Could the professional portfolio hold the key? Could it be used to demonstrate clinical competency in an area of expertise? And might it be the best way to show competence in a fast-changing healthcare landscape?
Nurse Practitioners (NP) will often ask if they can start a business or practice doing “x.” Frequently, this question makes its way to me after the NP has called their state Board of Nursing to ask the same, often without getting the information they need.
First and foremost, it’s important all RNs and APNs understand that Boards of Nursing are not in place to provide nurses with advice. Their prime directive is to protect the healthcare consuming public from us. This holds true for every State Board of Medicine, Pharmacy, Physical Therapy, etc.
Their charge is to ensure, to the best of their ability, that nurses have demonstrated competency (licensure and board certifications), and that they operate within their scope of practice, following standards of care. They monitor that nurses follow the rules and regulations set forth by state legislature, evidenced-based practice, and the National Council of State Boards of Nursing.
The National Council of State Boards of Nursing (NCSBN) sums it up nicely in their mission statement. (Note: the emphasis is mine.)
The National Council of State Boards of Nursing (NCSBN) provides education, service, and research through collaborative leadership to promote evidence-based regulatory excellence for patient safety and public protection.
Now the question has come up about evidenced based practice and competency for some nurse practitioners practicing in newer areas; areas that are not traditionally defined.
Are they within the scope of practice? Where is the evidence for what they are practicing? Does it follow practice guidelines or even is it legal? In some of these new and emerging areas and therapeutic techniques, national standards and state regulations may not even exist as of yet, at least not as they pertain to NPs.
These are timely questions. We live in a time where information is exploding all around us. For example:
- In 2013, SINTEF (one of Europe’s largest independent research organizations), posted that a “full 90% of all the data in the world has been generated over two years”.
- And Forbes posted an article stating “The amount of data we produce every day is truly mind-boggling. There are 2.5 quintillion bytes of data created each day at our current pace, but that pace is only accelerating with the growth of the Internet of Things (IoT). Over the last two years alone 90 percent of the data in the world was generated”
- At the time I’m writing this, Google alone has over 3.5 biller search per day, approximately 68,141 searches per SECOND.
- And as of mid-July 2018, Facebook states, worldwide there are over 2.20 billion monthly active FB users and 1.45 billion people, on average are considered daily users. We can only guess how many of them are accessing health information!
While most of this information is not about healthcare or APRN practice, this gives the reader a glimpse at how fast things are moving. Healthcare itself is moving at a rapid rate. New areas of specialization, medication, and procedures are available today that did not even exist a mere five years ago.
APRNs, employed or self-employed, are being asked and in some cases expected to perform in areas considered non-traditional, yet appear to be reasonable, given their practice area. Indeed, many NPs go on to get educated in new areas related to their field and scope of practice…again, in areas that did not previously exist.
What’s more, in many areas, we don’t yet have a sanctified “board certification” for emerging areas of practice.
Does that mean we don’t practice in these areas? Does it mean we don’t bring new techniques and treatments to our patients and clients? Or do we need to wait for years before we can take board certifications? As shown by how fast technology and information is moving…waiting is not always feasible or desirable.
So how do we show our competence in emerging areas of practice? How do we demonstrate our own due diligence in an area?
Enter the professional portfolio
Portfolios are not a new concept. There certainly have been discussions of using a professional portfolio for things such as board re-certifications, license renewals, university placement and the like. While some have adopted the use, portfolios are not yet mainstream.
That said, I believe it’s a great way to showcase our clinical expertise in an area where other proof is not yet available. Not only that, but it’s a great way to document your clinical expertise as well as your body of work.
NPs frequently ask me about becoming a Fellow. The portfolio is a great way to organize your professional life and the contributions you’ve made as you consider your applications for advanced recognition.
Just What is a Portfolio?
It’s a repository of your professional work. A portfolio is not just a Curriculum Vitae* (CV), it’s so much more. Many people have portfolios for job search, academic or professional advancement, and more. (*Curriculum Vitae is Latin for “course of life”. Quite appropriate don’t you think?)
Today, I want to focus on how we address the issue of can we do “x” in our practice, are we competent? Can we prove that we have indeed spent time learning a new skill, technique, theory that we can put into practice?
Portfolios can be an electronic portfolio (e-portfolio), or it can be as simple as a binder with all the documentation and samples. In today’s world, having an e-portfolio only makes sense.
Today, it’s easy enough to create a website to hold your portfolio. It can be public, or you can keep it hidden, sharing it only with those who matter.
You can also create a file which houses a variety of documents, keeping it in a cloud sharing apps such as DropBox, Box, or iCloud and share a link to it as needed.
What to Include?
Here are some things you’ll want to include in your portfolio. Make sure you have obtained permission to post if you are posting something from a colleague, patient or client.
- Board Certifications
- Any other relevant certifications you hold
- Copy of your Resume and CV
o Job description
o Note, some of the information below may already be in your CV. However, including it below will allow it to stand out on its own
• Diplomas and transcripts from colleges and universities attended
- Letters of Recommendations/Testimonials/Thank you notes
o From employers, co-workers, patients, clients
o Copies of work evaluations
- Honors and Awards
- Professional and community involvement (paid and volunteer)
o Committees, boards
- Professional presentations – these can include presentations at work, in the community, at local, state, and national organizations.
o Include topic, learning objectives, a brief synopsis of the presentation and where you made the presentation. If you have access to presentation evaluations, include a statement about the results as well.
o Poster presentations. Include a copy of the poster
- Professional residency programs
- Certificates from Continuing Education and ALL postgraduate training programs you’ve attended
o Include an overview (or better yet, the syllabus) of the course/program, including the number of hours
o If the program included any hands-on training and post-training supervision/mentoring, make sure to include this as well
- Project Development
o This can be a unit or institution related project or a community-wide project. Include information about the projects, outcomes, grants or other funding and results.
o The project may be research or quality improvement
o Books, text-books – where you are the author, co-author, editor, contributing author.
o Peer-reviewed publications
o Other professional publications
o Other publications including community newsletters, newspaper articles, etc
o Media appearances on radio or television
o Video content you have created
o Any material you have produced such as patient or professional information – teaching materials, checklist, QI, etc
o What project/studies have you been involved with? Include work you did in your academic program as well as post-graduate work.
- Specialty Practice? If you are working in a specialty area make sure you include any of the following, even if it’s a repeat. Make this information easily seen by a regulatory agency looking for credentials to attest to your clinical competence in this area.
o Formal educational program, including clinical hours, specific to the practice specialty
o Post master’s certificate specific to the clinical specialty, population, or role
o Certificate of completion for a specialty specific workshop or seminar.
o Extensive continuing education in the specialty area
o Training that is formal and documented provided by another expert in the area. Include competencies, demonstration and the like.
- Anything else that is relevant to the work you have done to prove your competence.
While putting together your portfolio can be a daunting task, start small and work on it in small bites. It’s essential you begin now. Focus on the areas of clinical expertise you have amassed, pointing to your knowledge in your specialty area; then build it out from there.
Have you ever created a professional portfolio? Do you have a hard copy, is it electronic or both?