| Course | NUR-4450 Validating Nursing Competence |
|---|---|
| Module | Module 5 |
| Paper type | Competency self-assessment |
| Length | About 1,026 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | Bachelor of Science in Nursing |
| Updated | October 2026 |
Free sample paper for NUR 4450 Module 5
Where My Ratings and My Reviewer's Disagree: A Candid Self-Assessment Across Six Nursing Competencies
Student Name
Bachelor of Science in Nursing, Thomas Edison State University
NUR-4450: Validating Nursing Competence
Mentor Name
Month Day, Year
Where My Ratings and My Reviewer's Disagree: A Candid Self-Assessment Across Six Nursing Competencies
Self-assessment is the part of a competency portfolio most likely to flatter its author. Research on physicians, who are not so different from nurses in this respect, suggests why. Davis et al. (2006) reviewed studies comparing clinicians' self-assessments with external measures and found that most comparisons showed little, no or even an inverse relationship, and that confidence and weak skill often went together with the worst self-ratings. Eva and Regehr (2005) argued that self-assessment works poorly as a single global judgment and better as a habit of seeking out and using external information about one's performance. This paper follows that advice. I scored myself on all six competencies, had the colleague who audits my calls score me separately with the same four-point scale, and wrote about where the two sets of ratings differ.
The Method and the Ratings
We used a four-point scale for each competency, where one meant beginning, two developing, three proficient and four exemplary, with written descriptions for each level drawn from the knowledge, skills and attitudes in the framework. I completed my ratings first and sealed them; my reviewer, a senior triage nurse who has scored my recorded calls for two years, completed theirs from the audit record and from what they had seen at team huddles. We then met for half an hour to compare them. The table shows the results.
On four of six competencies the ratings matched or differed by one step in my favor. On two they differed in the other direction: my reviewer rated me higher on quality improvement than I rated myself, and lower on patient-centered care. The second difference was the one that surprised me, and it is where most of this paper goes. It is worth saying why the agreements matter too. Where an outside reader and I see the same level, the rating is more likely to be accurate, and those competencies need less of my attention in the next year than the ones where we disagree.
| Competency | My rating | Reviewer's rating |
|---|---|---|
| Patient-centered care | 4 | 3 |
| Teamwork and collaboration | 3 | 3 |
| Evidence-based practice | 3 | 3 |
| Quality improvement | 2 | 3 |
| Safety | 4 | 3 |
| Informatics | 3 | 3 |
The Gap I Did Not See: Patient-Centered Care
I rated myself as exemplary on patient-centered care because I open every call by asking what worries the caller most, a habit I described in the first module of this course. My reviewer agreed that the opening is consistent. The lower rating came from what happens later in the call. Listening to a sample of my recordings, the reviewer noticed that when the queue is long, I move from the caller's concern to the protocol questions quickly and begin to finish callers' sentences. On two audited calls I gave a disposition before the caller had finished describing a symptom. In both cases the disposition was correct, but the caller had no chance to say what they would do with the advice, which is where patient-centered care meets safety. A parent who feels hurried may agree to go to the emergency department and then decide in the car that the nurse did not really understand the situation. Nothing in my audit score would show that, because the checklist records whether I gave the right disposition, not whether the caller felt heard.
That observation connects to research on telephone nursing. Purc-Stephenson and Thrasher (2010), synthesizing studies of telenurses' experience, found pressure and stress running through telenurses' accounts and showed that a good phone decision rests on the picture the nurse assembles of the person on the line. When I hurry, I build the picture from the protocol rather than from the caller. I could not see this myself because I remember my calls by their outcomes, and the outcomes were fine. My reviewer heard the calls as the callers did.
The Gap in the Other Direction: Quality Improvement
I rated myself as developing on quality improvement because I have never led a formal improvement project. My reviewer rated me proficient, pointing to the protocol gap I reported after a near miss involving a blood thinner and the documentation problem I traced with the informatics nurse, both of which led to system changes. The reviewer's view was that I had done improvement work without calling it that. I accept part of that reasoning. I can identify problems and contribute to fixes, but I have not yet used formal methods such as measuring a baseline, testing a change and tracking results over time. I will keep my own rating at developing for formal methods while recording the reviewer's observation as evidence of proficiency in identifying and reporting system problems.
Safety: A One-Step Difference That Matters
My reviewer rated my safety competency one step below my own rating. The reason was specific: my rate of confirming the caller's understanding of the disposition, at 81 percent over two years, is below the team average, and the reviewer considers that a safety behavior rather than a communication nicety. I agree. Confirming understanding is the last barrier between a correct triage decision and a caller who acts on a misunderstood one. My earlier paper reported that I had started using a teach-back phrase; the self-assessment makes clear that until the rate rises above the team average, I should not call my safety practice exemplary.
