Jo-Anne McShane

1. i
Professional Portfolios
Jo-Anne McShane
Thesis submitted in fulfilment for the requirement of the
Award of Masters of Clinical Nursing
School of Nursing, Midwifery and Postgraduate Medicine
Edith Cowen University
Western Australia
2010

2. ii
Declaration
I certify that this work does not, to the best of my knowledge and belief;
(i) Incorporate without acknowledgement any material previously submitted for a
degree or diploma in any institution of higher education.
(ii) Contain any material previously published or written by another person except
where due reference is made in the text; or
(iii) Contain any defamatory material
Signature………J McShane………………..Date: October 2010…………
.

3. iii
Table of Contents
DECLARATION……………………………………………………………………………...ii
ABSTRACT…………………………………………………………………………………..v
ACKNOWLEDGEMENTS……………………………………….…………………………vi
TERMS USED………………………………………………………………………………vii
LIST OF APPENDICES…………………………………………………………………...viii
LIST OF FIGURES………………………………………………………………………….ix
Chapter 1…………………………………………………………………………………...1
INTRODUCTION…………………………..………………………………………………..1
Background to the Study…………..……………………………………………….1
Purpose of the Study…………………………………………………..……………3
Research Question……………………………………………………………….....3
Significance of the Study…………………………..………………….……………3
Theoretical Framework…………………………………………...………………...3
Chapter 2…………………………………………………………………………………...5
REVIEW OF THE LITERATURE…………………………………………………………..5
What is a Portfolio?......................................................................................................5
Presentation Portfolios……………………………………………………………...5
Learning Portfolios…………………………………………………………………..6
Assessment Portfolios………………………………………………………………7
E-Portfolios……………………………………………………………….……..…………...8
Paper versus Electronic………………………………………………..…………….……..9
Chapter 3………………………………………………………………………………….11
Competence………………………………………………………………………………..11
Competency Standards……………………………………………………………..…….11
Competency Frameworks………………………………………………………………...12
Demonstrating Competence………………………………………………………………13
Self Declaration…………………………………………………………………….14
Continuing Professional Development…………………………………………..14
Recency of Practice……………………………………………………………….15
Learning Plans……………………………………………………………………..15
Challenges for the Australian Competency Framework……………………………….17
Learning Plans……………………………………………………………………..17
CPD Standards……………………………………………………………….……18

4. iv
Portfolios and Competence…………………………….………………………………....18
Chapter 4…………………………………………….………………………...........…...20
Is teaching about portfolios a worthwhile experience for the participants?................20
Chapter 5………………………………………………………………………………….22
METHOD…………………………………………………...……………………………….22
Design, Setting and Sample……………………………………...………………22
Analysis………………………………………………………………………….….23
Chapter 6…………………………………………………….…………………………...24
RESULTS………..…………………………………………………………………………24
Introduction and National Registration…………………………………………..24
Continuing Professional Development…………………………………………..25
Portfolios………………………………………………………………………….…26
E-portfolios………………………………………………………………………….27
Learning Plans……………………………………………………………………..28
Reflection…………………………………………………………………………...29
Have you used a portfolio before?..................................................................30
Would you be interested in maintaining a e-portfolio over a paper portfolio?.30
Did you find the handouts helpful?..................................................................31
What was good about the workshop?.............................................................31
What could have been improved?..................................................................32
Additional comments……………………………………………..………………..32
Overall satisfaction…………………………………………………………………33
Chapter 7………………………………………………………………………………….34
DISCUSSION…………………………..…………………………………………………..34
Competence………………………………………………………………………..34
Workshop…………………………………………………………………………...34
Recommendations…………………………………………………………………35
Conclusion………………………………………………………………………….36
REFERENCES………………………………………………..……………………………37

5. v
Abstract
This report was written to detail the findings found during an extensive literature
review on professional portfolios in nursing practice and the feedback received on a
workshop designed to educate nurses on the benefits of maintaining a professional
portfolio.
Professional portfolios in nursing are well established within the academic arena,
particularly since the advent of e-portfolios as an assessment tool. Despite an
overwhelming amount of articles promoting portfolios as a standard of practice, there
is a distinct lack of evidence suggesting portfolios are beneficial when applying for
employment or promotions. One of the emerging uses of portfolios in the literature is
the use of portfolios to demonstrate competence to practice.
Australia is entering a new era of nursing with the introduction of National
Registration. The Continuing Competence Framework developed by the ANMC
promoted the use of the portfolio to provide evidence of ongoing competence to
practice nursing. However, APHRA has chosen to endorse only the CPD and
Recency of Practice elements of the framework. Nurses have been given very little
to guidance and support in the new expectations, which may leave nurses feeling
slightly confused. Despite this, portfolios can still be used as a tool to document the
standards and showcase the nurse’s experience and best work.
A workshop was developed to educate, innovate and motivate nurses to document
their achievements in a professional portfolio. The interactive workshop covered the
following topics:
 National Registration
 Continuing Professional Development
 Portfolios
 E-portfolios
 Competency Standards
 Reflection
The feedback received showed that a majority of participants rated the workshop as
either ‘very helpful’ or ‘excellent’. Despite the workshop being a success, it is evident
that further research is needed to validate portfolios in professional practice.

6. vi
Acknowledgements
Thank you to my friends and colleagues at Robina Emergency Department, Gold
Coast, who encouraged me to take my nursing career one step further.
Thank you to my supervisor Christopher Churchouse steering me in the right
direction. The librarians and nurse researcher Dr Julia Crilly from the Gold Coast
Hospital were very helpful in assisting me to understand research.
Thank you to Sarah Stewart for introducing me to e-portfolios and to Richard for
taking an interest in what we could do as an emergency department to help nurses
meet their registration expectations.
Also, thank you to my Manager Jo Timms and educator David Corkill for letting me
‘do what I needed to do’, and Lyn Armit and Sarah Burston from the Nursing
Education and Research Unit who allowed me to develop and present the workshop
within the district.
Finally, thanks to my son for helping mummy to colour in the articles- I did the
straight lines, he did the squiggly ones.

7. vii
Terms Used
ANF: Australian Nursing Federation
ANMC: Australian Nursing and Midwifery Council
APHRA: Australian Health Practitioners Regulation Agency.
CCF: Continuing Competence Framework
COAG: Council of Australian Governments
CPD: Continuing Professional Development
NMBA: Nursing and Midwifery Board of Australia
NMC-UK: Nursing and Midwifery Council United Kingdom
QNC: Queensland Nursing Council
QUT: Queensland University of Technology

8. viii
List of Appendices
Appendix A- Portfolio and CPD Requirements…………………………………… 42
Appendix B- Professional Portfolios Workshop Objectives and Learning Plans 43
Appendix C- Professional Portfolios Flyer………………………………………… 50
Appendix D- Certificate of Attendance………………….………..……………….. 51
Appendix E- Feedback Form………………………………………………………. 52
Appendix F- Preparation Checklist………………………………….………….… 53
Appendix G-Agenda…………………………………….…………………………. 54
Appendix H- PowerPoint Presentation…………………….…………………….. 55
Appendix I- Optional Survey Results…………………………………………….. 56
Appendix J- Conference Abstract and Autobiography………..……………….. 57

9. ix
List of Figures
Figure 1- Continuing Competence Frameworks World-Wide…………… 12
Figure 2- ANMC Continuing Competence Framework………………….. 13
Figure 3- Introduction and National Registration………………………… 24
Figure 4- Continuing Professional Development…………………………. 25
Figure 5- Portfolios…………………………………………………………... 26
Figure 6- E-portfolios………………………………………………………… 27
Figure 7-Learning Plans……………………………………………………. 28
Figure 8-Reflection………………………………………………………….. 29
Figure 9- Previous Portfolio Use…………………………………………… 30
Figure 10- E-portfolios………………………………………………………. 30
Figure 11- Handouts…………………………………………………………. 31
Figure 12-Overall satisfaction………………………………………………. 33

