Analysising_Current_Student_Assessment_Practices_in_Clinical_Settings

Analysising Current Student Assessment Practices in Clinical Settings Establishing the competency and safe practice of a student is never more valuable then with the provision of patient care. In nursing education, instructors are not only responsible for assessing student progress towards course objectives, they are responibile for ensuring the student has demonstrated the ability of safe practice as well as extending learning beyond a task mentality to include application of critical reasoning (Henderson, 2012). The challenge is to determine criteria and develop a tool with sufficient written, non-task driven standards that can guide clinical instructors in evaluation (Henderson, 2012). Many evaluation tools have been developed in an effort to produce valid and reliable results. Examples of clinical evalution tools are direct observation of patient interaction, simulation, care plans, portfolios, journals, scenarios, case presentations, videotaping or recordings, self-evaluations and self-reflections, as well as written or oral tests.). Research Analyses of Evaluation A literary review of research regarding evaluation of students in clinic settings was conducted to analysis current evidenced-based practice. Three articles were selected for review with focus placed on the three of the many evaluation methods currently applied to clinical assessement; Simulation, Structured Observation and Assessment of Practice (SOAP), and Self-assessment. The use of simulation was assessed in two of the articles reviewed with favorable results. One project was called the Simulation and Practice Learning Project which was conducted in 17 educational institutions with the goals of determine for simulation could be successfully used as part of the clinical experience to promote safe and effective direct patient care skills without placing the student at a disadvantage (Fitzgerald, Gibson, and Gunn, 2010). Although simulation was the primary focus of the project, several underlying problems were discovered such as descrepencies in mentor documentation and feedback regarding students abilities to practice safely. The project emphasized the need for students to receive constructive critique. Mentor training and quality of the clinical experience were identified as key elements of student nurse success (Fitzgerald, Gibson, and Gunn, 2010). The second research article analyized discussed clinical assessment using the SOAP practice-driven method of evaluation which is structured observation and assessment of practice of the student nurse. This method is a six hour holistic assessment that measures clinical competence, promotes critical reasoning, and endorses student readiness for professional practice (Levett-Jones, Gersbach, Arthur, & Roche, 2011). SOAP does not have a competency checklist. Students are assessed by situation, action, and outcome. Open-ended questions reveal rationale, knowledge, and attitudes that guide the the students behavior. The enduring concerns of bias and judgements without specific criteria or training are a common theme throughout the researched information. An important element of success with this method is the well-defined role of the assessor and the requirement of 2 hours of training to maintain consistancy and rigor of standards (Levett-Jones, Gersbach, Arthur, & Roche, 2011). The last article was an indepth analyizes of the effectiveness of self-assessment as a evaluation method. This a method that has become common practice in clinical settings. In 1999, Kruger and Dunning examined the idea that competent students underestimate personal levels of competency and incompetent students overestimate levels of proficiency. The theory proposed that the incompetent do not know enough to realize a lack of ability exist; and this inability to recognize deficits persists. Whereas those who are competent tended to underestimate personal ability, although accuracy of self-assessment increased once success was achieved. benchmarking, whereas the less competent students tended to be more inaccurate after viewing others’ performances. This theeory was supported by the results of the study that noted individuals more accurately assess their peers’s ability than their own. This important when considering methods of validity of self-assessment. Recommendations Validity of competence in the evaluation of students in the clinical setting has been an ongoing issue in nursing education (Levett-Jones, Gersbach, Arthur, & Roche, 2011). As identified by Orchard, 1994 the criteria of student performance should be established and communicated before implementation. Expectations should be practical, constant, and applied equally. The student’s knowledge, behavior, and attitudes are assessed with the primary goals of patient safety and quality patient care (Billings and Halstead, 2009, p. 449). Instructors must be conscious of the possibile inconsistency and subjectivity in evaluating clinical performance despite the use of objective evaluation tools. For optimal evaluation and a reduction in bias, several apporaches should be implemented from the vairous methods of learning assessment; observation, written or oral communication, simulation, and self-assessment (Billings and Halstead, 2009, p. 452). Evaluation tools should be selected according to criteria of what is being measured and when it is being assessed, using formative and summative evaluations (Billing and Halstead, 209, p. 464). Data gathered from the evaluations should be used to enhance the learning experience as well as promote the mission, goals, and standards of stakeholders . Who Should Evaluate Students in Clinical Setting Students should be evaluated by faculty, preceptors, and mentors that have been formally prepared through specific training in student assessment (Levett-Jones, Gersbach, Arthur, & Roche, 2011). The asessor is often an experinced registered nurse (RN) selected for clinical experise in the specific area of nursing. Evaluation requires the evaluator to be consistent with criteria as outlined in competency requirements, be proficient in the identified areas to be critiqued, and diligent in clear and explicit feedback (Levett-Jones, Gersbach, Arthur, & Roche, 2011). The Univeristy of Minisota requires every faculty member successfully complete 10 hours of education in the principles and methods of evalution (University of Mniisota, 2012). Student Role in the Evaluation Process The student should do a self-assessment before clinical rotation to establish a baseline of knowledge, areas of strength, and areas of potential growth. Results will help guide the clinical learning experience. A self-assessment after the educational experience promotes reflection on the practicum recognizing instructive gains, skills development in collaboration, and acclimation in ot the professional environment. Summative critique should include evaluation of the course content for relativity and applicability for goal obtainment. Evaluation should note if clinical environment was student friendly and availablity of learning opportunities. Feedbck from students should include interactions assessor. Responses from student evalutions can be used for process improvement of the course, faculty development, and may help guide professional development of the student through self-awareness and educational empowerment (Billings and Halstead, 2009, p.458). Conclusion Regardless of the tools used in clinical evaluation, the threat of bias and subjective influences from the evaluator will remain. Identifying the course objectives, goals, and grading criteria then ensuring the expectations are explained and clearly defined for the students and evaluators will enhance the accuracy of the resulting evaluation data. The ultimate goal is to have a meaninful learning experince that reinforces course objectives, institutional goals and philosophy (Billings and Halstead, 2009, p. 452). The evaluation process is a necessary ongoing cycle intended to improve the value of learning. Referencess Billings, D. M. & Halstead, J. A. (2009). Teaching in nursing: A guide for faculty (3rd ed.). 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