Assessment of nursing students' competence in clinical practice: A systematic review of reviews

Background: The assessment of nursing students' nursing competence is a matter of concern worldwide and the complexity of assessing students' clinical competence has challenged educators for decades. It has been recognized that there is inconsistency among assessment methods and tools between countries and institutions.

Objective: To identify the current best evidence on the assessment of nursing students' competence in clinical practice.

Design: Systematic review of reviews.

Data sources: The electronic databases CINAHL, PubMed, Eric, Medic and the JBI Database of Systematic Reviews and Implementation Reports were searched in autumn 2018.

Review methods: Two researchers independently assessed the eligibility of the studies by title, abstract and full-text, and then assessed the methodological quality of the included studies. Analysis of study findings was conducted using the thematic synthesis approach.

Results: Six reviews were included following critical appraisal. Assessment tools used to assess students' nursing competence commonly focus on the domains of professional attributes, ethical practices, communication and interpersonal relationships, nursing processes, critical thinking and reason. Clinical learning environments and mentoring provide important support structures and guide the learning of students. The availability of assessment tools and criteria along with providing individualized feedback and time for reflection strengthen the objectivity and reliability of assessment.

Conclusions: There continues to be a need to develop consistent and systematic approaches in assessment, and to use reliable and valid instruments in assessment. Mentors find assessment of students' competence to be particularly challenging and emphasize the importance of clear assessment criteria, support from nurse educators and further education on assessment. Further development in feedback practices and providing students with opportunities for reflection are important in supporting the continuous learning process of students.

Keywords: Assessment; Clinical practice; Evaluation; Nursing student; Systematic review.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Similar articles

Tuomikoski AM, Ruotsalainen H, Mikkonen K, Kääriäinen M. Tuomikoski AM, et al. Nurse Educ Today. 2020 Feb;85:104258. doi: 10.1016/j.nedt.2019.104258. Epub 2019 Nov 6. Nurse Educ Today. 2020. PMID: 31830638

MacKinnon K, Marcellus L, Rivers J, Gordon C, Ryan M, Butcher D. MacKinnon K, et al. JBI Database System Rev Implement Rep. 2015 Jan;13(1):14-26. doi: 10.11124/jbisrir-2015-1694. JBI Database System Rev Implement Rep. 2015. PMID: 26447004

Pramila-Savukoski S, Juntunen J, Tuomikoski AM, Kääriäinen M, Tomietto M, Kaučič BM, Filej B, Riklikiene O, Vizcaya-Moreno MF, Perez-Cañaveras RM, De Raeve P, Mikkonen K. Pramila-Savukoski S, et al. J Clin Nurs. 2020 Mar;29(5-6):684-705. doi: 10.1111/jocn.15127. Epub 2019 Dec 23. J Clin Nurs. 2020. PMID: 31794105

Øvrebø LJ, Dyrstad DN, Hansen BS. Øvrebø LJ, et al. Nurse Educ Pract. 2022 Jan;58:103258. doi: 10.1016/j.nepr.2021.103258. Epub 2021 Nov 18. Nurse Educ Pract. 2022. PMID: 34847502 Review.

Rieger KL, Chernomas WM, McMillan DE, Morin FL, Demczuk L. Rieger KL, et al. JBI Database System Rev Implement Rep. 2016 Nov;14(11):139-239. doi: 10.11124/JBISRIR-2016-003188. JBI Database System Rev Implement Rep. 2016. PMID: 27941518 Review.

Cited by

Tomas N, Italo M, Eva B, Veronica L. Tomas N, et al. BMC Med Educ. 2024 Aug 7;24(1):852. doi: 10.1186/s12909-024-05771-x. BMC Med Educ. 2024. PMID: 39112978 Free PMC article.

Alkhelaiwi WA, Traynor M, Rogers K, Wilson I. Alkhelaiwi WA, et al. Healthcare (Basel). 2024 May 16;12(10):1031. doi: 10.3390/healthcare12101031. Healthcare (Basel). 2024. PMID: 38786441 Free PMC article. Review.

Øvrebø LJ, Dyrstad DN, Hansen BS. Øvrebø LJ, et al. BMC Nurs. 2024 May 23;23(1):348. doi: 10.1186/s12912-024-01951-8. BMC Nurs. 2024. PMID: 38783235 Free PMC article.

Ti-Enkawol Nachinab G, Armstrong SJ. Ti-Enkawol Nachinab G, et al. BMC Nurs. 2024 Apr 23;23(1):263. doi: 10.1186/s12912-024-01915-y. BMC Nurs. 2024. PMID: 38654226 Free PMC article.

Zhang R, Wu Y, Li L. Zhang R, et al. Heliyon. 2024 Jan 24;10(3):e24553. doi: 10.1016/j.heliyon.2024.e24553. eCollection 2024 Feb 15. Heliyon. 2024. PMID: 38317997 Free PMC article. Review.