What I Will Do With This
The self-assessment produced three actions. First, I will use a queue-independent closing script on every call: ask the caller to repeat the disposition and the reason, and ask what might stop them from following it. Second, I will ask my reviewer to listen specifically for interrupted callers in the next three months of audits, so that the patient-centered care rating rests on evidence rather than on my impression. Third, I will complete a short course in improvement methods before proposing the outcome follow-up audit planned for my final portfolio. Eva and Regehr (2005) described good self-assessment as a continuing process of seeking and using external feedback rather than a single judgment, and this paper is one round of that process rather than its conclusion.
References
Davis, D. A., Mazmanian, P. E., Fordis, M., Van Harrison, R., Thorpe, K. E., & Perrier, L. (2006). Accuracy of physician self-assessment compared with observed measures of competence: A systematic review. JAMA, 296(9), 1094-1102. https://doi.org/10.1001/jama.296.9.1094
Eva, K. W., & Regehr, G. (2005). Self-assessment in the health professions: A reformulation and research agenda. Academic Medicine, 80(10 Suppl.), S46-S54. https://doi.org/10.1097/00001888-200510001-00015
Purc-Stephenson, R. J., & Thrasher, C. (2010). Nurses' experiences with telephone triage and advice: A meta-ethnography. Journal of Advanced Nursing, 66(3), 482-494. https://doi.org/10.1111/j.1365-2648.2010.05275.x
Reading the NUR 4450 Module 5 assignment instructions
The fifth module of NUR-4450 typically asks for an honest self-assessment of your competence against the framework you chose. Most versions of the prompt want a rating on every competency, evidence behind each number, the places you most need to grow, and the steps you will take. Some sections encourage or require external input, such as a supervisor's or peer's ratings, and some supply a rating tool. Read the TESU course directions for the scale to use, whether external feedback is expected, and whether your plan must include timelines. Mentors in this course tend to value specific weaknesses with evidence over uniformly high ratings, so plan to write more about gaps than strengths.
Inside the NUR 4450 Module 5 example
The example starts with research showing that self-assessment alone is unreliable and explains the method used to counter it: sealed self-ratings, independent ratings from a peer reviewer, and a comparison meeting. A table shows both sets of ratings. The paper then spends most of its length on three disagreements. Patient-centered care is lower in the reviewer's view because of interruptions under time pressure, linked to research on telenurses' stress. Quality improvement is higher in the reviewer's view, and the writer explains which part of that judgment to accept. Safety is lower because of the understanding-confirmation rate. Three actions with built-in feedback close the paper.
NUR 4450 Module 5 rubric: what earns full marks
Self-assessment papers are commonly marked on the use of the competency framework, the honesty and specificity of the assessment, the evidence behind each rating, the identification of growth areas, the development plan, and writing. Honesty and evidence carry the most weight in many rubrics: uniformly high ratings without support tend to land in the middle band, while ratings backed by external input and paired with specific weaknesses score higher. The development plan is judged on whether actions directly address the gaps identified and include a way to check progress. Use of literature on self-assessment or on the practice setting strengthens the analysis. Respectful treatment of feedback from others also reads well.
NUR 4450 Module 5 help: mistakes that cost marks
The most common weakness in a self-assessment is that it reads like a performance review written by the employee. Ratings are high, evidence is thin, and growth areas are stated in safe terms such as wanting more experience. Look for one gap that genuinely surprised you and write about it in detail. Another common issue is a plan that does not match the gaps, for example a certification goal when the gap is communication under pressure. Seek external input if you can; even a colleague's informal view adds credibility. Keep the tone professional when you discuss disagreements. If you want a self-assessment drafted from your own ratings and feedback, the desk can write one from your notes.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 4450 Module 5 questions, answered
Where can I find a free NUR 4450 Module 5 sample paper?
This page shows the whole self-assessment, with its ratings table, references and margin notes. It compares a nurse's own ratings with a peer reviewer's; use the method with your own ratings and whatever external feedback you can gather.
Do I need someone else to rate me for NUR-4450?
Not always, but it helps. Research shows clinicians are often poor judges of their own competence, so external ratings or audit results make a self-assessment more credible. Check your directions; if outside input is not required, cite other evidence for each rating.
How honest should the self-assessment be?
Honest enough to include at least one weakness that matters, with evidence for it. Mentors expect real gaps and a plan to address them. Uniformly high ratings without evidence tend to lower the grade rather than raise it.
What scale should I use for the ratings?
Use the scale your course provides. If none is given, a four-level scale from beginning to exemplary, with written descriptions for each level based on your framework, works well and is easy for a mentor to follow.
What should the development plan include?
Specific actions tied to each gap, a timeline, and a way to check progress, such as repeating a rating or reviewing audit results. Actions should change what you do in practice, not only add courses or reading.