Clinical Skills Observer Training

ROLE OF THE CLINICAL SKILLS OBSERVEREvaluate all candidates fairly and objectively

Clinical Skills Observer Training

CLINICAL SKILLS OBSERVER QUALIFICATIONS

Clinical Skills Observer TrainingAPPROVAL PROCESS• HCP CSO training is mandatory – training from other

testing vendors is not accepted• Trained by Test Site Coordinators• Training Includes:

• Training on local procedures for handling testing materials securely

• Review of CSO Training Powerpoint• Watching CSO Training video• Shadowing experience CSO during an exam

Clinical Skills Observer Training

APPROVAL PROCESS• After training is complete, the Test Site

Coordinator submits a CSO Request and supporting documentation to the state HCP office for approval.

• Approval letter and certificate are sent to the Test Site Coordinator to copy for test site records and then given to the evaluator

Clinical Skills Observer TrainingMAINTAINING “APPROVED” STATUS• CSOs must administer at least two clinical skills

exams per year• CSOs may be removed from the list for:• Inactivity• Change of employment• Lack of affiliation with an approved program• Expiration/loss of nursing license• Violating the confidentiality agreement

Clinical Skills Observer Training

MAINTAINING APPROVED STATUS• CSOs who jeopardize test security or engage

in misconduct will be permanently removed from the “approved” list.

• CSOs who are removed from the list for other reasons must retrain and resubmitted to the HCP office before testing

Clinical Skills Observer Training

HANDLING TESTING MATERIALS• Test site coordinator provides materials to

CSO on “as needed” basis.• CSO must handle testing materials following

state and local procedures • CSO must take care to prevent exposure of

test content and candidate personal information.

Clinical Skills Observer Training

HANDLING TESTING MATERIALS• CSOs may not:• Photocopy or reproduce test materials, OR• Sell or disclose the content of the tests to any

person or organization, OR• Teach students using testing materials, OR

Clinical Skills Observer Training

ADMINISTERING EXAMS• Must be administered and answered in

English – no translation • No resources allowed other than

information in exam packet• Exam is to be administered in one

uninterrupted session

Clinical Skills Observer Training

ADMINISTERING EXAMS• A CSO must evaluate all skills by a candidate

before evaluating another candidate• Candidates may not be rotated among CSOs

at skills stations• Candidates may not be rotated as a group

from one skill to another

Clinical Skills Observer Training

VOLUNTEERS/RESIDENTS• Skills can be demonstrated on a manikin, if

appropriate• CNAs and students in nurse aide training

programs cannot be volunteers/residents• Preferred: Healthcare providers or

students not be volunteers/residents

Clinical Skills Observer Training

MISCELLANEOUS• CSOs should not be instructors in nurse aide

training programs• RULE: If a CSO is an instructor, he/she cannot

administer the clinical skills exam to a student if he/she has had any role in that student’s training

• Test site coordinators have open access to testing at any time.

Clinical Skills Observer Training

CLINICAL SKILLS EXAM OVERVIEW• Several skills incorporated into a scenario• Designed to more closely replicate what

nurse aides encounter on the job• Contains critical and non-critical tasks

Clinical Skills Observer Training

CLINICAL SKILLS EXAM OVERVIEW• Four testing scenarios• Total LTC exam time– 1 hour, 15 minutes• 15 minutes for instructions and candidate and

volunteer/resident preparation• 1 hour for skills demonstration

Clinical Skills Observer Training

CLINICAL SKILLS EXAM MATERIALS1. Cover Sheet – completed by test site coordinator

prior to the exam2. Candidate Information pages

1. Scenario & Candidate Instructions2. Documentation Sheet

3. Volunteer/Resident Information – includes instructions and volunteer consent form

Clinical Skills Observer Training

CLINICAL SKILLS EXAM MATERIALS4. Clinical Skills Observer Information pages

1. Equipment List and CSO Instructions2. Scenario & Candidate Instructions3. Documentation Sheet

5. Clinical Skills Examination Evaluation Grid - marked by the CSO as the candidate performs tasks

6. Clinical Skills Score Sheet – completed by the test site coordinator

Clinical Skills Observer Training

CRITICAL SKILLS

1. General in nature2. Requires candidate to demonstrate safety

and infection control at all times when performing skills

3. Candidate must measure vital signs accurately

Clinical Skills Observer Training

CRITICAL SKILLS

• CSO marks tasks related to safety and infection control

• Test site coordinator determines whether or not the candidate measured vital signs within acceptable margins of error

