Using a scoring rubric to make practice-based assessment of pre-registration nursing students fit for purpose: A mixed methods study

Background
Globally, across all professions, assessing clinical practice has challenged educators for decades. The literature suggests that practice-based assessments are not fit for purpose. Problems relate to subjectivity, inaccuracy, difficulties in understanding the language used in competency statements and distinguishing different levels of competence. In nursing, threats to public safety have been identified when underperforming students enter the nursing register.
Aim
To make practice-based assessment of pre-registration nursing students fit for purpose.
Method
The critical pragmatist epistemology adopted in this study guided a solutions-focused, two-phase mixed method study. The theoretical framework comprised the concepts of assessment for learning and authentic assessment.
In Phase one, 100 stakeholders involved in pre-registration nurse education were invited to participate in a two-round Delphi study. In round one, participants (n=48) provided free-text interpretations of three level descriptors for the professional attitude, behaviour and responsibility competency statements in the Pan London Practice Assessment Document. Content analysis was used to develop a draft scoring rubric. In round two, participants (n=51) scored their agreement to the statements in the draft rubric using a five-point Likert scale. A clear stakeholders’ consensus (ranging from 86% to 100%) was reached in all categories of the rubric.
In Phase two, the consensus-based scoring rubric was evaluated regarding its effectiveness in enhancing practice-based assessments of student nurses’ practice performance. Paired mentors and final year nursing students were recruited (n=51) to use the rubric during a clinical placement. Two, specifically-designed online questionnaires collected quantitative and qualitative data from individual mentors and students. Descriptive statistics were used for quantitative data. Content analysis was used to analyse open-ended questions.
Results
Completed questionnaires were submitted by 44 nursing students and 39 practice mentors. Merged quantitative and qualitative results revealed that the consensus-based scoring rubric improved mentors’ and students’ understanding of the language and levels of competency statements, enhanced self-assessment and feedback provision, including enhanced mentor-student mutual understanding and dialogue. Intersubjectivity emerged as an original perspective to further understand practice-based assessment.
Conclusion
The consensus-based scoring rubric made practice-based assessment more fit for purpose.
Recommendations
All disciplines should consider adopting consensus-based scoring rubrics to make practice-based assessments fit for purpose. The psychometric properties of scoring rubrics and their usefulness in various contexts should be researched.