The current clinical workplaces present the students who are undertaking clinical internships with various challenging and dynamic learning situations. Here, there is the paramount need for students to realize that learning and competence development in a clinical setting is a continuous process, which relies on supervision, assessment and feedback as the main facilitators (Embo et al., 2010, p. 263).
Additionally, student assessment in clinical practice entails the process of determining each student’s mastery of complex issues and competencies in various clinical situations. However, Stuart (2007, p. xiii) notes that facilitation of competence development and learning in a clinical setting is a complex task, which calls for the application of multifaceted approaches and capabilities on the part of clinical supervisors and assessors.
Therefore, unlike the classroom setting whereby the learning processes are more amenable and easily controlled, learning in clinical practice can be very difficult to control because both students and their clinical assessors must align their learning experience and competencies with the ever-changing patient care circumstances (Embo et al., 2010). As a result, assessors are required to facilitate student learning by helping them to obtain as much information and competencies as possible from each clinical situation.
In this essay, a clinical assessor refers to a clinical professional who is involved in the process of supporting, supervising, and facilitating competence development and student learning in a clinical setting. Furthermore, the essay presents a review of different research articles regarding student assessment in clinical practice. As a result, the essay provides recommendations regarding the process of assessing students in clinical practice relative to the issues raised in the research articles.
Analysis of articles on Student Assessment in Clinical Practice
In the book, “Assessment, Supervision and Support in Clinical Practice”, the author looks at the process of assessment from different perspectives. Here, the author notes that assessment is an integral part of the day-to-day activities of different people particularly at home, the workplace, and in the public arenas whereby people pass judgment on other people and their activities to enable those being assessed to assimilate and accommodate different experiences. However, under an educational setting, Stuart (2007) notes that assessment plays a pivotal role in the development of different competencies and student learning. In addition, assessment is important to education because it enables the faculty to develop and accredit different educational courses.
Conversely, the assessment takes place in both the classroom and outside the classroom. Here, Stuart (2007) posits that the process of assessing students in the classroom is much easier and controllable as opposed to assessing students in clinical practice. In clinical practice, student assessment takes a multifaceted approach, which entails a particular student being under the scrutiny of assessors, colleagues, and even patients.
Therefore, as opposed to classroom assessment whereby the student relies on the feedback from teachers, clinical situations present students with various complex experiences that should be internalized and put into practice. As a result, the student’s mastery of different concepts and practices in different clinical situations determines the kind of feedback one should expect from assessors, colleagues, and patients (Stuart, 2007).
Conversely, the author notes that in clinical practice, assessors must play an active role in making inferences on their students’ ability to adapt teamwork in different clinical wards, their development into active practitioners, student learning under different situations, and student achievements. In this way, the assessor gets the chance to note changes in knowledge, competencies, and attitudes in students who are undergoing clinical internships. Finally, the author notes that the process of student assessment in clinical practice is complex, and therefore, several problems associated with the process hinder positive student assessment. For instance, standardization, fairness, and reliability in student assessment are contentious issues in clinical practice (Stuart, 2007).
Furthermore, in the book, “Teaching in Nursing”, the authors review the process of evaluation as an integral part of student assessment in which the quality and productivity of student learning are determined relative to pre-determined performance standards. Here, Billings and Halstead (2009, p. 443) note the important role played by the nursing faculty in evaluating different learning programs such as clinical internships, and reporting the outcomes to the critical stakeholders. Therefore, evaluation entails collecting program-related data, analyzing data, and appraising or reporting the findings to attract appropriate responses and interventions.
As a result, the authors note that the process of evaluating student performance or program efficiency may be influenced by the philosophical approaches associated with evaluation. That is, the philosophy of evaluation or the beliefs that different evaluators attach to the evaluation process determines the process design, the methodology, the type of results obtained, and the interpretation of the findings (Billings & Halstead, 2009).
However, through following a systematic process of evaluation that considers different philosophical dimensions of evaluation, there is the possibility of evaluators obtaining the desired results, which bring about a positive change in student performance and program effectiveness. Here, the authors recommend that the evaluation process should entail a series of steps, which begin with the identification of the purpose of evaluating students and the time frame within which the process should be carried out. Subsequently, the identified evaluators should design the most appropriate evaluation models, and select instruments for the study.
Furthermore, the evaluation model should guide data collection, interpretation of data, and reporting of findings. Lastly, the process should entail using the report findings in the evaluation process to maintain or improve different aspects of student performance and program outcomes (Billings & Halstead, 2009).
