Using portfolios for clinical practice learning and assessment: the pre-registration nursing student's perspective

Assessment of a Faculty and Preceptor Development Intervention to Foster Self-Awareness and Self-Confidence

Objective. To conduct and evaluate the outcomes of a pharmacy faculty and preceptor development program to foster self-awareness and self-confidence. Methods. A faculty and preceptor development intervention was implemented in a multi-campus college of pharmacy to promote and assess for improvements in self-awareness and self-confidence. Faculty members and preceptors were surveyed regarding their self-perceptions and confidence at baseline and following an intervention in which they completed the Birkman Method self-assessment and participated in a training program with an active-learning component. A longitudinal follow-up survey was conducted to assess the long-term impacts of the intervention. Results. Faculty members and preceptors experienced significant improvements in self-awareness from baseline following the development intervention. They also experienced increases in self-confidence related to coaching. A survey evaluating the longitudinal impact of the intervention indicated a positive association between receiving a sufficient level of Birkman Method training and improved ability of both faculty members and preceptors to manage professional relationships. Similarly, a positive association was identified between the sufficiency of training and preceptors' confidence in their ability to manage personal relationships and stress following the intervention. Conclusion. Faculty members and preceptors teach students to be more self-aware and confident, yet both groups often need to grow in these areas themselves. A faculty and preceptor development intervention using the Birkman Method self-assessment is one approach to facilitating growth in these educators' self-awareness and self-confidence.

The Portfolio as a Tool for Mentoring in Nursing Students: A Scoping Review

BACKGROUND

One of the processes leading to education and evaluation promotion in nursing is mentoring. Moreover, using a portfolio leads to promotion of the mentoring process. Due to the importance of mentoring in nursing, its strengthening by the portfolio, the weakness of mentoring in nursing, and the lack of widespread use of portfolio in nursing education, the aim of this study was to determine portfolio content, which can help the mentoring performance.

MATERIALS AND METHODS

The present scoping review study was conducted in 2017. Articles were searched using the keywords portfolio, mentoring, nursing education, logbook, teaching, learning, nursing, education, and evaluation. The search was conducted in SID, IranMedex, IranDoc, Magiran, PubMed, Google Scholar, Scopus, Web of Science, and ScienceDirect databases. Studies published in Persian and English from 1997 to 2017 were reviewed. The studies were extracted based on the inclusion and exclusion criteria.

RESULTS

Of the 1070 articles searched, 6 were extracted for the final assessment. The results indicated that a portfolio consists of a title page, content list, introduction, record of experience, mentor's feedback and comments, self-evaluation, and educational activities. Furthermore, nursing process is required to help conduct mentoring among nursing students.

CONCLUSIONS

Recording experiences, feedback, etc., in the portfolios of nursing students can be helpful in conducting mentoring for student's education. It is suggested that educational managers perform mentoring in educational environments using the contents suggested in this study.

[Effects of Learning Activities on Application of Learning Portfolio in Nursing Management Course]

PURPOSE

This study was conducted to examine effects of a learning portfolio by identifying the learning of nursing students taking a learning portfolio-utilized nursing management class.

METHODS

A non-equivalent control group pretest-posttest design was used. Participants were 83 senior students taking the nursing management course in one of the Departments of Nursing at 2 Universities. Experimental group (n=42) received a learning portfolio-utilized nursing management class 15 times over 15 weeks (3 hours weekly). Self-directed learning abilities, approaches to learning and learning flow of the participants were examined with self-report structured questionnaires. Data were collected between September 2 and December 16, 2014, and were analyzed using chi-square test, Fisher's exact test, independent t-test and ANCOVA with SPSS/PC version 21.0.

RESULTS

After the intervention the experimental group showed significant increases in self-directed learning abilities, deep approaches to learning and learning flow compared to the control group. However, no significant difference was found between groups for surface approaches to learning.

CONCLUSION

Learning activities using the learning portfolios could be effective in cultivating the learning competency for growth of knowledge, technology and professionalism by increasing personal concentration and organization ability of the nursing students so that they can react to the rapidly changing environment.

