Oslo Metropolitan University, Norway.
Oslo Metropolitan University, Norway; Centre of the study of profession, Oslo, Norway.
Nurse Educ Pract. 2022 May;61:103332. doi: 10.1016/j.nepr.2022.103332. Epub 2022 Mar 12.
The aim of this study is to increase knowledge about the assessment of nursing students' clinical practice, particularly concerning how teachers and clinical supervisors identify and assess the expected level of competence in mid-term evaluations and students, teachers and supervisors' experiences of mid-term assessment. Assessment is important to assure the quality of students' clinical competence and studies show that further research on this topic is required.
This study has an explorative qualitative design.
Thirty semi-structured interviews were conducted with nursing students, teachers and clinical supervisors along with 16 observations of mid-term assessments during clinical practice, as part of a bachelor's programme in nursing.
Two main challenges concerning establishing an expected level of competence were identified from the analysis of the interviews and observations: 1) a general formulation of learning outcomes and 2) vague expectations of what is the expected level of achievements at different points in time. Both challenges were at institutional level. Furthermore, at performance level, certain patterns were identified related to these challenges, such as teachers and supervisors needing to concretise the general formulation of learning outcomes and their discretion to set the expected level. Additionally, non-verbal language during mid-term assessment seemed to affect how the assessment situation was perceived.
We suggest that the institutional guidelines need to be critically reviewed to include greater focus on clarifying what students are expected to achieve, as well as what constitutes the expected level. We have emphasised that discretion is a necessary premise to identify an expected level of clinical competence at mid-term assessment, in particular when there is lack of a clear standard and the assessment form is vague, but also when there is no clear definition of the expected level of competence at different points in time. The consequences are that the student feel insecure about how the assessment ought to be perceived, what level they are at in their learning process, and subsequently, their level in the process of developing necessary clinical competence.
本研究旨在增进对护理学生临床实践评估的了解，特别是关于教师和临床督导员如何在中期评估中识别和评估预期能力水平，以及学生、教师和督导员对中期评估的体验。评估对于确保学生临床能力的质量至关重要，研究表明，需要进一步研究这一主题。
本研究采用探索性定性设计。
在护理学士学位课程的临床实践中，共对 30 名护理学生、教师和临床督导员进行了半结构化访谈，并对 16 次中期评估进行了观察。
从访谈和观察的分析中，确定了在建立预期能力水平方面的两个主要挑战：1）学习成果的一般表述，2）对不同时间点的预期成就水平的模糊期望。这两个挑战都存在于制度层面。此外，在表现层面，与这些挑战相关的某些模式被确定，例如教师和督导员需要具体说明学习成果的一般表述以及他们设定预期水平的自由裁量权。此外，中期评估中的非言语语言似乎会影响对评估情况的感知。
我们建议批判性地审查机构准则，以更加明确地阐明学生应达到的目标，以及构成预期水平的内容。我们强调，在中期评估中识别预期的临床能力水平需要有自由裁量权，特别是当缺乏明确的标准且评估形式模糊，或者在不同时间点没有明确定义预期能力水平时。其后果是，学生对评估应该如何被感知、他们在学习过程中的水平以及随后在发展必要的临床能力过程中的水平感到不确定。
