Assessment of student nurses' clinical learning in Rwanda

Abstract

Assessment of clinical learning is imperative in order to ensure that those who become registered nurses are safe and competent practitioners. Literature however reveals that the measurement of clinical skills performance continues to pose a challenge for nurse educators. There is an ongoing debate around the best assessment method in clinical learning, as well as, validity and reliability in assessing clinical learning. Hence, this study aimed at exploring and describing current practices in assessment of clinical learning in a nursing diploma programme in Kigali Health Institute (KHI) in Rwanda. The study used a quantitative descriptive Exploratory design. Data were collected through questionnaires. Participants included nurse educators, students and external examiners and only 117 returned questionnaires. The results showed that the clinical assessment strategies commonly used in KHI included OSCEs, case presentations, direct observations and standardised patients. Although the findings revealed that there was no policy that guided clinical assessments, data showed that the clinical examination process entailed the planning, preparation, implementation and evaluation phases. Furthermore, there were some measures in place to ensure validity and reliability of assessments. A need for developing a policy on clinical learning assessment emerged as crucial, and the need to build the capacity of nurse educators and external examiners in the area of planning, conducting and evaluating clinical assessment. Furthermore, it emerged as crucial to align assessments with clinical learning outcomes and what is taught in clinical settings; revisit the number of OSCE stations used as that affected the validity and reliability of assessments; review assessment instruments; prepare standardised patients for their roles to ensure consistency in the examination process; revisit the examination process and address the issue of inadequate material resources on the examination day. Recommendations focused on building nurse educators' and external examiners' capacities, improved preparation of students for clinical learning assessment, and further research to explore certain aspects of clinical assessment in depth.