STEP 1 - DEFINE THE AUDIENCE AND TOPIC AREA
Define the Audience
Defining a target professional audience is the first step in designing an effective program utilizing the Competency Statements. The Competency Statements are relevant to any health professional who has a generalized knowledge of cancer and who is able to initiate the continuum of cancer care from prevention and screening through palliative care including:
- Professionals who have diagnosing or prescribing privileges (e.g. MD, DDS, DO, APN, PA, and PharmD)
- Professionals who are developing implementing and evaluating care (e.g. RN, RDH, PT, OT, and RT)
- Professionals who are counseling and educating patients or families (e.g. psychologists, BSW/MSW, RD, and health educators)
Define the Topic Area
With an audience defined and their respective scope of practice in mind, the next step involves choosing a topic area. The Competency Statements encompass three domains including clinical aspects of the continuum of care, foundational aspects of cancer science, and interpersonal aspects of care collaboration and communication. These domains and related examples include:
| Cancer Domain I: Continuum of Care |
Topic
Prevention and Behavioral Risks |
Competency Sub-Topic
General Risk Reduction • Knowledge • Tobacco • UV Rays • Diet & Exercise • Sexually Transmitted Diseases
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| Screening and Early Detection |
General Screening Protocols • Knowledge • Oral • Skin • Breast • Cervical & Uterine • Colorectal • Prostate • Testicular
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| Treatment |
General Modalities • Clinical Emergencies • Symptom Management • Emotional Support
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| Survivorship |
Assess Resources • Family/Caregiver Support • Pain/Symptom Management • Continuing Treatment
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| Palliative and End-of-Life-Care |
Support Resources • Pain Assessment and Management • Hospice Care
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| Domain II: Basic Cancer Science |
Topic
Incorporate General Cancer Knowledge into Professional Practice |
Competency Sub-Topic
Review Literature • Cancer Education
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| Describe the Biologic Attributes of Cancer Etiology |
Cancer Myths • Genetics • Immunologic Responses |
| Reference the Cancer Epidemiology and Risk Fact Data for Individuals and Specific Communities |
Cancer Screening • Epidemiological Data • Tumor Registries |
| Discuss Complimentary and Alternative Therapies |
Cancer Treatment • Patient Beliefs • Side Effects |
| Support Participation in Clinical Trials |
Informed Consent • Rationale • Protocol |
| Adhere to the Data Collection Standards in Reporting Cancer Cases to Hospital, State, and National Tumor Surveillance Registries |
Appropriate Data Collection • Epidemiologic Principles • Cancer Incidence and Mortality |
| Domain III: Collaboration and Communication |
Topic
Participate Within an Interdisciplinary Cancer Care Team |
Competency Sub-Topic
Cancer Care Plan • Oncology Social Worker • Treatment Plan • Financial Implications |
| Incorporate Psychosocial Communication Strategies in Conveying Cancer Information |
Cancer Myths • Genetics • Immunologic Responses |
| Incorporate Cross-Cultural Communication Strategies in Conveying Cancer Information |
Depression & Anxiety • Mental Health Support Services • Coping Mechanisms |
| Describe Common Ethical and Legal Issues in Cancer Care |
HIPPA & Advanced Directives & Informed Consent |
| Incorporate Communication Strategies that Encourage the Process of Grieving |
Personal Death Awareness & Coping Strategies/Resources |
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Key Questions:
Who is my target professional audience?
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EXAMPLE
- Acute Care Nurses
What cancer topic(s) is a top priority?
- - - - - - - - - - - -
EXAMPLE
-Colon Cancer Screening
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STEP 2 - BUILD A BALANCED LEADERSHIP & PLANNING TEAM EQUIPPED TO MEET THE
CHALLENGES OF THE PROGRAM
In order to ensure the success of the Planning, Implementation, and Evaluation phases of a competency-based program, build a program planning and leadership team that is composed of professionals with specific skills: cancer expertise related to your topic area, educational event planning skills, analytic and data management skills, and scientific/educational writing experience. In addition to these skills, the leadership team should contain members of the targeted discipline(s). If the targeted professionals are employees, ideally, the leadership team contains a supervisor. Also, the team must contain or be able to secure political support from the organization in order to access the needed human, facility, and financial resources to support the initiative.
