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A systematic review of clinical assessment for undergraduate nursing students
Jönköping University, School of Health and Welfare. Alice Centre for Nursing Studies, Singapore.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
Alice Centre for Nursing Studies, Singapore.
Alice Centre for Nursing Studies, Singapore.
2015 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 2, 347-359 p.Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Consolidated clinical practicum prepares pre-registration nursing students to function as beginning practitioners. The clinical competencies of final-year nursing students provide a key indication of professional standards of practice and patient safety. Thus, clinical assessment of nursing students is a crucial issue for educators and administrators.

OBJECTIVE: The aim of this systematic review was to explore the clinical competency assessment for undergraduate nursing students.

DATA SOURCES: PubMed, CINAHL, ScienceDirect, Web of Science, and EBSCO were systematically searched from January 2000 to December 2013.

METHODS: The systematic review was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Published quantitative and qualitative studies that examined clinical assessment practices and tools used in clinical nursing education were retrieved. Quality assessment, data extraction, and analysis were completed on all included studies.

RESULTS: This review screened 2073 titles, abstracts and full-text records, resulting in 33 included studies. Two reviewers assessed the quality of the included studies. Fourteen quantitative and qualitative studies were identified for this evaluation. The evidence was ordered into emergent themes; the overarching themes were current practices in clinical assessment, issues of learning and assessment, development of assessment tools, and reliability and validity of assessment tools.

CONCLUSION: There is a need to develop a holistic clinical assessment tool with reasonable level of validity and reliability. Clinical assessment is a robust activity and requires collaboration between clinical partners and academia to enhance the clinical experiences of students, the professional development of preceptors, and the clinical credibility of academics.

Place, publisher, year, edition, pages
2015. Vol. 35, no 2, 347-359 p.
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-25358DOI: 10.1016/j.nedt.2014.11.016ISI: 000349500600010PubMedID: 25497138Scopus ID: 2-s2.0-84921388172Local ID: HHJCHILDISOAI: oai:DiVA.org:hj-25358DiVA: diva2:773044
Available from: 2014-12-18 Created: 2014-12-18 Last updated: 2016-05-17Bibliographically approved
In thesis
1. Holistic clinical assessment for undergraduate nursing students
Open this publication in new window or tab >>Holistic clinical assessment for undergraduate nursing students
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A major focus in nursing education is on the judgement of clinical performance, and it is a complex process due to the diverse nature of nursing practice. Difficulties in the development of valid and reliable assessment measures in nursing competency continue to pose a challenge in nursing education. A holistic approach in the assessment of competency comprises knowledge, skills and professional attitudes, wherein the notion of competency incorporates professional judgement and management skills in the clinical situation. Therefore, the thesis aims to develop a holistic clinical assessment tool with a reasonable level of validity and reliability to meet the needs of clinical education.

The conceptual framework underlying this research is formed by establishing a theoretical connection between the practice of learning, and of pedagogy and assessment. This research consists of five studies. In Study I, a systematic review was conducted to explore the current assessment practices and tools for nursing undergraduates. In Studies II, III and IV, a qualitative approach with focus group discussions was adopted to explore the views of final-year undergraduate nursing students, preceptors, clinical nurse leaders and academics on the clinical assessment. Based on the multiple perspectives, it therefore addresses concerns in clinical assessment. In Study V, a holistic clinical assessment tool was developed, for which a psychometric testing was conducted.

The systematic review indicated that limited studies adequately evaluate the psychometric properties of the assessment instrument. The qualitative studies have raised an awareness of professional and educational issues in relation to clinical assessment. Workload, time, availability of resources, adequate preparation of preceptors, and availability of valid and reliable clinical assessment tools were deemed to influence the quality of students’ clinical learning and assessment. In addition, the presence of support systems and formal educational programs for preceptors influenced their preparation and self-confidence. Nursing leaderships in hospitals and educational institutions have a joint responsibility in shaping the holistic clinical learning environment and making holistic clinical assessment for students. The involvement of all stakeholders in the development of a valid and reliable assessment tool for clinical competency is also essential to the process. The Holistic Clinical Assessment Tool (HCAT) was developed by the author based on the systematic review, qualitative findings and the core competencies of registered nurse from the professional nursing boards. The HCAT consists of 4 domains and 36 assessment items. Furthermore, testing of the psychometric properties indicated that the HCAT has satisfactory content validity, construct validity, internal consistency and test-retest reliability.

In conclusion, the HCAT is meritorious in that it carries the potential to be used as a valid measure to evaluate clinical competency in nursing students, and provide specific and ongoing feedback to enhance the students’ holistic clinical learning experience. The HCAT not only functions as a tool for self-reflection for the students, but also guides the preceptors in clinical teaching and assessment. In addition, the HCAT can be used for peer-assessment and feedback. It is imperative that the clinical and academic institutions establish various levels of ongoing support for both students and preceptors in the process of clinical assessment.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2016. 99 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 69
Keyword
Clinical assessment; transition to practice; clinical nursing education; clinical guidance; feedback; undergraduate nursing student; nurse preceptor; clinical nurse leader, academic, holistic clinical assessment tool; tool development; psychometric testing
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-29937 (URN)978-91-85835-68-3 (ISBN)
Public defence
2016-06-09, Forum Humanum, School of Health and Welfare, Jönköping, 13:00 (English)
Opponent
Supervisors
Available from: 2016-05-17 Created: 2016-05-17 Last updated: 2016-05-18Bibliographically approved

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