Measurung clinical competennce: problems and solutions
•Als PPTX, PDF herunterladen•
2 gefällt mir•140 views
Problems in the measurement of cliical competence in nursing education and practice
Empfohlen
Empfohlen
Weitere ähnliche Inhalte
Was ist angesagt?
Was ist angesagt? (20)
Ähnlich wie Measurung clinical competennce: problems and solutions
Ähnlich wie Measurung clinical competennce: problems and solutions (20)
Mehr von Roger Watson
Mehr von Roger Watson (20)
Kürzlich hochgeladen
Kürzlich hochgeladen (20)
Measurung clinical competennce: problems and solutions
- 1. Measuring clinical competence: Problems and solutions Roger Watson Faculty of Health Sciences University of Hull, UK
- 3. 23/08/2017 • Background • Issues • Measurement • Research
- 4. 23/08/2017 BACKGROUND A North American (USA) concept • An alternative to intelligence testing • Aimed at manual and not professional occupations
- 5. 23/08/2017 ISSUES • What is the definition of competence? • How does it relate to other similar concepts: – Capability? – Expertise? – Performance? • How is competence measured?
- 6. 23/08/2017
- 7. 23/08/2017 COMPETENCE IS NOT ‘VALUE NEUTRAL’ ‘…competence in practical matters must be preserved against the encroachment of the intellectuals’ (Eraut 1994) • ‘…competence may be preferred to excellence if it result(s) in quicker and cheaper service’ (Eraut 1994)
- 8. 23/08/2017 WHAT IS THE DEFINITION OF COMPETENCE? • There is no consistent definition of competence • Common words: – Level – Agreed – Standard – Performance – Competency – Ability – Capability
- 9. 23/08/2017 HOW DOES IT RELATE TO OTHER SIMILAR CONCEPTS?
- 10. 23/08/2017 COMPETENCE COMPETENCE AND RELATED CONCEPTS competency capability
- 17. 23/08/2017 MEASUREMENT • If we cannot define competence…how can we measure it? • If we can define it…what do we measure? • If we can measure it…how do we measure it?
- 18. 23/08/2017 PROBLEMS WITH MEASUREMENT • WHAT? • WHY? • WHERE? • WHEN? • WHO? • HOW?
- 19. 23/08/2017 PROBLEMS WITH MEASUREMENT • WHAT? – Performance – Knowledge – Skills – Attitudes
- 20. 23/08/2017 PROBLEMS WITH THE ‘WHAT’ OF MEASUREMENT • CONTENT – Authenticity – Directness Samuel Messick (1994) The Interplay of Evidence and Consequences in the Validation of Performance Assessments Educational Researcher 23, 13-23
- 21. 23/08/2017 PROBLEMS WITH MEASUREMENT • WHY? – …do we want to know that?* •*= knowledge, skills, attitude
- 22. 23/08/2017 PROBLEMS WITH MEASUREMENT • WHERE? – Classroom – Hospital – Both
- 23. 23/08/2017 PROBLEMS WITH THE ‘WHERE’ OF MEASUREMENT • Classroom – Not ‘real world’ • Hospital – Risk to patients • Both – Ideal but time-consuming
- 24. 23/08/2017 PROBLEMS WITH MEASUREMENT • WHEN? – …and how often? • At the start • In the middle • At the end…of placements; years, programmes, units?
- 25. 23/08/2017 PROBLEMS WITH THE ‘WHEN’ OF MEASUREMENT • Under-assessment • Over-assessment – ie ‘getting it right’
- 26. 23/08/2017 PROBLEMS WITH MEASUREMENT • WHO? – The student – The teacher – The clinician – The patient
- 27. 23/08/2017 PROBLEMS WITH THE ‘WHO’ OF MEASUREMENT • The student – Not objective (but students tend to be hard on themselves) • The teacher – Not familiar with the clinical area • The clinician – Socialisation processes at work • The patient – Find it hard to be honest
- 28. 23/08/2017 PROBLEMS WITH MEASUREMENT • HOW? – Self-assessment – Observation – Questionnaires/inventories – Qualitatively – Examination
- 29. 23/08/2017 PROBLEMS WITH THE ‘HOW’ OF MEASUREMENT • PSYCHOMETRICS – Reliability – Validity
- 30. 23/08/2017 RELIABILTY • Test-retest • Intra-rater • Inter-rater
- 31. 23/08/2017 VALIDITY • Content (including Face) • Criterion (Concurrent & Predictive) • Construct (Convergent/Divergent, Discriminant, Factorial)
- 32. 23/08/2017 ECOLOGICAL VALIDITY • Ecological Validity is the degree to which the behaviours observed and recorded in a study reflect the behaviours that actually occur in natural settings.
- 33. 23/08/2017 IN ANY CASE – WHAT ARE WE GOING TO DO WITH THE INFORMATION? Students rarely fail on the grounds of incompetence FACT!
- 34. 23/08/2017
- 35. 23/08/2017 A clear finding from this study is that no single method is appropriate for assessing clinical competence. A multimethod UK-wide strategy for clinical competence assessment for nursing and midwifery is needed if we are to be sure that assessment reveals whether or not students have achieved the complex repertoire of knowledge, skills and attitudes required for competent practice.
- 36. 23/08/2017
- 37. 23/08/2017 A lack of consistency in the training of student assessors in the clinical areas was identified. Some of these issues may be resolved with the development of a national instrument for competence assessment.
- 38. 23/08/2017
- 39. 23/08/2017 The conclusion is that a multimethod approach enhances validity and ensures comprehensive assessment of the complex repertoire of skills required of students in nursing.
- 40. 23/08/2017
- 41. 23/08/2017
- 42. 23/08/2017 Three categories of paper emerged: • Instrument development and testing (n=4) • Approaches to testing competence (n=7) • Assessment and related factors (n=12).
- 43. 23/08/2017
- 44. 23/08/2017 CONCLUSIONS ON COMPETENCE MEASUREMENT • Competence measurement is problematic • Competence measurement is controversial • Very few good quality studies • Competence inventories tend to be: – Long – Multidimensional
- 45. 23/08/2017 SOLUTIONS TO COMPETENCE MEASUREMENT • Derive professional NOT political competencies • Agree national/international standards • Develop psychometrically sound instruments • Conduct longitudinal studies of utility and efficacy
- 46. Capability
- 47. The concept of capability Capability can be observed when we see people with justified confidence in their ability to: • Take effective and appropriate action • Explain what they are about • Live and work effectively with others; and • Continue to learn from their experiences as individuals and in association with others, in a diverse and changing society. • Stephenson (1992 in Stephenson & Yorke 1998; p2)
- 48. Capability and competence ‘Capability includes but goes beyond the achievement of competence in present day situations to imagining the future and contributing to making it happen.’ Stephenson (1998; p3)
- 50. Unfamiliar Problems Familiar Problems Unfamiliar Contexts Familiar Context Y Z Competence Capability
- 52. 23/08/2017 52