STEP 3 - COMPLETE A NEEDS ASSESSMENT WITH THE TARGET AUDIENCE-INTERPRET
& INTEGRATE FINDINGS
Complete a Needs Assessment with the Target Audience
When working with adult learners, their readiness to learn and sense that the knowledge or skill is relevant to their role is directly related to
their likelihood to participate and truly engage in the program. Understanding the participants' baseline knowledge of the topic area and
their motivation for participating in the program will help to develop curriculum that will facilitate learning. This information will also help
to define participation incentives, rewards, and/or expectations - a key step in achieving the desired level of involvement from the target
professional population. The process of assessing the target audience can be carried out in a variety of ways. Some organizations may
wish to develop a formal survey while other institutions will confer informally with staff or other leaders.
When creating a program, consider carefully how adults learn best. Adult learners have clear expectations about the learning objectives,
assignments, and how they will be graded or assessed. The instructional methods should recognize participants previous experiences and
skills and be geared to maximize professional independence.
Interpret & Integrate Findings
With information from the needs assessment in mind, the leadership team will need to contemplate the following questions as they begin
development of the program:
- What will motivate your target population to participate? Should participation be mandatory? Incentives such as scheduled time off,
CEUs, reference books, and gift certificates may encourage participation. Presenting these incentives at the conclusion of a course may
help to ensure maximum participation. In some cases, participation may be a requirement or demonstrated competency may be a
performance expectation.
- How can the skill level and the competency content be integrated into instructional activities? Beyond the typical lecture format,
competencies can structure interactive learning experiences that are engaging to learners, such as case studies, role-plays, table top
exercises, and small group discussions.
- How can the competency-based educational experience be translated from the classroom environment into professional practice?
Competencies lend themselves to assist changes in human resource policy, including job classifications and workforce development criteria.
They also translate into toolkits, bedside resources, continuing education reference lists, and on-line self assessment tools.
- How will knowledge and skill be assessed to determine the competency attainment by the learners? Pre/post tests, case studies, peer
evaluation, clinical assessments/observations, return demonstrations, standardized patient interactions, and videotaping structured
experiences are some examples.
- What other factors will affect program enrollment? Program marketing; program fees, event timing, location, duration, and format
are examples of factors that can influence the success of the program.
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Key Questions:
Who can champion the program?
- - - - - - - - - - -
EXAMPLE
-Medical Director
-Gastroenterologist
-Staff Educator
Key Questions:
What activities will facilitate optimal learning?
- - - - - - - - - - -
EXAMPLE
-Review of screening guidelines and colon cancer statistics
-Case studies taught by colleagues
-GI lab observation
What will translate learning into practice?
- - - - - - - - - - -
EXAMPLE
-New patient education materials to facilitate discharge teaching
What is the best way to evaluate the learners?
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EXAMPLE
-Peer evaluation of patient education role play
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STEP 4 - REFINE COMPETENCY FOCUS
Defining more specific competency goals is the next step in program development. The Competency Standards provide an extensive list of potential competency goals. Choosing one or more of these statements will establish the fundamental goals of your program.
How you interpret a statement - generally or specifically - and with respect to the target professionals' scope of practice will directly affect the breadth and/or depth of the curriculum. For example, you may thoroughly address only one competency standard if you want learners to achieve an extremely high level of independence and expertise. This would be a sensible educational approach when the competency requires a high degree of proficiency in order to master the skill. If you want learners to gain a broader perspective on a variety of topics, you are more likely to choose several statements and address them more broadly. This would be an effective approach when the competencies cover the skills associated with particular themes or topics.
