“Strategies for Effective Clinical Teaching and Evaluation”

Assessing Clinical Competence (Part 4)

Patricia A. Mahoney, MSN, RN, CNE

This presentation is a portion of one presented at ASUCONHI May 2, 2007Used with permission of P. A. Mahoney – All rights reserved

This Section Includes:

• Assessment of:– Knowledge– Skills– Attitudes

• Strategies for Assessing Clinical Competence• Educator’s Responsibilities• Giving Feedback

Knowledge

• Widely tested by a range of methods e.g. multiple choice question

• Standardized testing

• NCLEX®

SkillsClinical skills and abilities • Traditionally these have been tested by

asking learners to care for a patient or patients, asking them to assess, develop and implement a plan of care and evaluate that care – faculty observe, assess and evaluate

Technical skills and abilities• Skill lab evaluations• Competency Performance

Examinations (CPE)

Attitude

• Clinical judgement • Interaction with patients and relatives • Ethics • Reliability • Professional development • Teamwork • Image or appearance.

Strategies for Assessing Clinical Competence

Piercey suggests that clinical competencies can be assessed by: Written communication methods:

Case studies Journaling Self-assessment

ADDITIONALLY

Observation Critical incidents

Piercey, C. (1995). Assessing clinical competencies. In Summers, L. (Ed), A Focus on Learning, p. 206-211. Proceedings of the 4th Annual Teaching Learning Forum, Edith Cowan University, February 1995. Perth: Edith Cowan University. http://lsn.curtin.edu.au/tlf/tlf1995/piercey.html

Self-Evaluation

• Useful in formative evaluation of clinical practice as learners can identify their progress towards meeting specific goals.

• Include journaling, videotape (skills) and self-rating scales– Can use clinical evaluation tool

• Goal of self-evaluation is to have learners work towards an independent state where they will eventually be able to judge and act upon their own behaviors.

Observation

• In many instances competence cannot be observed directly, it can only be inferred from assessment – communication in mental health

• Generally based on one sample of the learner's performance, because it is impossible for the educator to be present in all clinical situations

Observation

• Since inference on the learner's competence cannot be made from one situation, an adequate number of observations need to be recorded

Clinical Considerations

When evaluating learnersIf objectives are not met → learners need to repeat →delay in completing education → financial burden or removal from program

Clinical evaluations• Learners held to standards of RN • State Nurse Practice Acts (minimal competence)• Learners are accountable for own actions

Educators’ responsibilities:

Communicate expectations to learners

– evaluation tool given at beginning of semester

– course requirements and grading criteria included in syllabus

Educators’ responsibilities:

Determine if learner can successfully transfer knowledge to clinical arena

Provide formative evaluations (positive & negative) and maintain privacy

Maintain anecdotal records (formative evaluation), share with learner

Educators have ethical & legal responsibility to deny academic progress

Feedback may be given in a variety of ways:

Immediately after a student has performed a procedure or during the clinical experience.

Via written feedback on care plans in which rationale for actions is questioned or the student’s choice of actions, or comments about observations made during the care.

Observation checklists - these provide set criteria that a student should meet.

Anecdotal notes – various formats may be utilized.

Conferences at set times to discuss progress; these should always be at mid-term and the end of a term but may be at other times.

Educators’ responsibilities – unsatisfactory performance:

Provide learning contracts for learners not meeting objectives

Learner understands that there will be increased observation & evaluation

If unsafe can withdraw learnerMaintain effective communicationMaintain privacyProvide due process

Something to consider . . .

• Another facet of assessment is your own self-assessment for how well you are doing as a learner or educator

• Beginning with classroom research and continuing with a document called an educator’s dossier or portfolio, this is a collection of reflections, samples of learner work, improvements on the syllabus, comparisons with other courses, and many other products of your teaching.

TO SUMMARIZE

“When we observe students while they are learning and collect frequent feedback from them, we can learn much about how they learn and, more specifically, about how they respond to particular teaching practices.”

(Angelo & Cross, 1993)

Your Journey

• Assessment & Evaluation are challenging undertakings!

• I wish you well as you head down this winding road

• May the detours be short and the journey fulfilling

© 2007 Patricia Mahoney