10. 1
Chapter 1
Introduction
Background to the Study
In 2005 the Commonwealth Government (COAG) asked the Productivity
Commission1 to research the issues impacting the health workforce and make
recommendations that would ensure the continued quality of health care in an
environment of rising health costs, an aging population and advancing technologies.
National Registration and accreditation was just one of the many recommendations
the Productivity Commission proposed. The purpose of implementing National
Registration across Australia was to improve patient safety by ensuring that the
education and training standards of nurses are consistent. A safe competent and
mobile body of nurses therefore will be registered to look after patients in Australia
(Carrigan, 2008).
Prior to July 2010, nurses have been required to register state-wide with their
respective Nursing Councils. Each state was governed by their own Nursing
Councils and Nursing Acts, which subsequently had different expectations for
registration and competency. National Registration will eliminate the need for
multiple state registrations which will affect at least 11,783 nurses (2005 data: AIHW,
2009).
In July 2006, COAG decided to establish a national registration of healthcare
workers including Physiotherapists, Podiatrist, Optometrists, Chiropractors,
Pharmacists, Dentists, Psychologists, Osteopaths, Nurses, Midwives and Doctors of
Medicine. In March 2008, the Intergovernmental Agreement for a National
Registration and Accreditation Scheme for the Health Professions policy was signed
by the Premiers and Chief Ministers of each state, as well as the former Prime
Minister of Australia, Kevin Rudd. This agreement outlined the ‘objectives, scope
and governance, legislative, administrative and financial arrangements for the
1
‘The Productivity Commission is the Australian Government's independent research and advisory
body on a range of economic, social and environmental issues affecting the welfare of Australians...
help governments make better policies in the long term interest of the Australian community’
(ProductivityCommission, n.d.)

11. 2
scheme’ (COAG, 2008 p2) of National Registration by July 2010. However, it should
be noted at the time of writing that the state of Western Australia’s Legislative
Council has not passed the National Law Act. It is anticipated that Western Australia
will adopt the National Law Act by the 19th, October 2010 (NMBWA, 2010).
The new Health Practitioner Regulation National Law Act (Australian Government,
2009) was implemented in July 2010, and will cover all nurses registered in Australia
(except WA at time of submission). Nurses who are registered in each state will now
be registered with the new Nursing and Midwifery Board of Australia. Individual
states have had in the past different registration requirements in regards to
continuing professional development (Appendix A), competence, auditing, and
recency of practice. The new National Mandatory Registration standards will include
a criminal history check, English language skills competence, professional indemnity
insurance, recency of practice and continuing professional development (CPD)
standards (NMBA, 2010a).
The Australian Nursing and Midwifery Council (ANMC) was established in 1992 to
develop a national approach to nursing and midwifery regulation. The role of the
ANMC has changed with the advent of National Registration; now being the national
accrediting authority for nursing and midwifery (ANMC, 2010). The Continuing
Competency Framework (CCF) was previously developed to provide nurses and
midwives a national process for the demonstration of ongoing competence to
practice.The components of the framework included assessment, CPD and recency
of practice which would be contained in a professional portfolio (ANMC, 2009). At
this stage, APHRA has chosen not to endorse the CCF, therefore maintaining a
portfolio is an option for nurses rather than a mandate. A possible reason to this
decision maybe the ongoing disagreement by the ANF that the CCF was a suitable
method of assessing ongoing competence, however the use of a portfolio was
supported (ANF, 2008a, 2008b). It was an assumption by the author and many
Australian writers (Masson & Williams, 2008; Mills, 2009), that the ANMC- CCF
would be implemented as part of the National Registration standards, therefore the
original project was based on the idea that portfolios would be mandatory. Therefore,
a change in focus for the project was made; to educate nurses on the benefits of
portfolios for a wide range of usages.

12. 3
Purpose of the Study
The purpose of the study was to identify a current issue in nursing practice and
design a quality assurance activity and report. It was decided to write about portfolios
as it is a relevant and contemporary issue in nursing practice. A workshop was
designed and implemented, with feedback from participants analysed to establish if it
is a worthwhile project to continue.
Research Question
The primary hypothesis for the report was to confirm that portfolios are beneficial to
nurses, and that teaching nurses about portfolios is a worthwhile experience.
Significance of the Study
The project is significant as many nurses are not familiar with portfolios or the new
National Registration expectations. A workshop was developed to educate nurses
about portfolios and the new competence standards implemented with National
Registration. The NMBA has outlined that 20 hours of CPD must be completed by all
nurses registered in Australia. Portfolios are an ideal method/tool to document CPD
hours, learning plans and evaluation of learning.
Theoretical Framework
The theoretical framework behind portfolio use is based on Knowles theory of adult
learning, whilst developing competence as a nurse is outlined in Benners theory of
novice to expert nursing practice.
Knowles theory of adult learning is based on the assumption that adult learners are
self-directed, ready to learn, curious and self motivated (McMullan et al., 2003).
Portfolios users recognise that learning is self-directed and problem focused, with
relevant and realistic goals that encourage life-long learning (Cangelosi, 2008).
Patricia Benner outlines how nurses develop competence in her novice to expert
model of nursing practice. Nurses move through each stage of development –
novice, advanced beginner, competent, proficient to expert through experience and
education. Benner asserts that through each stage, nurses have different
educational needs and respond to strategies differently, which should be taken into
consideration when suggesting CPD activities. For example nurses who are

13. 4
proficient and expert would benefit from CPD that is based on case studies, or given
the opportunity to conduct research on clinical problems (Benner, 2001). Other
considerations include the span of generations that nurses cover, from baby
boomers to Gen-Y, and their perceptions of learning and technologies (Weingarten,
2009). This is potentially a reason why suggestions for CPD activities are broad and
cater to a variety of methodologies.

14. 5
Chapter 2
Review of the literature
What is a Portfolio?
Portfolios have traditionally been used by the visual arts community to showcase
best work; however portfolios are now widely promoted within the nursing arena to
demonstrate competence and promote nursing achievements.
A Professional Portfolio is:
‘a structured collection of different types of evidence that show
the individual’s professional goals, competencies, career
achievements and continuing professional development
activities and experiences’ (Andre & Heartfield, 2007 p2).
Professional portfolios usually fall into three different categories; presentation and
learning and assessment (Mills, 2009). Presentation portfolios are generally used by
nurses for job applications and promotions. Learning portfolios can be used for
registration purposes and performance appraisals. Assessment portfolios are
commonly used at undergraduate/postgraduate level. Portfolios can be
electronic/web based; also known as e-portfolios, or paper-based.
Whilst many authors refer to assessment portfolios as learning portfolios, for the
purpose of this literature review, assessment portfolios will be referred to in the
University setting, whilst learning portfolios will be referred to from a post registration
perspective.
Presentation Portfolios
Presentation portfolios are usually offered at job interviews, performance appraisals
and for audit purposes. Whilst portfolios ‘promote critical thinking, self assessment
and individual accountability’ (Byrne et al., 2007 p24), careful consideration of what
goes into a portfolio is essential to prevent overwhelming the audience. Portfolios
must be well planned, organised and presentable. There is limited research
evaluating the effectiveness of presentation portfolios, despite the overwhelming
promotion of portfolios in health literature as a standard of practice (Billings, 2008;
Dion, 2006; Johnson, 2002; Meister, Heath, Andrews, & Tingen, 2002; Shirey, 2009) .

15. 6
A study of nurse recruiters (n=34) from Jackson, USA showed that, 26.5% of
respondents believed that professional portfolios were not useful for promotions and
50.2% believed that professional portfolios were not useful in their organisation
(Patrick-Williams & Bennett, 2010). Nurses are encouraged to keep a portfolio for
presentation purposes such as interviews; however there is a distinct lack of
evidence suggesting portfolios are beneficial when applying for employment or
promotion.
Learning Portfolios
A learning portfolio’s purpose is to ‘reflect on practice, with the aim of self-
assessment and planning for continuing professional development’ (Mills, 2009
p207). Some Canadian states and the UK (See Figure 1) have implemented learning
portfolios to demonstrate ongoing competence to practice, whilst some hospitals
request a portfolio be presented at their annual performance review (Picton, 2009;
Thomas, 2005; Twaddell & Johnson, 2007). Learning portfolios can include annual
goals and career plans (Oermann , 2002; Shirey , 2009).
Careful selection of evidence for inclusion in the portfolio is advised to ensure that
the piece reflects ongoing competency to the nurse. It is suggested to provide a brief
rationale for why a piece has been included, which competency standard it relates
to, and a reflective component to link a change in practice (Andre & Heartfield,
2007; Billings, 2008; Mills, 2009). Evidence can be collected or reflected upon in
relation to the competency standards, and the identification of strengths and areas in
need of improvement can be highlighted (Masson & Williams, 2008). Cangelosi
(2008, p125) explains that learning portfolios should reflect the ‘acquisiton of
knowedge and the development critical thinking’. Learning portfolios rely on the
process of reflection to implement a change in practice.
The Texas Children’s Hospital in the USA implemented portfolios as it was ‘seen as
a tool to help provide a structure for identifying the strengths and learning needs of
staff’ (Williams & Jordan, 2007 p126). Seven purposes for the portfolio were outlined:
1. Establish career goals.
2. Showcase professional accomplishments.
3. Illustrate specific areas of expertise.

