EMERGENCY NURSES ASSOCIATION

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1 TRAUMA NURSING CORE COURSE AND EMERGENCY NURSING PEDIATRIC COURSE REVISED SEPTEMBER 1, 2012 ENA IS THE SOLE AND EXCLUSIVE OWNER OF ALL RIGHTS, TITLES, INTERESTS, AND ALL ANCILLARY RIGHTS TO ANY AND ALL MATERIALS AND INFORMATION PERTAINING TO TNCC AND ENPC INCLUDING TRANSLATIONS (INCLUDING WITHOUT LIMITATION, COPYRIGHTS, TRADEMARK RIGHTS, PATENT RIGHTS, AND TRADE SECRET RIGHTS)

2 Courses The Emergency Nurses Association (ENA) offers the following two courses which provide core-level nursing education based on emergency nursing practice in the United States. The goals of the courses are to improve patient care in the emergency setting and increase the skill and confidence of emergency nurses who care for the patients. Trauma Nursing Core Course (TNCC) TNCC is a standardized, interactive course recognized internationally for providing the learner with core-level trauma knowledge and psychomotor skill experience. TNCC integrates the trauma nursing process into the content. Emergency Nursing Pediatric Course (ENPC) ENPC is a standardized, interactive course recognized internationally for providing the learner with core-level pediatric emergency knowledge and psychomotor skill experience. The following course levels are offered: Provider Course Two day course in which a registered nurse (RN) participant receives verification as a TNCC/ENPC Provider for a four-year period. Prior to or upon expiration of the fouryear period, a Provider must again successfully pass the course to maintain Provider status. The Provider may attend a Reverification course (see below), if applicable, challenge a Provider course, or retake the entire Provider course. Reverification Course One-day Provider review course in which a RN with current Provider status may renew his or her Provider status for four (4) additional years. The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6 th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/2012. Instructor Course One day course in which a TNCC/ENPC Provider may receive TNCC/ENPC Instructor Candidate status. Additional time will be required for retesting of provider status prior to the start of the course. IMPORTANT THROUGHOUT THESE THE TERM TNCC/ENPC IS USED TO MEAN TNCC OR ENPC REVISED SEPTEMBER 2012 PAGE 2

3 Administrative Procedures Statement of Purpose The Administrative Procedures describe the requirements for TNCC/ENPC course administration. The Procedures are as follows: Prescribe the course organization structure; Assign responsibilities to ENA, the Course Administration Faculty, ENA State Councils, State Trauma and Pediatric Chairs, Course Directors, and Instructors; and Include criteria for Participants, Instructor Candidates, Instructors, Course Directors, and Faculty. ENPC and TNCC are standardized courses. Course requirements are defined in the Administrative Procedures. In the United States, no additional guidelines or procedures may be developed to restrict the dissemination of the courses. States may not place restrictions on who may serve as Course Directors, Instructors, and Faculty, or how they perform their roles across state lines beyond the requirements in the Administrative Procedures. International disseminations and course requirements are defined by contract. REVISED SEPTEMBER 2012 PAGE 3

4 Table of Contents COURSE ORGANIZATIONAL STRUCTURE AND RESPONSIBILITIES Course Elements...07 Emergency Nurses Association (ENA) Course Administration Faculty...07 ENA State Councils...08 State Trauma and Pediatric Committees...08 Course Directors...09 Instructors and Faculty...11 Marketing...11 Co-sponsorship...12 Librarying Manuals...12 Financial Elements...12 Course Fees Manuals, Indirect Fees, and Late Fees...12 Timely Payment...13 Course Assessments...13 PROVIDER COURSES Course Requirements...13 Course Authorization...13 Course Content and Format...13 Course Materials...14 Participant-to-Instructor Ratio...14 Allowable Number of Course Participants...15 Participant Requirements...15 Non-RN s as Attendees...15 Continuing Nursing Education Contact Hours...17 Verification...17 Provider and Reverification Course Testing Requirements...17 Verification Card...18 Instructor Potential...18 Course Director...19 Course Director Eligibility Criteria Course Director Requirement...19 Financial Obligations...20 REVISED SEPTEMBER 2012 PAGE 4

5 INSTRUCTOR COURSES EMERGENCY NURSES ASSOCIATION Course Requirements...20 Course Authorization...20 Course Content and Format...20 Course Materials...20 Participant-to-Faculty Ratio...21 Allowable Number of Course Participants...21 Participant Requirements...21 Pre-course Test Requirements...21 Option in the Event of Unsuccessful Pre-course Tests...22 Continuing Nursing Education Contact Hours...23 Instructor Status...23 Achievement of Instructor Candidate Status...23 Instructor Candidate Monitoring Requirements...23 Instructor Card...24 Maintenance of Instructor Status...24 Updating Instructor Status Course Revisions...24 Failure to Teach...24 Quality Assurance (QA) Scores...25 Faculty Status...25 Faculty Eligibility Criteria...25 Faculty Requirements...26 Maintenance of Faculty Status...26 Updating Faculty Status Course Revisions...26 Bridging...26 Instructors...26 Faculty...27 Course Director...28 Course Director Qualifications...28 Financial Obligations...28 INTERNATIONAL DISSEMINATION Contracts...28 Course Director/Instructor Selection Criteria...28 Translation Guidelines...29 REVISED SEPTEMBER 2012 PAGE 5

