National survey: Developing a common approach to grading of practice in pre-registration midwifery

The Impact of Noise on Nursing Preceptors' Assessment of Student Performance: A Qualitative Study

BACKGROUND

Noise is a relatively new concept highlighting the variability of cognitive inputs people grapple with when making a judgment. In this case, preceptors make a judgment of students' clinical performance during clinical practicum. There is scant literature examining the impact of noise on nursing student assessment.

PURPOSE

This article explores the noise that influences nursing preceptors' assessment of students in clinical practice.

METHOD

A qualitative descriptive design was used, and interviews were conducted with preceptors from the clinical setting.

RESULTS

Three themes were identified, describing the tensions faced by preceptors when assessing students and the noise that impacted those assessments.

CONCLUSION

Both system noise and individual noise impacted the process and outcome of nursing student assessment during clinical practicum.

Grading practice as a strategy to improve proficiencies in undergraduate nurse education: Modelling key areas of competence

BACKGROUND

In undergraduate nursing grading practice is generally avoided as it is considered educationally flawed.

OBJECTIVES

To test an innovative online grading practice tool (GPT) in undergraduate nurse education. To model the determinants of the final practice grade in four areas of clinical competence and in one cohort analysis the relationship between final practice grade and each area of clinical competence and an OSCE grade.

DESIGN

A cross-sectional study.

PARTICIPANTS

A convenience sample of 782 nursing students from one Higher Education Institution in the North-East of England were included. The sample involved two sequential cohorts of final-year students with 391 students in each cohort.

METHODS

A specifically designed online grading practice tool (GPT) composed of thirty-six objectives equally divided across four areas of clinical competence. The GPT was applied to two consecutive student cohorts on completion of their final practice learning placement.

RESULTS

There was a statistically significant difference in the mean final practice grade between the two cohorts. In the overall sample, regression modelling showed that all four areas of student assessment contributed equally to the final grade. Analysis by cohort showed that in Cohort 1 clinical thinking and professionalism had the most influence on the final grade with person-centered care and patient safety most strongly impacting on the final grades of Cohort 2. In Cohort 2 there is no statistically significant correlation between final practice grade, each area of clinical competence and an OSCE grade.

CONCLUSIONS

Practice learning is fundamental to how students develop professional awareness and learn to nurse. Findings from a novel grading practice tool applied in undergraduate nursing reveal how effectively the tool works. Nurse educators must be responsive to the realities of learning in practice and explore new ways of assessing clinical competence.

Psychometric properties of a clinical assessment tool in the postgraduate midwifery programme, Botswana

BACKGROUND

 The psychometric properties of a clinical assessment tool used in the postgraduate midwifery programme in Botswana have not been evaluated. A lack of reliable and valid clinical assessment tools contributes to inconsistencies in clinical assessment in midwifery programmes.

OBJECTIVES

 This study aimed to evaluate the internal consistency and content validity of a clinical assessment tool used in the postgraduate midwifery programme in Botswana.

METHOD

 For internal consistency, we calculated the total-item correlation and Cronbach's alpha coefficient. For content validity, subject matter experts completed a checklist to evaluate the relevance and clarity of each competency in the clinical assessment tool. The checklist included questions with Likert-scale responses, indicating the level of agreement.

RESULTS

 The clinical assessment tool had a good reliability, with a Cronbach's alpha of 0.837. The corrected item total correlation values ranged from -0.043 to 0.880 and the Cronbach's alpha (if item deleted) ranged from 0.079 to 0.865. Overall content validity ratio was 0.95, and content validity index was 0.97. Item content validity indices ranged from 0.8 to 1.0. The overall scale content validity index was 0.97 and the scale content validity index using universal agreement was 0.75.

CONCLUSION

 The clinical assessment tool used in the postgraduate midwifery programme in Botswana has acceptable reliability. Most of the competencies included in the clinical assessment tool were relevant and clear. Certain competencies need to be reviewed to improve the reliability and validity of the clinical assessment tool.Contribution: The clinical assessment tool currently used in the postgraduate midwifery programme in Botswana had acceptable internal consistency reliability and validity.