16. 7
4. Enhance knowledge and skills.
5. Plan for additional career opportunities.
6. Help gain admission to school in order to advance academic preparation.
7. Apply to participate in the hospitals clinical ladder program.
In addition, the portfolio was also introduced to the performance management
process. Managers felt that the portfolio was a valuable tool to outline professional
activities and development.
The University of North Carolina Hospital in the USA introduced portfolios as a
method of documenting learning experiences and competencies as part of their
leadership classes. There is an emphasis that the portfolio is a learning tool which
can assist in identifying strengths, weakness and encourage reflection. The
participant is encouraged to write a personal statement about the portfolio which
demonstrates integration of knowledge and practice, therefore giving meaning to the
portfolio (Lannon, 2007).
A literature review by Kostrzewski , Dhillon, Goodsman and Taylor (2008) on the
impact portfolios have on a health professionals practice, concluded that the
evidence that a portfolio contribute to practice is limited. More research was
recommended to assess the impact portfolios have on professional practice.
Assessment Portfolios
The concept of portfolio use in the literature is focuses mainly on the use of portfolios
to be used from an academic angle. The use of portfolios has been used in
University education since the early 1970’s (Parboosingh, 1996), however there has
been a renewed interest in the use of portfolios particularly with ongoing
technological advancements and the emergence of e-portfolios. Behind the push for
using portfolios as an assessment based method is the movement from faculty
centred teaching to student learning focussed curricula. Instead of the teacher being
at the podium lecturing, students are now being encouraged to participate in the
learning process (Allen, 2010; Jantzi & Austin, 2002), which correlates with the
principles of adult learning.

17. 8
A review of the literature of portfolios and the assessment of competence in nursing
education in the UK from 1989-2001, showed the use of portfolios to demonstrate
competency was evolving, that reflection was a integral aspect of learning and that
assessment should be qualitative (McMullan et al., 2003). A literature review of
portfolio use in undergraduate portfolio assessment (from all disciplines) showed that
time-consuming portfolios can detract from learning, despite showing improvements
in reflection. They suggest that comparative studies should be considered ‘which
observe changes in student knowledge and abilities directly, rather than reporting on
their perceptions once a portfolio has been completed’ (Buckley et al.,2009 p283).
Whilst portfolios are a useful assessment tool, it must be remembered that ‘a
portfolio is not transparent text through which to see clinical practice. The best place
to see clinical practice is in the practice itself’ (Shakespeare, 2002 p32).
E-portfolios
E-portfolios are at the forefront of innovative nursing education at present with many
Universities taking up this pedological experience. E-portfolios have been a recent
agenda for nursing acedamia and the broader education environment and the
Australian Government. There have been a number of reports and recommendations
in the recent years looking at the use of e-portfolios in the broader context of
universities and education, with much of the background work undertaken by the
Australian Government. They recognise that e-portfolios contain personal
information which may be compromised, therefore the Australian Flexible Learning
Framework was developed to provide national guidelines, functional specifications
and strategies to implement the use of e-portfolios by vocational education and
training networks (AFLF, 2009). Privacy impact statement reports have been
published to assist service providers in being aware of their obligations to the learner
(AFLF, 2010).
In 2007, the Australian Learning and Teaching Council (ALTC) commissioned a
research project to examine the use of e-portfolios by university students. The
Australian E-portfolio Project consisted of four universities; Queensland University of
Technology, The University of Melbourne, The University of New England and the
University of Wollongong. The results of this study highlighted a number of

18. 9
recommendations which focus on encouraging the government sector to promote the
use of e-portfolios to articulate employability skills, encourage life-long learning and
enhance the learning experience (Hallam, Harper, Hauville, Creagh, & McAllister,
2009).
The Queensland University of Technology (QUT) has successfully integrated
portfolios across all faculties with at least 23,000 e-portfolios in use (Harper,
McCowan, Hauville, Moody, & Chorazyczewski, 2007). Also, undergraduate nursing
students from QUT have trialled in the clinical setting, the use of handheld personal
computers to document in their e-portfolios with success, however there were
concerns about the security of the devices (Bogossian, Kellett, & Mason, 2009).
Although many universities are now using e-portfolios as part of their assessment
and learning, access to their e-portfolio may be terminated when the student ceases
their studies. The strategic ICT Advisory Service looked at extending the use of e-
portfolio from study to career by recommending an e-portfolio site which is
transferable. E-portfolios are relatively new and the ‘development of an Australian e-
portfolio in the current environment could only be undertaken on the basis of an
understanding that this is the way of the future’ (Leeson & Williams, 2009 p44).
Paper versus Electronic
The benefits of using an e-portfolio over a paper portfolio are:
 Templates can be set out for ease of use (Jantzi & Austin, 2002) i.e. reflection
hyperlink to competencies.
 Multiple portfolios can be created depending on the nature of the portfolio and
its audience (Dion, 2006).
 Eliminate the need to carry around large folders (Jantzi & Austin, 2002).
 Important documents can be uploaded and saved in the event of a fire or
flood (Dion & Smolenski, 2008; O'Malley, 2008).
Portfolios are well established within the academic arena, particularly since the
evolvement of e-portfolios and their technological advantages. Presentation

19. 10
portfolios have received wide input and notice in the literature, however there is a
lack of research supporting the theory that portfolios are useful for promotion and
employment. Learning portfolios are a method that many hospitals and registration
authorities are taking up to assist nurses in demonstrating ongoing competence to
practice. Whichever type of portfolio is used, the principles of adult learning can be
applied as the use of a portfolio encourages reflection, and the responsibility for
learning lies with the individual.

20. 11
Chapter 3
Competence
Competence is a ‘combination of skills, knowledge, attitudes, values and abilities that
underpin effective performance in the nursing role’ (ANF , 2005 p5). Maintaining
competence to practice includes ‘communication…clinical reasoning, problem
solving skills and the ability to have the psychological and social temperament to
adapt to changing environments and conditions’ (Burns, 2009 p222). Whilst many
articles address competence and what it is, in reality it is difficult to assess
competency due to differing skill levels, experience and expectations.
Competency Standards
The issue of competence in nursing has evolved since the 1980’s with the
introduction of entry to practice competency standards (ANF , 2005). The Australian
Nursing and Midwifery Council (ANMC) was established in 1992 to develop a
national approach to nursing and midwifery regulation. The ANMC competency
standards were developed by nurses for nurses to describe the expectations of a
nurse on entry to practice. Competency standards have been developed for
Registered Nurses, Enrolled Nurses, Midwives and Nurse Practitioners (NMBA,
2010b). At least thirty different specialities have developed competency standards in
addition to the accepted ANMC standard, as specific to their practice (Chiarella,
Thoms, Lau, & McInnes, 2008). This idea is based on the idea that the ANMC
competency guidelines are expected by all nurses; however the specialist
competencies can be used in addition to the ANMC competencies (Bryce , 2007).

