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[Auto-generated transcript. Edits may have been applied for clarity.]
Narrator: Welcome to the competency Conversation preparing practice ready Nurses through competency based education,
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presented by the MUSC Center for the Advancement of Teaching and Learning and the team at the Learning Curve podcast.
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Julia Liebenrood: Today, we are pleased to welcome Dr. Tese Stevens,
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Professor and Director of Accreditation Assessment in the College of Nursing here at Musk, to the podcast.
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With extensive experience in nursing practice and education,
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Doctor Stevens brings a wealth of knowledge and expertise in assessment, accreditation, resilience and workforce development.
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We appreciate you being here, Doctor Stevens, and for joining us today.
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We look forward to hearing your perspectives on competency based education and its impact on healthcare training.
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So welcome, Doctor Stevens. Tese Stephens: Well, thank you, Julia. It's a pleasure to be here.
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All right. Will you kick us off? Tell us a little bit about what competency based education means to you.
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That's a big question. Um, to me, it is truly a picture.
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If we if we are approaching competency based education the way we have defined it in nursing, it's the overall learning experience.
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So looking at what does the student experience and how do they get from point A to point B or A to Z.
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If you want to put it that way, from the start of their academic experience to where they, um,
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complete their learning program and are ready for practice or for whatever position that they have been preparing for,
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and it includes everything around that. So not just the teaching and learning, but assessments, um, the demonstration of competence, the interactions.
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And we define competence as the behaviors, attitudes, skills, knowledge, all of those things combined.
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So it's the it's the big picture of learning. And it's it it's a total form.
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Tell me a little bit about when you first heard competency based education and where you were,
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and how it impacted how you thought about and approach teaching from then forward.
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Um, to be honest, I don't remember exactly when I first heard of competency based education,
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but my PhD is in nursing education, so we looked at different models of education and competency based was one of those.
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Um, I really did not focus heavily on competency based education until I became a consultant, and that was around 2014, I believe.
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And at that time, there was a huge wave in nursing academia towards concept based education.
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And so some of the clients that I was working with were moving towards concept based,
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and there was a lot of confusion about the difference between concept based, competency based and the traditional models.
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So I think that was when I first really started thinking about the differences.
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Um, but, uh, it didn't really come to fruition personally in my own practice until 2018 when, um,
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the accrediting bodies and the American Association of Colleges of Nurses started actually,
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um, talking more about it being the approved or the preferred method for nursing education.
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And we started moving towards that holistically as a profession.
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And that was 2018. Yeah. But we know that nursing as a whole is kind of one of the front runner programs
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nationally within the space of CBE and the work that they have done and supported.
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And as you guys here in the College of Nursing at USC, you guys have started to implement some of these competency based approaches.
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How have you seen assessment practices shift through this new approach?
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It's ever evolving. And, um, you know, it was it was both, uh, a struggle, but also, uh,
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really a gift that we were one of the first programs in the United States to actually have our
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accreditation site visit in the first year after the after the expectation went into place.
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So, um, last year, 2025 was the first year nursing programs were evaluated for accreditation purposes on the implementation of competency based model.
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And, um, so it was really like a testing phase for us.
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And, uh, you know, we were we weren't really sure what to expect.
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And, uh, we had done a lot of work in preparing for that, but a lot of that work was around a competency based model of assessment.
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And so the three years prior to that was heavy.
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And faculty development because the tradition based model was more, uh, fragmented, and which was the problem from the beginning,
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that we were getting a lot of variability in what graduates across the United States were able to demonstrate competency wise.
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So the push was really to be more consistent in,
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in what graduates were able to do so that they could be proficient and competent no matter where they went,
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and not just reflect the institution's flavor or, um, preferences.
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So one of the benefits of the entire profession and accrediting body being behind that is that we were given a lot of resources to use.
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And and I have been honored and had the pleasure of participating in some of the development of those.
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And so a competency based framework was actually developed in this process.
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So a lot, as I said, was around faculty development, really teaching faculty.
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What is a competency based education? What does that look like?
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How does that change the way that you teach? How does that change the way that you approach, um, learners?
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And a lot of it was really getting back to basics in teaching backwards design, uh, looking at what is the preferred outcome,
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what are our end of program student learning outcomes and really everything being driven from that?
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Um, so a lot of that was around curriculum mapping, gapping, um, revisions.
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And the majority of that, Tom.
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And that work was really in getting everyone to see things from the student perspective
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and what they're experiencing and how every single class relates to the whole,
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and that they're not standalone, but everything, um, everything is important and contributes to that final competency development.
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Right. And that is so important to have that faculty understanding when you're going into this, um,
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as you guys have begun to roll things out and you're looking at assessments a little bit differently,
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what data has been most important for you guys to collect, and how have you guys looked at that data to make improvements along the way?
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I think all that is important, but I think, um, looking specifically at, you know,
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we have our a lot of the direct indicators and the quantitative data, which of course is is useful, but getting student feedback,
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more of that qualitative data and looking at their perspective on this transformation
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and how they're able to now understand their role in the teaching learning process,
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because a competency based model is very collaborative and students have to really understand their,
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uh, role and responsibilities in this process and in tracking their own competency development.
