Some issues in the assessment of clinical practice: a review of the literature

The assessment of students of nursing in clinical practice is acknowledged as a long-standing and difficult problem, and the validity and reliability of tools used to assess clinical practice are difficult to establish.

Abstract

This paper focuses on some issues in the assessment of clinical practice of particular interest to the author. The assessment of students of nursing in clinical practice is acknowledged as a long-standing and difficult problem. There is little consensus as to what is meant by the term competence when applied to clinical nursing practice, making the assessment of clinical practice a mainly subjective process. The English National Board (1989) has distinguished the term mentor as meaning counsellor and guide, nevertheless the roles of mentor and assessor are frequently confused. It is suggested that nurses are equally accountable for the accurate assessment of student nurses' clinical skills as they are for their own practice. The validity and reliability of tools used to assess clinical practice are difficult to establish, making objective assessment complex at best, and impossible at worst. The assessment of the reflective process has been suggested as one way out of the dilemma, but the ability to think and to write does not necessarily translate into competent clinical practice.