21. 12
Competence Frameworks
Continuing Competence Frameworks have been developed as a quality assurance
mechanism to protect the public from unsafe and incompetent practitioners (ANMC,
2007). A review of Continuing Competence Frameworks in Australia, Canada, New
Zealand and the United Kingdom, showed a variety of methods of demonstrating
ongoing competence to practice (Figure 1). World-wide in nursing, there are many
CCF’s that are based on self-declaration, CPD and recency of practice. Many of the
models promote a holistic approach, recognising that not one single method
demonstrates nursing competence.
Australia Canada New United
Zealand Kingdom
Recency of Self Assessment Recency of Personal
Practice Practice Professional
Learning Plan Profile (Portfolio)
CPD CPD
Ontario (CNO, 2010) Learning Plan
(AHPRA, 2010) Alberta (CARNA, Self Assessment
2010b) CPD
(NCNZ, 2008)
Above plus: Recency of
Practice
Recency of practice
(NMC-UK, 2010)
British Columbia
(CRNBC, 2010)
Saskatchewan
(SRNA, 2010)
Figure 1: Continuing Competence Frameworks World-Wide

22. 13
The ANMC developed the CCF (Figure 2) to assist nurses in demonstrating
ongoing competence to practice with the anticipation the framework would ‘become
part of the national suite of professional standards’ (ANMC , 2009 p3). The
components of the framework included assessment, CPD and recency of practice,
all to be documented in a professional portfolio (ANMC, 2009). National Registration
for all health professionals commenced in July 2010, and the role of the ANMC
moved from developing a national approach to nursing and midwifery regulation to
accreditation of nursing education. The CCF was handed over to APHRA; however
the recency of practice and CPD standards only were endorsed.
Component Requirement
Assessment • Annual self assessment of performance
Professional
in current role, against relevant ANMC
Portfolio
competency standards
Electronic or hard
• Annual professional review (PAD)
copy format to record
evidence of each • Annual self declaration of competence
component
CPD Annual completion of 20hrs
Recency of 3 months equivalent full time work within
Practice the last 5 years
Figure 2: ANMC Continuing Competence Framework
(ANMC, 2009; NMBA , 2010b)
Demonstrating Competence
Self declaration, CPD, recency of practice and learning plans are several methods of
demonstrating competence. This section will highlight some current arguments that
each method has in demonstrating competency, in reference to the competence
model that the NMBA was offered (ANMC-CCF), and the model that was chosen
(CPD and recency of practice).

23. 14
Self Declaration
A study by Pearson & FitzGerald (2001) commissioned by the Australian Nursing
Council Inc. (now known as the ANMC) surveyed nurses opinions on demonstrating
nursing competence. The randomised study was conducted in 1997/1998 were 1005
nurses around Australia responded to a questionnaire surveying nurse’s views on
competency and how nurses should demonstrate competency to regulating bodies.
The study showed that most nurses believed that signing a declaration of
competence (against the ANMC standards) was the preferred method of providing
evidence of continuing competence, followed closely by verifying recency of practice.
The ANF supports this method by asserting that the self declaration of competence
is the most appropriate mechanism to renew their registration. The mandatory model
of competence suggested by the ANMC by linking CPD, minimum hours of practice
and peer review was opposed (Bryce , 2008).
Walker and Godfrey (2008) highlighted the difficulties using the ANMC competencies
to demonstrate competency, due to a lack of knowledge nurses have about the
competency standards. The study of 11 community nurses from Longreach,
Queensland looked at their perceptions of evidence needed to demonstrate their
clinical practice meets the competency standards. The data was collected by
interview and questionnaire and analysed through percentages and content analysis.
Of the 11 nurses studied, three nurses did not know what the competency standards
were. The study identified that and only one participant knew that the competencies
for their particular area were based on the ANMC competencies. The remainder
were aware there were competency standards; however they were unable to identify
how many domains there were or the content of the competencies. This study
shows the self declaration of competence is limited as many nurses struggle to
define how the ANMC competencies relate to their clinical practice, or indeed are
even aware of what they are (Walker & Godfrey, 2008).
Continuing Professional Development
Although competence to practice has previously concentrated on entry to practice
nurses, there has been the assumption that nurses would perform CPD activities to
maintain competence; however this has been largely unregulated (ANMC, 2007).

24. 15
The ANMC developed a CPD standard within the CCF, whilst APHRA has endorsed
20hrs per year as the minimum number of hours that nurses must spend on CPD
activities with the advent of National Registration.
The ANF was in staunch opposition of the CPD requirements during the
development of the CCF due to a lack of evidence connecting CPD with
competence. Feedback from the ANF highlighted that some nurses lack access to
CPD activities and that the workforce may suffer if nurses cannot re-register if they
are unable to meet the CPD requirements (ANF , 2008a, 2008b). Yoder-Wise (2006
in Lannon 2007) agree that CPD may not be the most appropriate method in
gauging competence, however it shows that nurses are intent in staying up to date
with nursing knowledge.
Recency of Practice
Recency of practice was a common thread of all states in Australia to demonstrate
competency, except NSW prior to National Registration. Although recency of
practice is one indicator of competency, it does not recognise that nurses in current
practice may not be competent to practice. It is recommended that other indicators
are used in combination with recency of practice to monitor competence (Pearson,
Fitzgerald, Walsh, & Borbasi, 2002).
Learning Plans
A method of identifying learning needs that has been embraced by Canada, the
United Kingdom and Australia (although not clearly defined as a method of
identifying learning needs for self-directed study), is the learning plan and reflection
on activities. This concept is based on linking competency standards with learning
needs and outcomes.
The use of learning plans and reflection has been criticised by authors Nelson and
Purkis (2004) in an analysis of the mandatory reflection requirements of Canadian
nurses. They argue that the reflective component of the framework ‘radically fails as
a tool for auditing quality and assessing competency’ (Nelson & Purkis, 2004 p247).
Namely because for auditing purposes a plan is only required, with no requirements
of demonstration of that activity. The paper asserts the process of reflection causes
a nurse to ‘routinely scrutinises her skill set, and works to remedy deficits’ as a

25. 16
‘confessional’ (Nelson & Purkis, 2004 p255). On reviewing the College and
Association of Registered Nurses of Alberta’s Continuing Competence Program
audit requirements, nurses are required to submit a questionnaire answering
questions about their participation in the program, learning plans and outcomes-in
the form of a tick box answer (CARNA , 2010). The form however, resembles a
research questionnaire rather than an audit of competency.
The United Kingdom however has a contrasting attitude towards learning plans with
the belief that learning plans help a nurse ‘keep up with new developments in
practice, think and reflect for yourself, demonstrate that you are keeping up to date
and developing your practice and provide a high standards of practice and
care’(NMC -UK, 2010 p3). Examples of learning plans are given to the participant to
gain an understanding of the expectations of the standards.
The end point of a learning plan includes reflecting or evaluating what you have
learnt from that activity. Refection on practice has become a popular method of
demonstrating competence (Byrne, Delarose, King, Leske, Sapnas, et al., 2007;
Byrne, Schroeter, Carter, & Mower, 2009; Cangelosi, 2008; Masson & Williams,
2008), whilst others believe that developing clinical competence and leadership
through reflection shows emotional intelligence (Horton-Deutsch & Sherwood, 2008)
Maintaining competence to practice as a nurse is an issue at the forefront of nursing
regulation around the world. Various competency frameworks have been developed
in many countries that is centred around recency of practice. A variety of methods
such as portfolio use, learning plans, self-assessment and CPD requirements have
lead to much controversy and discussion; however it is recognised that a
combination of methods is required to demonstrate ongoing competence to practice.

26. 17
Challenges for the Australian Competency Framework
Learning Plans
Nurses in Australia are expected to identify and prioritise their learning needs based
on:
 Evaluation of their practice against the relevant competency or professional
practice standards.
 Developed a learning plan based on identified learning needs.
 Participated in effective learning activities relevant to their learning needs.
 Reflected on the value of the learning activities or the effect that will have on
their practice (NMBA, 2010a).
However, this is the extent of the explanation of the requirement. No examples are
given as to how a learning plan should be developed or the quality or depth of
reflection that is required. Indeed, one can wonder if the ‘relevant’ competency
standards are referring to the ANMC competency standards or from other relevant
competency standards available to nurses.
A paper written by Campbell and Mackay (2001) from the Professional Practice
Department of the College of Nurses of Ontario, Canada asserts that an effective
professional development program must contain tools and resources to help nurses
maintain their competence to practice. A statement made by Campbell and Mackay
(2001 p24)- ‘Many times professional are left to develop an effective learning plan,
identify tools, and acquire the appropriate resources to effectively implement the plan
on their own’, sums up the experience the NMBA has left to Australian nurses. It will
be interesting to see the quality of learning plans, if nurses feel that the 20hrs of CPD
must be related to the learning plans, and indeed if the learning plans will be
required in the event of auditing at all. o process for audit has been posted on the
website making it difficult for nurses to identify audit requirements and expectations.

