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Development and psychometric testing of Holistic Clinical Assessment Tool (HCAT) for undergraduate nursing students
Jönköping University, School of Health and Welfare. National University of Singapore.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.ORCID iD: 0000-0001-8596-6020
Tan Tock Seng Hospital, Singapore.
National University Hospital, Singapore.
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2016 (English)In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, 1-9 p., 248Article in journal (Refereed) Published
Abstract [en]

Background:A major focus in nursing education is on the judgement of clinical performance, and it is a complexprocess due to the diverse nature of nursing practice. A holistic approach in assessment of competency is advocated.Difficulties in the development of valid and reliable assessment measures in nursing competency have resulted in thedevelopment of assessment instruments with an increase in face and content validity, but few studies have testedthese instruments psychometrically. It is essential to develop a holistic assessment tool to meet the needs of the clinicaleducation. The study aims to develop a Holistic Clinical Assessment Tool (HCAT) and test its psychometric properties.

Methods:The HCAT was developed based on the systematic literature review and the findings of qualitative studies.An expert panel was invited to evaluate the content validity of the tool. A total of 130 final-year nursing undergraduatestudents were recruited to evaluate the psychometric properties (i.e. factor structure, internal consistency and test-retestreliability) of the tool.

Results:The HCAT has good content validity with content validity index of .979. The exploratory factor analysis revealsa four-factor structure of the tool. The internal consistency and test-retest reliability of the HCAT are satisfactory withCronbach alpha ranging from .789 to .965 and Intraclass Correlation Coefficient ranging from .881 to .979 for the foursubscales and total scale.

Conclusions:HCAT has the potential to be used as a valid measure to evaluate clinical competence in nursingstudents, and provide specific and ongoing feedback to enhance the holistic clinical learning experience. In addition,HCAT functions as a tool for self-reflection, peer-assessment and guides preceptors in clinical teaching and assessment.

Place, publisher, year, edition, pages
2016. Vol. 16, 1-9 p., 248
Keyword [en]
Holistic clinical assessment tool, Psychometric testing, Tool development, Undergraduate nursing students
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-29936DOI: 10.1186/s12909-016-0768-0ISI: 000384493700004PubMedID: 27658587Scopus ID: 2-s2.0-84995390536Local ID: HHJCHILDISOAI: oai:DiVA.org:hj-29936DiVA: diva2:929149
Available from: 2016-05-17 Created: 2016-05-17 Last updated: 2017-11-30Bibliographically 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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Wu, Xi VivienEnskär, Karin

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