Clinical Evaluation Tools

Copyright 2008 by The Health Alliance of MidAmerica LLC

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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.

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Clinical Evaluation Tools

Direct Observation Preceptor Observation Anecdotal Notes Clinical Performance Rubrics

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Tools for Evaluation: Assignments

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

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Observation

Observation Guides

• Checklists

• Simulation Lab Direct Clinical Observation

• Anecdotal Notes

• Clinical Rubrics

• Preceptor Observation

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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

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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

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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

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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

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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.

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Clinical Outcome 1.1a Identifies disease processes, psychological and

sociocultural factors that affect the client's health

SatisfactoryThe 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.

UnsatisfactoryThe student is unable to identify patient’s primary medical diagnosis or surgical procedure.

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Patient Assessment

May accompany the nursing care plan and/or concept map

Graded weekly

One assessment per assigned patient

Configuration may vary

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Patient Assessment

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

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Nursing Care Plan

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

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Nursing Care Plans

Advantages

• 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

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Concept Maps

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

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Concept Maps

Advantages

• Synthesis of knowledge

• Less writing

• Shows student understanding Disadvantages

• Map may be large

• No two will be alike in format

• Attractiveness may influence assessment

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Concept Maps

Types of Maps

• Pathophysiologic Focus

• Nursing Care Focus

• Combination Pathophysiologic and Nursing Care Focus

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Clinical Evaluation Activity

Handouts Needed:

• Student Scenario

• Clinical Performance Rubric

• Patient Assessment Tool

• Nursing Care Plan

• Concept Care Map

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Clinical Evaluation Activity

Issues

Concerns

Likes and Dislikes

What if…?

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Student Self-Evaluation

Clinical performance

Strengths

Areas of improvement

Strategies for improved performance

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Student-Faculty Relationships

Positive relationships require:

• Confidence

• Respect

• Realistic clinical expectations

• Honest and direct

• Approachable

• Caring behaviors

• Support and encourage

Gaberson & Oermann, 1999

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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.