Abstract
BackgroundA major focus in nursing education is on the judgement of clinical performance, and it is a complex process due to the diverse nature of nursing practice. A holistic approach in assessment of competency is advocated. Difficulties in the development of valid and reliable assessment measures in nursing competency have resulted in the development of assessment instruments with an increase in face and content validity, but few studies have tested these instruments psychometrically. It is essential to develop a holistic assessment tool to meet the needs of the clinical education. The study aims to develop a Holistic Clinical Assessment Tool (HCAT) and test its psychometric properties.MethodsThe HCAT was developed based on the systematic literature review and the findings of qualitative studies. An expert panel was invited to evaluate the content validity of the tool. A total of 130 final-year nursing undergraduate students were recruited to evaluate the psychometric properties (i.e. factor structure, internal consistency and test-retest reliability) of the tool.ResultsThe HCAT has good content validity with content validity index of .979. The exploratory factor analysis reveals a four-factor structure of the tool. The internal consistency and test-retest reliability of the HCAT are satisfactory with Cronbach alpha ranging from .789 to .965 and Intraclass Correlation Coefficient ranging from .881 to .979 for the four subscales and total scale.ConclusionsHCAT has the potential to be used as a valid measure to evaluate clinical competence in nursing students, and provide specific and ongoing feedback to enhance the holistic clinical learning experience. In addition, HCAT functions as a tool for self-reflection, peer-assessment and guides preceptors in clinical teaching and assessment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-016-0768-0) contains supplementary material, which is available to authorized users.
Highlights
A major focus in nursing education is on the judgement of clinical performance, and it is a complex process due to the diverse nature of nursing practice [1]
According to the American Association of Colleges of Nursing [7], clinical practicum provides opportunities for nursing students to learn in multiple care settings and receive appropriate guidance that fosters the development of clinical competence and professionalism
The results indicated that Holistic Clinical Assessment Tool (HCAT) has a four-factor structure, and satisfied level of internal consistency
Summary
A major focus in nursing education is on the judgement of clinical performance, and it is a complex process due to the diverse nature of nursing practice. It is essential to develop a holistic assessment tool to meet the needs of the clinical education. The study aims to develop a Holistic Clinical Assessment Tool (HCAT) and test its psychometric properties. Gonczi [5] advocated a holistic approach in the assessment of competency which combines the knowledge, skills and attitudes of professionals in clinical situations, and this notion of competence incorporates professional judgement, which involves complex structuring, bringing together disparate attributes and tasks required for intelligent performance in a particular clinical situation. Nursing students are equipped with theoretical knowledge and beginners’ skill competency throughout the undergraduate study. They may lack confidence and clinical experiences [4]. Research demonstrates that new graduate nurses’ confidence depends on the time spent during undergraduate clinical placements and the provision of workload of patients in conjunction with a preceptor to consistently improve issues of time management, competence and confidence with nursing tasks [8]
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