate mainly to planning (task analysis. learning need identification and written objectives) and organizing (choosing learning resources and teaching strategies) (Davies, 1973). The choice oflearning modules. assessment methods and grading systems will depend both on the learning programme and the educational institution (Hall and Jones, 1976). Davies (1973) offered criteria for teachers to use in deciding on a course of action in planning a CBL programme. He suggested that his text was designed for teachers in secondary and tertiary education. industrial and military training and management courses. According to Jarrett (1977). a number of institutions in the United States of America use a CBL format, particularly for Liberal Arts courses. These include Alvemo College (Wisconsin). Governor’s State University (Illinois), Mars Hill College (North Carolina). Minnesota Metropolitan State College and Sterling College (Kansas). The variations in application of CBL concepts between the different institutions again reflects an apparent need to modify CBL according to local needs. There were no examples found in the available literature describing the use of CBL in areas other than
COMPETENCYBASED
LEARNING:
A LITERATURE
REVIEW
121
North America, but the law of probabilities suggests that there are some. Given the adaptability of the basic theoretical constructs of CBL, perhaps some of these unidentified applications did not, or do not, use recognizable CBL terminology. For example, unless the terms “competence”, “performance-based” or related descriptors appear in printed material, retrieval of the information in most literature searches is unlikely. The use of student self-paced instructional modules, and transcripts of achieved competences rather than grades, is one variation in use at Governor’s State College (Hanken, 1979). At Mars Hill College, programming includes “inquiry courses, extensive travel, field experiences and work study” (Jarrett, 1977, p.22). Hanken (1979) also described the CBL development at Ohio State University in the allied health divisions, and at the University of California. In the latter, the Kellogg Foundation supported the Health Educator courses, and competencies were developed. According to Hanken (1979) problems were encountered with staff resistance to the changes, and progress was slow. CBL in nursing
CBL has not been widely applied in nursing, and the only appropriate text found was by Guinee (1978) who gave step by step directions for developing comptency statements from nursing situations. The theoretical basis adopted by Guinee was very similar to that of Jarrett (1977) Spady (1977) and Strange (1977) in that competencies must be explicitly stated and measurable, and that learning resources and strategies should be designed to involve the student actively in the learning process. During the mid 1970s de1 Bueno began to examine the literature on the notion of competency in nursing, firstly in relation to cost (de1 Bueno, 1975). Subsequent articles concentrate on in-service education programmes for qualified nurses, using selflearning packages (de1 Bueno, 1976) discussing performance evaluation (de1 Bueno, 1977) and the principles of applying CBL to adult learners (de1 Bueno, 1978). In implementing these principles in a staff orientation programme, de1 Bueno et al. (1980) considered the CBL approach to be successful in achieving the programme’s objectives. Del Bueno (1978) saw two applications of CBL: firstly, as a conceptual framework for a total curriculum, and secondly, as a framework for a single learning unit or module. Strange (1977) reported the use of a CBL approach to the development of a total programme: the College of Public and Community Service of the University of Massachusetts/Boston chose this approach in order to meet its objectives. Criticisms
The problem of resistance to change, discussed by Hanken (1979) was not unique to the University of California. Resistance to educational innovation is to be expected (Spady & Mitchell, 1977; Strange, 1977) and “new” educational approaches very often attract critics. Criticisms of CBL stem from political, conceptual or administrative differences of opinion (Houston &Warner, 1977; Jarrett, 1977; Strange, 1977). Reformation of teacher training was, and is, opposed on political grounds because it threatens established power-bases (Houston and Warner, 1977). Conceptually, humanists resist the mechanistic aspects of CBL, in that all of the students are processed through a constrained
122
BE VERLEY
SCOTT
course and their performances are measured without giving them the traditional reward of a letter or number grade (Chambliss. 1976: de1 Bueno, 1978; Spady and Mitchell, 1977). Administrative criticisms are related to the maintenance of time- and space-consuming records with written transcripts. scheduling problems due to individualization of learning programmes. and expense due to the need to expand learning resources (Hanken. 1979: Jarrett, 1977). Nevertheless. the problems ofCBL that attracted criticism were not considered insurmountable. Hanken (1979) was cautiously optimistic for future successes with CBL models. as were de1 Bueno (1978). Houston and Warner (1977) and Strange (1977). Measurement of competence