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And so I think that's been a very important data there.
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Um, and also from the faculty side, the same thing we one of the things that we worked on and, um,
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we're privileged as the College of Nursing to participate in was the development of progression indicators,
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uh, for the national framework and make the making these meaningful.
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And translating that into data has been an important step in this process.
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And I think it's been useful for both faculty and learners to understand the importance of leveling competencies and looking at the plan of study.
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Where should students be? Um, at this point, and what level of competency should they be able to demonstrate and what does that look like?
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So rubric development is the development of both formative and summative assessments etc..
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So the qualitative data from both faculty and the learners has been useful, and especially in my role as the former, um, associate dean for academics.
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And now that I'm stepping down and preparing for retirement in a couple of years, assuming the role of Director of Accreditation and Assessment,
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it's been useful to me to really look at, at this qualitative data as a meaningful guide in how do we, um, further improve what we're doing.
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And it really does help to shed light and help us to better understand the
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quantitative data that we're getting from the student outcomes and faculty outcomes.
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ET cetera. Yeah. And one of the things that we've heard is that when you switch over your your rubrics to a competency based approach,
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they become more meaningful, more helpful to both the faculty member and the student.
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And they're not just a grading tool anymore if they're set up correctly. Um, and you mentioned those progression indicators in the leveling.
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So it's a lot of upfront work, but once they're done,
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it does provide data both again to the faculty and to the student that can be really supportive of their growth and of the learning that's
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supposed to be happening within their programs and helping students to identify maybe where they're lacking in some areas of growth,
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where they can take initiative and begin to spend a little bit of extra time, um,
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learning for themselves and kind of taking that advocacy role for their own learning.
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Absolutely.
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It's, um, we're still so early in this, you know, we've, uh, while, you know, while we have been through accreditation, I, I remind everyone,
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you know, as often as I can and I think everybody understands this, that it's not a one and done thing, that this is a continuous improvement effort.
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And so we we always see opportunities for improving what we've already done.
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But um, you're exactly right. There was a lot a lot of time and effort was done on the front end and the the early estimates of time,
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you know, like a from a time frame of converting to a CBE, uh, model was a minimum of three years.
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And now I think we're seeing it's more, um, of initial, uh, time, um,
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requirement of probably more like 4 to 5 years to actually convert everything and to get everything in place.
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But then after that there's there's continuous improvement in those efforts.
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And a lot of it, uh, is, is again, like what I said, faculty development, really understanding some of these processes because,
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you know, many faculty don't have a background or extensive training in, um, Andrew G.
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Pedagogy and, you know, the science of teaching and learning.
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So you have to start at the basics and, uh, work your way through that to really understand the, you know, what's happening cognitively.
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And, um, how do how does learning actually occur and how does competency based education improve that and help with retention?
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And one of the things that I have seen that I really see a lot of hope for.
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Um, in addition to what we were already hoping for with competency based is the improvement on remediation.
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So I believe it's going to assist us in, uh,
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better identifying at risk learners earlier in the process and with them partnering in this model and being participants in their own learning.
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I think we're going to be able to help rescue, um, some students who may fall through the cracks with the traditional model,
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but actually give us a way through these progression indicators to better understand their needs
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and to address those much earlier in the process with them as partners in this to hopefully,
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um, increase their ability to successfully complete the programs. Yep.
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And I think just to add to that, as far as like students having advocacy for their own learning, a lot of times folks think that 80% is mastery.
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80% is pretty good. But when you think about a nurse or a health care worker in general going out into practice,
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if they only know 80%, I don't necessarily want them working on me.
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Um, so I think this shift to competency based education makes sense in the healthcare space.
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Um, and I think when you can look at it from that perspective, a lot of people will naturally buy in.
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Is there anything else that the College of Nursing has done to increase faculty buy in through this process?
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Um, we've done about everything that we could possibly do.
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Probably overkill in many ways.
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Um, but Arc and the American Association of Colleges of Nursing, who has directed much of this work, um, has provided multiple resources.
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So we have fact sheets, we have, um, standards and, um, you know,
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different kinds of information that we can share with stakeholders, with faculty, with administrators.
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With students. You name it. So it's I think a big thing is just being consistent in the messaging and making
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sure that all key stakeholders are informed and understand what is happening.
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Um, a lot of communication, frequent ongoing communication of these, uh, repeated.
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So really just using best practices and teaching and learning for our own faculty and, um,
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stakeholders, our communities of interest, just repeating it often and being consistent in what we do.
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Uh, we've done a lot of faculty development. Um, when I first, um, assumed this role and we, we started actively working on this.
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We developed a monthly lunch and learns. And, um, each month we would focus on a different aspect of this.
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As for faculty Development. We did faculty forums that would immediately follow our um.
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College of Nursing assemblies,
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which was monthly specific to some of the key standards and the accreditation requirements around competency based learning.
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Um, we did, uh, individual work sessions with the different programs because the competencies are defined based on entry level versus advanced level.
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So there's different um levels that are defined.
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So within each um within the competency framework we have ten domains.
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And then those ten domains are further divided into competencies and sub competencies.