6 APPENDICES Appendix A: Procedure for Suspension/Revocation of TNCC/ENPC Provider and/or Instructor Status...30 Review and Appeal Process...32 Appendix B: Sample Text from Committee Member to Course Director Regarding Designee Appointment...35 Appendix C: Course Director Provider Course Activities...36 Appendix D: Course Director Instructor Course Activities...40 Appendix E: Guidelines for Use of Computerized Patient Simulators in TNCC/ENPC Courses...42 Appendix F: Guidelines for Videoconferencing of TNCC/ENPC...43 Appendix G: Contact Hour Breakdown for Each Course...44 Appendix H : Thirty Day ENPC/TNCC Book Receipt Waiver...49 REVISED SEPTEMBER 2012 PAGE 6

7 I. Course Organizational Structure and Responsibilities A. Course Elements 1. Emergency Nurses Association (ENA) a. Approves all TNCC/ENPC applications for both Provider and Instructor Courses. No courses will be held without prior ENA approval. b. Maintains records of TNCC/ENPC course applications, post-course materials, and related financial transactions. c. Provides course materials, mailings, and manuals, upon payment. d. Monitors course quality by reviewing and approving Course Director and Instructor eligibility, as well as participant-to-instructor ratios. e. Maintains a database of Providers and Instructors. f. Assures that Instructor evaluation scores are periodically reported to the State Trauma and Pediatric Chairpersons. g. Serves as a resource to the ENA State Councils, State Trauma and Pediatric Committees/Chairpersons, Course Administration Faculty, and Course Directors and Instructors. Assists in resolving issues regarding course administration, Instructor or Instructor Candidate performance, and reverification issues. h. Individuals who have concerns regarding courses and/or procedures within a state are encouraged to contact the State Chairpersons and/or State Councils. If there is not a satisfactory resolution after making contact with appropriate resources within the state, individuals may contact ENA for additional assistance. i. Provides the continuing nursing education contact hours for the courses. j. Revises course content on a periodic basis. k. Facilitates changes to the Administrative Procedures as approved by the Course Administration Faculty. 2. Course Administration Faculty a. Serves as a resource to the ENA Board of Directors, ENA Staff, ENA State Councils, State Trauma and Pediatric Committees/Chairpersons, and Course Directors and Instructors. b. Serve as course liaisons to facilitate communication at all levels and promotes the dissemination of TNCC/ENPC. c. Assists in developing or enhancing quality improvement mechanisms. d. Reviews and updates Administrative Procedures as needed. e. Supervises the suspension/revocation process (see Appendix A). REVISED SEPTEMBER 2012 PAGE 7

8 f. Develops and reviews standards for the roles of State Trauma and Pediatric Chairs. g. Reviews any identified interstate issues or those that cannot be resolved. h. Reviews the applications for international course dissemination faculty, to make recommendations to the ENA President; acts as a resource for international disseminations. i. Makes recommendations to the Board related to International course disseminations to countries rated at the lowest two economic rankings, by the World Bank. 3. ENA State Councils a. Appoint a Chairperson and members of the Trauma and Pediatric Committees for their states based upon qualifications identified by the Course Administration Faculty as established in these Administrative Procedures. b. Ensure that members of the Committees are geographically located throughout the state as much as possible. State Councils may choose to have one combined Trauma and Pediatric Committee. c. Assign charges and/or goals to the Trauma and Pediatric Committees based upon the State Council s planning priorities and with consideration of the course activities. d. Monitor course activities for consistency and quality. e. Develop and approve budget plans for TNCC/ENPC assessments and grants and other course monies. State Councils are encouraged to use course assessments to promote and support courses. 4. State Trauma and Pediatric Committees a. Consist of members who meet the following requirements: i. Current RN license (or equivalent as defined by country outside of the United States); ii. Current membership in ENA (or equivalent organization defined by country outside of the United States); iii. Involvement in Chapter, State, or National ENA projects to demonstrate leadership; and iv. CEN and/or CPEN preferred b. Committee Chairpersons must have at least two (2) years experience in emergency, trauma, or pediatric nursing care and must be current TNCC/ENPC Instructors. c. Are responsible to the State Council (or country outside of United States). REVISED SEPTEMBER 2012 PAGE 8