The measurement of competence in CBL programmes was referred to by Reilly et al. (1970, p.70) as its “Achille’s heel”. This view was supported by Hanken (1979) and Houston and Warner (1977). and is attributed mainly to the measurement tools: their inadequacy. weak validity and questionable reliability (Spady. 1977). As Hanken pointed out. “Criterion testing raises the issue of standards” (1979. p.43). Several writers expressed concern over the standards set for student performance. particularly that they may be set too low. or perpetuate the status quo (Hanken. 1979: Houston and Warner. 1977). Spady (1977) stated that: The technology surrounding the assessment and measurement of successin life role activities is only in its infancy, even though the rush toward adopting CBE-like programs is upon us. Those systems seriously concerned with the quality of data they will accept as evidence of competent performance will have to pay a steep price in time and personnel resources required for the task. (p.11)
Measurement of competence in nursing
The measurement of nursing competence is a problem which has received an enormous amount of attention in the literature. The following are only a few examples of measurement techniques which have been described in recent years: criterionchecklists referenced measurement (Krumme. 1975: Rogers. 1976). performance (McCaffrey, 1978; Scott. 1979: Smania et al.. 1978), anecdotal records (Craig. 1978). competency rating scales (Wandelt and Stewart, 1975) and self-evaluation procedures (Palmer. 1967). For various reasons. none of these techniques have been widely accepted (Woolley. 1977). Preparation for nursing in the latter half of the 20th century requires adaptability. creativity and competence. It may be that adherence to traditional nursing roles and evaluation modes. where conformity to inherited norms is an unspoken but powerful demand. is the key to the problem. Perhaps more recent measurement techniques provide only a thin patina over deeply-rooted value systems. and, in reality. very little is changed in spite of their adoption. Spady (1977) implied that using traditional assessment approaches with innovative learning models was the essence of the problem in CBL programmes. He recommended that CBL courses should use student assessment data to diagnose learning weaknesses and permit remediation, rather than just for grading purposes. It is here. then. that the delicate balance between student and system accountability is most apparent and the ultimate vitality of a system will be reflected. (Spady. 1977. p.12)
COMPETENCY
BASED LEARNING:
A LITERATURE
REVIEW
123
Summary and conclusions
According to recent literature, CBL as a teaching/learning approach is growing in its applications. Despite modifications necessitated by its application to varied learning situations, there was general acceptance of the critical elements of Spady’s (1977) definition: the statement of explicit learning outcomes, flexible time parameters, selected instructional approaches and criterion-referenced measurement. The main criticisms of CBL, apart from the political and conceptual opposition encountered, were concerned with measurement of competence and selection of performance criteria. The dangers of perpetuating “mass mediocrity” were noted, as without due care, performance standards could be set too low. Published literature related to applications of CBL notions in undergraduate education (other than teacher education) is sparse. Most of the literature reviewed either discussed CBL theoretically and in very general terms, or dealt with applications in postgraduate courses or continuing education programmes. Avenues for further study in CBL were suggested as follows: The future of CBE may well be linked to its development in three areas - new bases for specifying competencies. linking training procedures with outcome specifications, and competency assessment. (Houston &Warner, 1977, p.17)
an approach to teaching/learning in nursing, CBL would seem to have some merit, at least in principle. Certainly, the notion of competence in professional education is attractive, because it suggests that students of an educational programme, who are competent, “can, and want to, master the various socially-ascribed and self-prescribed roles they will play on graduation . . .” (Block 1978, p.16). The use of CBL in nursing education could provide a systematic framework for a nursing programme in which the goals of the programme and the standards of nursing performance are explicit. Programme evaluation could be a part of the systematic framework both for formative and summative uses, because the maintenance of comprehensive records is a component of CBL. And, because competency measurement is necessarily built into a CBL model, there should be congruence between the planned teaching/learning strategies and the measurement of learning outcomes.