27. 18
CPD standards
Whilst the NMBA is attempting to keep the CPD broad and non prescriptive, further
explanation of the CPD standard document may be required. The statement
‘Documentation of self-directed CPD must include dates, a brief description of the
outcomes, and the number of hours spent in each activity’ (NMBA, 2010a), has lead
to confusion and frequent questioning. Exactly ‘what is self-directed learning’ the
author asks? Some colleagues have taken this explanation to mean, that if an
activity was held by an outside source, because it is not self-directed, a learning plan
is not required. To get around this, many nurses will therefore attempt to ‘rack’ up
their 20hrs of CPD requirement by attending in-services and workshops, with little
planning in advance for their learning needs and no reflection.
Portfolios and Competence
Behind the phenomena of portfolio use to demonstrate competence is the notion that
competence can be demonstrated through the collection of evidence and documents
that show ongoing competence to practice. Therefore portfolios are a tool, rather
than a method to demonstrate competence. Some states have previously asked
nurses to keep portfolios to demonstrate ongoing competence to practice (See
Appendix A), whilst others have required recency of practice and self review. The
new NMBA has adopted the CPD and Recency of Practice standards only.
The ANMC (2007) developed the CCF based on the results of a literature review
focusing on ‘Trends in Continuing Competence’. The literature review looked at
current competence requirements in each state from nursing and other professions
such as medicine, law engineering etc. International nursing requirements were also
reviewed focussing on Canada, New Zealand and the USA. It was generally agreed
by many authors that the portfolio was the most ‘effective and appropriate means of
recording the maintenance of competence’ (ANMC, 2007 p30). Some articles have
linked the maintenance of portfolios with the new Australian nursing legislative
requirements, emphasizing the use of the competency standards and reflection
(Masson , 2008; Mills, 2009).
Pearson and FitzGerald (2001 p23) survey of 1005 nurses showed that portfolios
was the preferred method of a nurses ‘ability to provide evidence of professional

28. 19
development’ followed by the combination of a portfolio and a self assessment based
on a competency questionnaire .This is in contrast to the belief that self assessment
is the preferred method of providing evidence of continuing competency as
mentioned earlier.
Much controversy surrounds determining the best method of demonstrating
competence to practice from nursing regulatory bodies around the world. Despite
significant research by the ANMC into to best method of determining competence to
practice, the new NMBA has chosen to endorse the CPD and recency of practice
standards only. Without clear guidelines for nurses to refer to such as the auditing
procedures, nurses may fail in their attempt to meet the new standards as expected
by the NMBA.

29. 20
Chapter 4
Is teaching about portfolios a worthwhile experience for the participants?
As keeping a portfolio is a new concept for many nurses, literature on teaching
portfolios development classes was looked at to ascertain if nurses need assistance
in developing portfolios. Feedback given by participants who had attended classes
on portfolio development and by employer’s feedback was evaluated.
A workshop by Lannon (2007) provided professional development classes for nurses
working at the University of North Carolina Hospital in America, with workshops on
presenting, poster development, portfolios, interview skills and resume writing. The
most popular workshop was the portfolio development workshop which was
designed to prepare nurses for leadership roles beyond clinical expertise. Feedback
by assessors of the portfolios commented ‘there was a definite difference between
the applicants who attended the portfolio development class and those who had not’
(Lannon, 2007 p21).
Serembus (2000) reported on a workshop series aimed at undergraduate nursing
students in Pennsylvania, America. Feedback by participants included ‘that the
professional portfolio gave them the edge over other candidates’ (Serembus, 2000
p286) which supports the assumption that portfolio development may assist nurses
in gaining employment, however was not backed up with solid research to support
this theory.
Whyalla Hospital in South Australia, introduced portfolios to assist nurses in the
development of nursing skills. Ten senior nursing staff piloted the project with the
challenge ‘to define the purpose of the portfolio, determining what was appropriate
and reasonable to expect of nurses and ensuring the whole process did not become
so burdensome it was rendered insignificant' (Emden , Hutt, & Bruce, 2003 p126).
For the project to work, the nurses decided the journey of self-development was
more important than demonstrating competency. The participants were provided with
a book about portfolios and had a clear objective of relating the portfolio building
experience to their clinical practice.
On implementing portfolios at the Texas Children’s Hospital in the US, feedback from
staff concluded that the long-term benefits were recognised, however compiling the
portfolio was ‘overwhelming for many nurse’s’ (Williams & Jordan, 2007 p129).

30. 21
These types on comments are thematic in many portfolio articles, supporting the
possibility of offering educational sessions on how to develop a nursing portfolio.
Whilst nurses in the UK have been using portfolios for years now, some are still not
confident in preparing or presenting their portfolios despite guidelines being
available. Bower and Jinks (2004) suggest nurses could be mentored through the
process of developing their portfolio. Clearly and Freeman (2005) believe
appropriate resources should be made available to nurses when developing a
portfolio. Workbooks were developed to support life-long learning in clinical practice
which gave guidance to nurses when developing clinical skills. Whilst the onus of
portfolio development is ultimately the nurse’s responsibility, a workbook can assist
in helping nurses develop learning objectives in accordance with departmental goals.

31. 22
Chapter 5
Method
Design, Setting and Sample
The research was a descriptive study to ascertain if it was beneficial to educate
nurses on the benefits of portfolio use. A workshop was designed and implemented
to see if the workshop was a viable project to continue.
Invitations to participant in the workshop were sent to Emergency Department
nurses across two campuses however there was a poor response rate, partially
attributed to previous in-services already held by the author on the same topic. With
the assistance and support of the Nursing Education and Research Unit of the Gold
Coast Hospital, the workshop was opened to all nurses across the district. Requests
to attend the workshop were overwhelming; however participation was limited to 25
nurses.
The workshop was held in the Nurse Education building with 27 participants
attending. Several people did not show up and others attended without a booking.
There was a variety of participants from all nursing areas including educators,
midwives, mental health and community nurses. The workshop was designed and
officiated by the author. Two participants (who had not booked in), came in for the
first two sessions only, and 21 participants completed the feedback form.
The morning covered the following topics:
 National Registration
 CPD
 Portfolios
 E-portfolios
 Learning Plans
 Reflection
Participants were asked to fill out the feedback form honestly and were verbally
advised the results would be used for research purposes.

32. 23
Analysis
The feedback form was the data collection tool used to assess the workshop by
participants. The results were graphed on a ‘helpfulness’ scale, giving participants
five levels to select as well as allowing for comments.
0- Not helpful at all
1- Mildly helpful
2- Helpful
3- Very helpful
4- Excellent
Each session was graphed on a pie chart to show an overall impression if they found
the session helpful in percentage, whilst column graphs were used to show yes/no
answers.
Whilst no cross analysis was undertaken comparing if participants usually gave a
particular score, it was noted that one participant scored a one for all six sessions;
however no written feedback was given to ascertain why the workshop was overall
rated as mildly helpful.

33. 24
Chapter 6
Results
Introduction and National Registration
This session focussed on introducing the workshop and highlighting the changes that
National Registration will bring to nurses in Australia. General housekeeping issues
were brought up such as turning off phones, emergency exits and plan for the day.
All participants were given handouts, a CD and outline for the day. A brief
background of how and why National Registration was brought about and the five
new registration standards were discussed.
Results
Introduction and National Registration
1-mildly helpful 2- helpful 3- very helpful 4- excellent
5%
33% 19%
43%
Figure 3: Introduction and National Registration
Comments from the session:
Increased awareness of changes.
This information should be shared with all nursing staff, perhaps make it part
of mandatory skills (included CPD session).
A good introduction to the workshops learning objectives.
Very helpful information revising updates in National registration requirements
and changes.

34. 25
Continuing Professional Development
This section discussed the CDP requirements of National Registration and the
documentation required in the event a nurse is audited. Examples were given of
different types of CPD and documentation templates.
Results
Continuing Professional Development
1-mildly helpful 2- helpful 3- very helpful 4- excellent
5% 5%
52% 38%
Figure 4: Continuing Professional Development
Comments from the session:
Helped understand how this is calculated better.
I learnt there is much more you can do to reach your CPD points.
Excellent info -clear explanation.

35. 26
Portfolios
This session looked at different types of portfolios and how to compile one
depending on the audience looking at the portfolio. In preparation, several portfolios
where designed to show different types of portfolios, and participants were
encouraged to look at these during morning tea. A teacher kindly let me show her
portfolio to the group.
Results
Portfolios
1-mildly helpful 2- helpful 3- very helpful 4- excellent
5%
14%
48%
33%
Figure 5: Portfolios
Comments from the session:
Hearing about types of portfolios and their uses.
Having the opportunity to look through portfolios was very useful.
Provided info, examples +broke it down.

