U.S. Army Professional Filler System Nursing Personnel: Do They Possess Competency Needed for Deployment?

Military Medicine, Feb 2006 by Rivers, Felecia M, Wertenberger, Dana H, Lindgren, Katherine

Theoretical Framework and Sampling Frame

The model of novice to expert described by Benner7 equates well with the design of the questions used in the READI. Benner uses a five-tier format (novice, advanced beginner, competent, proficient, and expert) in her model. The READI also encompasses a five-tier format in the design of the questions, ranging from not competent to totally competent. The three domains expressed in the theory of stress resistance described by Flannery8 adapts appropriately to the individual sections of the READI. The domain of mastery is expressed in the sections of clinical nursing competency, operational nursing competency, soldier and survival skills, personal and physical readiness, and psychosocial readiness. The domain of attachment is demonstrated in the section relating to group integration and identification. Finally, the domain of meaning is portrayed in the section relating to leadership and administrative support. Therefore, there is a logical rationale supported by the theoretical framework described by Flannery.8

The sample for this study (N = 131) included research participants from two of the nine MTFs across the Great Plains Regional Medical Command. Army Nurse Corps officers and their enlisted counterparts who were assigned as PROFIS personnel to a combat support unit in the 1st Medical Brigade were used as subjects. An Army community hospital and an Army medical center were chosen for statistical comparisons of nursing competency and readiness for deployment. The MTFs selected for the study were Darnall Army Community Hospital (Fort Hood, Texas) and William Beaumont Army Medical Center (Fort Bliss, Texas). The initial sampling frame (N = 364) consisted of the names and unit addresses of personnel assigned to a PROFIS position in these two locations. Names and unit addresses were requested through points of contact at the individual medical facilities. The sampling frame was considered an adequate representation because it covered -50% of the enure Great Plains Regional Medical Command PROFIS population (-750 PROFIS personnel).

Institutional Review

This study was approved and funded by the Tri-Service Nursing Research Program, Uniformed Services University of the Health Sciences (Bethesda, Maryland), the Department of Clinical Investigation, University of Tennessee at Chattanooga (Chattanooga, Tennessee), and the Department of Clinical Investigation of Brooke Army Medical Center (Fort Sam Houston, Texas) and William Beaumont Army Medical Center (Fort Bliss, Texas).

Results of a Pilot Test/Retest for the Electronic READI

To convert the previous paper-and-pencil version of the READI into an electronic version, a pilot test/retest study was conducted. The only changes made to the electronic version of the READI, compared with the paper-and-pencil version, were changes in demographic factors adapted to fit the sample.

An initial sample of 25 PROFIS participants assigned to Darnall Army Community Hospital were invited to participate in the pilot study. Nine (36%) of the 25 participants completed the pilot study. Of those participants, five were male and four were female. Six of the individuals were officers (66.7%) and three (33.3%) were enlisted personnel. Five of the nine individuals held a bachelors degree in nursing. A bachelors degree in nursing is required by the active component of the Army to enter the service as an officer and registered nurse. Of the remaining four participants, educational levels ranged from a high school diploma to a masters degree in nursing. Only one individual had been previously deployed in his military occupational specialty/ area of concentration. Two officers had previous enlisted service. All participants had field training within the current year (2002), with an average of 4 days of training. No variance in the demographic data between the test and retest phases was noted.