Remodeling a clinical ladder: an action research design

Area of Science:

• Nursing Practice
• Professional Development
• Clinical Ladder Implementation

Background:

• Assessing nurse development is crucial for effective patient care and staff progression.
• Existing performance appraisal systems may not fully capture the nuances of advanced nursing practice.
• Action research provides a framework for integrating practice changes and evaluation.

Purpose of the Study:

• To evaluate practice descriptors for assessing nurses along the advanced beginner to expert continuum.
• To inform the integration of a registered nurse (RN) performance appraisal and clinical ladder.
• To identify distinct patterns in how nurses at different expertise levels perceive their practice.

Main Methods:

• Utilized a larger action research program framework.
• Informed participants selected practice descriptors from randomized lists across nursing domains.
• Analyzed selection patterns based on nurse proficiency and expertise levels.

Main Results:

• Distinct descriptor selection patterns were observed in proficient and expert nurses across most domains.
• Findings indicated significant differences in how advanced nurses describe their routine practice.
• One nursing domain did not show distinctive selection patterns between expert and proficient nurses.

Conclusions:

• Practice descriptors effectively differentiate between nurses at various stages of the advanced beginner to expert continuum.
• The study supports the utility of these descriptors in performance appraisal and clinical ladder development.
• Further refinement of descriptors may be needed for specific nursing domains.