36. 27
E-portfolios
This session discussed the potentials for storing portfolios online. Examples of
several e-portfolios were given and the benefits/problems were discussed.
Results
E-portfolios
1-mildly helpful 2- helpful 3- very helpful 4- excellent 0- not helpful
5% 9%
38%
38%
10%
Figure 6: E-portfolios
Comments from the session:
Food for thought.
Not personally techno savvy at all hence not a lot gained personally, but interesting
to know.
Further exploration will make this a valuable tool for employer to access, previously
unaware thank u.
I had never heard of e-portfolios- will want to give this a go.
Inspiring- demystified this for me.

37. 28
Learning Plans
This interactive session dived participants into groups after showing them how to
write a learning plan. Although mostly rated as excellent, most participants had
problems grasping the concept of linking the ANMC competencies with learning
plans; however most participants had a good understanding of how the
competencies related to their work. Example of learning plans from Canada and the
UK were given out in the handouts and referred to.
Learning Plans
1-mildly helpful 2- helpful 3- very helpful 4- excellent
5%
43% 33%
19%
Figure 7: Learning Plans
Comments from the session:
Felt re-capping previously learnt information.
Difficult to relate to ANMC.
Group activity not clearly explained, needs further explanation prior to discussion in
separate groups.
I felt this part difficult as when you don’t know something you automatically see
resources. Hard to put on paper.
Requires better explanation.
Great group activity.

38. 29
Reflection
This session talked about reflection in five steps. Participants were then encouraged
to discuss in groups reflection situations. Whilst participants were advised not to
discuss emotionally disturbing situations that may upset them, most concentrated on
positive outcomes, rather than negative.
Results
Reflection
1-mildly helpful 2- helpful 3- very helpful 4- excellent
5%
33% 29%
33%
Figure 8: Reflection
Comments from the session:
Re-capped prior learning.
Good until exercise.
Good exercise.
Good group activities and examples.

39. 30
Have you used a portfolio (as opposed to a CV or resume) previously?
When discussing who had used portfolios in the past, nurses who had worked in NZ
or the UK have had previous portfolio use.
Previous portfolio use
n=16
n=3
n=2
yes no no answer
Figure 9-Previous portfolio use
Would you be interested in maintaining an e-portfolio over a paper portfolio?
This graph shows that most of the participants would be interested in setting up an e-
portfolio. Of those who answered yes (n=14), 11 said they would need help setting
one up.
16
14
12
10
interested in e-
8 portfolios?
6 need help setting one
up?
4
2
0
yes no maybe no answer
Figure 10- E-portfolios

40. 31
Did you find the handouts helpful?
Did you find the handouts helpful?
20
1
yes no
Figure 11- Handouts
Comments:
However have not read all- would have been nice to have been presented in a
folder.
Could have been assembled and stapled- very confusing.
What was good about the workshop?
Prior to the workshop I was fearful of portfolios and had no idea. Now I am much
more comfortable and feel I have some understanding. Will definitely recommend
this workshop to others.
Engaging presenter who walks the talk.
Clarified the obligations that we have to adhere to and a practical way to achieve
that.
Everything was relevant to the day.
Give me idea on how to start my portfolio folder.
Presented well and with easy, simple language.

41. 32
What could have been improved?
Several participants suggested more visual examples of portfolios and learning
plans.
Some of it confusing in short space of time.
Lengthen course to have staff commence with help some completion of templates to
add to portfolio.
The session could be shortened. Not all of it was relevant to what we need to
provide.
Spending more time on the development of a portfolio from the start. The learning
plan section.
Additional comments:
Highly recommend other staff to attend, very helpful and informative- especially for
those who portfolios are new to.
To learn more about writing a CV +resume- what is the difference.
Well presented by a facilitator with clear understanding of portfolio development.
Competency standards- discussion was informative- encouraged us to critically
analyse competencies and learning plans. Needed more breaks- it was a very long
session.
Thankyou Jo-Anne for a brilliant in-service where I learnt loads. Cheers.
Great to network with other staff from other departments.
Highly recommended.
Thank you for researching this topic and sharing this information which is so useful
and valuable for my professional life.

42. 33
Overall satisfaction
All scores were graphed to show an overall satisfaction rating. Most participants
(40%) gave the workshop an ‘excellent’ rating.
Overall satisfaction
52
38
28
7
1
0 1 2 3 4
0- Not helpful at all, 1- Mildly helpful,2- Helpful,3- Very helpful, 4-Excellent
Figure 12- Overall satisfaction

43. 34
Chapter 7
Discussion
Competence
The hypothesis of the study was to identify if teaching about portfolios was beneficial
to nurses. The initial idea to develop the workshop was based on the idea that the
ANMC CCF would be implemented with the advent of National Registration;
therefore maintaining a portfolio would be mandatory. However, as only the recency
of practice and CPD standards were endorsed, there was a change in focus. This
lead to the author asking what is competence and how is it demonstrated?, which
was explored in the literature review.
Much of the literature review focuses on competence in nursing with reference to
CCF’s around the world. Some of the issues highlighted by Nelson & Purkis (2004)
in their review of Canada’s use of learning plans has relevance to the Australian
nursing community. Due to a lack of explanation and direction it is anticipated by the
author that nurses will have difficulties in developing a learning plan as expected by
the NMBA. Even though the concept of learning plans was explained and examples
given, nurses still found it difficult to write a learning plan in relation to the ANMC
competencies during the workshop. Perhaps it would be wise of the NMBA to review
the UK model- PREP handbook (NMC-UK, 2010) to assist in developing guidelines
for developing learning plans.
Workshop
Much of the interest in the workshop was centred on learning what was expected for
registration purposes. This is why it was decided to open with the background of
National Registration and the mandatory standards. One participant believed that
‘this information should be shared with all nursing staff, perhaps make it part of
mandatory skills’. The most successful session of the workshop was the CPD
session which 52% of participants giving it an excellent rating. E-portfolios generated
attention with 76% (n=16) of participants interested in starting an e-portfolio.
Most nurses in Queensland have not had exposure to portfolios unless advocated by
their hospitals or from living in states or countries that require one for registration
usage. This was confirmed by the response rate that only three participants had

44. 35
used portfolios in the past. Overall, it was found that 40% of participants rated the
workshop as excellent, which confirms the hypothesis that teaching about portfolios
is beneficial to nurses.
Whilst no literature was found specifically reporting feedback from a workshop on
portfolios, a paper from Lannon (2007) reported that the portfolios workshop was the
most popular class of five leadership classes, with assessors noting the benefits of
portfolio development. The results of the feedback on the portfolio workshop show
that whilst portfolio development is a worthwhile topic to explore, research is lacking
in the experience of being taught portfolios. There is a large amount of literature
relating the student’s experience of assessment portfolios; however no feedback on
the actual learning experience (i.e. learning about portfolios) was noted.
Recommendations
The impact of nurses using e-portfolios as an option supported by APHRA would be
useful to nurses and the Nursing and Midwifery board alike. APHRA could outline
clear and concise expectations by providing templates within an e-portfolio site.
Nurses could submit their portfolio for audit at the press of a button, and portfolios
could be transferable between employment as the system would be Australia wide,
rather than hospital or university dependent. The use of an e-portfolio could be
absorbed by registration costs or an additional optional fee. Privacy and
confidentiality notices could be set into the templates, as well as assuring nurses that
access to their site by APHRA would not be undertaken unless permission given.
Whilst portfolios are recommended for nurses to use, there is very little research
backing up many of the claims made. Research looking at the following questions
would be beneficial in establishing the usefulness of portfolios and assist the
competency movement that is still evolving within Australia.
1. Do employers look at portfolios when hiring new staff? Do portfolios improve
the chances of gaining employment?