9 d. Serve as a resource for TNCC/ENPC courses conducted within their jurisdiction. e. Monitor compliance with these Administrative Procedures. f. Monitor and evaluate the quality of the courses and Instructors within their state (or country outside the United States). Each committee should comply with quality monitoring procedures as outlined in these Administrative Procedures. g. Address problems or concerns with courses or instructors. ENA encourages resolution of issues at the state level. In addition, the committees may use ENA and/or the Course Administration Faculty as resources regarding adherence to the Administrative Procedures. h. Evaluate Instructor Candidates. In order to carry out this responsibility, the committee member must be a TNCC or ENPC Instructor. i. Designate in their absence, the authority to evaluate Instructor Candidates and/or remonitor Instructors. Instructors who will be considered qualified for this authority shall include: Course Administration Faculty members State Faculty members Course Directors in good standing Experienced Instructors in good standing State Committees are encouraged to develop a process for this delegation of authority. The designation must be made by the State Chair or a member of the Committee. j. Provide opportunities to observe an Instructor Course, and subsequently teach in a separate instructor course (Faculty eligibility requirements must be met, and a letter of intent must have been submitted to the State Chair and/or President to be eligible for this process). k. Provide opportunities and support to Instructor Candidates to be mentored and monitored teaching in a Provider Course in a timely fashion. 5. Course Directors a. Ensure course integrity by conducting TNCC/ENPC courses in a professional manner in accordance with these Administrative Procedures. b. Adhere to copyright law in regards to all TNCC and ENPC products. ENA is the sole and exclusive owner of all rights, titles, interests, and all ancillary rights to any and all materials and information pertaining to TNCC and ENPC including translations (including without limitation, copyrights, trademark rights, patent rights, and trade secret rights). This includes, but is not limited to: course materials; testing materials; and student scores. c. Annually ensure that the Conflict of Interest Disclosure forms for Course Director, Instructors, and Instructor Candidates shall be completed online and submitted to REVISED SEPTEMBER 2012 PAGE 9

10 ENA. Conflict of Interest Disclosure forms reside on the ENPC and TNCC pages of the ENA web site and can be filled out and submitted from that location. d. Complete and submit course applications, fees, and appropriate post-course documents to ENA in a timely manner. Appendices C and D outline Course Director Activities for the Provider and Instructor Courses. e. Ensure the adherence to these Administrative Procedures. Maintain the security of testing materials and ensure exams are graded accurately. Report any concerns regarding adherence to the Administrative Procedures or test security to the State Chair or a Committee Member, and ENA Course Operations. f. Maintain immediate in-person availability during the entire course to assist with problems and ensure Faculty and/or Instructors are prepared, utilize current materials, and maintain time schedules for lectures and psychomotor skill stations. Appendices C and D outline Course Director Activities for the Provider and Instructor Courses. g. Review Instructor evaluations to provide immediate feedback to Instructors regarding their performance. h. Notify State Chairpersons of course or Instructor concerns. Course Directors will not be required to send copies of the scantron evaluations to State Trauma or Pediatric Chairpersons, unless asked to do so by the Chairpersons. i. Review course evaluations for consideration in planning future courses. j. Maintain a copy of the final course materials, including final participant roster, final instructor roster, summary performance form, and psychomotor skill station evaluation sheets for participants who were unsuccessful, for a period of six (6) years. k. Advise and support new Instructors and/or Faculty by providing constructive feedback including maintenance of course integrity and meeting course objectives. l. When teaching outside his/her home state, the Course Director must inform the State Chairperson that he or she is teaching. m. Maintain an environment conducive to learning and sensitive to students different learning and testing styles. Describe the testing environment at the beginning of the course, and inform students that if issues arise, they must let the course director know. n. The Course Director must verify current provider status for all Reverification course and Instructor course attendees prior to the course. The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6 th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/2012. REVISED SEPTEMBER 2012 PAGE 10

11 NOTE: Course Directors may serve solely as a Course Director, or as both Course Director and Instructor. Prior to defining their role, Course Directors should consider potential late schedule changes, Instructor cancellations and Instructor Candidate monitoring. 6. Instructors and Faculty a. Present lectures and psychomotor skill stations according to the current edition of the Provider Manual and in accordance with the Administrative Procedures. b. Evaluate psychomotor skill stations according to the current edition of the Provider Manual and in accordance with the Administrative Procedures. c. Adhere to copyright law in regard to all TNCC and ENPC products. ENA is the sole and exclusive owner of all rights, titles, interests, and all ancillary rights to any and all materials and information pertaining to TNCC and ENPC including translations (including without limitation, copyrights, trademark rights, patent rights, and trade secret rights). d. Maintain a professional and supportive learning environment. e. Administer the multiple-choice examination as required by the Course Director. f. Complete all documentation as required by the Course Director. g. Ensure the adherence to the Administrative Procedures and security of testing materials. Report any concerns regarding adherence to the Administrative Procedures to the State Chair or a State Committee member, and ENA Course Operations. h. If an Instructor teaches in a state where he/she was not monitored, the Instructor should inform the State Chairperson that he or she is teaching. i. Annually submit a Conflict of Interest Disclosure form to ENA. The form resides on the ENPC and TNCC pages of the ENA website and can be filled out and submitted from that location. 7. Marketing a. It is important to market TNCC/ ENPC courses well in advance in order to ensure timely identification of course participants. Any marketing materials should clearly identify required course registration dates and deadlines. A clearly identified cancellation policy is also required. b. The marketing materials must clearly state that only registered nurses (or the equivalent as defined in each country) who successfully complete the course can receive verification status and a Provider card. REVISED SEPTEMBER 2012 PAGE 11

