Quality assessment of student performance in the real world: A case of the holy grail

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Quality assessment of student performance in the
real world A case of the holy grail?

• Dr. Robyn Nash, Faculty of Health, QUT
• Ms Pam Lemcke, School of Nursing, QUT
• Dr. Sandy Sacre, Faculty of Health, QUT
• ACEN-WACE Asia Pacific Conference
• Manly, Sydney 30 Sept 3 Oct 2008

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The School of Nursing, QUT

• QUT is one of Australias largest universities
  enrolling 40,000 students
• The School of Nursing offers a comprehensive
  range of undergraduate and postgraduate courses
• We have approx. 2,300 UG students across 4
  undergraduate degrees
• We manage approx. 3,500 nursing WIL placements
  per year

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WIL context ..

• clinical placement begins in Sem 2/Year 1
  culminates with an 8-week practicum in Sem 2/Year
  3
• placements are generally undertaken in block
  arrangements of x number of weeks and occur
  during/before/after semester
• students are placed in a wide variety of
  different settings from acute hospitals
  community mental health services, aged care
  facilities rural health settings

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WIL context

• students provide direct patient care in
  accordance with their level in the course
• supervision (formal) provided by clinical
  facilitators employed through sessional/seconded
  arrangements (18 basis)
• informal supervision by RN buddies
• students performance assessed both formatively
  and summatively during every practicum
• must meet specified performance criteria to pass
  the prac
• performance appraisal tools consistent with
  National Competency Standards

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Assessment of clinical performance

• early methods relied on discrete observation of
  students using specific clinical assessment tools
• ? emphasis on competence
• integration of knowledge, attitudes and skill
  within the performance
• more recent methods include continuous
  observation, (competency-based) assessment tools
  and reflection on practice

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Assessment of Clinical Performance

• Expectations and clinical competence
• Novice tell me, show me ?
• Advanced Beginner think I can ?
• Competent I can cope ?
• Proficient a bigger picture emerges ?
• Expert intuitive understanding
• Benner, 1984 (based on Dreyfus Model of Skill
  Acquisition)

E x p e r i e n c e
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Assessment of Clinical Performance

• Some general principles
• cognitive, psychomotor affective learning
  domains
• valid and reliable
• fair
• unambiguous understanding by students and
  assessors of expectations standards

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Complexities of the WIL Environment

• Academics
• positive learning environments
• students supported to consolidate knowledge and
  skills

• Employers
• service provision and staff workloads
• staffing profiles
• work ready graduates

• Students
• they want us there staff are friendly,
  positive, supportive
• they know what were doing
• we can practice what were learning
• theyll give us good feedback that helps us to
  learn

• Clinical staff
• timely information about what, who, when etc.
• but what can the students do?
• We never get a break from students!
• I havent got time.
• Just give us a skills list!

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Assessment of Clinical Performance

• Some general issues
• Academic Vs clinical/real world perspectives
• Competence Vs checklist assessments
• Realistic expectations of students performance
• Experience and confidence of assessors
• Impact of context
• Feedback on progress - formative Vs summative
  assessment
• University context expectations, policies,
  procedures etc.

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Assessment of Clinical Performance

• Some issues (Assessors)
• Why is this student here? She/he cant do X
• Its not relevant/not applicable here
• She/he can pass they will get better with more
  prac
• This student should fail she/he did X today
• Low performing students it takes too much time
  and its not fair to other students

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Assessment of Clinical Performance

• Some issues (students)
• my assessment wasnt fair.
• the ward staff said I was OK. Why did the
  facilitator fail me?
• the facilitator never really sees what I do how
  can they assess me?
• they expect too much Im not an RN yet!
• but what have I learned?

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Working off the same assessment page

• Clinical Assessment Tools and Guidelines
• specific performance criteria aligned to
  unit/course expectations
• performance assessed as achieving/not achieving
  (formative) and satisfactory/unsatisfactory
  (summative)
• Observation (including dialogue) on multiple
  occasions
• Anecdotal Notes
• Learning Contracts

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Reflections ..and the way forward?

• Bilateral relationships built on genuine respect
  and understanding of each others context
• Sense of local ownership at the coalface
• Student preparation for learning in the workplace
• Ongoing development of key staff
• User-friendly assessment tools that fit the
  academic/professional purpose
• Support in the workplace
• onsite academic liaison
• ready access to just-in-time resources
• Continued commitment to finding win-win
  solutions

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Summary
I think we learn faster and better when we have
more good people with good knowledge who can show
us and tell us how were going
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Thank YouQuestions? Comments?

• Robyn Nash
• Assistant Dean-Teaching and Learning
• Faculty of Health, QUT
• r.nash_at_qut.edu.au