Impact of the Birkman Method Assessment on Pharmacy Student Self-Confidence, Self-Perceptions, and Self-Awareness

Objective. To identify changes in pharmacy student self-confidence, self-perceptions, and self-awareness after completing the Birkman Method assessment and training program. Methods. Survey tools were developed to evaluate students at baseline and following the co-curricular Birkman Method program. Following IRB approval, students participating in the Birkman Method program were recruited for enrollment in this survey-based study. Results. Student self-confidence was high at baseline (mean=4 out of 5) and did not significantly change after Birkman Method testing and training. Self-perceptions regarding usual and stressed communication style and behaviors and behavioral needs under stress changed significantly after Birkman Method testing and training for these endpoints. The Birkman Method intervention resulted in a significant improvement in self-awareness, as indicated by a mean self-perception accuracy score increase of 1.6 points (95% CI: 1.3-1.9). Conclusions. A Birkman Method assessment and training program is an effective self-assessment tool for students, and may be useful for accomplishing Accreditation Council for Pharmacy Education (ACPE) 2016 Standard 4 affective domain elements, particularly self-awareness.

A model of engagement in reflective writing-based portfolios: Interactions between points of vulnerability and acts of adaptability

BACKGROUND

Portfolios are widely used for meeting new accreditation standards in the age of competency-based medicine. However, the method of learning through portfolio has been suggested to be vulnerable.

AIM

The aim of this study was to explore conditions affecting the experience of teaching and learning from the perspective of both students and mentors in a reflective writing-based portfolio initiative.

METHOD

Using mixed-methods rooted in grounded theory, 139 students and 13 mentors completed questionnaires, 23 students participated in four focus groups and 9 mentors in individual interviews.

RESULTS

The overarching theme in our data was student-mentor engagement. Our results confirm previous literature describing portfolio as a vulnerable method of learning, extend this concept by identifying and categorizing specific points of vulnerability, and contribute new knowledge regarding acts of adaptability, which serve to strengthen the student-mentor relationship.

CONCLUSION

Engagement is central to the success of portfolio and is shaped by a dynamic interaction between points of vulnerability and acts of adaptability. We propose a model of engagement in portfolio that can be used for faculty development to optimize student-mentor engagement.

Nursing students' and preceptors' perceptions of using a revised assessment form in clinical nursing education

Assessment of students' learning is a crucial question when great changes occur in the higher education sector. One such educational reform is the Bologna declaration, the requirements of which have resulted in significant modifications in documents as assessment forms for clinical education. The aim of this study was to investigate students' and preceptors' perceptions of using the revised version of an assessment form, the AssCE form. Using convenience sampling, a questionnaire survey was completed by 192 nursing students and 101 preceptors. Most of the participants found that the revised AssCE form was possible to use during different years of the programme, and factors in the AssCE form were possible to combine with learning outcomes in the course syllabus. Most participants perceived that the scale added to each factor facilitated the assessment dialogue and offered possibilities to illustrate the students' development during clinical periods. Findings also showed that students were most often prepared with self-assessment before the assessment discussions. More information about the use of the AssCE form, also in combination with learning outcomes in the course syllabus, may further support the use of the form and contribute to students' development during clinical practice.

Challenges to student learning in the clinical setting: a qualitative descriptive study

Clinical education is used throughout nursing to promote competency. Although this experience can be rewarding, students may face a variety of challenges within this context. The purpose of this qualitative descriptive study is to explore senior nursing students' perceptions of challenges to learning within the clinical setting. Three interrelated themes emerged from the data: (a) internal reactions to external limitations; (b) barriers experienced within the clinical environment; and (c) ineffective programme organisation. Findings are meant to guide educators and policy makers during decision making. The goal is advancement towards making the clinical environment a superior form of nursing education.

The development of evidence based guidelines for clinical practice portfolios

AIMS

Although the use of portfolios is widespread within healthcare education, agreement on their purpose, content, assessment and value is still debated. The objective of this study was to achieve consensus on quality criteria for clinical practice portfolios that would act as guidance for students and lecturers.

METHODS

A Delphi survey was undertaken to seek consensus on the opinions of 23 'expert participants' through a series of rounds of structured questionnaires. The Delphi tool was produced as an on-line survey questionnaire and panel experts were invited to score statements using a discrete 7 point visual analogue scale. The statements were written as quality criteria relating to portfolio development which had been identified from the literature and by the research team. The survey employed three rounds of feedback and consensus was measured as 80% agreement for each quality criteria scoring 5 and above.

RESULTS

Consensus was reached on 31 quality criteria which were categorised into 4 areas: structured collection of labelled evidence; nature of evidence; critical reflection; and assessment and judgement. Mean scores for the final wording of the quality criteria ranged from 5.3 to 6.8 with the standard deviation for all of the mean scores being below 1.5. There was consensus that these quality criteria were relevant to health and social care professionals involved in developing clinical practice portfolios.

CONCLUSIONS

The Delphi process facilitated exchange of ideas amongst panel 'experts' about the content and evaluation of clinical practice portfolios, with most debate relating to judgement of competence and rewarding originality and creativity. These issues illustrate the tensions between educational values and professional constraints. The Delphi process proved to be an effective method for achieving consensus on quality criteria for clinical practice portfolios and enabled the development of validated guidelines.

