The role of the external examiner in the assessment of clinical practice

Assessing student nurse clinical competency: will we ever get it right?

In 1997, a revised system was introduced at the University of Glamorgan, Wales, to assess student nurse clinical competency. This was firstly as a result of concerns that the previous system was based on limited documentary evidence, and, secondly as the Welsh National Board for Nursing and Midwifery issued new competency statements. This article reports an evaluative research study which aimed to determine whether the revised system was an effective measure of clinical competency. A series of focus groups were conducted with students, tutors and clinical preceptors to discuss their experiences of using the revised system. A content analysis was conducted of all evidence written by students to support the achievement of clinical competency. The findings of the focus groups indicated that each group had some initial problems with the assessment process. The main concern for all groups was lack of consistency and uncertainty in the assessment process. Although the introduction of written evidence to support clinical competency was welcomed, many felt that too much evidence was required. Content analysis of competency documentation aimed to compare student evidence and to determine whether there were inconsistencies in the assessment process. There were many variations in the evidence obtained from students, in particular the amount of evidence written by each student. The findings clearly indicate that further revisions are necessary to ensure that the system is implemented in the most effective way. The Fitness for Practice report (UKCC, 1999) has ensured that competency-based assessment is here to stay in the UK. Evaluative research of this type is important to ensure that we adopt the most suitable approach to assessing clinical competency.

Assessing nurse graduate leadership outcomes: the "typical day" format

Readiness for professional nursing practice in the current diverse and complex healthcare environment requires leadership capabilities. Faculty are challenged to identify specific leadership capabilities needed by graduate nurses upon entry into professional practice and to develop models from which they can accurately and authentically assess their demonstration. This article presents the development and implementation of an innovative leadership outcome assessment model. The model was developed in collaboration with nurse practice leaders and uses nurse practice leaders as external assessors and a "typical day" in nursing practice format.

The classification of specialist student practice: results of an exploratory study

An exploratory study investigating the feasibility and acceptability of an assessment tool designed to allow practice educators(1)to classify Specialist Practitioner student practice, identifies issues of interest to all educators involved with practice assessment. Within 3 months of commencing education leading to Specialist Practitioner Awards, the spread of marks awarded for practice achievements was already consistent with final degree classification and within 6 months slightly higher than normal. By the end of the course, continued improvements in practice achievements resulted in 73% of practice marks being 70% and over. The implications for total degree classification are less catastrophic than they appear; even if this trend continues there will only be a slight increase in first class Honours degrees. Although the strategy for practice assessment includes practice educators and students working together to discuss and agree marks for practice achievements, in the study practice educators and students provided marks intentionally without discussion or consultation with each other. Two comparisons of these marks showed that many students overestimate or underestimate their practice achievements as perceived by practice educators. Continuous monitoring of how marks are determined will be a priority for the Specialist Practice team. In most cases, practice educators considered the marked assessment of practice to be a reasonable working proposition, though there were concerns about the timing of assessments and the applied terminology. The main conclusions are that some practice educators may award marks for effort, despite contradictory written comments, and that the ability of specialist students to self-assess remains an unknown quantity but a potential moderating influence. The role of the HEI will be to ensure essential preparation and ongoing support for practice educators to enable a tri-partite assessment process and to provide a robust strategy for internal and external moderation. The marked assessment of practice was implemented in September 2000; to date progress has been remarkably unproblematic with practice educators and students accepting the process with relative ease and much enthusiasm.

External examiners: quality assurance in nursing education

External examining is a system of quality assurance in nursing education that is quite foreign to most American nurses. The concept of an external examiner-a visiting assessor of high academic standing and possessed of integrity and objectivity-supports a notion of the universality of educational standards and justice for the individual student. Potential external examiners are appointed primarily through informal social and professional networks within educational institutions of the host country. Criteria for appointment, roles and functions of an examiner, and the four stages of the external examination process are discussed. Suggestions to facilitate each stage as well as implications for potential American external examiners are included. The manuscript concludes with insights from two American nurse educators about their experience as external examiners.

Classifying specialist student practice: debates and dilemmas

At present, the practice elements of the Specialist Community Practitioner Awards within the BSc (Hons) in the Community Health degree course at Manchester Metropolitan University do not directly contribute to degree classification. Student evaluation and external examiner concerns about the heavy assessment load motivated the course team to consider classifying practice at 20 Level III credits which would replace 20 theory credits. The process of developing a credible assessment tool for specialist practice was long and hard but the course team is now in a position to undertake an exploratory study of the assessment and classification of practice. This paper provides an overview of the discussion and debates that took place in the years before the study began. A future paper will provide detail of the study and will include practice educators, students and managers views on the structure, process and outcomes of marking specialist student practice in community settings.