The assessment of practical skills in student nurses.

RATIONALE: During the last decade assessment of clinicalskills in student nurses preparing for state registration has undergone a number of developments. According to contemporary literature, written examinations, which represent one feature of assessment for state registration, often bear little relationship to the level of nursing skills demonstrated by a student in the clinical setting. Having observed contemporary methods of clinical assessment, the researcher here explores the theoretical and practical considerations underlying these methods; their reliability and validity; and the related question of what could constitute useful and appropriate instruments for assessment of clinical nursing skills.NATURE, SCOPE AND METHOD: Two methods of clinical assess-ment in general use were explored, employing guided interviews with a sample of senior nursing staff regularly involved in clinical assessment (N = 44). This was a sample of ward sisters located in four centres: Centre A, an est-ablished teaching hospital (N = 14.); Centre B, a busy district general hospital (N = 8); Centre C, a new postgraduate medical school hospital (N = 12); and Centre D, a small suburban general hospital (N = 10). Following a review of the literature, a guided interview schedule was developed by means of preliminary unstructured discussion with assessors in order to establish general categories; followed by a small pilot study. Interview data were stored on audiotape and comparisons made between responses from assessors in the four centres. The researcher wished to collect accurate information in respect of specific issues involved in the current procedures. Interviews were wide-ranging, covering numerous aspects of assessment as these affect student, assessor and patient; and the instruments currently used. Numerical data is supported by anecdotal material illustrative of typical responses. Additionally to the interviews, a retrospective analysis of specimen assessments carried out for a specific group of third-year students was undertaken in order to. obtain data on reliability and validity of such assessments.FINDINGS: These illustrate a variety of strengths andweaknesses in current assessment procedures as perceived by senior clinical nurses: and serve to emphasise issuesrequiring further study. Of greatest interest are implications for preparation, training and continued development of clinical assessors. Respondents viewed both current assessment systems critically; and a specimen analysis illustrated the shortcomings of progress assessments. Inferences were drawn from the data regarding potential future ways of improving organisational, assessmental and educational aspects of clinical nurse assessment.