As
Acknowledgemenrs - The author wishes to acknowledge the guidance and valuable suggestions of Miss Merle Parkes and Dr John Dekkers. Their encouragement and support are sincerely appreciated.
References Baris, R (1978). Comptency-based education and creative thinking. Am .I occup. Ther. 32. 363-368 Block J. H. (1978). The “c” in CBE. Educ Res. 7. 13-16. Bro& D. (1977). Competency-based curriculum development: A pragmatic approach. J allied Hlth. 6,38-44. Chambliss, E. J. (1976). An application of PBTE principles in a humanistic framework. Educ. Leadership 33. 534-537. Craig, J. (1978). Anecdotal records. Can. Nurse 74, 25-27. Davies, I. (1973). Competency-based Learning: Technologv. Management, and Design. McGraw-Hill, New York. de1 Bueno, D. J. (1975). The cost of competency. J. Nurs. Admin. 5. 16-17. de1 Bueno. D. J. (1976). No more Wednesday matinees. Nurs. Outlook 24, 359-361. de1 Bueno, D. J. (1977). Performance evaluation: When all is said and done, more is said than done. J. Nurs. Admin. 7. 21-23. de1 Bueno, D. J. (1978). Competency-based education. Nurse Educ. 3, 10-14. de1 Bueno. D. J.. Barker, F. and Christmyer. C. (1980). Implementing a competency-based orientation programme. Nurse Educ. 5. 16-20. Gale. L. E. and Pol. G. (1977). Determining required competence: A need assessment methodology and computer program. Educ. Technol. 17. 24-28.
124
BE VERLE Y SCOTT
Guinee, K K (1978). Teaching and Learning in Nursing: A Behavioural Objectives Approach. Macmillan, New York. Hall. G. E. and Jones. H. L. (1976). Competency-based Education: A Process for the Improvement ofEducation. Prentice-Hall. New Jersey. Hanken, M. A (1979). Should institutions of higher education adopt a competency-based educational philosophy? Med. Rec. News 50.41-44. Houston, W. R and Warner. A. R. (1977). The competency-based movement: Origins and future. Educ. Technol. 17, 14-19. Jarrett H. H. (1977). Implications of implementing competency based education in the liberal arts. Educ. Technol. 17, 2 1-26.
Krumme, U. S. (1975). The case for criterion-referenced measurement. Nurs. Outlook 23, 764-770. McCaffrey. C. (1978). Performance checklists: An effective method of teaching, learning and evaluating. Nurse Educ. 3, I I-13. Menne. J. M. (1975). A comprehensive set of counsellor competencies. J. Couns. Psychol. 22. 547-553. Nagel, T. S. and Richman, P. T. (1972). Competenq Based Instruction: A Strategy to Eliminate Failure. Charles E. Merril, Columbus, Oh. Palmer, M. E. (1967). Self-evaluation of clinical performance. Nurs. Outlook 15. 63-65. Reilly. D. H., Barclay. J. and Culbertson, F. (1977). The current status of competency-based training, Part 1: Validity, reliability, logistical and ethical issues. J: School Psycho/. 15.68-74. Rogers. S. (1976). Testing the RN students’ skills. Nurs. Outlook 24, 446-449. Russell, M. L. and Weinstein, H. M. (1978). Guidelines for competency-based instruction in psychiatry. Med. Educ. 12.214-221.
Scott. B. M. (1979). Clinical assessment and identifying learning difficulties. Aust. Nurses’J 9. 32-33. Smania, M. A. McClelland, M. G. and McClosky. J. C. (1978). And still another look at clinical grading: Minimal behaviours. Nurse Educ. 3. 6-9. Spady. W. G. (1977). Competency-based education: A bandwagon in search of a definition. Educ. Res. 6,9-14. Spady, W. G. and Mitchell. D. E. (1977). Competency based education: Organizational issues and implications. Educ. Res. 6. 9-15. Strange, J. H. (1977). The experience of the College of Public and Community Service. Liberal Educ. 63.176-189. Wandelt. M. A. and Stewart D. S. (1975). Slater Nursing Competencies Rating Scale. Appleton-Century-Crofts. New York. Wooley. A S. (1977). The long and tortured history of clinical evaluation. Nurs. Outlook 25, 308-315.
