Development of a Geriatric Nursing-Specific Mini-CEX and Evaluation of the Professional Competence of Nursing Students: A Novel Approach to Clinical Evaluation in Implementing Case Study

Abstract

Background: Geriatric nursing is professional holistic care that requires special attention and the development of professional competence. No valid and reliable tool exists to evaluate professional geriatric competencies (PGC) of nursing students in professional practice which remains a debatable issue in nursing education. Therefore, the present study was conducted to fill data scarcity. Objectives: The present study aimed to develop a Geriatric Nursing-Specific Mini-CEX (GN-Specific Mini-CEX) tool to evaluate the professional geriatric competencies of internship nursing students. Methods: The present study is descriptive observational quantitative with a cross-sectional design. The Geriatric Nursing-Specific Mini-CEX tool was developed in seven skill domains and 40 items based on the core competencies of geriatric nursing, published literature, and expert opinions. Delphi method was applied to evaluate the face and content validity, and reliability was determined using Cronbach's alpha test through a pilot test. The modified tool was scored between 1 to 9 in each item of skill domains with a total score of 40 to 360. Higher scores indicate a higher professional geriatric competence for nursing students. Then, 160 internship undergraduate nursing students were selected by convenience sampling from Mashhad University of Medical Sciences (MUMS) as one of the major medical sciences universities of Iran ,in January 2020. One-day workshop of evaluators was held in two sessions and the professional geriatric competencies of students were evaluated by implementing case studies. The results were analyzed with inter-rater reliability and descriptive statistics. Results: ICC values for seven components of geriatric nursing-specific Mini-CEX ranged from 0.639 to 0.919, indicating an acceptable level of reliability for this scale. The mean score of overall geriatric competence was (M= 6.12, SD=.33), which indicated that the geriatric competencies of students enrolled in the study were at a satisfactory moderate level. The highest and the lowest mean scores were observed in history taking /communication (M= 6.71, SD=.71) and physical examination skills (M= 4.99, SD=.67), respectively. Conclusion: The results of this study indicate the feasibility of using new developed geriatric nursing-specific Mini-CEX tool to evaluate the professional geriatric competencies of nursing students through implementing case studies in professional clinical settings. The data obtained from the present study could be useful for nursing education to evaluate and redesign a curriculum for integrative core geriatric competencies as a process of quality improvement.