The chart below provides the competency statements with corresponding examples. For a complete listing of the competency standards, please
refer to the Competency Standards page.
| Cancer Domain I: Continuum of Care |
Topic
Prevention and Behavioral Risks |
Competency Sub-Topic
Describe evidence-based early detection guide-lines based upon risk factors |
| Screening and Early Detection |
Explain the benefits and risks of screening tests |
| Treatment |
Manage diseases and treatment-related symptoms |
| Survivorship |
Manage late and continuing effects of cancer and cancer treatment |
| Palliative and End-of-Life-Care |
Refer patients to community palliative and end-of-life care and support resources |
| Domain II: Basic Cancer Science |
Topic
Incorporate General Cancer Knowledge into Professional Practice |
Competency Sub-Topic
Participate in professional cancer education opportunities |
| Describe the Biologic Attributes of Cancer Etiology |
Explain the relationship between cancer and genetics |
| Reference the Cancer Epidemiology and Risk-factor Data for Individuals and Specific Communities |
Apply epidemiologic principles of sensitivity and specificity to cancer screening recommendations |
| Discuss Complimentary and Alternative Therapies |
Assess patient and family beliefs regarding complimentary and alternative therapies |
| Support Participation in Clinical Trials |
Describe a clinical trial process beginning with informed consent |
| Adhere to the Data Collection Standards in Reporting Cancer Cases to Hospital, State, and National Tumor Surveillance Registries |
Describe the role of tumor surveillance registries |
| Domain III: Collaboration and Communication |
Topic
Participate Within an interdisciplinary Cancer Care Team |
Competency Sub-Topic
Define interdisciplinary care |
| Incorporate Psychosocial Communication Strategies in Conveying Cancer Information |
Recognize the signs and symptoms of cancer related anxiety and depression |
| Incorporate Cross-Cultural Communication Strategies in Conveying Cancer Information |
Define culture-specific beliefs and practices |
| Describe Common Ethical and Legal Issues in Cancer Care |
Adhere to HIPAA policies, procedures, and regulations |
| Incorporate Communication Strategies That Encourage the Process of Grieving |
Assist oncology team members with the coping strategies over the death of patients with cancer |
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Key Questions:
What do I want the targeted professionals to know or do?
- - - - - - - - - - -
EXAMPLE
Select a competency statement to support goals such as:
- Incorporate evidence-based cancer prevention guidelines in their professional practice.
- Incorporate the shared decision-making process into cancer risk reduction counseling.
- Explain the continuum of comprehensive cancer care: prevention, early detection, treatment, survivorship, and palliative care.
- Refer individuals to resources for cancer prevention, screening, and management of precancerous conditions.
- Describe evidence based early detection guidelines based upon risk-factors.
- Explain the importance of colorectal screening.
- Describe the procedures for conducting colorectal cancer screening.
- Perform a fecal occult blood test.
- Refer for colonoscopy based upon age and other risk factors.
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STEP 5 - DEVELOP LOGIC MODEL & VALIDATION TEMPLATE
Develop Logic Model
A logic model provides a map for program development. Logic models do not have to be complicated. Simply stated, the logic model ensures that the competency goals are directly supported by the curriculum, instructional method, and evaluation methods much like a S.O.A.P. note (Subjective Objective Assessment Plan) or nursing care plan ties a diagnosis to an intervention or an evaluation in order to archive a treatment goal. It is important to remember that the logic model will be unique to your particular program and institution.
The figure below illustrates the basic structure of a logic model. By utilizing this tool, faculty will consider the Inputs (human and material program resources) and Outputs (programmatic activities and participation) that will ultimately result in the desired outcome (short, medium, and long-term effects and goals).
Logic models are used to illustrate how a program will work. They provide a way for you to test your assumptions regarding program planning and implementation while emphasizing how you will carry out the evaluation phase of the project. By developing a logic model, you are afforded the opportunity to make adjustments before the program is carried out.
The following links provide additional resources regarding logic models:
Develop Validation Template
The validation template guides the development of more specific plans to achieve the desired competency outcomes.
For example, the general template illustrates the components of the validation template. Faculty must consider the competencies that will be applied as well as the characteristics of the learners and how the learners will prepare for the course. A downloadable WORD version of the validation template can be found on the Resources and Reports page.
The validation template instructs faculty to consider the instructional activities including how the material will be introduced, didactic and interactive exercises, and how the course material will be integrated at the conclusion of the program. As with any learning environment, students may grasp the course content at different levels and may require supplemental materials. The template includes remedial activities for students who need more information and enhancement activities for students who desire additional course content. The site specific validation templates provide clear examples of how to effectively use this tool and can be found on the Resources and Reports page.
The faculty is urged to consider strategies for evaluating the learners such as observational checklists, interactive exercises, and paper assessments as well as specific indicators when gauging the progress of the participant during the learning activity.