Selected additional reading Bureau of Occupational and Adult Education (lY76). Competency-based Adult Education and innovation Catalogue. DHEW/DE Div. of Adult Education. Washington. D.C. (ERIC Document Reproduction Service No. ED 124 872). Bureau of Vocational Technical and Aduft Education (1974). Competency-based Education. An Annotated Bibliography. West Virginia State Dept. of Education, Charleston, VA (ERIC Document Reproduction Service No. ED 112 244). Endland, D.. Mears. M. and Mercadente. L. T. (1978). Development ojCompetencies in Associate Degree Nursing: A Nursing Service Perspective. NLN Pub. No. 23- I7 13. National League for Nursing New York. McCleary. I. (1976) Competencies in clinical supervision. J. Res. Dev. Educ. 9. 31-35. Morgan. M. K and Irby. D. M. (1978). Evaluating Clinical Competence in the Health Professions. C. V. Mosby. St Louis. Mount Hood Community College (1975). An investigation of the cost-beneJits and consumer outcomes related IO competency based education in a communitv college nursingprogram. Final Report. Mount Hood Community College, Gresham, OR (ERIC Document Reproduction Service No. ED 146 972). Torshen. K P. (1977). The Mastety Approach to Competency-based Education. Academic Press. New York. Voight. J. W. (1979). Assessing clinical performance: A model for competency. .I Nurs. Educ. 18, 30-33. White. R. T. (1979). Achievement. mastery. proficiency. competence. Studies Sci. Educ. 6. l-22. (Received 1 June 1982: accepted for publication 28 June 1982)
Beverley Scott is a member of the academic staff of the School of Nursing at the Western Australian Institute of Technology. An interest in nursing competence and its evaluation led to the preparation of this literature review. The review contributed towards the development of a Competency Based Learning model for one component of the undergraduate nursing course at WAIT.
pp.1 19-124.
1982
0020-7489/82/0301 I906 $03.00/O 0 1982 Pergamon Press Ltd.
Competency Based Learning: a literature review BEVERLEY
SCOTT,
R.N.,
B. App.
SC. (W.A.I.T.),
F.C.N.A.
Senior Tutor, School of Nursing, Western Australian Institute of Technology, Kent Street1 Bentley 6102. Western Australia.
Competency Based Learning is one of several approaches to learning which have developed over the past four decades. As with any educational development, Competency Based Learning has interesting facets which warrant examination by the Nurse Educator. This review covers the uses of Competency Based Learning (CBL) as a teaching/learning strategy, its applications and criticisms, and the relevance of this learning approach to nursing education.
Origins and definition
CBL models began to evolve during the 1960s as an approach to teacher education (Houston and Warner, 1977). A learning model may be described as a conceptual representation of an approach to the process of acquiring knowledge or skills. Since the 1960s the applications of CBL have spread to many educational fields, from secondary schools to University courses and continuing education programmes (Hanken, 1979). Specific examples to be found in the literature include courses preparing health professionals (Baris, 1978; Broski, 1977; de1 Bueno, Barker and Christmyer, 1980; Menne, 1975; Russell and Weinstein, 1978) and education in the liberal arts (Jarrett, 1977). CBL has been defined as: A data-based, adaptive, performance-oriented set of integrated processes that facilitate, measure, record and certify within the context of flexible time parameters the demonstration of known, explicitly stated, and agreed upon learning outcomes that reflect successful functioning in life roles. (Spady. 1977. p.10)
On examination, this complex definition contains the essential theoretical aspects of CBL, but it is possible that the scope of the definition mitigates against its “pure” application in many situations. Competence in relation to life roles was further clarified by Gale and Pol (1977): That which binds competence to a role are the abilities. skills, judgement. attitudes andvalues for successful functioning in that position. (p.24)
If competence
in a professional
role consists of the above characteristics, 119
required
and it seems
120
BE VERLE Y SCOTT
appropriate that it should, then professional education should help the student to attain that successful functioning (Strange. 1977). Being a relatively new approach to teaching/learning, the overall concept of CBL is possibly still evolving. Spady’s (1977) definition was mirrored by Jarrett (1977) in its essential features of learning objectives, flexible time parameters, criterion-referenced measurement and student performance-centred approach. As the applications of CBL grew outside the teacher education field (where it was called Competency Based Teacher Education - CBTE). so did the apparent modifications of the original model (Spady and Mitchell, 1977). It may be that the theoretical basis developed for teacher education was not easily applied to other fields of learning. as suggested by Chambliss (1976) and Reilly, Barclay and Culbertson (1977). Jarrett (1977) mentioned administrative and logistical difficulties, especially with voluminous record-keeping, scheduling and allocation of staff and learning resources.
