目的:本研究旨在更好地理解和阐明有经验的临床促进者在评估从事临床实习的护生时通常使用的评估前判断过程。
背景:在澳大利亚的背景下,临床协调员是注册护士,主要是教育,监视器,支持和评估护理学生在临床实习中的小组,而无需承担患者负担。临床协调员的职责和范围在国际和机构环境中可能有所不同。然而,尽管存在这些差异,但本文的核心概念仍将是相关的,因为主持人对在安置期间对个别护理学生的表现做出预评估判断的信心的重要性已得到普遍认可。护理学生经常被评估他们提供的安全实践,以患者任务为导向的结果和专业行为。在正式评估之前清楚地阐明成绩判断对于确保学生的渐进式学习至关重要。文献报道,许多临床促进者对做出表现判断的艺术缺乏信心,并呼吁在护理专业学生的临床评估中进行有针对性的专业培训和支持。为了更好地理解和解决这个问题,临床促进者需要对个别护生在安置体验期间的评估前表现判断有共同的理解.
方法:采用定性案例研究,通过半结构化访谈收集的数据。15名澳大利亚临床促进者参加了会议,每个人都有超过六个月的经验。
方法:通过解释-建构主义范式分析访谈笔录。主题分析揭示了主题,然后通过应用认知连续理论进行演绎描述。
结果:数据综合过程中出现了六种评估前判断模式:1)识别模式,2)承认不确定性,3)了解关键参与者,4)验证或反驳信息,5)基准性能和6)上下文信息。通过认知连续理论的演绎应用验证了每种模式。
结论:了解有经验的临床主持人如何做出评估前的绩效判断,有可能增加对绩效判断决策的信心。反过来,对判断的信心将增加临床促进者给护生提供可以解释和证明的反馈的能力。预评估判断框架还提供了一个初步模型,用于向护理以外的学科的临床教育工作者传授准确的表现判断的艺术。
OBJECTIVE: This study aims to better understand and articulate the pre-assessment judgement processes commonly used by experienced clinical facilitators when assessing nursing students undertaking clinical placement.
BACKGROUND: In the Australian context, clinical facilitators are registered nurses who primarily educate, monitor, support and assess groups of nursing students on clinical placements without carrying a patient load. The duties and scope of clinical facilitators may differ across international and institutional contexts. However, the core concepts of this paper will be relevant despite these differences as the importance of facilitators\' confidence in making pre-assessment judgements of individual nursing student performance while on placement is universally acknowledged. Nursing students are often assessed on their provision of safe practice, patient task-orientated outcomes and professional behaviour. Clearly articulating performance judgements prior to formal assessment is vital to ensure progressive learning of students. Literature
reports that many clinical facilitators lack confidence in the art of making performance judgements and call for targeted professional training and support in the clinical assessment of nursing students. To better understand and address this problem, clinical facilitators need a shared understanding of how individual nursing students\' pre-assessment performance judgements are reached during placement experiences.
METHODS: A qualitative
case study was used, with data collected via semi-structured interviews. Fifteen Australian clinical facilitators participated, each with over six months of experience.
METHODS: Interview transcripts were analysed through an interpretive-constructivist paradigm. Thematic analysis revealed themes that were then deductively described through the application of the Cognitive Continuum Theory.
RESULTS: Six modes of pre-assessment judgement emerged from the data synthesis process: 1) Recognising patterns, 2) Acknowledging uncertainty, 3) Understanding key players, 4) Verifying or refuting the information, 5) Benchmarking performance and 6) Contextualising information. Each mode is validated through the deductive application of the Cognitive Continuum theory.
CONCLUSIONS: Understanding how experienced clinical facilitators make pre-assessment performance judgements has the potential to increase confidence in performance judgement decisions. In turn, confidence in judgements will increase clinical facilitator\'s capacity to give nursing students feedback that can be explained and justified. The pre-assessment judgement framework also provides a preliminary model for teaching the art of reaching accurate performance judgements to clinical educators in disciplines beyond nursing.