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Nursing Students’ Experiences on Clinical Competency Assessment in Ghana

Oboshie Anim-Boamah orcid  -  Department of Nursing Education, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, South Africa
*Christmal Dela Christmals orcid  -  Department of Nursing Education, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, South Africa
Susan Jennifer Armstrong  -  Department of Nursing Education, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, South Africa
Open Access Copyright (c) 2021 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: More countries are establishing licensing examination systems for nursing education, including clinical competency assessment. In Ghana, clinical competency assessment forms part of the nursing licensing examination and is perceived as the benchmark for nursing licensing examination in the sub-region. The nationalised assessment system is established with some ad hoc changes over the last decade which requires continual evaluation. It is essential to find out how students experience this assessment system. 

Purpose: This study aimed to explore nursing students’ experiences of the clinical competency assessment in Ghana. 

Methods: An exploratory descriptive qualitative design was used in this study. Eight focus group discussions (FGDs) were conducted with 68 final year students purposively selected from eight nursing education programs. The FGDs lasted between 90 to 120 minutes. Content analysis was used to analyze the data.

Results: Although the pre-examination conference between students and examiners helped lessen students’ anxiety, limited resources, incongruence in teaching, practice and assessment, inherent biases due to the unstandardised assessment system, and a financial burden compromised the quality of the assessment.

Conclusion:Clinical competency assessment is central to nursing licensing examinations; hence the ability of the system to discriminate competent and incompetent nurses otherwise cannot be overemphasised. Standardisation, training of the examiners and continuous evaluation of the assessment system are imperative for quality improvement in clinical competency assessment.

 

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Keywords: Clinical competency assessment; Ghana; licensing examination; nursing education
Funding: Department of Nursing education, University of Witwatersrand,

Article Metrics:

  1. Amilia, R., & Nurmalia, D. (2020). A comparison of patient safety competencies between clinical and classroom settings among nursing students. Nurse Media Journal of Nursing, 10(1), 66–75. https://doi.org/10.14710/nmjn.v10i1.25231
  2. Bifftu, B. B., Dachew, B. A., Tadesse Tiruneh, B., Mekonnen Kelkay, M., & Bayu, N. H. (2016). Perceived clinical competence among undergraduate nursing students in the University of Gondar and Bahir Dar University, Northwest Ethiopia: A cross-sectional institution based study. Advances in Nursing, 2016, 1–7. https://doi.org/10.1155/2016/9294673
  3. Bradshaw, C., O’Connor, M., Egan, G., Tierney, K., Butler, M. P., Fahy, A., Tuohy, D., Cassidy, I., Quillinan, B., & McNamara, M. C. (2012). Nursing students’ views of clinical competence assessment. British Journal of Nursing, 21(15), 923–927. https://doi.org/10.12968/BJON.2012.21.15.923
  4. Burke, E., Kelly, M., Byrne, E., Ui Chiardha, T., Mc Nicholas, M., & Montgomery, A. (2016). Preceptors’ experiences of using a competence assessment tool to assess undergraduate nursing students. Nurse Education in Practice, 17, 8–14. https://www.sciencedirect.com/science/article/pii/S1471595316000056?via%3Dihub
  5. Christmals, C. D., & Gross, J. J. (2019). An analysis of the introduction of digital nursing licensing examination in Ghana. International Journal of Caring Sciences, 12(3), 1892–1897
  6. Clarke, M. (2011). Framework for building an effective student assessment system. https://files.eric.ed.gov/fulltext/ED553178.pdf
  7. Committee on Patient Safety and Quality Improvement. (2015). Clinical guidelines and standardization of practice to improve outcomes. http://www.rand.org/content/
  8. Council on Licensure Enforcement and Regulation. (2020). CLEAR - CLEAR exam review. council on licensure, enforcement and regulation (CLEAR). https://www.clearhq.org/cer
  9. Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches (4th ed.). Sage
  10. Daly, M., Salamonson, Y., Glew, P. J., & Everett, B. (2017). Hawks and doves: The influence of nurse assessor stringency and leniency on pass grades in clinical skills assessments. Collegian, 24(5), 449–454. https://doi.org/10.1016/j.colegn.2016.09.009
  11. Fahy, A., Tuohy, D., McNamara, M., Butler, M., Cassidy, I., & Bradshaw, C. (2011). Evaluating clinical competence assessment. Nursing Standard (Royal College of Nursing (Great Britain) : 1987), 25(50), 42–48. https://doi.org/10.7748/ns2011.08.25.50.42.c8656
  12. Farahani, M. A., Emamzadeh Ghasemi, H. S., Nikpeyma, N., Fereidooni, Z., & Rasoli, M. (2015). Development and psychometric evaluation of the nursing instructors’ clinical teaching performance inventory. Global Journal of Health Science, 7(3), 30–36. https://doi.org/10.5539/gjhs.v7n3p30
  13. Gorham, J., Woo, A., & Sutherland, K. (2012). What’s in a score? Principles and properties of scoring. CLEAR Exam Review, 23(2), 15–17
  14. Gulikers, J. T. M., Bastiaens, T. J., & Kirschner, P. A. (2004). A five dimensional framework for authentic assessmnt. Educational Technology Research and Development, 52(3), 67–86
  15. Gurková, E., Žiaková, K., Zanovitová, M., Cibríkova, S., & Hudáková, A. (2018). Assessment of nursing student performance in clinical settings – Usefulness of rating scales for summative evaluation. Central European Journal of Nursing and Midwifery, 9(1), 791–798. https://doi.org/10.15452/cejnm.2018.09.0006
  16. Hou, J., Chen, S., Sabharwal, S., Fan, V., Yan, M., & Wang, W. (2019). Comparison of RN licensure examination: China and the United States. International Journal of Nursing Sciences, 6(1), 111–116. https://doi.org/10.1016/j.ijnss.2018.11.002
  17. Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288. https://doi.org/10.1177/1049732305276687
  18. Hudges, S. J., & Quinn, F. M. (2013). Quinn’s principles and practice of nurse education (6th ed.). Cengage learning EMEA
  19. Hughes, L. J., Mitchell, M., & Johnston, A. N. B. (2016). ‘Failure to fail’ in nursing – A catch phrase or a real issue? A systematic integrative literature review. Nurse Education in Practice, 20, 54–63. https://doi.org/10.1016/j.nepr.2016.06.009
  20. Imanipour, M., & Jalili, M. (2016). Development of a comprehensive clinical performance assessment system for nursing students: A programmatic approach. Japan Journal of Nursing Science, 13, 46–54. https://doi.org/10.1111/jjns.12085
  21. Immonen, K., Oikarainen, A., Tomietto, M., Kääriäinen, M., Tuomikoski, A. M., Kaučič, B. M., Filej, B., Riklikiene, O., Flores Vizcaya-Moreno, M., Perez-Cañaveras, R. M., De Raeve, P., & Mikkonen, K. (2019). Assessment of nursing students’ competence in clinical practice: A systematic review of reviews. International Journal of Nursing Studies, 100, 103414. https://doi.org/10.1016/j.ijnurstu.2019.103414
  22. Kim, K. K., Kjervik, D. K., & Foster, B. (2014). Quality indicators for initial licensure and discipline in nursing laws in South Korea and North Carolina. International Nursing Review, 61(1), 35–43. https://doi.org/10.1111/inr.12069
  23. Lai, C. Y. (2016). Training nursing students’ communication skills with online video peer assessment. Computers and Education, 97, 21–30. https://doi.org/10.1016/j.compedu.2016.02.017
  24. Levett-Jones, T., Gersbach, J., Arthur, C., & Roche, J. (2011). Implementing a clinical competency assessment model that promotes critical reflection and ensures nursing graduates’ readiness for professional practice. Nurse Education in Practice, 11(1), 64–69. https://doi.org/10.1016/J.NEPR.2010.07.004
  25. Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Sage
  26. Márquez-Hernández, V. V., Gutiérrez-Puertas, L., Granados-Gámez, G., Rodríguez-García, M. C., Gutiérrez-Puertas, V., & Aguilera-Manrique, G. (2019). Development of a web-based tool to evaluate competences of nursing students through the assessment of their clinical skills. Nurse Education Today, 73, 1–6. https://doi.org/10.1016/j.nedt.2018.11.010