Applications
of Competency
Based Learning
In general terms. viewing the essential theoretical features, CBL is usable in a variety of educational settings. To this end, several writers, for example, Davies (1973), Hall and Jones (1976) and Nagel and Richman (1972). have described the technology and management of CBL programmes in detail. The variation in application of CBL theoretical constructs was noted by Hall and Jones (1976. p.10): “variety is one characteristic that is most notable when examining different operational CBE programs”. (The term CBE refers to Competency Based Education, which appears to be used interchangeably with CBL in the literature.) It may be that the key to the variety in operationalized CBL is the evolving concept of the teacher-manager (Davies. 1973). The management of the learning environment is very important: individualized instruction. self-paced learning and remediation require careful planning and coordination (Nagel and Richman, 1972). The teacher-manager therefore brings to the learning situation an individual philosophy, management ability and teaching-style preference. The decisions made in relation to CBL application may be as varied as are the individuals making those decisions (Davies, 1973). The management decisions in CBL relate mainly to planning (task analysis. learning need identification and written objectives) and organizing (choosing learning resources and teaching strategies) (Davies, 1973). The choice oflearning modules. assessment methods and grading systems will depend both on the learning programme and the educational institution (Hall and Jones, 1976). Davies (1973) offered criteria for teachers to use in deciding on a course of action in planning a CBL programme. He suggested that his text was designed for teachers in secondary and tertiary education. industrial and military training and management courses. According to Jarrett (1977). a number of institutions in the United States of America use a CBL format, particularly for Liberal Arts courses. These include Alvemo College (Wisconsin). Governor’s State University (Illinois), Mars Hill College (North Carolina). Minnesota Metropolitan State College and Sterling College (Kansas). The variations in application of CBL concepts between the different institutions again reflects an apparent need to modify CBL according to local needs. There were no examples found in the available literature describing the use of CBL in areas other than
COMPETENCYBASED
LEARNING:
A LITERATURE
REVIEW
121
North America, but the law of probabilities suggests that there are some. Given the adaptability of the basic theoretical constructs of CBL, perhaps some of these unidentified applications did not, or do not, use recognizable CBL terminology. For example, unless the terms “competence”, “performance-based” or related descriptors appear in printed material, retrieval of the information in most literature searches is unlikely. The use of student self-paced instructional modules, and transcripts of achieved competences rather than grades, is one variation in use at Governor’s State College (Hanken, 1979). At Mars Hill College, programming includes “inquiry courses, extensive travel, field experiences and work study” (Jarrett, 1977, p.22). Hanken (1979) also described the CBL development at Ohio State University in the allied health divisions, and at the University of California. In the latter, the Kellogg Foundation supported the Health Educator courses, and competencies were developed. According to Hanken (1979) problems were encountered with staff resistance to the changes, and progress was slow. CBL in nursing
CBL has not been widely applied in nursing, and the only appropriate text found was by Guinee (1978) who gave step by step directions for developing comptency statements from nursing situations. The theoretical basis adopted by Guinee was very similar to that of Jarrett (1977) Spady (1977) and Strange (1977) in that competencies must be explicitly stated and measurable, and that learning resources and strategies should be designed to involve the student actively in the learning process. During the mid 1970s de1 Bueno began to examine the literature on the notion of competency in nursing, firstly in relation to cost (de1 Bueno, 1975). Subsequent articles concentrate on in-service education programmes for qualified nurses, using selflearning packages (de1 Bueno, 1976) discussing performance evaluation (de1 Bueno, 1977) and the principles of applying CBL to adult learners (de1 Bueno, 1978). In implementing these principles in a staff orientation programme, de1 Bueno et al. (1980) considered the CBL approach to be successful in achieving the programme’s objectives. Del Bueno (1978) saw two applications of CBL: firstly, as a conceptual framework for a total curriculum, and secondly, as a framework for a single learning unit or module. Strange (1977) reported the use of a CBL approach to the development of a total programme: the College of Public and Community Service of the University of Massachusetts/Boston chose this approach in order to meet its objectives. Criticisms
