Saturday, 7 November 2015
The goal of this study was to investigate faculty and student perceptions related to the use of the clinical performance evaluation tool (CPET) in a baccalaureate undergraduate nursing program. The CPET was developed to measure Quality and Safety Education for Nurses (QSEN) competencies specifically within the context of nursing student clinical performance. Clinical evaluation of undergraduate nursing students is ubiquitously recognized as a difficult and long-standing problem for nursing faculty. The CPET was chosen as a clinical evaluation tool at the research institution because of its theoretical foundations and perceived relevance to the nursing program. However, many faculty and students had voiced concerns related to the utility of this particular evaluation tool. The CPET incorporates clear and adaptable methods for clinical evaluation of nursing students based upon the QSEN competencies and was selected by the research institution specifically for those reasons. However, it is not clear whether such a clinical evaluation tool is functionally effective and limited evidence has been published supporting its use in educational practice. Six fulltime nursing faculty and six undergraduate nursing students were recruited for this qualitative study. Participants were asked a series of five questions related to their use of the CPET during medical/surgical clinical rotations. These questions addressed the participants impressions of the evaluation tool, how well they thought the tool was preparing students to become competent nurses, what participants found most useful versus most challenging about the tool, and their impressions of how they would best like to be evaluated in the clinical setting. Respondent interviews were transcribed and analyzed categorically and several recurring themes were found. The recurring themes pointed out primarily that it is not the CPET as an evaluation tool that is problematic, rather students and faculty were found to be ambivalent towards the tool, the tool was used inconsistently, students and faculty were not oriented in how to effectively use the tool, and the tool was used in isolation and did not follow the student as they grew throughout the program. Faculty uniformly recognized that the QSEN competencies were useful in guiding clinical evaluation, feedback and dialogue, and remediation with the students. However, there was no evidence of consistent use and application of the CPET. Student and faculty concerns that were identified in this study suggest that before any nursing program implements a clinical evaluation rubric, the most important first step might be too closely evaluate the proposed evaluation tool, ensure it aligns with existing curricular goals and outcomes and ensure that the clinical evaluators are all trained in how to consistently and appropriately use the evaluation tool. Students should be regularly oriented to the tool also and be made aware of its purpose. These recommendations are in alignment with current best practices in evaluation as reported in the literature. The CPET was recognized as a valuable tool by faculty primarily because of its QSEN foundation. In order to help students see the relevance of the tool and use it most effectively consistency in the implementation and application of the tool should be considered as a high priority.
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