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And then those are defined based on whether they're entry level.
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So that's pre licensure or advanced level. So for our masters and doctoral students.
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So we would do very targeted work with those specific faculty depending on which level they were at.
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And then very intensive curriculum mapping and gapping to see where we were already,
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so that we could really focus our efforts and, um, energy on where we really needed to target.
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And there were some really interesting things that came out of the mapping and gapping that, uh,
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really allowed us to dig deeper into some of these things and to really improve many of the things that we were already doing.
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Well. Yep.
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And it does absolutely give you time to reflect and see maybe things that were, um,
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lacking things for opportunities for growth, um, both for students and for faculty and our approach to teaching,
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as you guys have been working either within your own work or at work that you've seen within the College of Nursing,
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have there been any unexpected wins as you guys have been working through this?
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I know you just spoke about the curriculum mapping. Um, but just in general with either students or with faculty.
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Have you seen any unexpected wins that you weren't quite sure that were on your radar before all of this?
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Sure. Lots of things. There have been so many wins that have already come from this,
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but I think probably the biggest wins have been around faculty development and the buy in that we have gotten from faculty.
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We have a great team anyway, and our faculty are, um, just amazing student centered human beings as a whole.
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But I think that, uh, this, this whole movement has sparked an intense interest in teaching,
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um, as advanced practice, uh, in those who may have never considered that before.
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I often, um, jokingly say that, you know, being an educator in nursing academia is, you know, being like a multi-sport athlete.
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You come in with your areas of expertise in practice and in research, usually, um, but you don't really think of teaching as an area of practice.
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But I think many have discovered a love for that, and it has advanced their own scholarship in many areas.
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We have seen scholarship in this area from our faculty grow in leaps and bounds,
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and it has been interprofessional in many ways, and it has been, um, very, uh, broad across all of our programs.
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So we're seeing a lot of collaborative work come from this.
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And faculty reach across programs and across disciplines to integrate and to share and disseminate some of the work they're doing.
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So I think that has been a huge, um, win from from my point of view, that we have faculty who have really excelled in this.
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They didn't just do what they had to do, um, to convert to competency based, but they have really, uh,
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understood and appreciated the value in it and have taken it to heart in all aspects
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of their their practice as an educator and are taking that on themselves to grow and,
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um, doing beautiful things with it. We've been able to highlight some of those wonderful things too.
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We had, um, y'all's VR partnership with the College of Pharmacy was highlighted, um, this spring within our learning circles, jigsaw.
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And that was wonderful to hear about and how that tied in with competency based education.
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And I also know that you guys have some folks from the College of Nursing headed to an international conference,
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um, down in Florida in the fall to present about their journey with competency based education.
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So we were so excited to see some of the scholarship that's coming out of it,
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and their pride in the work that they're doing and how they want to share that with them, USC and beyond.
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So we have gotten to, um, hear all about that, which is wonderful, and I'm sure you'll be hearing even more.
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They're doing amazing things. I'm just so proud of all of them. That's wonderful to hear.
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As we wrap up today, where do you hope competency based education goes next to the MSC?
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Well, we you know, we still have work to do.
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Like I said, I mean it's ever evolving, but I really think that, um, what we have done has, has demonstrated already it's worth the effort.
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And there's a lot of benefits in moving towards that.
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I think that over the next couple of years, and as we see these cohorts graduate that have experienced competency based model,
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we'll have more data, um, we're learning every day and refining what we do.
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And as far as the university goes, I, I hope to see it integrated across the disciplines in the near future.
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I believe that it's something that makes a lot of sense for, um, all health professions.
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And it's certainly, I believe, going to improve practice readiness for anyone that graduates from a competency based model.
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The the imperative to do this came from years of research looking at the practice readiness gap,
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and we're already seeing our learners demonstrate higher levels of competence before they even graduate.
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So I know it's going to make a big difference in hopefully, retention of new nurses when they get into the practice settings,
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but also their performance as, uh, as, as nurse nurses at whatever level they graduate at.
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But I do hope that the other, uh, disciplines, the other colleges will follow suit,
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and if not totally converting to competency based at least looking at some of the things that have been so beneficial to us,
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such as the progression indicators and those types of things.
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Yes, and we hope that our Summer series, as well as this podcast, is going to be a great platform to hear those voices.
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So we have five other guests lined up for the summer from different programs, departments and colleges across the university.
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So we are going to get to hear about what they are doing as well.
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Is there anything else that you would like to share with folks that you would like them to walk away with today?
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No, I just think that, um, if it's if you're interested in this to, you know,
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to dig in a little bit deeper and to pick an area that interests you and, uh,
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learn more about that, and to just have an open mind that there are many different definitions of competency based education,
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and it's approached in different ways. So clarifying how someone is using that I think is very important.
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But, um, I just appreciate the opportunity to share a little bit about what the College of Nursing has done and,
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and is continuing to do and look forward to hearing from the other colleges and the other speakers.
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Well, thank you so much, Doctor Stevens, for joining us today.
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We are excited to hear about the future of competency based education within the College of Nursing,
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as well as here at USC, and we appreciate your time so much. Well, thank you very much.
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Have a great day. You too.
