Nursing Education and Clinical Evaluation of Students and Its Phases Part-I
What Is Clinical Evaluation Process in Nursing Education, Preparation Phase, Choosing the Clinical Setting and Patient Assignment as Part of the Evaluation Process, Determining the Standards and Evaluation Tools in Nursing Education, Clinical Activity Phase.
What Is Clinical Evaluation Process in Nursing Education
Process Before the evaluation
process begins, faculty and students need a clear understanding of the outcomes to be attained at the culmination of the experience. Clinical evaluation is a systematic process that can be considered as having three consecutive phases:
(1) preparation
(2) clinical activity phase
(3) final data interpretation and feedback
A listing of sample tasks within each phase and the roles faculty will assume during each phase are provided.
Preparation Phase
Choosing the Clinical Setting and Patient Assignment as Part of the Evaluation Process
Faculty are responsible for providing each student with ample opportunities to achieve course objectives and must give careful attention to choosing a clinical site that will give students these opportunities. Especially when traditional clinical settings will be the evaluation site, advance planning is needed.
Even in the ideal clinical setting, daily variability exists in terms of patients, providers, and the activity level of the unit, which can complicate evaluation. In addition to unit assignments, specific patient clinical assignments should also be considered as part of a fair evaluation. This includes both the types of patients assigned to students and the duration of clinical assignments.
Teaching and learning in a natural setting provide unique challenges for both students and faculty. Negotiating the balance between student independence and supervision is complex. Faculty must provide adequate supervision to ensure safe delivery of care with the welfare and safety of patients as the priority.
Before the clinical experience begins, the faculty must develop criteria for what is considered unsafe or inappropriate behavior and what consequences will occur if such behavior is observed. Communication between faculty and students before the clinical experience begins is essential, including orientation to the grading process (Walvoord et al., 2010).
The faculty must be prepared to remove a student from the clinical setting if the student is not adequately prepared to provide safe nursing care; Students have the right to know the standards used for safe practice and evaluation. Students should also be given an orientation to the clinical facility and to the policies and procedures that will apply to the clinical experience.
Unit orientations, as well as orientation to evaluation methods, are important in decreasing the anxiety that can hamper student clinical performance. Students and faculty are essentially visitors to an established system, and the status of student comfort and support in the clinical environment should also be considered in evaluation.
Chan (2002) noted the importance of a positive clinical learning environment for student learning; Students should have the opportunity to share with faculty their evaluation of the clinical setting.
Determining the Standards and Evaluation Tools In Nursing Education
Faculty have the responsibility for choosing the appropriate methods and tools for evaluation of the learners’ clinical performance. Specific evaluation instruments chosen will be the means of documenting and communicating judgments made about student performance. These tools should document performance expectations relevant to course objectives and be practical and time efficient.
The concepts of interrater reliability (whether results can be replicated by other raters) and content validity (whether a tool measures what is desired) at a minimum should be considered in selection of a specific clinical evaluation instrument.
Inconsistencies in evaluation can result if each course coordinator develops course tools independently. Wiles and Bishop (2001) recommend that faculty work in groups to determine or develop tools that reflect the increasing complexity of competencies required as students’ progress from program beginners to graduating seniors and to promote consistency from course to
course.
Clinical Activity Phase
In both obtaining and analyzing clinical evaluation data, faculty need to make professional judgments about the performance of students, being aware of the subjective nature of evaluation.
To prevent biased judgments, faculty need to be aware of the factors that can influence decision making and must actively use strategies to prevent biases. Strategies that can help support trustworthiness of the clinical evaluation data include the following:
1:Have specified objectives or competencies on which to base the evaluation.
2:Use multiple strategies and combined methods of evaluation for compiling data.
3:Include both qualitative and quantitative measures.
4:Determine a practical sampling plan and evaluate it over time.
5:Provide clear scoring directions for tools to promote consistency between raters in collection and interpretation of data.
6:Train faculty in the use of specific clinical evaluation tools and approaches for consistency and fairness in grading.
7:Be aware of common errors such as the halo effect (assuming that positive behaviors in one evaluated competency will be similar in others).
8:Incorporate teacher self-assessment of values, beliefs, or biases that might affect the evaluation process (Oermann & Gaberson , 2014).