12 i. In the United States, all marketing materials must contain the following ADA (Americans with Disabilities Act) statement: In accordance with the Americans with Disabilities Act, please advise [insert name] if you have any disability that requires special materials and/or services so that appropriate personnel can be advised. ii. Use of the ENA TNCC/ENPC logos is strongly encouraged. 8. Co-sponsorship a. TNCC/ENPC courses may be presented in conjunction with other organizations including State Councils and Chapters, health care facilities, academic institutions, governmental agencies, and product companies. Co-sponsors may provide a source of financial support, equipment, or Instructors to assist in presenting the course. A co-sponsor may not alter the course content. 9. Librarying Manuals a. All participants must have their own manual (current edition) for use during the course. Manuals cannot be shared during the course. Librarying of books is not allowed because the participants should be able to use the manual as a reference before, during, and after the course. B. Financial Elements 1. Course Fees Manuals, Indirect Fees, and Late Fees a. The fee structure for TNCC/ENPC courses includes the cost of a manual plus an indirect fee. i. The Course Director is responsible for collecting all fees from participants and submitting timely payment to ENA. Single payments from individual participants should NOT be submitted to ENA. ii. Payment for manuals must be received by ENA prior to shipment. Course Directors are encouraged to order manuals at least six (6) weeks in advance of the course in order to make certain that participants have sufficient time to read the manual prior to the course. (Note: Once manuals are shipped to the Course Director or designee, they are the responsibility of the Course Director and cannot be returned to the ENA National Office for a refund or credit.) iii. Indirect fees must be paid within 30 days of course end. A 10% discount will be applied to all indirect fees paid prior to the course start date. iv. Indirect fees must be paid for all participants, including Auditors and non- RN participants. REVISED SEPTEMBER 2012 PAGE 12

13 II. Provider Courses EMERGENCY NURSES ASSOCIATION 2. Timely Payment v. A late fee will be charged for applications received less than three (3) weeks prior to the course start date. vi. International countries will follow their contractual arrangements regarding fees. a. All fees must be paid within 30 days of course end. Course Directors with outstanding invoices 120 days beyond the course date, are subject to suspension of their Course Director status. If a Course Director s status is suspended and the director s accounts are not brought current within 150 days of the course date, his or her instructor status may be suspended as well. 3. Course Assessments a. ENA provides an assessment payment to State Councils for every participant in Provider Courses conducted within the state. The payments are made quarterly. Assessments are paid on the following basis: i. All post-course materials have been received; and ii. All fees have been paid and the course balance is zero (any credits must have been refunded or applied to other courses). A. Course Requirements 1. Course Authorization a. Provider Courses must be conducted within the guidelines described in these Administrative Procedures. Authorization must be obtained from the ENA National Office prior to conducting any course. It is recommended that applications be submitted to the ENA National Office at least eight (8) weeks prior to the course date. Applications received less than three (3) weeks prior to the course start date will be subject to a late fee. b. International countries must adhere to their contractual agreements. 2. Course Content and Format a. Provider Courses are designed to provide core-level knowledge and psychomotor skills associated with the delivery of professional nursing care to the pediatric or trauma patient. This content is presented through lectures, online materials, and psychomotor skill stations. i. While the courses are standardized with specific lectures and skill stations, it is recognized that nursing practice varies among states and countries. Nurse practice acts and institutional policies, which prescribe specific REVISED SEPTEMBER 2012 PAGE 13

14 independent and interdependent nursing activities, must be considered when implementing the described assessments, interventions, and evaluations for specific patients. b. The use of computerized patient simulators in TNCC/ENPC courses may be a valuable adjunct to teaching and learning. However, each program using a simulator must be approved by ENA in advance. Appendix E outlines the ENA Guidelines for Use of Computerized Patient Simulators. c. Videoconferencing is an acceptable method for teaching TNCC/ENPC courses, with prior approval from ENA Course Operations. In order to make this method of delivery a quality service, the guidelines outlined in Appendix F must be followed. d. Provider Courses are designed as minimum 16-hour courses and are most commonly conducted in a two-day format. Internet based course materials may be provided as part of the course format. Supplemental didactic material and/or alternate scheduling formats may be implemented at the discretion of the Course Director provided that the 16-hour core didactic and psychomotor skills are presented. Examples of alternate schedules are courses scheduled over three (3) or four (4) consecutive evenings or over two (2) or three (3) weekends. i. Reverification Provider Courses are commonly completed in one (1) day. The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6 th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/2012. e. Pre-tests are included as part of the course format to enhance learning validation. 3. Course Materials a. All participants must have their own Provider Manual (current edition) for use during the course. Manuals cannot be shared during the course. Librarying of books is not allowed because the participants should be able to use the manual as a reference before, during, and after the course. b. It is strongly recommended that all students be provided with their course manuals at least 30 days prior to the course. c. Access to online material, where applicable, will be provided by course directors to participants. 4. Participant-to-Instructor Ratio a. It is recommended that the participant-to-instructor ratio for psychomotor skill stations be 4:1. The maximum participant-to-instructor ratio may not exceed 6:1. If the ratio is extended from 4:1 to 6:1, the skill station times must be lengthened to allow a minimum of 15 minutes per participant, per station. Instructor REVISED SEPTEMBER 2012 PAGE 14

