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Integrating Best Practices of Participant Evaluation in Clinical Instruction

This article explores the best practices for participant evaluation in clinical instruction, including formative and summative assessments, clinical evaluation tools, and high-stakes testing. It also discusses types of simulations that can be used for evaluation and provides caveats for instructors.

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Integrating Best Practices of Participant Evaluation in Clinical Instruction

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  1. Integrating Best Practicesof Participant EvaluationClinical Instructor IntensiveAdrienne Small, DNP, FNP-C, CNE, CHSEMedical InstructorDuke University School of Nursing

  2. Standards of Best Practice For Participant Evaluation Reference: INACSL Standards of Best Practice: SimulationSM https://www.inacsl.org/i4a/pages/index.cfm?pageid=3407

  3. All simulation-based experiences require participant evaluation Determine the type of evaluation prior to the simulation experience: - Formative evaluation - Summative evaluation - High-stakes evaluation 

  4. Participant evaluation is: • Directed by desired objectives and outcomes  • Guided by the type of evaluation:  formative, summative, or high-stakes

  5. Formative Assessment •Learner-centered •Ongoing, focused on learning and growth •Provides feedback to learners •Measures progress toward outcomes •Can be ungraded

  6. Methods of Formative Assessment

  7. Observation

  8. Questioning

  9. SUMMATIVE EVALUATION -Graded -Focused on competencies and outcomes - May occur at the end of a unit or module - End-of-course or end-of-program testing *Students should be told what to expect * For instructors:  end-of-course evaluations

  10. Tools for Summative Evaluation: •Anecdotal notes •Clinical evaluation tools •Written work •Written exams •Practical exams •OSCEs

  11. Clinical Evaluation Tools  Objective assessment of clinical abilities and professionalism Can be formative (e.g. Midterm eval) or summative (e.g. Final eval) Specific to programs/program outcomes Evaluate competencies and behaviors Include student self-eval and faculty eval Increased complexity and autonomy are expected as students progress

  12. Types of simulations that can be used for evaluation Simple:  Task trainer with a skilled observer Mechanical:  hi-fidelity mannikin with a skilled observer Standardized patients Virtual reality: programs like I-Human and Shadow Health

  13. OSCE Objective Structured Clinical Examination An instructor observes the students perform a certain task, or an examination.  Standardized patients are often used for OSCEs.

  14. High Stakes Testing – benefits for students Conducted at the end of a learning process  Can also be used at other times to assess gaps in knowledge Identifies safety issues in learning. Provides proof of learners' clinical competencies Assesses readiness for real-world practice

  15. High Stakes Testing – Caveats for instructors • MUST be pilot tested to work out bugs • Consequences and outcomes must be explained to participants • Participants should have been exposed to simulation in the past • Needs a comprehensive rubric or checklist that clear outlines expectations • Train the raters on the tool • Establish interrater reliability • Video recording is preferable • Use more than 1 evaluator for each participant, either live or recorded

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