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Understanding the clinical evaluation practices of a clinical nurse teacher : a critical descriptive-exploratory case study Mahara, Mary Star

Abstract

The importance of clinical evaluation is well established. However, many facets of clinical evaluation require further investigation including how clinical nurse teachers (CNTs) actually evaluate students in clinical courses. The purpose of this research was to inquire into the clinical evaluation practices of a CNT in a manner that captured the complexity of these practices, promoted her understanding of her practices, and contributed to a general understanding of clinical evaluation in nursing education. A critical descriptive-exploratory case study was selected as the research method because of its potential to achieve all three purposes. Data were collected from seven tape recordings using a modified think-aloud technique, nine semi-structured interviews, examination of the participant's weekly anecdotal (instructor) notes, five students' final evaluation documents, and a concept map of the participant's evaluative practices and influencing variables. Data collection and analysis occurred concurrently in a recursive and cyclical manner. Themes, issues and questions that arose from the preliminary analysis of each week's set of data were compared to units of data from previous tapes and interviews and were discussed and clarified with the participant each week. Understandings and questions from each week's interview were then used to guide the next data collection set. At the end of the data collection period the data were analyzed further and the findings were discussed and validated with the participant. Clinical evaluation emerged as a complex and dynamic process that was embedded in the teaching-learning process. The participant, J, utilized a number of practices for collecting data and determining its meaning with respect to the student's level of performance and the teaching and evaluating strategies that should follow. The data indicated that J attempted to be accurate, objective, fair, comprehensive, and caring in her evaluative decision making, particularly when an evaluative decision could result in the student failing the course. J had made many changes to her evaluative practices over her years as a CNT. Her greatest gains were in developing awareness of the impact of her practices on the student's performance and in her ability to create an educative environment in the clinical area where evaluation was considered an important part of the student's clinical learning experience. J's data collection and evaluative decision making practices were influenced by her ability to find opportunities to sample student practice, her skill at data collection, the amount of time she had with each student, the nature of her relationship with the student, and whether the intent of her thinking was teaching or evaluating. The number of clinical days she had with the students turned out to be a major determinant of her ability to compile an accurate and comprehensive picture of the students' practice. What J chose to focus on in evaluation was influenced by her own way of practicing nursing, how nursing was practiced on the unit, the expectations of the workplace/employers and the licensing body, and the ideal view of nursing practice envisioned in the curriculum. Finally, the findings raised several questions about the evaluative practices of CNTs which have implications for both nursing education and further nursing research.

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