15 Candidates are not included in the 4:1 or 6:1 ratios. In general, ratios beyond 4:1 are not intended to be planned in advance, but to accommodate last minute changes in instructor availability to avoid course cancellation if a scheduled instructor is unable to teach unexpectedly. 5. Allowable Number of Course Participants a. Provider Courses will be approved by ENA as long as the application reflects an adequate number of instructors for the number of participants scheduled to take the course. There is no limit to the number of participants that may attend a course; however, the participant-to-instructor ratios must be maintained and adequate equipment must be available. All attendees who are participating in the teaching and testing of the skill stations are included in the student count when calculating the ratio. 6. Participant Requirements a. Registered nurses (or equivalent as defined in each country outside of the United States) are the only health care providers eligible for TNCC/ENPC verification. b. Nurses in a variety of clinical areas would benefit from and should be encouraged to take TNCC/ENPC. (see #7 below) c. Regardless of clinical background, all participants must be encouraged to thoroughly read the TNCC/ENPC Provider Manual prior to the start of the course. d. To attend a Reverification Course, the participant must be a registered nurse with a current Provider status. The Course Director must verify current provider status for all Reverification Course attendees prior to the course. The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6 th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/ Non-RN s as Attendees Course Directors may elect to allow non-rn participants into a Provider course, at their discretion. If non-rn participants are registered for a particular course, they should not exceed 25% of the total course participants without prior ENA National office permission. There are two types of non-rn participants: i. Non-RN Healthcare Providers who work in an emergency setting. ii. Auditors, which would primarily be student nurses who do not also work in an emergency setting as a part of their employment. REVISED SEPTEMBER 2012 PAGE 15

16 a. The following guidelines apply to non-rn Healthcare Providers: (individuals who work in an emergency setting) i. Can participate in the written and skill station portion of the TNCC/ENPC Provider course as long as the participant-to-instructor ratio is maintained. ii. iii. iv. Should be provided with a Provider manual to facilitate the learning process. Must be listed on the non-rn Summary Performance Report as non-rn participants. Indirect fees must be submitted to ENA for all non-rn Healthcare Provider participants. v. Will receive a certificate of attendance with the appropriate number of nursing Contact Hours awarded, but will not receive a verification card or verification status. This Certificate of Attendance is a different form than the one provided to RN attendees. The Course Director must request these forms from Course Operations prior to the course. * Effective with the 4 th Edition of the ENPC Provider course, which began on September 1, 2012, non-rn Healthcare Providers who work in an emergency setting can participate in the written and skill station testing portion of the ENPC Provider course. Effective January 2013, the same is true for the TNCC Provider course. b. The following guidelines apply to Auditors: (individuals who do not work in an emergency setting) i. Cannot participate in the written and skill station testing portion of the TNCC/ENPC Provider course. ii. Can participate in the skill station teaching as long as the participant-toinstructor ratio is maintained. iii. Should be provided with a Provider manual to facilitate the learning process. iv. Must be listed on the non-rn Summary Performance Report as non-rn participants. v. Indirect fees must be submitted to ENA for all Auditors. vi. Will receive a certificate of attendance with the appropriate number of nursing Contact Hours awarded, but will not receive a verification card or verification status. This Certificate of Attendance is a different form than the one provided to RN attendees. The Course Director must request these forms from Course Operations prior to the course. REVISED SEPTEMBER 2012 PAGE 16

17 8. Continuing Nursing Education Contact Hours a. The Emergency Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation. Contact hours are provided to participants for the portion of the Provider Course they attend regardless of performance during evaluation (see Appendix G, Contact Hour Breakdown for Each Course). b. Participants will receive Contact Hour certificates from the Course Director at the end of the course. The Course Director will indicate the number of Contact Hours earned by each participant on the Summary Performance Report form. c The ENPC Reverification course will no longer be available after 12/31/2012. The TNCC 6 th Ed Reverification course can continue to be offered beyond 12/31/2012; however, no contact hours will be awarded after 12/31/2012. B. Verification 1. Provider and Reverification Course Testing Requirements a. The vast majority of participants attend the lectures and the psychomotor skill station teaching portions of the course prior to the evaluation and testing portion. It is also important that ENPC 4 th Ed Provider Course attendees access the online pre-course modules, or borrow the available DVD s from their course director and complete those materials in order to be successful in the course. Some participants may challenge the course at a full 2 day Provider Course by attending only the evaluation and testing portion of the course. Those who successfully challenge the course receive their 4-year verification, but do not qualify for Contact Hours. It is up to the discretion of the Course Director to allow Challengers in a two day Provider Course, and if so, how many. Challengers must be registered for the course so that the proper participant to instructor ratio will be met. Course Directors must submit an indirect fee for Challengers as well. b. For verification, the participant must complete the following requirements: i. Multiple-Choice Examination The multiple-choice examination consists of 50 questions. The examination evaluates the acquisition of the content presented in the TNCC/ENPC lectures, course manual, and psychomotor skill stations. The passing score is 80% (40 correct answers). If a passing score is not achieved, but the participant has successfully completed all psychomotor skill station testing, the participant may complete one (1) retest of a different version of the test. If a participant wishes to review his or her scored exam, the review must be done at the course, with the appropriate security in place. It is encouraged that the participant has the opportunity to REVISED SEPTEMBER 2012 PAGE 17

