Mentor judgements and decision‐making in the assessment of student nurse competence in practice: A mixed‐methods study

Abstract

Mentor decisions were reasoned and there was a shared understanding of judgement criteria and their importance. This impression-based nature of mentor decision-making questions the reliability and validity of competency-based assessments used in nursing pre-registration programmes.

Mentors' self‐assessed competence in mentoring nursing students in clinical practice: A systematic review of quantitative studies

“…Several factors that may ameliorate or exacerbate related problems have been identified: mentors may need nurse teachers' support and expertise in making evaluations at the start of clinical practice periods, before final summative evaluations (Helminen et al, ); mentors’ attitudes affect their evaluations of students, decision‐making and provision of constructive feedback (Burden, Topping, & O'Halloran, ); reflective discussion between mentors and students enhances students' knowledge and clinical reasoning (McSharry & Lathlean, ); a further, increasingly important skill is the cultural competence required to mentor international students, who may feel unsupported and face severe communication challenges because of language barriers (Mikkonen et al, ; Pitkäjärvi, Eriksson, & Pitkälä, ). Such students reportedly need more support from nurse teachers than native students (Mikkonen et al, ).…”

Gut feeling: A grounded theory study to identify clinical educators' reasoning processes in putting students on a learning contract

“…Dane, Pratt, Baer, and Oldham () asserted that the process of gut feelings is rapid and often triggered by an observation that does not conform to the clinical competency patterns stored in the instructors' cognitive database of what is perceived as standard or safe. In a mixed‐methods design, Burden et al () concluded that impressions based on gut feelings tend to have more impact on the clinical instructors' decision‐making process than summative assessment strategies. Chaffey, Unsworth, and Fossey () echoed a similar observation in asserting that while clinicians with experiential knowledge are likely to make fast and reasonable judgements, they often fall short of articulating how they processed their decisions.…”

“…This grounded theory adds evidence to the current state of knowledge about gut feeling. The explication of the process of gut feeling implies the occurrence of a process rather than impulse reaction based on just emotions and impressions as suggested by Burden, Topping, and O'Halloran (). As a process, it often needs time and context.…”

Clusters of competence: Relationship between self‐reported professional competence and achievement on a national examination among graduating nursing students

“…Structured methods including different evaluation tools are common in evaluations of nursing students’ clinical competence (Lejonqvist, Eriksson, & Meretoja, ). However, validity and reliability in assessments of competence may vary and pre‐existing expectations from mentors, in addition to their shared understanding of educational goals, are present in this assessment process (Burden, Topping, & O´Halloran, ). The ability to identify one's own knowledge gaps and need for competence development is a competence that is clearly formulated in the educational goals for Swedish nursing programmes (Higher Education Ordinance (:100).…”

“…Previous research illustrates the complex relationship between self‐perceived performance and actual performance and how the ability to make accurate self‐assessments might differ between students in nursing education (Burden et al, ; Lejonqvist et al, ; Ugland Vae et al, ). It is essential that this is studied further since correct self‐assessments are crucial to both learning and patient safety in clinical practice.…”