45. 36
2. If the ANMC CCF was implemented in Australia, what would be the ‘marking
guide’ and would the resources be available to review portfolios in the event
of auditing?
3. Since the advent of National Registration, how many nurses are developing
learning plans and partaking of 20hours of CPD?
4. What sort of CPD activities are Australian nurses undertaking and how is this
being documented?
Conclusion
Nurses can choose to maintain a portfolio for a variety of purposes such as
demonstrating ongoing competence to practice, evidence for job promotions or for
assessment purposes. There is a lack of evidence to suggest that portfolios are
beneficial when applying for employment or promotion despite a overwhelming
amount of literature stating it is advantageous. Assessment portfolios are well
ingrained in the academic arena to show ongoing learning and reflection. As portfolio
use may be new for many nurses, and potentially overwhelming the literature
suggests that a workshop to teach nurses about portfolios may be appropriate and
helpful.
Countries such as Australia, Canada, New Zealand and the United Kingdom have
defined various competency frameworks which are based on recency of practice.
These countries have adapted their competency frameworks to include either CPD,
portfolios, self assessment and learning plans, which has generated a great deal of
discussion and controversy. Some hospitals around the world are now asking nurses
to maintain portfolios to demonstrate nursing competency, and to provide evidence
in performance reviews. The new legislative requirements as expected by the NMBA
of CPD and learning plans may need further clarification to avoid confusion and non-
compliance. This may cause problems in the near future as audit requirements have
yet to be made public.

46. 37
References
AFLF. (2009). Australian Flexible Learning Framework. In E. a. W. R. Department of
Education (Ed.): Australian Government.
AFLF. (2010). E-portfolio draft privacy guidelines released. Retrieved 28 May, 2010, from
http://flexenews.flexiblelearning.net.au/pub/pubType/EL/pubID/87144154b99bd653b
eb1/nc/97779924b99bfbe18df8/interface.html
Allen, S. (2010). The revolution of nursing pedagogy: a transformational process. Teaching
and Learning in Nursing, 5(1), 33-38.
Andre, K., & Heartfield, M. (Eds.). (2007). Professional Portfolios: Evidence of Competency
for Nurses and Midwives: Churchill Livingstone, Marrickville, NSW, Australia.
ANF. (2005). Competency standards for the advanced registered nurse. Retrieved 28 May
2010, from http://www.anf.org.au/pdf/Competency_Standards_Adv_RN.pdf
ANF. (2008a). Project to Develop a National Framework for Continuing Competence DRAFT
2 December 2007 Feedback Questionaire.
ANF. (2008b). Project to Develop a National Framework for Continuing Competence DRAFT
3 May 2008 Feedback Questionaire.
ANMC. (2007). Trends in Continuing Competence, ANMC.
ANMC. (2009). Continuing Competence Framework. Retrieved 22 March, 2010, from
http://www.anmc.org.au/userfiles/file/Continuing%20Competence%20Framework%2
0-%20Jan%202009.pdf
ANMC. (2010). Australian Nursing and Midwifery Council, from http://www.anmc.org.au/
Benner, P. (2001). From novice to expert- Excellence and power in clinical nursing practice.
New Jersey: Prentice Hall Health.
Billings, D. M. (2008). Teaching tips. Developing your career as a nurse educator: the
professional portfolio. Journal of Continuing Education in Nursing, 39(12), 532-533.
Bogossian, F., Kellett, S., & Mason, B. (2009). The use of tablet PCs to access an electronic
portfolio in the clinical setting: A pilot study using undergraduate nursing students.
Nurse Education Today 29, 246–253.
Bowers, S. J., & Jinks, A. M. (2004). Professional issues. Issues surrounding professional
portfolio development for nurses. British Journal of Nursing (BJN), 13(3), 155-159.
Bryce, J. (2007). The answer is competency standards. Australian Nursing Journal, 14(11),
29.
Bryce, J. (2008). A new national agenda. Australian Nursing Journal, 15(8), 20.
Buckley, S., Coleman, J., Davison, I., Khan, K. S., Zamora, J., Malick, S., et al. (2009). The
educational effects of portfolios on undergraduate student learning: a Best Evidence

47. 38
Medical Education (BEME) systematic review. BEME Guide No. 11. Medical
Teacher, 31(4), 340-355.
Burns, B. (2009). Continuing Competency -Whats ahead? Journal of Perinatal and Neonatal
Nursing, 23(3), 218-227.
Byrne, M., Delarose, T., King, C., Leske, J., Sapna, K., & Schroeter, K. (2007). Continued
Professional Competence and Portfolios. Journal of Trauma Nursing 14(11) 24-31.
Byrne, M., Delarose, T., King, C., Leske, J., Sapnas, K., & Schroeter, K. (2007). Continued
professional competence and portfolios. Journal of Trauma Nursing, 14(1), 24-31.
Byrne, M., Schroeter, K., Carter, S., & Mower, J. (2009). The Professional Portfolio: An
Evidence-Based Assessment Method. The Journal of Continuing Education in
Nursing, 40(12), 545.
Campbell, B., & Mackay, G. (2001). Continuing competence: an Ontario nursing regulatory
program that supports nurses and employers. Nursing Administration Quarterly,
25(2), 22-30.
Cangelosi, P. (2008). Learning Portfolios Giving Meaning to Practice. Nurse Educator, 33
(33) 125-127.
CARNA. (2010). College and Association of Registered Nurses of Alberta Continuing
Competence Program Audit Questionnaire, from http://www.nurses.ab.ca/carna-
admin/Uploads/2010_CCP_Questionnaire_RN.pdf
Carrigan, C. (2008). Eight into One: National Registration by 2010. Australian Nursing
Journal, 15(11), 24-27.
Chiarella, M., Thoms, D., Lau, C., & McInnes, E. (2008). An overview of the competency
movement in nursing and midwifery. Collegian, 15(2), 45-53.
Clearly, M., & Freeman, A. (2005). Self-directed learning and portfolio development for
nurses: developing workbooks as a facilitative tool. Contemporary Nurse, 20(1), 14.
Dion, K. W. (2006). Nursing portfolios: drivers, challenges, and benefits. Dean's Notes,
27(4), 1-3.
Dion, K. W., & Smolenski, M. (2008). Why you need an electronic professional portfolio.
American Nurse Today, 3(9), 13-14.
Emden, C., Hutt, D., & Bruce, M. (2003). Portfolio learning/ assessment in nursing and
midwifery: an innovation in progress. Contemporary Nurse, 16 (1-2), 124-132.
Government, A. (2009). Health Practitioner Regulation National Law.
Hallam, G., Harper, W., Hauville, K., Creagh, T., & McAllister, L. (2009). Australian ePortfolio
Project.
Harper, W., McCowan, C., Hauville, K., Moody, K., & Chorazyczewski, D. (2007). Voluntary
or compulsory: Using a variety of approaches and models to implement the Student

48. 39
e-Portfolio across 40,000 students at QUT, ePortfolio Australia Conference 2007:
Imagining New Literacies.
Horton-Deutsch, S., & Sherwood, G. (2008). Reflection: an educational strategy to develop
emotionally-competent nurse leaders. Journal Of Nursing Management, 16(8), 946-
954.
Jantzi, J., & Austin, C. (2002). Measuring learning, student engagement, and program
effectiveness: A strategic process. Nurse Educator, 30(2), 69-72.
Johnson, S. (2002). Development of educator competencies and the professional review
process. Journal for Nurses in Staff Development, 18(2), 92-102.
Kostrzewski, A. J., Dhillon, S., Goodsman, D., & Taylor, K. M. G. (2008). The impact of
portfolios on health professionals' practice: a literature review. International Journal
of Pharmacy Practice, 16(6), 339-345.
Lannon, S. (2007). Leadership skills beyond the bedside: Professional development classes
for the staff nurse. The Journal of Continuing Education in Nursing, 38(1), 17-21.
Leeson, J., & Williams, A. (2009). E-portfolios beyond education and training; strategic ICT
advisory service: Department of Education, Employment and Workplace Relations.
Masson, R., & Williams, A. (2008). Reflective practice and the national continuing
competency framework. HNE Handover for nurses and midwives, 1(2), 32-35.
McMullan, M., Endacott, R., Gray, M. A., Jasper, M., Miller, C. M. L., Scholes, J., et al.
(2003). Portfolios and assessment of competence: a review of the literature. Journal
of Advanced Nursing, 41(3), 283-294.
Meister, L., Heath, J., Andrews, J., & Tingen, M. S. (2002). Professional nursing portfolios: a
global perspective. MEDSURG Nursing, 11(4), 177-182.
Mills, J. (2009). Professional portfolios and Australian registered nurses' requirements for
licensure: developing an essential tool. Nursing & Health Sciences, 11(2), 206-210.
Nelson, S., & Purkis, M. (2004). Mandatory reflection: the Canadian reconstitition of the
competent nurse. Nursing Inquiry, 11(4), 247-257.
NMBA. (2010a). Fact sheet: New obligations for Nurses and Midwives. Retrieved 5 May
2010, 2010, from
http://www.nursingmidwiferyboard.gov.au/documents/New%20obligations%20for%20
Nurses%20and%20Midwives.pdf
NMBA. (2010b). Nursing and Midwifery Board of Australia. Retrieved 15 August, 2010, from
http://www.nursingmidwiferyboard.gov.au/Codes-and-Guidelines.aspx
NMBWA. (2010). Nursing and Midwifery Board of Western Australia. Retrieved 29
September, 2010, from http://www.nmbwa.org.au/
NMC-UK. (2010). The PREP handbook, from http://www.nmc-uk.org/Educators/Standards-
for-education/The-Prep-handbook/

