Clinical nursing competency assessment: a scoping review
, und
30. Dez. 2021
Über diesen Artikel
Artikel-Kategorie: Review
Online veröffentlicht: 30. Dez. 2021
Seitenbereich: 341 - 356
Eingereicht: 08. Mai 2021
Akzeptiert: 07. Juni 2021
DOI: https://doi.org/10.2478/fon-2021-0034
Schlüsselwörter
© 2021 Oboshie Anim-Boamah et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Figure 1
Figure 2
Figure 3
Data matrix_
| Author, country and region | Aim of the study | Design | Data analysis, outcomes, instruments | Key findings |
|---|---|---|---|---|
| Quantitative studies included in the review | ||||
| 1. Ahn and Hyun-Young, |
To implement two high-fidelity simulations to help nursing students integrate their cognitive and psychomotor skills to evaluate the students’ simulation experience using the Simulation Design Scale and learning outcomes. |
Quasi-experimental post-test design. | Five nursing experts and 69 nursing students ANCOVA was used to compare the experimental and control groups, and correlation coefficient analysis was used to determine the correlation among them. | Students rated guided reflection and fidelity highly in the designed simulations. |
| 2. Oetker-Black et al., |
To psychometrically evaluate the Clinical Skills Self-Efficacy Scale in a population of nursing students in Tanzania. | Psychometric evaluation. | 287 nursing students enrolled in the preservice or in-service nursing programs at two schools |
Evidence of construct validity. |
| 3. Teixeira et al., |
To compare the level of anxiety and performance of nursing students when performing a clinical simulation through the traditional method of assessment with the presence of an evaluator and a filmed assessment without the presence of an evaluator. | Randomized control trial. | 20 nursing students were randomly assigned to one of two groups. |
The final scores of the two groups correspond to mild anxiety. |
| 4. Alamri and Almazan, |
To examine the barriers to physical assessment skills among nursing students in a government university in the Arab Peninsula. | A cross-sectional research survey. | 206 nursing students participated. |
Physical assessment is not often practiced in clinical settings. |
| 5. Alquwez et al., |
To assess the perceived patient safety competence during clinical training of Saudi nursing students. | Descriptive, cross-sectional design. | 829 nursing students. |
Students expressed positive perceptions toward their patient safety competencies. |
| 6. Arbabshastan et al., |
To determine the status of clinical competencies nurse practitioner students – self and instructor assessment. | Analytical cross-sectional study. | All senior nurse students ( |
The lowest scores of competencies were from communication and hygiene |
| 7. Daly et al., |
To determine the extent of assessor variability in clinical skills assessments in an undergraduate nursing program. | Prospective follow-up study design | The results of students’ clinical skills assessments in three clinical units were extracted from an administrative database. |
Overseas-born students had lower pass grades than Australian-born students. |
| 8. Gurkova et al., |
To investigate the use and effectiveness of a valid and reliable rating scale for summative clinical evaluation of student performance. | Descriptive cross-sectional study | 82 students participated in the study. |
A valid and reliable tool may allow an objective evaluation of nursing student performance in clinical settings. The Nursing Student Clinical Performance Evaluation Scale is useful for summative evaluation of student performance. Teachers and clinical mentors can rate students’ performance over time and note patterns of performance. |
| 9. Iglesias-Parra et al., |
To develop an evaluation system of clinical competencies for the practicum of nursing students based on the NIC. | Psychometric validation study a cross-sectional study. | Reliability and construct validity, as well as responsiveness, were tested by the evaluations performed by clinical mentors on 107 students over two consecutive years. |
A competency system for the nursing practicum, structured on the NIC, is a reliable method for assessing and evaluating clinical competencies. |
| 10. Kajander et al., |
To assess the congruence between graduating nursing students’ self-assessment and their mentors’ assessments concerning nurse competence with a particular focus on nursing skills. | Cross-sectional study | Completed questionnaires were received from 60 students and 50 mentors. |
Students’ rated their performance higher than the mentors. |
| 11. Langari et al. |
To examine and compare the self-assessment of patient safety competence between British and Finnish nursing students. | Cross-sectional study. | The PaSNEQ, 502 surveys to the final year nursing students |
No separate module for patient safety was included in the curriculum. Both groups of students ranked their competence to prevent patient safety incidents (attitude) the highest and their competence to act after errors (skill) relatively low. |
| 12. Macia-Soler et al., |
To determine the level of involvement of clinical nurses accredited by the Universitat Jaume I (Spain) as mentors of practice (Reference Nurses) in the evaluation of competence of nursing students. | Cross-sectional study | 200 clinical nurses completed the CPAM tool. | 63% of CPAM were completed correctly, without reaching the quality threshold established (80%). Nurses’ performance on the CPAM tool was determined by their respective clinical units There are significant differences according to clinical units. Collaboration and training of clinical nurses was recommended. |
| 13. Murray et al., |
An evaluation of a NTS framework that could potentially be used to measure ward round skills of student nurses. | Observation (cohort) study. | Development of NTS framework |
The proposed NTS framework included seven categories which were rated as important and relevant to practice and could be used as a means of evaluating student nurse competencies in respect of many NTS required for a successful ward round. |
