School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin 4, Ireland.
Brighton & Sussex Medical School, University of Sussex, UK.
Nurse Educ Today. 2022 Dec;119:105615. doi: 10.1016/j.nedt.2022.105615. Epub 2022 Oct 21.
Developing evaluative measures that assess clinical reasoning remains a major challenge for nursing education. A thorough understanding of biosciences underpins much of nursing practice and is essential to allow nurses to reason effectively. A gap in clinical reasoning can lead to unintended harm. The Script Concordance test holds promise as a measure of clinical reasoning in the context of uncertainty, situations common in nursing practice. The aim of this study is to develop and validate a test for first year undergraduate nursing students that will evaluate how bioscience knowledge is used to clinically reason.
An international team, teaching biosciences to undergraduate nurses constructed a test integrating common clinical cases with a series of related test items: diagnostic, investigative and treatment. An expert panel (n = 10) took the test and commented on authenticity/ambiguities/omissions etc. This step is crucial for validity and for scoring of the student test. The test was administered to 47 first year undergraduate nursing students from the author sites. Students rated educational aspects of the tool both quantitatively and qualitatively. Statistical and content analyses inform the findings.
Results indicate that the test is reliable and valid, differentiating between experts and students. Students demonstrated an ability to identify relevant data, link this to their bioscience content and predict outcomes (mean score = 50.78 ± 8.89). However, they lacked confidence in their answers when the scenarios appeared incomplete to them.
Nursing practice is dependent on a thorough understanding of biosciences and the ability to clinically reason. Script concordance tests can be used to promote both competencies. This method of evaluation goes further than probing factual knowledge. It also explores capacities of data interpretation, critical analysis, and clinical reasoning. Evaluating bioscience knowledge and real-world situations encountered in practice is a unique strength of this test.
开发评估临床推理的评估工具仍然是护理教育的主要挑战。对生物科学的透彻理解是护理实践的基础，对于使护士能够有效地进行推理至关重要。临床推理能力的差距可能导致意外的伤害。在不确定的情况下，脚本一致性测试有望成为衡量护理实践中临床推理的一种方法，因为这种情况在护理实践中很常见。本研究的目的是为一年级本科护理学生开发和验证一种测试，该测试将评估如何将生物科学知识用于临床推理。
一个国际团队，向本科护士教授生物科学知识，构建了一个测试，将常见的临床病例与一系列相关的测试项目结合起来：诊断、调查和治疗。一个专家小组（n=10）参加了测试，并对真实性/歧义/遗漏等进行了评论。这一步对于测试的有效性和学生测试的评分至关重要。该测试在作者所在的 47 名一年级本科护理学生中进行。学生对工具的教育方面进行了定量和定性评估。统计和内容分析提供了研究结果。
结果表明，该测试具有可靠性和有效性，能够区分专家和学生。学生能够识别相关数据，将其与生物科学内容联系起来，并预测结果（平均得分为 50.78±8.89）。然而，当他们认为情景不完整时，他们对自己的答案缺乏信心。
护理实践依赖于对生物科学的透彻理解和临床推理能力。脚本一致性测试可以用于促进这两个能力。这种评估方法不仅可以探查事实性知识，还可以探索数据解释、批判性分析和临床推理的能力。评估生物科学知识和实践中遇到的实际情况是该测试的独特优势。