Moreover, in the book, “Clinical Education in the Health Professions”, the authors review the implications of different theories during student assessment in clinical education. Here, Delany and Molloy (2009, p. 147) emphasize the need to apply socio-cultural theories in learning to various student assessment procedures. In so doing, the authors want to bring forth the importance of recognizing that clinical learning occurs in different socio-cultural contexts, and involves participants from different socio-cultural backgrounds.
Therefore, through recognizing socio-cultural diversity in clinical learning, the assessors are better placed in terms of devising individualized approaches in student assessment because different social and cultural backgrounds of students and patients do influence the learning process in different aspects (Delany & Molloy, 2009). Additionally, other theories such as critical reflection enable assessors to reflect on their assessment practices in order to recognize different cognitive errors and mistakes in decision-making during student assessment.
Furthermore, apart from informing student assessment in clinical practice, the authors note that different theories in learning can play a pivotal role during curricular and program development. In addition, various theories are also important in terms of informing different clinical education methods. Overall, the authors note that the first step in student assessment should entail the identification of the most acceptable assessment practices in the greatest percentage of participants (Delany & Molloy, 2009).
Recommendations regarding Student Assessment
Given the foregoing discussions, it is clear that student assessment in clinical practice entails different multifaceted approaches, which depend on various historical models and the practical experiences of different assessors as opposed to the psychometric characteristics of assessment tools (Delany & Molloy, 2009, p. 150). Additionally, the current practices in student assessment require that the procedures used to assess student competence and learning should be feasible, reliable, practical, and valid to the extent of standardizing the complexities associated with differences in assessment methods, patients, test items, and different assessors.
Therefore, because of these difficulties in student assessment, there is the need for assessors to develop feasible assessment procedures that address various issues without compromising the purpose of the student assessment. As a result, the tailored assessment procedures and practices should aim at:
- Assessing the competence and experience of students in clinical practice before the students can embark on active clinical practice
- Assessing student learning relative to the quality of clinical education obtained to control the quality of learning in clinical practice and nursing
- Assessing the progress of student learning in clinical practice, and giving students the appropriate feedback to motivate them, and
- Promoting teaching and student learning through providing written assignments for students during clinical internship
Evaluation of Students outside the Classroom
The foregoing discussions show that student evaluation or assessment outside the classroom is a complex procedure because it is not easily controlled, and sometimes it presents both the assessors and students with challenging opportunities, which require that both parties should adjust their tactics to fit different situations. As a result, student evaluation outside the classroom cannot be the role of a single entity in clinical practice. Therefore, student evaluation outside the classroom calls for the active participation of the nursing faculty, the students, and different clinical practitioners (Stuart, 2007).
Here, the role played by students in the evaluation process entails situations where the students are involved in active self-assessment. Through self-assessment, the students get the opportunity to discover their abilities and competencies, which can be used in different clinical situations to support the learning process. Additionally, self-assessment allows students to adjust their attitudes in such a way that they can fit into different socio-cultural and clinical contexts.
The essay reviews various articles on student assessment in clinical practice. Relative to the issues covered in the articles, the essay recommends various changes in practice, which should be embraced in student assessment to produce excellent results. In addition, the essay reviews the process of evaluating students outside the classroom relative to the key players in the evaluation process and the role played by students in terms of enhancing the evaluation process. The discussions above show that student assessment in clinical practice is a complex process when compared to assessment in the classroom because the process involves different multifaceted approaches whose aim is to appraise the degree to which students adjust and learn from different clinical situations.
Therefore, it is recommended that assessors should devise different assessment procedures that address various issues in student assessment without compromising the purpose of the assessment process. In addition, student assessment entails the active participation of the nursing faculty, clinical practitioners, and students. However, the students have an extra role to play in the evaluation process in terms of adjusting their abilities, attitudes, and socio-cultural practices to fit different clinical situations.
Billings, D.M. & Halstead, J.A. (2009). Teaching in nursing: A guide for faculty (3rd ed.).Philad elphia: WB Saunders.
Delany, C. & Molloy, E. (2009). Clinical education in the health professions. Chatswood, NSW: Elsevier Australia.
Embo, M.P., Driessen, E.W., Valcke, M. & Van der Vleuten, C.P. (2010). Assessment and feedback to facilitate self-directed learning in clinical practice of midwifery students. Med Teach., 32 (7), 263-269.
Stuart, C. (2007). Assessment, supervision, and support in clinical practice: A guide for nurses, midwives, and other health professionals. New York: Elsevier Health Sciences.