| 14. Numminen et al., |
To evaluate whether educational outcomes of nurse education meet the requirements of nursing practice by exploring the correspondence between nurse educators’ and nurse managers’ assessments of novice nurses’ professional competence. | A cross-sectional, comparative design using the Nurse Competence Scale. | 86 Nurse educators and 141 nurse managers. |
Examiners who are educators rate novice nurses’ competence higher than examiners who are managers in all competence areas. Differences between educators’ and managers’ assessments scores were strongly associated with their age and work experience. |
| 15. Meskell et al., |
To explore electronic OSCE delivery and evaluate the benefits of using an electronic OSCE management system. |
A descriptive survey. | An electronic software in the management of a four-station OSCE assessment with first-year nursing students over two consecutive years ( |
Electronic software facilitated the storage and analysis of overall group and individual results thereby offering considerable time savings. |
| 16. Oermann et al., |
To explore the feasibility of developing scenarios for high-stakes evaluation of students’ clinical performance. | Video recordings of students performing in standardized scenarios. |
Most of the nursing students were able to competently perform most of the skills assessed on the CCEI. There was some inconsistency in the inter-rater agreement. |
|
| 17. Ossenberg et al., |
To advance the assessment properties of a new instrument, the ANSAT, and investigate the acceptability of this instrument when applied to the evaluation of the professional competence of nursing students in authentic practice settings. | Cross-section survey study | A validation study of ANSAT was conducted by 23 clinical assessors from two universities, completing 220 instruments for nursing students. |
The instrument is sensitive to different levels of performance across different year levels. |
| 18. Solheim et al., Norway |
To develop and evaluate a new reflection and feedback tool for formative assessment. | Descriptive design | 129 nursing students participated in the study. After high fidelity simulation, data were collected using a questionnaire with 19 closed-ended and 2 open-ended questions. | The tool provided a structure for self-assessment and made visible items that are important to be aware of in clinical skills. The tool has the potential for enabling students to learn about reflection and developing skills for guiding others in practice after they have graduated. |
| Qualitative studies | ||||
| 19. Cassidy et al., |
To develop a theoretical explanation of how mentors experience borderline competency achievement of nursing students in clinical practice. | Grounded theory study. | Interviews and focus group discussions with Registered Nurse mentors and practice educators. |
There were conflicts regarding mentors’ assessment decision-making where students were on the borderline of achievement of competence in clinical practice. |
| 20. Meier et al., |
To examine how the ISP was used to assess interpersonal skills in a university pre-registration nursing program. | Realistic evaluation approach | Interviews with clinical nursing mentors, practice education facilitators, and education champions. Documentary analysis of student assessment booklets was also done. | The ISP tool is used for formative and summative assessment. It supports the overt assessment of interpersonal skills, support to mentors, and provides feedback and “feed-forward” to students. |
| 21. Ochylski et al., |
To demonstrate the use of a multidimensional evaluation method as applied to a new simulation-based remediation course to enhance the clinical skills of prelicensure nursing students. | Seven who participated in a variety of simulation scenarios and skill-building activities were interviewed on the last day using 12 open-ended questions. | Student scores reflected positive skill performance 2 months after participating in the course. Some students expressed concern over a potential negative stigma among peers for needing and participating in a skills enhancement course. | |
| 22. Tommasini et al. |
To compare the clinical competence assessment processes and instruments adopted for nursing students during their clinical placement abroad. | A case study design | Tools for evaluating competences and written procedures were scrutinized through a content analysis method. Seven European countries participated in the study. | Great variability emerged in the tools, with between five and 88 items included. Twelve different core competence categories were identified. |
| Mixed method | ||||
| 23. Burke et al., |
To explore Irish preceptors’ experience of using a competence tool to assess undergraduate nursing students’ clinical competence. | Six focus group interviews to explore preceptor's experience of using an assessment tool to assess clinical competence. |
Preceptors had difficulty understanding the content of the tool as it was too academic. Challenges of using the assessment tool include difficulty understanding the content, negotiating complex repetitive language, time constraints and the need to facilitate qualitative commentary. | |
| 24. Zasadny et al., |
To develop a model in response to the inadequacies of existing tools to assess competence. | The ASAP tool was trialed in three public tertiary hospitals and four private hospitals. Quantitative and qualitative feedback was collected from students and clinical facilitators. | The ASAP model can be used as a focused diagnostic tool, removal from PEP support tool, and a framework for documenting evidence. |
|
| 25. Lai, |
To implement an online video peer assessment system to scaffold their communication skills and examine the effects and validity of the peer assessment. | Expert evaluation scores showed that peer assessments led to significant improvement in students’ communication performance. | Online peer assessment could be perceived as a valid assessment method for nursing communication skills training. Communication became more patient-centered gradually due to peer assessments. Peer assessment activities contributed to the improvement of the communication skills of students | |
