The Model of Practical Skill Performance
The model consists of six mutually dependent categories; substance, sequence, accuracy, fluency, integration and caring comportment. These categories are not seen as elements in a hierarchy. They are depicted as layers in a circle, a symbol of unity, wholeness and integration. The model is normative in the sense that all the categories within the circle must be realized in a good performance of a practical skill in nursing.
Substance refers to the inclusion of relevant content in the form of movement steps, instruction and information.
Sequence reflects if movement steps, instruction and information come in a logical order.
Accuracy refers to exactness of each movement step and the correctness and
precision of instruction and information included.
Fluency is when each element of performance give an impression of ease and smoothness, when they seem finished and without hesitation.
Integration reflects ability to harmonize and time the parallel aspects of an action such as movement steps, physical support and verbal interaction. Integration also includes being attentive to what the patient in total needs while taking care of the specifics of the ongoing action.
Caring comportment relates to how the nurse creates an atmosphere that is respectful, accepting and encouraging. It includes concernof the whole person by relating to the patients' feelings and reactions to the instrumental steps of the action, and to the total experience of being a patient. Caring permeates all the elements of performance.
* Bjork IT. (1999) Practical skill development in new nurses. Nursing Inquiry; 6: 34-47.