Nursing Education and Role Play, Self-Reflection and Self-Evaluation for Clinical Setting
Role Play and Clinical Scenarios for Evaluation in Nursing Education, Standardized Patient Examinations for Evaluation in Nursing Education, Self-Reflection and Self-Evaluation for Evaluation In Nursing Education, Portfolio as Evaluation In Nursing Education, Journals and Logs for Evaluation In Nursing Education
Role Play and Clinical Scenarios for Evaluation in Nursing Education
Role play provides an opportunity for students to try out new behaviors, simulating aspects of nursing care in relation to clinical practice. As students implement the roles called for in specified case guidelines (or scripts for role plays), they gain opportunities to practice competent nursing interactions and behaviors. Students practice interpersonal communication skills and gain opportunity to observe, evaluate, and provide feedback to each other.
Additionally, clinical scenarios created with audio or video clips provide students with the opportunity to review an approach to a clinical scenario and actively learn while faculty facilitate the procedure (Dearman, 2003). Students can respond to audiovisual scenarios orally or in writing.
The potential for diverse, varied cases promotes relevance to most nursing arenas and can be used as evaluation in a variety of settings. An advantage that these methods offer is a readily available means of judging specific clinical practices without having to wait for a similar opportunity to arise in the clinical setting.
Clinical scenarios can be economically beneficial in the educational setting with large groups of students. Additionally, many of these clinical scenarios have the potential to be used in online settings.
Standardized patient examinations, sometimes referred to as objective structured clinical examinations (OSCEs), are another way to evaluate competencies in clinical education. These OSCEs can be described as actors or “pretend patients” in a created environment designed to simulate actual clinical conditions A simulation center, modeled as an authentic clinical environment with standardized patients, can provide a safe setting in which to observe and document student competencies.
Standardized patients can provide feedback to students and help ensure competence before students begin practice in the complex “real” world. Potential exists for multiple evaluators to observe and test students in the performance of numerous skills during brief examination periods.
The OSCE process, considered an acceptable and powerful approach in clinical performance evaluation, allows rapid feedback to students about identified clinical deficits. Many programs use the OSCE as a learning tool with formative feedback. If the OSCE is used as high-stakes testing, then building in a remediation plan should be considered (McWilliam & Botwinski, 2010).
Specific approaches for implementing standardized patients into clinical evaluation across a curriculum have been described; students have reported learning and satisfaction with the standardized patient experience (Ebbert & Connors, 2004; Gibbons et al., 2002).
Self-Reflection and Self-Evaluation for Evaluation in Nursing Education
Reflecting on one’s practice has been described as an integral component of clinical learning (Freshwater, Taylor, & Sherwood, 2010). Reflection, considered to be an introspective process with self-observation of one’ s thoughts and feelings, provides opportunity to consider and make sense of experiences; it can both instruct and help evaluate the learners’ progression.
Potential outcomes of reflection include new perspective on experience, change in behavior, readiness for application, and commitment to action (Sherwood & Horton Deutsch, 2012). Self-evaluation and self-reflection are related concepts.
In self-evaluation students’ complete criteria-based assessments using self-reflection. Self-evaluation against a standard has been noted as a critical tool for assisting students to gain lifelong learning skills (Fink, 2013).
In self-evaluation, students describe and make qualitative judgments about specified experiences, helping balance the quantitative nature of evaluation with qualitative data. Self-evaluation against a rubric or standard can be a significant student learning tool, helping students examine their progress, identify their strengths and weaknesses, and set goals for improvement in the areas indicated.
It can also help faculty better understand student attitudes and values as well as thinking processes (Suskie, 2009). Self-reflection provides students with an opportunity to think about what they have learned and promotes becoming reflective clinicians. Clinical reasoning depends on both cognitive and metacognitive (thinking about one’s thinking) skill development (Kuiper & Pesut, 2004).
There are different ways to incorporate reflection into clinical practice, including proactivity, during activity, and post activity. As faculty consider reflection as an important tool for clinical evaluation, continued focus is needed on being precise and thoughtful about approaches, including purposes and the key elements students are being asked to reflect on (Wear et al., 2012)
A potential disadvantage of self-evaluation is that students may not be honest about their level of self-understanding to protect themselves against potential criticism (Walker & Dewar, 2000). The ability to critically reflect on individual performance may be influenced by the maturity and self-esteem of the student.
Students are more likely to share summaries and reflections with faculty if a foundation of trust has been established. If self-evaluation begins at the onset of the students’ clinical experience, students can benefit from examining their ongoing progress.
Through the teacher–student interaction process, observations and perceptions can be shared, student strengths and weaknesses can be discussed, and self-evaluation strategies can be improved. Student–teacher relationships can become stronger and more constructive as students’ progress.
Portfolio as Evaluation in Nursing Education
Portfolios provide students opportunity to assemble evidence that documents different types of learning, providing opportunity for a holistic approach to evaluation (Kaplan, Silver, LaVaque -Manty, & Meizlish, 2013). Described as collections of evidence prepared by students, they provide a collage or album of student learning rather than a one-time snapshot.
Portfolios allow integration of a few assessments and can help provide progressive documentation of specified clinical learning outcomes. Reflective portfolios are designed to help students consider their progress in clinical learning and also help faculty understand students’ clinical learning processes. Faculty can provide
portfolio guidelines that help students organize their portfolio components and incorporate reflective summaries (Suskie, 2009).
Portfolios can help students learn strategies for documenting clinical competencies as a part of lifelong learning. Evidence exists that when portfolios are well implemented, they prove practical and effective in helping students take learning responsibility and supporting their professional development (Tochel et al., 2009).
Journals and Logs for Evaluation in Nursing Education
Journals and logs are, in essence, written dialogues between the self and the designated reader. These written dialogues provide an opportunity for students to share values and critical thinking abilities. Journals give students the opportunity to record their clinical experiences and review their progress. This enables students to recall areas of needed improvement and allows them to work on problems and clinical performance weaknesses.
The concepts of clinical logs and journals are sometimes used synonymously, but clinical logs can vary in the amount of detail, ranging from a listing of types of patients and noted student care roles to a more detailed log with a reflection on each patient care experience. A guided reflection, such as reflective prompts based on a clinical judgment model, provides clear direction for helping students communicate about their clinical thinking (Lasater & Nielsen, 2009).
Other criteria for written reflections are noted to include description of an event, student’s reaction to the event, perceived value of the learning event, learning that occurred, and student’s future plans (Blake, 2005). Students have described more active learning and thinking about their actions and processes with the use of a detailed reflective clinical log.
Faculty should provide specific guidelines as to the amount of detail required in clinical journals or logs and provide clear guidelines as to how (or if) journals or logs will be graded (Kennison & Misselwitz, 2002). If self-reflective materials such as journals are to be graded, concepts such as student depth of thought, making connections between theory and practice, and relating beliefs and behaviors may be developed as an evaluation rubric.
Faculty feedback about student self-reflections provides opportunity for further dialogue on learning experiences (Murphy, 2005). Self-reflection and self-evaluation can become part of the process for lifelong, self-directed learning.