Clinical Evaluation Tools

Objectives Discuss a variety of clinical evaluation tools. Discuss the development and use of a clinical performance rubric. Discuss methods of providing feedback to students. Compare the traditional nursing care plan with the concept map. Discuss how to develop positive student-faculty relationships. Practice using the performance rubric for a selected case study.

Tools for Evaluation Direct Observation Preceptor Observation Anecdotal Notes Clinical Performance Rubrics

Tools for Evaluation: Assignments Journaling/Reflection Papers Process Recordings Portfolios Patient Assessment Tools Nursing Care Plans Concept Maps Student Self-Evaluation

Observation Observation Guides Checklists Simulation Lab Direct Clinical Observation Anecdotal Notes Clinical Rubrics Preceptor Observation

What is a clinical performance rubric? Predetermined behaviors/criteria Delineates safe and satisfactory student performance Derived from course outcomes Describes different levels of quality such as: Satisfactory Needs Improvement Unsatisfactory

Why develop a clinical rubric? Provide new students with expected behaviors Provide students with a concrete view of their performance Identification of poor levels of performance early Provide new faculty with examples of behaviors

Rubric Rating Scale Examples Clinical Competence Rating Scale Independent Supervised Assisted Marginal Dependent Not Applicable Not Observed Keele University Clinical Criteria Outstanding Very good Good Average Poor Unacceptable Not Assessed

Faculty Guidelines for Clinical Rubric Management Give student a copy of the rubric Allow student to review and ask questions Checkmark the behaviors observed Write comments in space available Give student a copy of the rubric with feedback Review your comments with the student

Example of Clinical Outcomes 1. Provide care for clients in a variety of settings based on the relationship of the client, health, and environment. 2. Demonstrate professional nursing knowledge, attitudes, and behaviors in the delivery of person-oriented health care. 3. Apply critical thinking skills when caring for clients in a variety of settings. 4. Employ effective communication with clients, health team members, faculty, and peers. 5. Implement therapeutic nursing interventions to meet client needs.

Clinical Outcome 1.1a Identifies disease processes, psychological and sociocultural factors that affect the client's health Satisfactory The student defines/describes patient’s primary medical diagnosis and/or surgical intervention. Needs Improvement The student defines patient’s medical diagnosis or surgical intervention with assistance of faculty. Unsatisfactory The student is unable to identify patient’s primary medical diagnosis or surgical procedure.

Patient Assessment May accompany the nursing care plan and/or concept map Graded weekly One assessment per assigned patient Configuration may vary

Patient Assessment Patient Demographics Chief Complaint History Current/Past Medical and Surgical Allergies and Current Medications IV Information Laboratory, Diagnostic Tests, and Procedures Physician Orders Pathophysiology Review

Nursing Care Plan Application of nursing process Preparation for clinical experience Standardized format Key points for evaluation Formative evaluation Graded

Nursing Care Plans Advantages Disadvantages Standard approach or format Thought to show critical thinking Helpful in learning to think like a nurse Disadvantages Standardized care plans Use of critical thinking skills Linear approach Real nurses do not write care plans

Concept Maps Diagrammatic strategy Demonstrates relationships Organizes data Used in place of nursing care plans Formative evaluation Graded

Concept Maps Advantages Disadvantages Synthesis of knowledge Less writing Shows student understanding Disadvantages Map may be large No two will be alike in format Attractiveness may influence assessment

Concept Maps Types of Maps Pathophysiologic Focus Nursing Care Focus Combination Pathophysiologic and Nursing Care Focus

Tips for Concept Mapping Both theory driven and an evidence-based teaching/learning strategy Integral part of learning how to think like a nurse Demonstrate how to construct a concept map Use concept map to keep notes throughout shift Assessment tool of student learning Collaborative learning and critical thinking (Torre, Durning, & Daley, 2013)

(Torre, Durning, & Daley, 2013)

Concept Map Configurations (Noonan, 2011)

Risk for Powerlessness Admission Info Pathological Effects Pathological Effects #5 Risk for Powerlessness #4 Disturbed Body Image Spinal Cord Compression #2 Self-care Deficits #3 Risk of Impaired Skin Integrity #1 Impaired Physical Mobility Assessment Findings 4/17 Meds for Compression Constipation

Clinical Evaluation Activity Handouts Needed: Student Scenario Clinical Performance Rubric Patient Assessment Tool Nursing Care Plan Concept Care Map

Clinical Evaluation Activity Issues Concerns Likes and Dislikes What if…?

Student Self-Evaluation Clinical performance Strengths Areas of improvement Strategies for improved performance

Student-Faculty Relationships Positive relationships require: Confidence Respect Realistic clinical expectations Honest and direct Approachable Caring behaviors Support and encourage Gaberson & Oermann, 2015

Summary: What was accomplished? Introduced a variety of clinical evaluation tools available to faculty. Discussed the development and use of a clinical performance rubric. Reviewed guidelines for providing clinical feedback to students. Compared the traditional nursing care plan with the concept care map. Discussed how to develop positive student-faculty relationships. Practiced using the clinical performance rubric based on a case scenario.