Clinical Evaluations Using QSEN KSAs: Developing Tools and Strategies

The Catholic University of AmericaCindy Grandjean, Mary Paterson

And Terry Walsh

June, 2008QSEN Annual Meeting

Charlotte, NC

• Challenges with Prior Evaluation Tool• Difficult grading algorithm.• Inconsistent grading implementation of clinical

behaviors by part time clinical faculty.

• Major Change in Curriculum.• Expanding and growing undergraduate

enrollment.• Change in Grading Schema.

The Catholic University of AmericaSchool of Nursing

OLD GRADING SCHEME

A 96-100%A- 95%-92%B+ 91%-89%B 88-86%B- 85-83%C+ 82%-79%C 77%-74%C- 73%- 70%D 69%- 60%F 59% or Below

NEW GRADING SCHEME

A 94%-100%A- 90%-93%B+ 89%-86%B 85%-83%B- 82%-80%C+ 79%-76%C 75%-73% C- 72%-70D 69%-60%F 59% or Below

In both schemes studentsHad to achieve at least aC to pass the clinical course

The Catholic University of AmericaSchool of Nursing

OLD GRADING SCHEME

A A- B+BB-C+CC-DF

NEW GRADING SCHEME

PASS FAIL

Matriculated according to class level

Matriculated according to Key for each course

The Catholic University of AmericaSchool of Nursing

OLD GRADING SCHEME

Average of

•Didactic Grade (Ex., A, A-, B+, etc.) AND

•Clinical Evaluation Grade (Ex., A, A-, B+, etc.)

NEW GRADING SCHEME

•Didactic Grade (Ex., A, A-, B+, etc.) IF AND ONLY IF

•Clinical Evaluation Grade is PASS

•If Clinical Evaluation is a FAIL, student does not progress and FAILS the course

The Catholic University of AmericaSchool of Nursing

•Major outline of criteria tool needed to meet determined by BCC (Baccalaureate Curriculum Committee)•Sub-committee developed to create a draft document•Review of AACN’s Core competencies•Review of QSEN’s KSA’s•Examination of School’s Terminal objectives and mission•Draft document approved by Baccalaureate Curriculum Committee and in undergoing pilot testing this summer

The Catholic University of AmericaSchool of Nursing

The Catholic University of AmericaSchool of Nursing

If you can’t measure it – you can’t manage itIf you can’t measure it – you can’t manage it

DonabedianDonabedian

S = SatisfactoryNI = Needs ImprovementU = Unsatisfactory

•Each student will fill out an evaluation at (1) midterm (2) final.Each faculty member will fill out an evaluation at (1) midterm (2) final.•Each row item (boxes) must be checked at (1) midterm (2) final. •The Clinical Score will be completed by the Clinical Faculty by placing a “ √ “ or a “ x “ in the appropriate box for each student.•The Clinical Score will be completed by the Student by placing a “ √ “ or a “ x “ in the appropriate box for each student.•The score for Clinical Evaluation will be either “Passing” or “Failing”.•A passing grade will only be assigned if all the items are checked “S” at the time of the final evaluation.

The Catholic University of AmericaSchool of Nursing

•Each core competency (as outlined in BOLD on the tool and seen below) will have a template or key, which specifies individual guidelines and examples for each.

• Provides Patient-Centered Care• Exhibits Teamwork and Collaboration• Incorporates Evidence-Based Practice• Understands & Applies Quality Improvement Methods• Promotes Safety• Understands & Utilizes Informatics

**The keys are based upon level of matriculation in each clinical course in the following specialties: Medical Surgical, Psychiatric, Obstetric and Community Health Nursing. Developmental goals within each competency will be established by literature review and faculty experts

The Catholic University of AmericaSchool of Nursing

360 Senior evaluation that would include staff nurse preceptors, patient opinion, clinical faculty opinion and student review. Intended for final clinical evaluation at the end of senior year.

Validity and reliability assessment of core competency key will include expert review, score-rescore assessment, and efficiency evaluation.

Student rating expectation management to assure clear understanding of pass/fail criteria.

Use of clinical evaluation in student portfolios.

The Catholic University of AmericaSchool of Nursing

•Meet with faculty & students for input on tool post summer clinical session, revise tool and prepare for full pilot test in the fall.

•Define procedure/criteria for assessing validity and reliability of tool post pilot test

•Outline the evaluation protocol to be used and orient all faculty and students to the new tool and protocol

The Catholic University of AmericaSchool of Nursing