Assessing student nurse clinical competency: will we ever get it right?

Abstract

In 1997, a revised system was introduced at the University of Glamorgan, Wales, to assess student nurse clinical competency. This was firstly as a result of concerns that the previous system was based on limited documentary evidence, and, secondly as the Welsh National Board for Nursing and Midwifery issued new competency statements. This article reports an evaluative research study which aimed to determine whether the revised system was an effective measure of clinical competency. A series of focus groups were conducted with students, tutors and clinical preceptors to discuss their experiences of using the revised system. A content analysis was conducted of all evidence written by students to support the achievement of clinical competency. The findings of the focus groups indicated that each group had some initial problems with the assessment process. The main concern for all groups was lack of consistency and uncertainty in the assessment process. Although the introduction of written evidence to support clinical competency was welcomed, many felt that too much evidence was required. Content analysis of competency documentation aimed to compare student evidence and to determine whether there were inconsistencies in the assessment process. There were many variations in the evidence obtained from students, in particular the amount of evidence written by each student. The findings clearly indicate that further revisions are necessary to ensure that the system is implemented in the most effective way. The Fitness for Practice report (UKCC, 1999) has ensured that competency-based assessment is here to stay in the UK. Evaluative research of this type is important to ensure that we adopt the most suitable approach to assessing clinical competency.

Working and learning: Post-registration student midwives' experience of the competency assessment process

“…(Fraser 2000a and b) This is also supported by Dolan (2003) where preceptor/assessors underestimated the time required for the assessment process and while many of the preceptors were described as 'highly motivated', others did not appear to be interested. Availability and continuity of preceptors was sometimes an issue in Dolan's study and preceptors often signed evidence and competencies even though they had not worked with the student.…”

“…Preceptors often felt pressurised regarding balancing competence assessment and the reality of their work on the practice areas (Dolan 2003). Philips (2006) also found that time constraints was a factor inhibiting the preceptor role.…”

Evaluación de las competencias clínicas en estudiantes de enfermería

“…Sin embargo, aún existen dificultades en su conceptualización y en el desarrollo de una estrategia de evaluación eficaz 4 .…”

“…En este sentido, la literatura reporta que se necesitan estrategias o modelos efectivos de evaluación 4,7 , que logren integrar todos los elementos de esta concepción, pues aún existen pocos acuerdos en cómo medirlas 7 .…”

Hand hygiene competence in the intensive care unit

“…1,2 Competency testing can also provide feedback to educators on knowledge deficits that need to be addressed, or on the efficacy of current educational programs, and at the same time highlight for the staff themselves areas in which their knowledge and skills need updating. 3 Additionally, competency testing offers a way of encouraging staff to be accountable for their practice.…”