18 review their initial test in order to assure that they understand the correct answers to the questions that they missed. The participant may retake the multiple-choice examination either immediately following the course or within two (2) weeks of the last day of the course. The arrangements are at the discretion of the Course Director. If the participant is unsuccessful on retest, he/she must register to take another course or to challenge a subsequent course in order to pursue verification status. ii. Psychomotor Skill Station Evaluation The skill stations are graded based on objective data that are tallied on the Skills Evaluation Sheet. To successfully pass the skill station, all critical criteria and at least 70% of the total points identified on the evaluation sheet must be demonstrated. Double-starred criteria must be completed during the primary assessment and sequentially. Single-starred criteria must be done before completing the station. The participant who does not successfully pass one (1) of the psychomotor skill station evaluations but has achieved a passing score on the written exam may be re-evaluated in that skill station once, on a different testing scenario. If there is an alternate testing instructor available, the participant should be tested by a different instructor. If the participant does not successfully pass the evaluation on retest, he/she must register to take another course or to challenge a subsequent course in order to pursue verification status. iii. If the participant does not achieve a passing score on the multiple-choice examination AND is unsuccessful at one or more skill stations, he or she may not retest at either the multiple-choice examination or the skill stations. He or she must register to take another course or to challenge a subsequent Provider course in order to pursue verification status. 2. Verification Card a. Successful participant RNs will receive a card verifying the successful completion of the Provider Course. Expiration of verification status will occur four (4) years from the last day of the month in which the course was completed. 3. Instructor Potential a. The Course Directors and Instructors review RN participants performances to determine which participants meet the guidelines for Instructor Potential. It is recommended that the providers be considered for Instructor Potential if they have the following: REVISED SEPTEMBER 2012 PAGE 18

19 i. Achievement of at least 90% on the Provider multiple-choice examination ii. Achievement of at least 85% of total points in each Provider skill station iii. Two years of experience in the nursing care of the trauma or pediatric patient. iv. Experience in teaching v. Recommendation by more than one (1) instructor (unless there is only one (1) instructor) b. A Provider Course attendee who passes the Provider Course but does not score at the Instructor Potential level may not retest just to improve his/her score. c. It is required that the designation of Instructor Potential be formalized in a recommendation letter furnished by the Provider Course Director to the participant. The participant must submit a copy of the letter when applying for the Instructor Course. Upon successful completion of the Instructor Course, those participants who are designated with Instructor Potential will become Instructor Candidates. C. Course Director (Provider Course) 1. Course Director Eligibility Criteria a. Course Directors must meet the following requirements: i. Must be a registered nurse with a current license to practice (or equivalent as defined by each country outside of the United States); and ii. Must have current TNCC/ENPC Provider and Instructor status; and iii. Must be a current ENA member (or membership in an equivalent organization defined by country outside of the United States). iv. In addition, it is strongly recommended that the Instructor teach in a minimum of two (2) Provider Courses prior to becoming mentored as a Course Director. 2. Course Director Requirement a. Once the eligibility criteria are met, the potential Course Director must be mentored by a current Course Director in at least one Provider Course, prior to the potential Course Director holding his/her own course independently. Both the mentoring Course Director and the potential Course Director must be physically present for the course, and must fill out and sign the Course Director Mentoring form, and submit it to ENA with the post-course materials. b. Once the Instructor has been mentored as a Course Director in TNCC, for example, the Instructor does not need to be mentored again in the other course, ENPC, for example, in order to move from an ENPC instructor to Course Director. REVISED SEPTEMBER 2012 PAGE 19

20 III. Instructor Courses EMERGENCY NURSES ASSOCIATION c. Ongoing communication with the mentoring Course Director is recommended when acting as a first time Course Director. 3. Financial Obligations a. Course Directors are responsible for all course fees. They must maintain their accounts in good standing. Course Directors with outstanding invoices, 120 days beyond the course date, are subject to suspension of their Course Director status. If a Course Director s status is suspended and the Director s accounts are not brought current, within 150 days of the course date, his or her Instructor status may be suspended. A. Course Requirements 1. Course Authorization a. Instructor Courses must be conducted within the guidelines described in these Administrative Procedures. Authorization must be obtained from the ENA National Office prior to conducting any courses. It is recommended that applications be submitted to the ENA National Office at least eight (8) weeks prior to the course date. Applications received less than three (3) weeks prior to the course start date will be subject to a late fee. b. International countries must adhere to their contractual agreements. 2. Course Content and Format a. The Instructor Course is a one day course, almost always presented in a one-day format. Additional time will be required for reverification of Provider status, prior to the course start. (Refer to item 7 on Page 21 for specifics). The Instructor Course is designed to prepare Providers with Instructor Potential status to become instructors. The TNCC/ENPC instructor courses emphasize appropriate teaching strategies as well as correct evaluation methods. 3. Course Materials a. Upon successful pretesting, the Instructor Supplement may be distributed to the participants. All participants must have their own Instructor Supplement (current edition). Supplements cannot be shared. Librarying of books is not allowed. To prepare for the microteaching lecture assignment, the Course Director should provide the Instructor Candidate with the relevant pages from the book, prior to the course. b. The Instructor Supplement is designed to guide new Instructors on teaching the provider chapter content. The Supplement also includes material to prepare new Instructors with the principles of adult learning, methods for teaching content and REVISED SEPTEMBER 2012 PAGE 20