Clinical Skills Observer Training

NON-CRITICAL SKILLS – 80% Accuracy Required

• Tasks related to performing skills in the scenario

Clinical Skills Observer Training

PREPARING THE EXAMINATION AREA

• Administered in care-giving situation or a laboratory setting that has access to running water and closely resembles the environment in which nurse aides function

• All equipment and supplies provided by the test site

Clinical Skills Observer Training

PREPARING THE EXAMINATION AREA• Supplies are listed in the CSO Information in

the clinical skills exam packet• CSO does not gather the supplies and

equipment for the exam, but must make sure that everything is accessible to the candidate and the candidate knows where to retrieve them

Clinical Skills Observer TrainingPREPARING THE CANDIDATE & VOLUNTEER/RESIDENT• Remind both that cell phones and electronic devices

are not permitted; allow them to secure if needed• Confirm the candidate’s identify as shown on the

cover sheet• Provide candidate with sheets on packet labeled

“Candidate Information” to review while preparing the volunteer/resident

Clinical Skills Observer TrainingPREPARING THE VOLUNTEER/RESIDENT• Take the volunteer/resident to testing area and

instruct him/her to remove shoes, put on a hospital gown over his/her clothes, and sit in the hospital bed

• Review the volunteer/resident Information & answer questions

• Have volunteer/resident sign information sheet/consent form

Clinical Skills Observer Training

PREPARING THE CANDIDATE• Bring candidate into testing area and review

the Scenario & Candidate Instructions together

• Candidate may take notes on the information sheet and refer to the information sheet and his/her notes during the examination

Clinical Skills Observer Training

PREPARING THE CANDIDATE• CSO demonstrates how to operate the

bed, wheelchair, and other equipment (if needed)

• Answer candidates questions, if any.• Candidate and CSO each sign their

respective copies of the Information Sheet.

Clinical Skills Observer Training

ADMINISTERING THE EXAM• When the candidate is ready to begin the

exam, the CSO will mark the start time on the evaluation grid.

• The CSO must mark each task as it is performed

• An explanation must be provided for all tasks marked “No”

Clinical Skills Observer Training

ADMINISTERING THE EXAM• Although the scenario and evaluation grid

are in a logical order, the candidate can go out of sequence as long as he/she observes standard precautions and does not endanger the volunteer/resident, the CSO, or the candidate.

Clinical Skills Observer Training

ADMINISTERING THE EXAM• If a candidate makes mistake or forgets a

task, he/she may correct and re-demonstrate the skills as long as the error or omission is noted before the exam is finished and the allotted time for the exam is not exceeded.

Clinical Skills Observer Training

ADMINISTERING THE EXAM• Candidates are required to demonstrate

hand washing the first time it is needed in the exam; in all subsequent instances that require hand hygiene, the candidate need only verbalize that he/she would was hands or use hand sanitizer

Clinical Skills Observer TrainingADMINISTERING THE EXAM• During the exam, the CSO may give the candidate up to

three attempts to obtain the correct vital signs measurements.

• This is the only time when the CSO may provide feedback to the candidate

• If multiple blood pressure readings are required, the candidate must observer or verbalize, without prompting, the correct waiting time between attempts.

Clinical Skills Observer Training

ADMINISTERING THE EXAM• The CSO may not prompt the candidate,

answer questions from the candidate about a skill, or indicate whether a skill was performed correctly.

• The CSO may periodically remind the candidate that the resident/volunteer is wearing a hospital gown

Clinical Skills Observer Training

ADMINISTERING THE EXAM• If the candidate does anything during the

exam that compromises infection control or resident safety, the CSO will mark that task “no” and provide an explanation of the action(s) that were incorrectly (or not done at all)

Clinical Skills Observer Training

FINISHING THE EXAM• CSO marks the end time on the evaluation

grid• CSO collects all pages of the clinical skills

examination packet – the candidate may not take the scenario or instruction sheet!

• The CSO will advise the candidate on how his/her results will be communicated

Clinical Skills Observer Training

FINISHING THE EXAM• All clinical skills exam packets (used or

unused) must be returned to the test site coordinator - CSOs may not keep unused packets for use at a later time