Assessing clinical reasoning competency in enrolled nursing students: Development and validation of a novel clinical competency assessment tool

Lai Ching Christee LEUNG

Research output: ThesisDoctoral Theses

Abstract

Background: As the rapid growth of the diversity and complexity of clinical situations in Hong Kong, nurses always encounter different clinical situations of uncertainty in daily practice that need to make timely decisions and implement immediate nursing interventions, therefore, clinical reasoning competency is a crucial capability that the nurses are required to have; however, there are lack of assessment tools designed for measuring the clinical reasoning competency of nursing students especially those who are in transition to the qualified nurses; thus, construction of a clinical reasoning competency assessment tool (CRCAT) is necessary.

Aim: To establish a reliable and valid clinical assessment tool, named “Clinical Reasoning Competency Assessment Tool (CRCAT)”, to examine the clinical reasoning competency of the Enrolled Nursing students.

Design: A cross-sectional design

Participants: Forty-one Enrolled Nursing students from first year class and Forty-one from final year class at the school of general nursing training in Hong Kong and fifteen clinical nurses who are the clinical nursing instructors of the Enrolled Nursing students. Ninety-seven participants in total.

Methods: This study has two phases. Phase one is the development of clinical reasoning competency assessment tool (CRCAT). Phase two is the establishment of validity and reliability of CRCAT. All the participants including the Enrolled Nursing students and the clinical nursing instructors completed the CRCAT and the problem solving inventory (PSI) within the allowed time. The Enrolled Nursing students in first year class repeated the CRCAT two weeks after the first attempt.

Results: The results show that the clinical reasoning competency assessment tool (CRCAT) has good model-data fit with high intra-class correlation coefficient at 0.829, the person reliability with Cronbach alpha coefficient is acceptable at 0.64. ANOVA shows a significant difference in clinical reasoning competency among the three groups (p < 0.05). A significant difference (p = 0.01) in clinical reasoning competency found between the two groups of Enrolled Nursing students.

Conclusion: The clinical reasoning competency assessment tool (CRCAT) can be used as a clinical assessment tool to assess the clinical reasoning competency for the Enrolled Nursing students. Further study using a larger sample size with extended scope of sample subjects to improve the representative and generalizability of the CRCAT is necessary. All rights reserved.
Original languageEnglish
Publication statusPublished - 2020

Keywords

  • Thesis (Ed.D.)--The Education University of Hong Kong, 2020.

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