A review of clinical competence assessment in nursing

AIMS

To investigate trends in the evaluation of clinical competence in nursing students and newly qualified nurses over the last 10 years.

DESIGN

A literature review following PRISMA guidelines.

METHODS

The following databases were searched: Cochrane, Medline and CINAHL using the terms competenc*, nurs*and assess*, evaluat*, measure*, from January 2001-March 2010. Strict inclusion and exclusion criteria were applied.

RESULTS

Twenty three papers were included and these mainly considered the following topics: instrument development and testing; approaches to testing competence; assessment and related factors. A holistic concept of competence is gaining popularity, and consensus around definitions is emerging. Some methods and instruments to measure competence are under systematic development and testing for reliability and validity with large samples and rigorous statistical method. Wider national and international cooperation is evident in competence-based assessment.

CONCLUSIONS

Competence-based education is evident, but this does not mean that issues related to competence definition have been resolved. Larger and more international cooperation is required to reach common agreement and validity in competence-based education and assessment.

Barriers to electronic portfolio access in the clinical setting

BACKGROUND

The University of Queensland has developed the Clinical Practice Performance electronic Portfolio (CPPeP) as a learning and assessment tool for third year nursing students. To promote effective use of the CPPeP in the clinical setting, barriers must be identified and strategies developed to overcome them.

METHODS

A 24-question survey exploring the use and perceptions of the CPPeP was administered to 42 third year nursing students. Questions explored actual barriers encountered while eight open-ended questions were thematically analysed for perceived barriers.

RESULTS

A 100% response rate was achieved. Students were comfortable with working with computers. Twenty nine students (69%) encountered specific barriers. Of the 152 written comments to the open-ended questions, perceived barriers were evident in 72 of them. Barriers experienced related to gaining access, finding time and staff attitude. The majority of students made their portfolio entries at home.

CONCLUSION

Students enjoyed using the CPPeP but competed with staff for the limited numbers of computers available. Heavy workloads and 'busyness' of the wards also prohibited access along with negative staff attitudes and reluctance of registered nurses to engage as student preceptors. The issue of overcoming barriers is more complex than simply providing more computers or overcoming staff prejudices. Finding time is a barrier not easily overcome given the current and projected nursing shortage.

Mentoring portfolio use in undergraduate and postgraduate medical education

AIM

Mentoring is widely acknowledged as being crucial for portfolio learning. The aim of this study is to examine how mentoring portfolio use has been implemented in undergraduate and postgraduate settings.

METHOD

The results of interviews with six key persons involved in setting up portfolio use in medical education programmes were used to develop a questionnaire, which was administered to 30 coordinators of undergraduate and postgraduate portfolio programmes in the Netherlands and Flanders.

RESULTS

The interviews yielded four main aspects of the portfolio mentoring process--educational aims, individual meetings, small group sessions and mentor characteristics. Based on the questionnaire data, 16 undergraduate and 14 postgraduate programmes were described. Providing feedback and stimulating reflection were the main objectives of the mentoring process. Individual meetings were the favourite method for mentoring (26 programmes). Small group sessions to support the use of portfolios were held in 16 programmes, mostly in the undergraduate setting. In general, portfolio mentors were clinically qualified academic staff trained for their mentoring tasks.

CONCLUSION

This study provides a variety of practical insights into implementing mentoring processes in portfolio programmes.

An exploration of the current use and benefit of nursing student portfolios

AIM

This study aims to identify the structure and of student portfolios and to ascertain their views on their usefulness.

BACKGROUND

Portfolios are in common use in undergraduate nursing programmes although there are considerable variations in approaches. As a result a wide variety exists in the quality of work presented and students are often unclear as to constituent contents. This latter, while a reflection of the current status and development of portfolio use within the discipline is a source of dissatisfaction for students, and warrants further investigation.

METHODS

This project aimed to quantitatively capture student views using an on line survey approach utilizing a previously validated questionnaire (McMullen, 2006) [McMullen, M. 2006. Students' perceptions on the use of portfolios in pre-registration nursing education: A questionnaire survey. International Journal of Nursing Studies 43 (3), 333-343]. A survey tool is used to examine the structure, process and content of portfolios (n=481) in current use in one school.

RESULTS

The study provides an evidence base for hitherto anecdotal comments and provides useful information for future development. While students see potential value in the portfolio use there are several areas of dissatisfaction including lack of clear guidelines.

CONCLUSION

As an evolving structure within universities and practice there is much room for process improvement.