Expectations and realities : a critical analysis of the assessment of nursing practice

Payne, Rachel Ann (1999) Expectations and realities : a critical analysis of the assessment of nursing practice. University of Southampton, Doctoral Thesis.

Record type: Thesis (Doctoral)

Abstract

This thesis is a critical evaluation of the ways in which the practice of student nurses is assessed in clinical settings. This subject merits study since most practice schemes are considered to be poorly designed, ineffectively used, and in some case do result in appropriate decision making.

This critical evaluation has been made by comparing the expectations held by one School of Nursing about the conduct of its practice assessment with the ways in which it is conducted and experiences by the assessors and students in clinical settings.

This thesis is offered as a contribution to existing knowledge about practice assessment, and provides a number of original suggestions about how current methods can be improved. Its findings are presented as a series of 'mosaic' portraits that depict what happens to students in practice settings under the aegis of assessment; and demonstrate that in many cases assessments were not conducted in the manner envisaged, nor were the accompanying records adequate to support the decisions made.

Recommendations are made about how to develop and implement a practice assessment scheme that is practicable to conduct, and has demonstrable relevance to the clinical settings in which nurses work. Questions have also been raised about the use of different forms of assessment evidence, for example, that evidence which is not collected from direct observation of the students practice has a limited value. Hence the importance of students' learning and developing their practice under the direct supervision of suitable assessors is a key recommendation. Suggestions are also made about how assessors should be prepared and supported for their role, with particular attention being given the improvement of assessment records.

The study is intended also to be of value to other Nursing Schools, and to any practice oriented occupational group in which teaching, supervision and assessment 'from a distance' forms a significant part of the educational programme.

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