The validation template is a worthwhile tool in the curriculum development process and can be seen as a "quality control" step. Examples from pilot phase of the C-Change Cancer Core Competency Initiative can be found below and illustrate both the flexibility and utility of the validation template
- Audrain Medical Center Logic Model & Validation Template Joint Page
- California University of Pennsylvania School of Social Work Logic Model & Validation Template Joint Page
- The University of Pittsburgh Medical Center Cancer Centers Logic Model & Validation Template Joint Page
- Marshall University School of Medicine Logic Model & Validation Template Joint Page
Examples of logic models and validation templates designed by the pilot sites for the C-Change Cancer Core Competency Initiative can be found below and illustrate both the flexibility and utility of the tools. Participating organizations used the tools for developing programs with different competency goals, target student and professional populations, and with different education and evaluation methods.
Printer friendly PDF versions of the site-specific logic model and validation templates can be found on the Resources and Reports page.
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Key Questions:
What resources are currently available to support my program?
EXAMPLE
- - - - - - - - - - -
- Expert faculty
- Skills lab
- CE classroom
What activities will occur during the program?
- - - - - - - - - - -
EXAMPLE
- Change of shift lecture series for review of pathophysiology and guideline evidence
- Case presentations
- Optional GI lab, observation
What are the desired changes in the participants?
- - - - - - - - - - -
EXAMPLE
- Knowledge of colon cancer risks and screening guidelines
- Skills and confidence to teach patients effectively
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STEP 6 -MANAGE WITH ATTENTION TO DETAILS
For programs offering CEU credit, complete the necessary steps to securing CEU credit approval from governing bodies.
If the evaluation data from the program will be used for anything beyond learner assessment and feedback such as quality improvement studies or professional publications, IRB approval might be necessary.
Reserving venues and coordinating program times to suit scheduling needs is another basic, but important planning step. Some programs m may need to address staff working throughout the 24 hour day, rotational schedules, or academic calendars.
It will also be important to begin taking care of the practicalities of the program such as registration, AV equipment orders, catering orders, and other last minute details and day-of event logistics
STEP 7- EVALAUTE & INTERPRET DATA
It will be essential to evaluate the program participants. Many organizations utilize pre- and post-tests, skills tests, and gather participant perceptions to assess knowledge skills and attitudes. This data is critical to understanding if the participants have mastered the material and to gauge the success of the program. In addition, investment in the logic model will facilitate a smooth evaluation process.
STEP 8 - SUSTAIN EFFORT THROUGH SHARING WITH THE PROFESSIONAL COMMUNITY
Efforts to document and publish project findings are highly encouraged as they stand as a contribution to the health professions' community. We request that organizations that have implemented projects utilizing a cancer core competency-based approach contribute their materials to the C-Change repository. With permission, these materials will be posted to the C-Change website. These materials and information will be made widely available so that others may benefit.
Key Success Factors
As with any program, several factors are key to developing and implementing a successful and effective program.
Review Resources & Reports Page - The final reports provide deeper insight into the program development process and present the methodology and explanation of tools that will increase the success of reaching program participants. They will stimulate ideas and provide programmatic illustrations.
Assess the Target Audience - Understanding the target audience and their readiness to learn, their baseline knowledge of the topic area and motivation for participation is essential to defining participation reward and incentives. These steps will result in a higher level of participation within the target professional population.
Assure Leadership - Broad-based leadership support creates access to the resources (human, material, facility, and financial) needed in the short-term. Long-term program sustainability is also linked to leadership support. Making the program an institutional priority will ensure the yield from your program investment in the form of learner outcomes and farther reaching benefits to the institution and community.
Establish a Multidisciplinary Planning Team - A carefully constructed planning team including topic experts, data analysts, science/education writers, and an individual specializing in communications will work together in the development of the curriculum and related materials as well as evaluating the learners and the trajectory of the program.
Develop a Reasonable Project Timeframe - The planning phase of the project is often more time consuming than anticipated and is more time intensive than typical continuing education programs. In an effort to maximize the benefits from a rigorous planning process, adequate time should be invested to utilize the logic models and validation templates to ensure the maximum impact of the program.
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