Clinical Evaluations Using QSEN KSAs: Developing Tools and Strategies

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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
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Impetus For Change
The Catholic University of America School of
Nursing

• 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.

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Grading SchemeDiadatic Scheme
The Catholic University of America School of
Nursing
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 F 59 or Below
In both schemes students Had to achieve at least
a C to pass the clinical course
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Grading SchemeClinical Evaluation Tool
The Catholic University of America School of
Nursing
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
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Grading SchemeComplete Clinical Course Grade
The Catholic University of America School of
Nursing

• 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

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Development Process
The Catholic University of America School of
Nursing

• Major outline of criteria tool needed to meet
  determined by BCC
• Sub-committee developed to create a draft
  document
• Review of AACNs Core competencies
• Review of QSENs KSAs
• Examination of Schools Terminal objectives and
  mission
• Draft document approved by Baccalaureate
  Curriculum Committee and in undergoing pilot
  testing this summer

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Description of Tool
The Catholic University of America School of
Nursing
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Core Competencies Midterm Midterm Midterm Final Final Midterm Comments Final Comments
S NI U S 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 SatisfactoryNI Needs ImprovementU
  Unsatisfactory

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Pilot Guidelines Summer 2008 N376 
The Catholic University of America School of
Nursing

• 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 v or a x
  in the appropriate box for each student.
• The Clinical Score will be completed by the
  Student by placing a v 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.

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Core Competency Key 
The Catholic University of America School of
Nursing

• 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.

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Implementation focus areas
The Catholic University of America School of
Nursing

• 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.

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Plan for Evaluation
The Catholic University of America School of
Nursing

• 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