LEVERAGING COMPETENCY-BASED EDUCATION AND DIRECT ASSESSMENT TO ADVANCE MIDWIFERY EDUCATION

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Presented by Dr. Charla Long

Learning Objectives

¨  Define and describe competency-based education; ¨  Explain the CBE movement in the U.S., including the

reasons for its bipartisan support; ¨  Differentiate between and articulate the pros and

cons of credit-hour and direct assessment models; and

¨  Visualize how CBE and a direct assessment model can be leveraged by midwifery educators.

WHAT IS COMPETENCY-BASED EDUCATION (CBE)?

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Every workplace role, profession and academic discipline, is, at the simplest level, a collection of competencies.

¤  Every role has a unique competency combination. ¤  Every role requires different levels of competence.

What are Competencies?

Knowledge Skills Ability Attitude

The focus is on what is needed to be successful in that role.

Competency Example

¨  Midwives provide high quality, culturally sensitive care during labor, conduct a clean and safe birth and handle selected emergency situations to maximize the health of women and their newborns.

¨  Knowledge: Physiology of first, second and third stages of labor

¨  Skill: Perform a complete abdominal assessment for fetal position and descent

¨  Ability: Perform vacuum extraction

What is CBE?

¨  Pedagogical approach ¨  Time is variable, learning is fixed ¨  Flexible, self-paced approach ¨  Demonstration of learning ¨  Mastery or proficiency of standard, consistent

behaviors ¨  Rigorous assessments ¨  Focused on the student journey ¨  May be alternative to credit-hour system

More CBE Definitions

¨  Competency-based education (CBE) is focused on actual student learning, and the application of that learning, rather than time spent in class/on material.

¨  Learners’ progress is measured when they demonstrate their competence through a system of rigorous assessments, meaning they prove they have mastered the knowledge and skills, required for a particular competency or area of study.

UNDERSTANDING THE NATIONAL CBE MOVEMENT

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Higher Education Today

¨  General education and major fields of study ¤ Composition of courses ¤ Learning outcomes

¨  Fixed time periods for coursework ¨  Know what you know when time runs out ¨  Faculty variability

¤ Learning materials and activities ¤ Assessments

¨  “D” stands for “Does It”

The Need to Be First

¨  Percentage of jobs requiring postsecondary education has doubled over last 40 years.

¨  In 1970, rough ¾ of middle class had H.S. diploma. By 2007, decreased to less than 40%.

¨  In 1990, U.S. 1st in the world for completion. Today, ranked 12th.

¨ ½ of children from high income families have bachelor’s degree by 25, while only 1 in 10 for low-income.

¨  Spend $126 billion on T&D or $1,200 per employee

¨  Another $20 billion on tuition reimbursement ¨  Yet, employers report dissatisfaction

¤ Only 7% believe higher education does “excellent” job in preparing students for the workplace

¤  84% say “underprepared” for the workplace

Employers Seeking Solutions

¨  Meeting President Obama’s 2020 College Completion Goal (2011) ¤  Increase U.S. college degree attainment from 40 to 60% ¤  10 million additional Americans ¤  Keys: Access and affordability; quality and completion

¨  Lumina’s Big Goal ¤  60% of Americans to possess post-secondary credentialing by

2025

¨  Bill and Melinda Gates Foundation ¤  Mozilla Open Badge Program ¤  Countless programs like Breakthrough Models Incubator and

National Research & Shared Practices project

¨  Cracking the Credit Hour by Amy Laitinen

The Movement’s Origins

¨  Saving Higher Education (2012)

¨  SNHU President’s Letter (Jan. 31, 2013)

¡  College for America ¡  Flips the relationship - lets time be variable, learning well-

defined, fixed, and non-negotiable ¡  120 “Can Do” Competency Statements

¨  Dear Colleague Letter from DOE (March 19, 2013)

¡  Direct assessment of student learning “in lieu of measuring student learning in credit hours or clock hours” may qualify for federal financial aid

SNHU was Catalyst

Key Quote

“Competency-based approaches to education have the potential for assuring the quality and extent of learning, shortening the time to degree/certificate completion, developing stackable credentials that ease student transitions between school and work, and reducing the overall cost of education.” ~Dear Colleague Letter, DOE, March 19, 2013

Today’s Broad Support Base

¨  U.S. Department of Education ¤  First in the World Grants ¤  Experimental sites

¨  Congressional Support ¤  Bi-partisan interest in CBE ¤  Senator Lamar Alexander (R-TN) ¤ Higher Education Reauthorization

¨  Competency-Based Education Network ¤  34 pioneer institutional members

¨  Foundations and Higher Ed Organizations

CBE & The Iron Triangle

Cost

Access Quality

Organizational Engagement

Who’s Engaged?

COURSE-BASED VS. DIRECT ASSESSMENT MODELS

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CBE Framework Continuum

Wide Range of Models Nationally

Course-based, integrates discrete competencies into a credit bearing course(s)

No courses, no credit hours,

know competencies, receive credential

Learning measured by direct assessment

standardized tools

Learning measured by seat time and teacher-created assessments

Design Decisions

THIS THAT

Credit hour Direct Assessment

Deconstruct/Reconstruct Build from Ground Up

Traditional Faculty Role Unbundled Faculty Role

Textbooks, Prescribed Readings Open Educational Resources

Flexible Sequencing Scaffolded Learning

Formative Assessment Summative Assessment

On-ground Learning Online Learning

Existing Structure Separate Entity

OR

OR

OR

OR

OR

OR

OR

OR, something in between?

OR

Direct Assessment Defined

¨ Feds: “An instructional program that, in lieu of credit hours or clock hours as a measure of student learning, utilizes direct assessment of student learning, or recognizes the direct assessment of student learning by others.” ¤ The assessment must be consistent with the

accreditation of the institution or program utilizing the results of the assessment.