| Multimethod | ||||
| 26. Marquez-Henandez et al., |
To design, develop, and implement a tool to evaluate the clinical skills of nursing students. | 250 Nursing students were randomly placed in an experimental group and a control group. |
The web-based tool designed is an effective strategy to evaluate clinical skills. The need for innovative strategies that can determine the development and acquisition of the skills required for future nursing professional | |
| 27. Imanipour and Jalili, |
To develop a comprehensive assessment system for nursing students in their critical care rotation based on a programmatic approach | -Expert review |
38 nursing students in their critical care course. |
The new assessment system had high validity, reliability, and a positive impact on learning. |
| 28. Wu et al., |
To develop and test psychometric properties of a holistic clinical assessment | -Systematic review |
Synthesis of the literature, exploratory and confirmatory factor analysis, Content Validity Index | HCAT was developed and validated through psychometric testing. The tool was internally consistent and reliable. |
Clinical competency assessment systems/tools/frameworks/models_
| Tools | Purpose | Development | Validated | Publicly available | Remarks |
|---|---|---|---|---|---|
| The ISP |
To assess students interpersonal and professional skills | It comprises 40 statements about interpersonal skills, professionalism, and engagement with the learning process, against which students’ performance in practice may be graded | Yes | Yes | Can be used for both formative and summative assessment |
| QLCCT |
To assess formative and summative competency skills of students based on Tanners (2006) model. | The tool, which is grounded in the seminal work of Tanner, |
Yes | Yes | The tool provides a clear and reliable way of measuring the clinical competency of students at various stages of training |
| ENS Assessment tools ENS |
To compare the clinical competence assessment processes and instruments adopted for nursing students during their clinical placement abroad | The tool composes 196 items which were categorized into 12: “Technical skills competence; Self-learning and critical thinking; Nursing care process; Ethical behavior; Patient communication; Risk prevention’ competence category; Self-adaptation; Clinical documentation; Managing nursing care; Patient/family education; and Theory and practice integration” | Yes | Not applicable | Increases transparency in learning expectations and evaluation |
| ASAP tool amalgamated student assessment in practice model |
The ASAP model functioned effectively as an assessment tool, focused diagnostic tool, removal from PEP support tool, and a framework for documenting evidence | The model comprises an assessment tool, a clinical reasoning framework and a negotiated learning contract. |
Yes | Yes | It is useful for both formative and summative assessment |
| ICAS tool |
To assess the communication competencies of students in undergraduate programs | This tool is a 23 items tool. |
Yes | Yes | Used for summative and formative assessment clinical performance |
| H-PEPSS |
To assess patient safety competencies of students | Six domains of the safety competencies: “Contribute to a culture of patient safety; Work in teams for patient safety; |
Yes | Yes | It is an effective tool in assessing summative clinical performance |
| NSCPES |
To assess the summative clinical performance of nursing students | Instrument development consists of 77 items of clinical responsibilities of nursing students. | Yes | Yes | A valid and reliable tool may allow an objective evaluation of Nursing students’ performance in clinical settings. |
| DOPS |
To assess students clinical performance through direct observation | Many variant forms of tools are in use. Khanghahi and Azar (2018) presented a systematic review of the DOPS used. | Not applicable | Not applicable | Insufficient training, poor feedback, time constraints. Attention needs to be paid to the quality of the tests |
| NTS-NAS |
To assess the not technical skills of nursing students | NTS-NAS resulted in a list of 63 items that are assessed on a 5-point Likert scale: “totally disagree to totally agree” with intermediaries. A “non-applicable” option was also added. | Yes | Yes | This tool could be used in teaching and assessment in undergraduate and postgraduate programs |
| CCEI |
To assess clinical competency of nursing students in simulation or traditional clinical settings | The tool focuses on 22 general nursing behaviors which were divided into four categories: “assessment, communication, clinical judgment, and patient safety”. | Yes | Yes | This tool has been validated and is used in many countries |
| ANSAT |
The instrument tested contained 17 items spread across 4 domains of practice used to assess the student's level of ability. The items are rated using a | A 17 item tool which is rated on a 1–4 scale. The tool is categorized into 4 domains: “professional practice; critical thinking and analysis; provision and coordination of care; and collaborative and therapeutic practice”. The scale is calibrated as: “1 = minimum standards not met, 2 = minimum standards met, 3 = performs above minimum standards in some areas, 4 = performs above minimum standards in most areas”. | Yes | Yes | It allows for clarity, reliability, and collaboration in clinical competency assessment |
| COPP |
It is intended to help students in their formative assessment and reflection on themselves and their peers before, during, and after learning clinical skills. | Measures five main areas: “Preparation and planning, Performance |
Yes | Yes | The tool provided a structure for self-assessment indicates essential components of skills for students |