Assessment of competence in clinical practice: a phenomenological approach*

Abstract

Using a phenomenological approach, this study explores the different dimensions of student nurse assessment in clinical practice from the perspective of 10 experienced practitioners. Phenomenology, one of the various types of qualitative research methods, is used to discover and understand the meaning of human life experiences through an analysis of the subjects' descriptions of situations. It is therefore of particular value when addressing the questions posed in the present study: (a) what attributes characterize competence and non-competence in learner nurses, (b) how they recognize these attributes in practice, and (c) how they measure competence at different levels of preparation. Rather than provide answers, the phenomenologist explores the meaning of the language used in determining competence in practice. Through this contribution to the understanding of the notion of competence and its measurement by these experienced practitioners, it may be possible in some way to unravel the confusion that surrounds the meaning of competence represented in the literature. It is hoped that, through the discovery of the lived world of these clinicians, others may be better facilitated for and within their role as assessors in the future.

Becoming a professional: What is the influence of registered nurses on nursing students' learning in the clinical environment?

“…Trust was represented as students knowing their own limitations, not being over confident and therefore could be trusted to act in a safe way. In her study, Girot (1993b) also noted that a caring and patient focused attitude combined with good communication skills were cited as important components of competence by the ward sisters. It was also noted in the study that the ward sisters acknowledged the difficulty in measuring attitudes as an example of the challenges staff faced when teaching and assessing clinical performance.…”

“…Each of the ward sisters described their own experiences of working with and assessing nursing students. The findings of Girot's (1993b) phenomenological study concluded that the characteristics of competence had 'trust' by the senior nurses in the students as a central component. Trust was represented as students knowing their own limitations, not being over confident and therefore could be trusted to act in a safe way.…”

“…This view of learning could potentially be in conflict with a graduate philosophy of education that may seek to encourage new ways of thinking and risk taking. Interestingly and importantly, Girot (1993b) did not identify how the ward staff knew that they could 'trust' a student. From my review of Girot's (1993b) work I believe the ward sister participants were drawing on their own tacit knowledge and applying their confidence in a student's safe performance as a proxy indicator of competence.…”

“…This section builds on the student experience of learning by exploring the qualities and abilities that constitute and 'make' a good nurse. Girot (1993b) interviewed ten experienced U.K. ward sisters about their _____________________________________________________________________ ___ 55 experiences of teaching and assessing nursing students and the qualities they felt were necessary in demonstrating suitability to be a nurse. Each of the ward sisters described their own experiences of working with and assessing nursing students.…”

The competencies of newly qualified psychiatric nurses

“…Recognito be supported by various studies. Girot (1993) revealed that sisters commented that newly qualified graduates knew nothing and that they actually expected to be "spoon-fed" all the way. Lathlean & Corner (1991) also indicated staff attitudes as a major reason affecting newly registered nurses' competency.…”