A Participatory Approach to Development of the Community Nursing Student Assessment Scale (CNSAS) to Measure Student Learning Outcomes

Purpose: Community-based service-learning has a long and distinguished history as pedagogy in nursing education programs including in the UNF Home-base Model which places students in community settings throughout the length of their nursing program to work with community partners and faculty around mutually identified service-learning projects. A challenge to continuous quality improvement is the scarcity of psychometrically tested tools to measure student learning outcomes. The purpose of this presentation is to report on the participatory process and the development and testing of the Community Nursing Student Assessment Scale (CNSAS) to evaluate community nursing student learning outcomes.

Methods: The CNSAS evolved over several semesters and iterations with the involvement of faculty, students, and community partners. The initial items arose from analyses of student focus groups, reflective journals, and end of program surveys. A subsequent IRB approved study convened 15 faculty, 15 community partners, and 48 students in focus groups to validate survey items. The CNSAS consists of 39 items, measured on a 5 point Likert scale, to assess student experience within the six domains of 1) health promotion and education, 2) knowledge of community, 3) partnering and collaboration, 4) ecological perspective, and 5) self-efficacy. A convenience sample of graduating senior students (n=191) were invited to complete the survey and share narrative reflections on their community experience.

Results: The CNSAS demonstrates high internal consistency (α = 0.986) with each sub-scale yielding strong reliability (α = 0.933 - 0.963). Deductive content analysis of student narratives (n=167) supported validity of survey items.

Conclusion: The CNSAS has application for research and education, particularly for programs seeking to develop and/or refine an emphasis on community engagement. A participatory approach can be applied to any curricular evaluation process.