21 teaching psychomotor skill stations. c. The Supplement defines the expectations of Instructor Candidates and Faculty. 4. Participant-to-Faculty Ratio a. It is recommended that the participant-to-faculty ratio be 4:1. The maximum participant-to-faculty ratio may not exceed 6:1. Observers and first-time faculty, as defined below under Faculty Status, C.2.a. (page 26), are not included in the 4:1 or 6:1 ratios. 5. Allowable Number of Course Participants a. Instructor Courses will be approved by ENA as long as the application reflects an adequate number of Faculty for the number of participants scheduled to take the course. There is no limit to the number of participants that may be in a course; however, the participant-to-faculty ratios must be maintained and adequate equipment must be available. 6. Participant Requirements a. TNCC/ENPC Instructor Courses may be attended by selected registered nurses (or equivalent as defined by another country outside of the United States) with current licenses who are currently verified as TNCC/ ENPC Providers. Instructor Course admission requirements are: i. A letter furnished by a Provider Course Director stating that the Course Director will assist the participant with the monitoring necessary for completion of Instructor Candidate requirements is required; and ii. Current TNCC/ENPC Provider status. iii. The letter of recommendation received from the TNCC/ENPC Provider Course Director indicating Instructor Potential is required and must be forwarded to the Instructor Course Director. 7. Pre-Course Test Requirements a. Instructor Candidates must reverify as a TNCC/ENPC Provider at the beginning of the Instructor Course they are attending. This includes achieving at least 90% on the Provider multiple-choice examination and achieving at least 85% of the total points on the Provider skill stations. No retests are allowed on either the multiple-choice examination or skill station testing. b. The only exception to the above pre-testing requirement is an Instructor Candidate who has taken the Provider Course within 90 calendar days of the Instructor Course, and received Instructor Potential status from the Course Director, and scored at the Instructor Potential level on their first attempt, meaning they received a 90% or better on the written exam and an 85% or better on the skill station testing. (No retesting was involved). Any Instructor Candidate meeting REVISED SEPTEMBER 2012 PAGE 21

22 those specific requirements does not need to be pretested. There are no exceptions to this. In order to facilitate this, the Provider Course Director must provide the Instructor Potential attendee with the letter of recommendation that includes his/her scores, to bring to the Instructor Course. The Course Director of the Instructor Course must submit a copy of that form to ENA Course Operations with the Instructor Course post-course materials, along with a separate Summary Performance Report for those attendees who did not need to be pretested. Those Instructor Course attendees, who are not required to pretest, must still complete a test scantron form to ensure that ENA Course Operations has their most current demographic information. Note that an Instructor Candidate who has taken the Provider Course within 90 calendar days of the Instructor Course, and received Instructor Potential status from the Course Director, but did not score at the Instructor Potential level, must participate in the pretesting of the Instructor Course, on both the written test and the skill station testing. All Instructor Candidates who have taken the Provider Course more than 90 calendar days prior to the Instructor Course, must retest regardless of their scores. c. All pretesting must be done by the Course Director of the Instructor Course, or their designee. All pretesting must be done within the 2 4 weeks (maximum of 28 calendar days) prior to the Instructor Course. d. Note that any participant in an Instructor Course whose provider status is from an earlier edition of the course, MUST successfully pretest prior to the course regardless of whether or not their Provider Course was within 90 days of the Instructor Course. e. Participants who are unsuccessful in achieving these criteria may not attend the Instructor Course, however their paperwork must be returned with the Instructor Course material. In this circumstance, the ENA National Office will not charge the Instructor Course indirect fee. See the next section regarding the potential for renewed Provider status in the event of unsuccessful pre-course tests. 8. Option in the Event of Unsuccessful Pre-course Tests a. It is possible for a Provider with Instructor Potential to score too low to warrant continuing in the Instructor Course, but high enough to renew Provider status. In that event, the Provider will have the option to receive a new Provider card. b. For those participants who are given a new Provider card, the Instructor Course Director must submit a Provider indirect fee to the National ENA Office along with a second Summary Performance Report listing those specific participants awarded Provider status. The National ENA Office will automatically assign a new Provider Course number upon receipt of the performance report. REVISED SEPTEMBER 2012 PAGE 22