The problem of resistance to change, discussed by Hanken (1979) was not unique to the University of California. Resistance to educational innovation is to be expected (Spady & Mitchell, 1977; Strange, 1977) and “new” educational approaches very often attract critics. Criticisms of CBL stem from political, conceptual or administrative differences of opinion (Houston &Warner, 1977; Jarrett, 1977; Strange, 1977). Reformation of teacher training was, and is, opposed on political grounds because it threatens established power-bases (Houston and Warner, 1977). Conceptually, humanists resist the mechanistic aspects of CBL, in that all of the students are processed through a constrained
122
BE VERLEY
SCOTT
course and their performances are measured without giving them the traditional reward of a letter or number grade (Chambliss. 1976: de1 Bueno, 1978; Spady and Mitchell, 1977). Administrative criticisms are related to the maintenance of time- and space-consuming records with written transcripts. scheduling problems due to individualization of learning programmes. and expense due to the need to expand learning resources (Hanken. 1979: Jarrett, 1977). Nevertheless. the problems ofCBL that attracted criticism were not considered insurmountable. Hanken (1979) was cautiously optimistic for future successes with CBL models. as were de1 Bueno (1978). Houston and Warner (1977) and Strange (1977). Measurement of competence
The measurement of competence in CBL programmes was referred to by Reilly et al. (1970, p.70) as its “Achille’s heel”. This view was supported by Hanken (1979) and Houston and Warner (1977). and is attributed mainly to the measurement tools: their inadequacy. weak validity and questionable reliability (Spady. 1977). As Hanken pointed out. “Criterion testing raises the issue of standards” (1979. p.43). Several writers expressed concern over the standards set for student performance. particularly that they may be set too low. or perpetuate the status quo (Hanken. 1979: Houston and Warner. 1977). Spady (1977) stated that: The technology surrounding the assessment and measurement of successin life role activities is only in its infancy, even though the rush toward adopting CBE-like programs is upon us. Those systems seriously concerned with the quality of data they will accept as evidence of competent performance will have to pay a steep price in time and personnel resources required for the task. (p.11)
Measurement of competence in nursing
The measurement of nursing competence is a problem which has received an enormous amount of attention in the literature. The following are only a few examples of measurement techniques which have been described in recent years: criterionchecklists referenced measurement (Krumme. 1975: Rogers. 1976). performance (McCaffrey, 1978; Scott. 1979: Smania et al.. 1978), anecdotal records (Craig. 1978). competency rating scales (Wandelt and Stewart, 1975) and self-evaluation procedures (Palmer. 1967). For various reasons. none of these techniques have been widely accepted (Woolley. 1977). Preparation for nursing in the latter half of the 20th century requires adaptability. creativity and competence. It may be that adherence to traditional nursing roles and evaluation modes. where conformity to inherited norms is an unspoken but powerful demand. is the key to the problem. Perhaps more recent measurement techniques provide only a thin patina over deeply-rooted value systems. and, in reality. very little is changed in spite of their adoption. Spady (1977) implied that using traditional assessment approaches with innovative learning models was the essence of the problem in CBL programmes. He recommended that CBL courses should use student assessment data to diagnose learning weaknesses and permit remediation, rather than just for grading purposes. It is here. then. that the delicate balance between student and system accountability is most apparent and the ultimate vitality of a system will be reflected. (Spady. 1977. p.12)