  27. McGibbon, E., Mulaudzi, F. M., Didham, P., Barton, S., & Sochan, A. (2014). Toward decolonizing nursing: The colonization of nursing and strategies for increasing the counter-narrative. Nursing Inquiry, 21(3), 179–191. https://doi.org/10.1111/nin.12042
  28. McGillis Hall, L., Lalonde, M., Kashin, J., Yoo, C., & Moran, J. (2018). Changing nurse licensing examinations: Media analysis and implications of the Canadian experience. International Nursing Review, 65(1), 13–23. https://doi.org/10.1111/inr.12367
  29. Meier, K., Parker, P., & Freeth, D. (2014). Mechanisms that support the assessment of interpersonal skills: A realistic evaluation of the interpersonal skills profile of pre-registration nursing students. The Journal of Practice Teaching and Learning, 12(3), 6–24. https://doi.org/10.1921/7701240205
  30. Millett, C. M. (2016). Dollars and sense: The policy implications of financing an accelerated nursing degree. Journal of Professional Nursing, 32(5), S14–S23. https://doi.org/10.1016/j.profnurs.2016.02.009
  31. National Council of State Boards of Nursing. (2020). NCLEX Research Opportunities. National Council of State Boards of Nursing. https://www.ncsbn.org/nclex-research-opportunities.htm
  32. Nursing and Midwifery Council of Ghana. (1971). Practice of nurses LI 683. Nursing and Midwifery Council of Ghana
  33. Nursing and Midwifery Council of Ghana. (2016). Training institution and clinical/field practice schedule for registered general nursing (RGN) students. Nursing and Midwifery Council of Ghana
  34. Norcini, J., Anderson, B., Bollela, V., Burch, V., Costa, M. J., Duvivier, R., Galbraith, R., Hays, R., Kent, A., Perrott, V., & Roberts, T. (2011). Criteria for good assessment: Consensus statement and recommendations from the Ottawa 2010 conference. Medical Teacher, 33(3), 206–214. https://doi.org/10.3109/0142159X.2011.551559
  35. Numminen, O., Laine, T., Isoaho, H., Hupli, M., Leino-Kilpi, H., & Meretoja, R. (2014). Do educational outcomes correspond with the requirements of nursing practice: educators’ and managers’ assessments of novice nurses’ professional competence. Scandinavian Journal of Caring Sciences, 28(4), 812–821. https://doi.org/10.1111/scs.12115
  36. Nurakhir, A., Palupi, F. N., Langeveld, C., & Nurmalia, D. (2020). Students’ Views of classroom debates as a strategy to enhance critical thinking and oral communication skills. Nurse Media Journal of Nursing, 10(2), 130–145. https://doi.org/10.14710/nmjn.v10i2.29864
  37. Nyoni, C. N., & Botma, Y. (2017). Aligning summative clinical examination with competence-based curriculum: Midwifery educators experiences in Lesotho. International Journal of Africa Nursing Sciences, 7, 11–17. https://doi.org/10.1016/j.ijans.2017.05.003
  38. Oducado, R. M. F., Sotelo, M., Ramirez, L. M., Habaña, M., & Belo-Delariarte, R. G. (2020). English language proficiency and its relationship with academic performance and the nurse licensure examination. Nurse Media Journal of Nursing, 10(1), 46–56. https://doi.org/10.14710/nmjn.v10i1.28564
  39. Oermann, M. H., Kardong-Edgren, S., & Rizzolo, M. A. (2016). Towards an evidence-based methodology for high-stakes evaluation of nursing students’ clinical performance using simulation. Teaching and Learning in Nursing, 11(4), 133–137. https://doi.org/10.1016/j.teln.2016.04.001
  40. Park, I. S., Suh, Y. O., Park, H. S., Ahn, S. Y., Kang, S. Y., & Kim, K. S. (2016). Relevance of the test content of the Korean nursing licensing examination to nursing job. Journal of Educational Evaluation for Health Professions, 13, 23. https://doi.org/10.3352/jeehp.2016.13.23
  41. Shin, S. J., Kim, Y. K., Suh, S. R., Jung, D. Y., Kim, Y., & Yim, M. K. (2017). Perception survey on the introduction of clinical performance examination as part of the national nursing licensing examination in Korea. Journal of Educational Evaluation for Health Professions, 14, 26. https://doi.org/10.3352/jeehp.2017.14.26
  42. Silva, K. L. da, & Cabral, I. E. (2018). National licensure exam for Brazilian nurses: Why and for whom? Revista Brasileira de Enfermagem, 71(suppl 4), 1692–1699. https://doi.org/10.1590/0034-7167-2017-0929
  43. Solheim, E., Plathe, H. S., & Eide, H. (2017). Nursing students’ evaluation of a new feedback and reflection tool for use in high-fidelity simulation – Formative assessment of clinical skills. A descriptive quantitative research design. Nurse Education in Practice, 27, 114–120. https://doi.org/10.1016/j.nepr.2017.08.021
  44. Tsai, T. H., & Kramer, G. A. (2014). Content validity of the national board dental hygiene examination. Evaluation and the Health Professions, 37(4), 503–523. https://doi.org/10.1177/0163278713501073
  45. Wilmot, E., Kumfo, J., Danso-Mensah, D., Antwi-Danso, S., Darko, V., & Nyante, F. (2013). An investigation into the factors that contribute to nurse/midwife trainees’ poor performance in the final licensing examination in Ghana. Nursing and Midwifery Council of Ghana
  46. Woo, A., & Dragan, M. (2012). Ensuring validity of NCLEX® with differential item functioning analysis. Journal of Nursing Regulation, 2(4), 29–31. https://doi.org/10.1016/S2155-8256(15)30252-0
  47. Woo, A., Wendt, A., & Liu, W. (2009). NCLEX pass rates: An investigation into the effect of lag time and retake attempts. JONA’s Healthcare Law, Ethics, and Regulation, 11(1), 23–26. https://doi.org/10.1097/NHL.0b013e31819a78ce
  48. World Health Organization. (2020). State of the world’s nursing 2020: Investing in education, jobs and leadership. https://www.who.int/publications-detail/nursing-report-2020
  49. Zasadny, M. F., & Bull, R. M. (2015). Assessing competence in undergraduate nursing students: The Amalgamated students assessment in practice model. Nurse Education in Practice, 15(2), 126–133. https://doi.org/10.1016/j.nepr.2015.01.003

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