49. 40
O'Malley, P. A. (2008). Profile of a professional. Nursing Management, 39(6), 24.
Oermann, M. H. (2002). Developing a professional portfolio in nursing. Orthopaedic Nursing,
21(2), 73-78.
Parboosingh, J. (1996). Learning portfolios: Potential to assist health professionals with self-
directed learning. The Journal of Continuing Education in Health Professions, 16, 75-
81.
Patrick-Williams, I., & Bennett, R. (2010). The effectiveness of the professional portfolio in
the hiring process of the associate degree nurse. Teaching & Learning in Nursing,
5(1), 44-48.
Pearson, A., & FitGerald, M. (2001). A survey of nurses' views on indicators for continuing
competence in nursing. Australian Journal of Advanced Nursing 19, 1, 20-26.
Picton, C. (2009). Putting portfolios to work. Emergency Nurse, 16(9), 1.
ProductivityCommission. (n.d.). Retrieved 3 June 2010, from http://www.pc.gov.au/
Serembus, J. (2000). Teaching the process of developing a professional portfolio. Nurse
Educator, 25(6), 282-287.
Shakespeare, P. (2002). Building Portfolios. Nursing Management, 9(1), 30-33.
Shirey, M. R. (2009). The nursing professional portfolio: leveraging your talents. Clinical
Nurse Specialist: The Journal for Advanced Nursing Practice, 23(5), 241-244.
Thomas, D. O. (2005). A better approach to performance reviews. RN, 68(4), 44-46.
Twaddell, J. W., & Johnson, J. L. (2007). A TIME for nursing portfolios: a tool for career
development. Advances in Neonatal Care (Elsevier Science), 7(3), 146-150.
Walker, S., & Godfrey, S. (2008). Primary and community health nurses' perception of
evidence needed to demonstrate that their clinical practice meets the ANMC
competencies. Studies in Learning, Evaluation Innovation and Development, 5(2),
15-24.
Weingarten, R. (2009). Four generations, one workplace: A gen X-Y staff nurses's view of
team building in the emergency department. Journal of Emergency Nursing, 35(1),
27-30.
Williams, M., & Jordan, K. (2007). The nursing professional portfolio: a pathway to career
development. Journal for Nurses in Staff Development, 23(3), 125-131.

50. 41
Appendix

51. 42
Appendix A: Portfolio and CPD requirements
Australian States Portfolios requirement CPD requirements
ACT (ACTNMB) Yes 10 hours per year
NT (NBT) No No
WA (NMBWA) Yes 20 hours per year
QLD (QNC) No No
SA (NBSA) No No
TAS (NBT) Yes Yes (?hours)
NSW (NMB) No No
VIC (NBV) No Yes (?hours)
National Registration No 20 hours per year
(ANMC, 2007)

52. 43
Appendix B: Workshop Objectives and Learning Plan
Time Learning Objectives Teaching Method Outcome and Evaluation
0800-0830 Topic: Welcome and Introduction to National PowerPoint Student will be able to identify and
Registration presentation compare changes by being able to
answer the following questions:
Housekeeping i.e. toilets, fire escapes, outline of Interaction: Asking
the morning and importance of feedback. questions to ascertain  What were the previous Nursing Act
participant’s level of and the new Nursing Law?
Students to demonstrate an understanding of knowledge throughout  What governing body were QLD
recent changes that will affect their nursing the presentation. nurses under, and what governing
registration. body are all Australian nurses under
now?
 Health Practitioner Regulation National Law  What are the new national
Act 2009 registration standards?
 Australian Health Practitioner Regulation
Agency. Score and comments from feedback
 Nursing and Midwifery Board of Australia form
 National Registration Standards
Rationale:
Introducing the national registration expectations
will provide the background evidence to why
developing a portfolio is desirable.

53. 44
Time Learning Objectives Teaching Method Outcome and Evaluation
0830-0900 Topic: PowerPoint presentation
Continuing Professional Development (CPD) The participant will be able to discuss
Interaction: Participant to what types of activities constitute CPD.
list different CPD
The participant will be able to outline
activities on white board The participant will be able to state
expectations of CPD and be able to discuss the how many hours of CPD are required
each year.
different types of CPD that can be undertaken.
Score and comments from feedback
Rationale: form.
Outlining the CPD requirements will support the
use of portfolios as a portal to document hours

54. 45
Time Learning Objectives Teaching Method Outcome and Evaluation
0900-1000 Topic: Portfolios PowerPoint The participant will be able to discuss
presentation the differences between a resume and
Different types of portfolios will be discussed and
a portfolio.
typical content. The participant will engage in the
Interaction: The
compilation of their portfolio.
participant will bring The participant will be able to outline
their portfolio and the components of portfolios.
Rationale:
documents to the class
Bringing the portfolio to class will encourage
and receive assistance The participant will be able to describe
nurses to commence the compiling of the portfolio.
with construction and the different applications of portfolios.
feedback
Score and comments from feedback
form

55. 46
Time Learning Objectives Teaching Method Outcome and Evaluation
1020-1035 Topic: Eportfolios PowerPoint presentation Participant will be able to locate
resources on the internet that could
The participant will explore the options of an
Interaction: Participant assist them in developing an eportfolio.
internet based portfolio. will be shown an e-
portfolio of a nurse and
be able to navigate Score and comments from feedback
Rationale:
through the site. form.
Nurses can document their CPD hours in any
form (not specified by the NWBA).

56. 47
Time Learning Objectives Teaching Method Outcome and Evaluation
1035-1115 Topic: -: Competency Standards PowerPoint presentation The participant will be able to
The competencies which make up the ANMC write a learning plan for the
Interaction: The class will be year which pertains to the
Competency Standards for Registered Nurses are
divided into four groups and
organized into 4 domains: ANMC competencies.
discuss how each of the
domains pertains to their own Score and comments from
Professional Practice
practice. The groups will then
feedback form.
Critical Thinking and Analysis present which types of CPD will
assist them in meeting their
Provision and Coordination of Care learning goals.
Collaborative and Therapeutic Practice
The aim of this session is to encourage
participants to link their nursing practice with the
ANMC competencies and think of evidence they
could provide which shows this.
Rationale:
Understanding the way the competencies relate to
practice is fundamental in providing appropriate
evidence.

57. 48
Time Learning Objectives Teaching Method Outcome and Evaluation
1115-1155 Topic: Reflection PowerPoint presentation The participant will be able to write
a reflective piece of writing linking
The participant will be able to explore and
Interaction: Participants are to how the ANMC competencies affect
apply the principles of reflection to clinical
anonymously state on two the situation.
situations.
different pieces of paper, a
strength and a weakness in their The participant will be able to
Participants will be able to link the ANMC identify learning needs for the year
nursing practice. The facilitator
standards to everyday nursing practice. by reflecting on their own practice.
will then encourage group
discussion to apply the principles
Score and comments from
of reflection to each situation.
Rationale: feedback form.
Reflection links theory to practice which
leads to an improvement in practice.
Reflection will also help identify learning
needs.

58. 49
Time Learning Objectives Teaching Method Outcome and Evaluation
1155-1200 Topic: Summery and Feedback PowerPoint Score and comments from feedback
presentation form
This session will summarise the content of the
workshop, highlighting the key points and essential
elements that the NMBA will expect of nurses.
(a) identified and prioritised their learning needs,
based on an evaluation of their practice against the
relevant competency standards.
(b) developed a learning plan based on identified
learning needs.
(c) participated in effective learning activities
relevant to their learning needs (CPD)
(d) reflected on the value of the learning activities
or the effect that participation will have on their
practice.
Final words: Work through your learning plan,
document your hours and evaluation/reflection as
you go. Start now!
Rationale:
Summarising the content of the workshop will
reinforce the objectives of the workshop.