Clinical Evaluations Using QSEN KSAs: Developing Tools and Strategies The Catholic University of America Cindy Grandjean, Mary Paterson And Terry Walsh June, 2008 QSEN Annual Meeting Charlotte, NC

Impetus For Change Challenges with Prior Evaluation Tool The Catholic University of America School of Nursing Impetus For Change Challenges with Prior Evaluation Tool Difficult grading algorithm. Inconsistent grading implementation of clinical behaviors by part time clinical faculty. Major Change in Curriculum. Expanding and growing undergraduate enrollment. Change in Grading Schema.

Grading Scheme Diadatic Scheme The Catholic University of America School of Nursing Grading Scheme Diadatic Scheme OLD GRADING SCHEME A 96-100% A- 95%-92% B+ 91%-89% B 88-86% B- 85-83% C+ 82%-79% C 77%-74% C- 73%- 70% D 69%- 60% F 59% or Below NEW GRADING SCHEME A 94%-100% A- 90%-93% B+ 89%-86% B 85%-83% B- 82%-80% C+ 79%-76% C 75%-73% C- 72%-70 D 69%-60% In both schemes students Had to achieve at least a C to pass the clinical course

Grading Scheme Clinical Evaluation Tool The Catholic University of America School of Nursing Grading Scheme Clinical Evaluation Tool OLD GRADING SCHEME A A- B+ B B- C+ C C- D F NEW GRADING SCHEME PASS FAIL Matriculated according to class level Matriculated according to Key for each course

Grading Scheme Complete Clinical Course Grade The Catholic University of America School of Nursing Grading Scheme Complete Clinical Course Grade OLD GRADING SCHEME Average of Didactic Grade (Ex., A, A-, B+, etc.) AND Clinical Evaluation Grade (Ex., A, A-, B+, etc.) NEW GRADING SCHEME Didactic Grade (Ex., A, A-, B+, etc.) IF AND ONLY IF Clinical Evaluation Grade is PASS If Clinical Evaluation is a FAIL, student does not progress and FAILS the course

The Catholic University of America School of Nursing Development Process Major outline of criteria tool needed to meet determined by BCC (Baccalaureate Curriculum Committee) Sub-committee developed to create a draft document Review of AACN’s Core competencies Review of QSEN’s KSA’s Examination of School’s Terminal objectives and mission Draft document approved by Baccalaureate Curriculum Committee and in undergoing pilot testing this summer

Description of Tool If you can’t measure it – you can’t manage it The Catholic University of America School of Nursing Description of Tool If you can’t measure it – you can’t manage it Donabedian

S = Satisfactory NI = Needs Improvement U = Unsatisfactory Core Competencies Midterm Final Midterm Comments Final Comments S NI U Provides Patient-Centered Care Values Caring Spirituality Human Dignity Ethics Exhibits Teamwork and Collaboration Communication Personnel (Faculty, Staff, Patients, Peers, Family) Oral (non-verbal) Written (Documentation) Roles Incorporates Evidence-Based Practice Critical Thinking Understands & Applies Quality Improvement Methods Leadership Assessment Promote Healing Promotes Safety Technical skills Understands & Utilizes Informatics Appropriate decision making based upon core competencies above and implemented with informatics support S = Satisfactory NI = Needs Improvement U = Unsatisfactory

Pilot Guidelines Summer 2008 – N376 The Catholic University of America School of Nursing Pilot Guidelines Summer 2008 – N376   Each student will fill out an evaluation at (1) midterm (2) final. Each faculty member will fill out an evaluation at (1) midterm (2) final. Each row item (boxes) must be checked at (1) midterm (2) final. The Clinical Score will be completed by the Clinical Faculty by placing a “ √ “ or a “ x “ in the appropriate box for each student. The Clinical Score will be completed by the Student by placing a “ √ “ or a “ x “ in the appropriate box for each student. The score for Clinical Evaluation will be either “Passing” or “Failing”. A passing grade will only be assigned if all the items are checked “S” at the time of the final evaluation.

The Catholic University of America School of Nursing Core Competency Key   Each core competency (as outlined in BOLD on the tool and seen below) will have a template or key, which specifies individual guidelines and examples for each. Provides Patient-Centered Care Exhibits Teamwork and Collaboration Incorporates Evidence-Based Practice Understands & Applies Quality Improvement Methods Promotes Safety Understands & Utilizes Informatics **The keys are based upon level of matriculation in each clinical course in the following specialties: Medical Surgical, Psychiatric, Obstetric and Community Health Nursing. Developmental goals within each competency will be established by literature review and faculty experts

Implementation focus areas The Catholic University of America School of Nursing Implementation focus areas 360 Senior evaluation that would include staff nurse preceptors, patient opinion, clinical faculty opinion and student review. Intended for final clinical evaluation at the end of senior year. Validity and reliability assessment of core competency key will include expert review, score-rescore assessment, and efficiency evaluation. Student rating expectation management to assure clear understanding of pass/fail criteria. Use of clinical evaluation in student portfolios.

The Catholic University of America School of Nursing Plan for Evaluation Meet with faculty & students for input on tool post summer clinical session, revise tool and prepare for full pilot test in the fall. Define procedure/criteria for assessing validity and reliability of tool post pilot test Outline the evaluation protocol to be used and orient all faculty and students to the new tool and protocol