23 9. Continuing Nursing Education Contact Hours a. The Emergency Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation. Contact Hours are provided to participants for the portion of the course they attend (see Appendix G: Contact Hour Breakdown for Each Course). b. Participants will receive Contact Hour certificates from the Course Director at the end of the course. The Course Director will indicate the number of contact hours earned by each participant on the Summary Performance Report Form. B. Instructor Status 1. Achievement of Instructor Candidate Status a. TNCC/ENPC Instructor Courses require that participants demonstrate their ability to lecture, teach and evaluate selected psychomotor skill stations. Individuals who successfully complete these Instructor Course requirements become Instructor Candidates. 2. Instructor Candidate Monitoring Requirements a. To become a fully recognized TNCC/ENPC Instructor, the Instructor Candidate must be successfully evaluated at a subsequent Provider Course within 12 months of the instructor course. The evaluation must be done by a current member of the State Trauma or Pediatric Committee (or of the comparable body for the military and country outside of the United States) who is a TNCC/ENPC Instructor, or a designee of the State Chair or Committee. b. The candidate must be monitored (mentored) 1:1 during the skill station teaching and evaluation. No one Faculty can monitor more than two Instructor Candidates in a single provider course. The candidate must teach and test the allotted skill station time (a full rotation of at least 4 students). c. Specifically, to achieve TNCC/ENPC Instructor status, the Instructor Candidate must: i. Be evaluated while teaching a minimum of two (2) lectures, not all on the same day, (and no more than 3 lectures) during a Provider Course (not a Reverification course); and ii. Be evaluated while conducting the teaching and testing of the entire skill station in a Provider Course during one (1) full rotation (a minimum of 4 students). For TNCC, the Instructor Candidate will be required to teach and test at the Trauma Nursing Process skill station. For ENPC, the Instructor Candidate is required to teach and test at the Management of the Ill or Injured Pediatric Patient skill station. The Instructor Candidate must teach the other skill stations to a simulated audience. REVISED SEPTEMBER 2012 PAGE 23

24 iii. Complete evaluation and monitoring requirements within those 12 months of successfully completing the Instructor Course. An Instructor Candidate has two (2) attempts within twelve (12) months to be successfully evaluated. On the second attempt, the Instructor Candidate cannot be monitored by the same person who monitored his or her first attempt. If unsuccessful on the second attempt, the Instructor Candidate must retake the Instructor Course if his/her provider status is still current, to continue to pursue Instructor status. 3. Instructor Card a. The ENA National Office will issue an Instructor card when all Instructor Candidate requirements have been met. 4. Maintenance of Instructor Status a. Instructors remain verified as Instructors and Providers by participating as an Instructor in at least one (1) Provider Course every 18 months and maintaining an average quality assurance score of 3.0 or greater. b. Instructors and Course Directors must carefully monitor the dates of their last course taught to maintain eligibility to teach. If there are questions regarding an Instructor s eligibility, the ENA National Office should be contacted. 5. Updating Instructor Status Course Revisions a. In the event of a course revision, all Instructors must be updated in order to retain their Instructor status. The updating process varies depending on what content is revised and the extent of the revisions. 6. Failure to Teach a. An Instructor who has not taught a Provider Course for more than 18 months, and less than 24 full months, must be remonitored to regain Instructor status. The remonitoring process is the same as for the monitoring of an Instructor Candidate. The Course Director must submit an Instructor Candidate/Instructor Evaluation form as documentation of the remonitoring process. If an Instructor does not meet these requirements, he or she will no longer be verified as an Instructor. b. An Instructor who has not taught a Provider Course for greater than 24 months must retake the Provider and Instructor Courses and then be successfully monitored as an Instructor Candidate to regain Instructor status. c. If an Instructor has not taught a Provider Course for greater than 18 months because of military deployment outside of the United States or FMLA, he or she may contact the ENA National Office for an extension (generally consistent with term of leave). If possible, this contact should take place prior to the expiration of the Instructors status. REVISED SEPTEMBER 2012 PAGE 24

25 7. Quality Assurance (QA) Scores a. It is expected that Instructors will maintain a composite quality assurance score of 3.0 or higher in order to continue teaching TNCC/ENPC. This score is a compilation of participant evaluation scores from courses submitted to the ENA National Office during the rating period. b. Course Directors are encouraged to review the quality assurance scores at the end of the course. This will allow Instructors more immediate feedback regarding their performance and the need for remonitoring. Course Directors who identify an Instructor with a quality assurance score less than 3.0 should develop a plan to address the problem in collaboration with the State Trauma or Pediatric Chairperson. This plan should be communicated to the ENA National Office via mail, fax, or . c. Semiannually, ENA will make available to the State Trauma or Pediatric Chairs, scores only for those Instructors with cumulative scores less than 3. The Chairpersons will notify the Instructors of the scores and will develop an action plan if a plan or remonitoring schedule has not already been established. Within 60 days of the ENA notice, the State Pediatric or Trauma Chairperson must notify the ENA National Office whether remonitoring or an alternative action plan has been agreed upon. d. If the Instructor fails to comply with the action plan, he or she will be placed in the suspension/revocation process. The Instructor will be immediately suspended from teaching, pending the outcome of the suspension/revocation process. e. The remonitoring process is the same as for the monitoring of an Instructor Candidate. The Course Director must submit an Instructor Candidate/Instructor Evaluation form as documentation of the remonitoring process. f. An Instructor can be remonitored a total of two (2) times. The second time, a different evaluator must do the remonitoring. If unsuccessful on the second attempt, the Instructor will no longer be able to teach TNCC/ENPC. C. Faculty Status 1. Faculty Eligibility Criteria Definition: Faculty are instructors who teach the Instructor Course. a. Eligibility criteria for TNCC/ENPC Faculty are: i. Must have current TNCC/ENPC Provider and Instructor status. ii. Must be a current ENA member (or membership in an equivalent organization defined by country outside of the United States). iii. Must have taught at least four (4) Provider Courses in the past four (4) years (TNCC or ENPC). iv. Must have served as Course Director in at least two (2) courses in the past four (4) years. REVISED SEPTEMBER 2012 PAGE 25

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