COMPETENCY
BASED LEARNING:
A LITERATURE
REVIEW
123
Summary and conclusions
According to recent literature, CBL as a teaching/learning approach is growing in its applications. Despite modifications necessitated by its application to varied learning situations, there was general acceptance of the critical elements of Spady’s (1977) definition: the statement of explicit learning outcomes, flexible time parameters, selected instructional approaches and criterion-referenced measurement. The main criticisms of CBL, apart from the political and conceptual opposition encountered, were concerned with measurement of competence and selection of performance criteria. The dangers of perpetuating “mass mediocrity” were noted, as without due care, performance standards could be set too low. Published literature related to applications of CBL notions in undergraduate education (other than teacher education) is sparse. Most of the literature reviewed either discussed CBL theoretically and in very general terms, or dealt with applications in postgraduate courses or continuing education programmes. Avenues for further study in CBL were suggested as follows: The future of CBE may well be linked to its development in three areas - new bases for specifying competencies. linking training procedures with outcome specifications, and competency assessment. (Houston &Warner, 1977, p.17)
an approach to teaching/learning in nursing, CBL would seem to have some merit, at least in principle. Certainly, the notion of competence in professional education is attractive, because it suggests that students of an educational programme, who are competent, “can, and want to, master the various socially-ascribed and self-prescribed roles they will play on graduation . . .” (Block 1978, p.16). The use of CBL in nursing education could provide a systematic framework for a nursing programme in which the goals of the programme and the standards of nursing performance are explicit. Programme evaluation could be a part of the systematic framework both for formative and summative uses, because the maintenance of comprehensive records is a component of CBL. And, because competency measurement is necessarily built into a CBL model, there should be congruence between the planned teaching/learning strategies and the measurement of learning outcomes.
As
Acknowledgemenrs - The author wishes to acknowledge the guidance and valuable suggestions of Miss Merle Parkes and Dr John Dekkers. Their encouragement and support are sincerely appreciated.
References Baris, R (1978). Comptency-based education and creative thinking. Am .I occup. Ther. 32. 363-368 Block J. H. (1978). The “c” in CBE. Educ Res. 7. 13-16. Bro& D. (1977). Competency-based curriculum development: A pragmatic approach. J allied Hlth. 6,38-44. Chambliss, E. J. (1976). An application of PBTE principles in a humanistic framework. Educ. Leadership 33. 534-537. Craig, J. (1978). Anecdotal records. Can. Nurse 74, 25-27. Davies, I. (1973). Competency-based Learning: Technologv. Management, and Design. McGraw-Hill, New York. de1 Bueno, D. J. (1975). The cost of competency. J. Nurs. Admin. 5. 16-17. de1 Bueno. D. J. (1976). No more Wednesday matinees. Nurs. Outlook 24, 359-361. de1 Bueno, D. J. (1977). Performance evaluation: When all is said and done, more is said than done. J. Nurs. Admin. 7. 21-23. de1 Bueno, D. J. (1978). Competency-based education. Nurse Educ. 3, 10-14. de1 Bueno. D. J.. Barker, F. and Christmyer. C. (1980). Implementing a competency-based orientation programme. Nurse Educ. 5. 16-20. Gale. L. E. and Pol. G. (1977). Determining required competence: A need assessment methodology and computer program. Educ. Technol. 17. 24-28.
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Guinee, K K (1978). Teaching and Learning in Nursing: A Behavioural Objectives Approach. Macmillan, New York. Hall. G. E. and Jones. H. L. (1976). Competency-based Education: A Process for the Improvement ofEducation. Prentice-Hall. New Jersey. Hanken, M. A (1979). Should institutions of higher education adopt a competency-based educational philosophy? Med. Rec. News 50.41-44. Houston, W. R and Warner. A. R. (1977). The competency-based movement: Origins and future. Educ. Technol. 17, 14-19. Jarrett H. H. (1977). Implications of implementing competency based education in the liberal arts. Educ. Technol. 17, 2 1-26.