Direct Assessment Further Defined

¨  Direct assessment of student learning means a measure by the institution of what a student knows and can do in terms of the body of knowledge making up the educational program. ¤  These measures provide evidence that a student has

command of a specific subject, content area, or skill or that the student demonstrates a specific quality such as creativity, analysis or synthesis associated with the subject matter of the program.

¤  Examples of direct measures include projects, papers, examinations, presentations, performances, and portfolios.

Direct Assessment and Financial Aid

¨  Must apply for approval from the US Department of Education ¤  Specify the equivalent number of credit or clock hours for a direct

assessment ¤  Explain how equivalent number of credit or clock hours for the

program were ¤  Demonstrate that its institutional accrediting agency has reviewed

and approved its offering of the direct assessment program.

¨  May use learning resources (e.g., courses or portions of courses) that are provided by entities

¨  Funds may be awarded only for learning that results from instruction provided, or overseen, by the institution. 

Why Course-Based Approach?

PROS ¨  Familiar to and accepted by faculty, students, and other

institutions ¨  The currency (credit hours) is established ¨  Ease of transferability ¨  Aligns with financial aid system CONS ¨  Doesn’t fit neatly into course framework ¨  Flexibility lacking ¨  Challenging to move at own pace

Why Direct Assessment Approach?

PROS ¨  Truly focused demonstration of learning ¨  Opens the door more widely to new entrants ¨  Freed from time constraints ¨  Does not matter how student learned material CONS ¨  Radical shift ¨  Pioneers have heavy lift ¨  Reengineer all systems and processes

BACKWARD DESIGN OF A CBE MIDWIFERY PROGRAM

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It All Starts with…

This student can do…

¨  What claims for learning are being made? ¨  Claims/competencies framed as “can do”

statements ¤ Looking for the student’s performance ability

¨  Claims have been clearly articulated upfront ¨  Claims are relevant, valid, valued, and appropriate

…therefore, a midwife.

Competency Example

¨  Midwives provide high quality, culturally sensitive care during labor, conduct a clean and safe birth and handle selected emergency situations to maximize the health of women and their newborns.

¨  Knowledge: Physiology of first, second and third stages of labor

¨  Skill: Perform a complete abdominal assessment for fetal position and descent

¨  Ability: Perform vacuum extraction

Competencies as “Can Do”

¨  I can provide high quality, culturally sensitive care during labor.

¨  I can conduct a clean and safe birth. ¨  I can handle selected emergency situations to maximize

the health of women and their newborns. ¨  I can identify the first, second and third stages of labor,

based on physiology. ¨  I can perform a complete abdominal assessment for

fetal position and descent. ¨  I can perform a vacuum extraction.

Then, it’s about…

Assessment of Learning

¨  KEY QUESTION: How do you know student “can do” what you claim they can do? ¤ Create and utilize consistent assessments

¨  OTHER QUESTIONS ¤ How has the reliability of the assessment been established? ¤ Does the assessment actually cover the domain it’s suppose

to measure? ¤ Does it predict the ability to perform outside the

assessment? ¤ Can student currently do the performance being assessed? ¤ Who created, what are their qualifications, etc.?

Start With The End In Mind

What claim do we make? How will we assess?

Student can identify the first, second and third stages of labor, based on physiology

Simulation – Student will participate in a virtual simulation where the stages of labor must be properly identified. Clinical Observation – Student will engage with women in labor and be observed consistently identifying the states of labor Written Exam – Student will be able to recall the normal functions which should occur at the various phases of labor.

Consistent, Well-Defined Rubrics

Learning Activities

Competencies

Assessments

Learning Activities

How Do We Teach The Competencies?

¨  Design by competency ¨  What are the learning activities that would

facilitate the demonstration of the competency? ¨  Utilize technology in the delivery of the content

¤ Adaptive learning ¤ Flipped classroom, online learning ¤ Mobile-ready ¤ Open education resources

How Do We Teach The Competencies?

What claim do we make? How will we assess? How will we teach?

Student can identify the first, second and third stages of labor, based on physiology

Simulation – Student will participate in a virtual simulation where the stages of labor must be properly identified. Clinical Observation – Student will engage with women in labor and be observed consistently identifying the states of labor Written Exam – Student will be able to recall the normal functions which should occur at the various phases of labor.

Reading assignment on the physiology of labor Watch video series: The Stages of Labor Interaction with dummies or actual patients Practice activities to properly identify stage

MIDWIFERY AND CBE: A VISION FOR CONSIDERATION

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Just Imagine…

¨  No shortages of qualified midwifery professionals ¨  Increased access to qualified midwives ¨  Greater diversity in midwives and in those they

serve ¨  Congruence between different standards,

credentials, accrediting bodies, and providers of educational content

Consistent Assessments by Competency

¨  Assessments designed by multi-institutional team ¨  Assessments reviewed and approved by accreditors

and academic institutions ¨  Multiple approved assessments by competency ¨  Transparent assessment process and scoring ¨  Aligned to college credit ¨  Institutions/Entities agree to serve assessment center

site

Establishment of Assessment Centers

¨  Students go to one of the centers in the U.S.

Assessment Process

¨  Entrance assessment based on what they know and can demonstrate ¤ Credit for what they know and can do

¨  Assign level of mastery ¨  Customized learning plan tailored to their gaps ¨  Microcredentials awarded for what they know

Stackable, Microcredential Eco-System

¨  Badges are recognized by academic institutions for credit or competency recognition

Consistent Development

¨  Institutions could offer competency development modules online

¨  Students receive support and mentorship in role ¨  Robust engagement with faculty through assessment

center

Mind Racing with Thoughts?