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Undergraduate nursing students' perspectives on clinical assessment at transition to practice
Jönköping University, School of Health and Welfare. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
Department of Education and Practice, Nursing Service, Tan Tock Seng Hospital, Singapore.
Nursing Education, National University Hospital, Singapore.
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2015 (English)In: Contemporary Nurse: health care across the lifespan, ISSN 1037-6178, E-ISSN 1839-3535, Vol. 51, no 2-3, 272-285 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Assessment of clinical competence requires explicitly defined standards meeting the national standards of the nursing profession. This is a complex process because of the diverse nature of nursing practice.

OBJECTIVES: To explore the perceptions of final-year undergraduate nursing students regarding clinical assessment at transition to practice.

METHODS: An exploratory qualitative approach was adopted. Twenty-four students participated in three focus group discussions. Thematic analysis was conducted.

FINDINGS: Five themes emerged: the need for a valid and reliable clinical assessment tool, the need for a flexible style of reflection and specific feedback, the dynamic clinical learning environment, students' efforts in learning and assessment, and the unclear support system for preceptors.

CONCLUSIONS: Workload, time, resource availability, adequate preparation of preceptors, and the provision of valid and reliable clinical assessment tools were deemed to influence the quality of students' clinical learning and assessment. Nursing leadership in hospitals and educational institutions has a joint responsibility in shaping the clinical learning environment and providing clinical assessments for the students.

Place, publisher, year, edition, pages
2015. Vol. 51, no 2-3, 272-285 p.
Keyword [en]
clinical assessment; clinical nursing education; transition to practice; undergraduate nursing students
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-29933DOI: 10.1080/10376178.2016.1163232ISI: 000375908400013PubMedID: 26956057Local ID: HHJCHILDISOAI: oai:DiVA.org:hj-29933DiVA: diva2:929132
Available from: 2016-05-17 Created: 2016-05-17 Last updated: 2016-06-02Bibliographically 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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