Krumme, U. S. (1975). The case for criterion-referenced measurement. Nurs. Outlook 23, 764-770. McCaffrey. C. (1978). Performance checklists: An effective method of teaching, learning and evaluating. Nurse Educ. 3, I I-13. Menne. J. M. (1975). A comprehensive set of counsellor competencies. J. Couns. Psychol. 22. 547-553. Nagel, T. S. and Richman, P. T. (1972). Competenq Based Instruction: A Strategy to Eliminate Failure. Charles E. Merril, Columbus, Oh. Palmer, M. E. (1967). Self-evaluation of clinical performance. Nurs. Outlook 15. 63-65. Reilly. D. H., Barclay. J. and Culbertson, F. (1977). The current status of competency-based training, Part 1: Validity, reliability, logistical and ethical issues. J: School Psycho/. 15.68-74. Rogers. S. (1976). Testing the RN students’ skills. Nurs. Outlook 24, 446-449. Russell, M. L. and Weinstein, H. M. (1978). Guidelines for competency-based instruction in psychiatry. Med. Educ. 12.214-221.
Scott. B. M. (1979). Clinical assessment and identifying learning difficulties. Aust. Nurses’J 9. 32-33. Smania, M. A. McClelland, M. G. and McClosky. J. C. (1978). And still another look at clinical grading: Minimal behaviours. Nurse Educ. 3. 6-9. Spady. W. G. (1977). Competency-based education: A bandwagon in search of a definition. Educ. Res. 6,9-14. Spady, W. G. and Mitchell. D. E. (1977). Competency based education: Organizational issues and implications. Educ. Res. 6. 9-15. Strange, J. H. (1977). The experience of the College of Public and Community Service. Liberal Educ. 63.176-189. Wandelt. M. A. and Stewart D. S. (1975). Slater Nursing Competencies Rating Scale. Appleton-Century-Crofts. New York. Wooley. A S. (1977). The long and tortured history of clinical evaluation. Nurs. Outlook 25, 308-315.
Selected additional reading Bureau of Occupational and Adult Education (lY76). Competency-based Adult Education and innovation Catalogue. DHEW/DE Div. of Adult Education. Washington. D.C. (ERIC Document Reproduction Service No. ED 124 872). Bureau of Vocational Technical and Aduft Education (1974). Competency-based Education. An Annotated Bibliography. West Virginia State Dept. of Education, Charleston, VA (ERIC Document Reproduction Service No. ED 112 244). Endland, D.. Mears. M. and Mercadente. L. T. (1978). Development ojCompetencies in Associate Degree Nursing: A Nursing Service Perspective. NLN Pub. No. 23- I7 13. National League for Nursing New York. McCleary. I. (1976) Competencies in clinical supervision. J. Res. Dev. Educ. 9. 31-35. Morgan. M. K and Irby. D. M. (1978). Evaluating Clinical Competence in the Health Professions. C. V. Mosby. St Louis. Mount Hood Community College (1975). An investigation of the cost-beneJits and consumer outcomes related IO competency based education in a communitv college nursingprogram. Final Report. Mount Hood Community College, Gresham, OR (ERIC Document Reproduction Service No. ED 146 972). Torshen. K P. (1977). The Mastety Approach to Competency-based Education. Academic Press. New York. Voight. J. W. (1979). Assessing clinical performance: A model for competency. .I Nurs. Educ. 18, 30-33. White. R. T. (1979). Achievement. mastery. proficiency. competence. Studies Sci. Educ. 6. l-22. (Received 1 June 1982: accepted for publication 28 June 1982)
Beverley Scott is a member of the academic staff of the School of Nursing at the Western Australian Institute of Technology. An interest in nursing competence and its evaluation led to the preparation of this literature review. The review contributed towards the development of a Competency Based Learning model for one component of the undergraduate nursing course at WAIT.