Abstract

Background. Current methods to assess clinical performance are known to be often invalid and unreliable1. Therefore, we pilot tested an objective assessment of clinical competence, "Time to Task" (ability to perform specific activities within 5 minutes) and compared it to two other assessments, the Lasater Clinical Judgement Rubric (Lasater) and the common "pass/fail" assessment (subjective measure of whether the subject would "pass" or "fail").

Methods. Using a prospective, "Known Groups" (expert vs. novice nurses) design, Expert nurses (ICU nurses) and Novice nurses (senior prelicensure nursing students) participated individually in a simulation. Academic and clinical experts reviewed each video and scored each performance on two assessments while the third assessment, "Time to Task", (key task elements to be completed in 5 minutes) was calculated from each video by the researcher. Statistical analysis consisted of T-Tests and Chi-square.

Results. Fourteen evaluators reviewed the videos. For "Time to Task". There was strong statistical significance between the novice and expert groups (p < 0.01) and sensitivity (0.80) and specificity (0.85) were good. The Lasater (p < 0.01) only had sensitivity (0.72) and specificity (0.40) while "pass/fail", sensitivity was high (0.90) but specificity was low (0.47) indicating an ability to identify "Expert" nurses but not "Novice" nurses.

Conclusion. "Time to Task" performed best as a measure of competency in simulation. While there have been similar objective measures in healthcare, they have not been adopted for assessment of clinical performance 2,3. One instrument is not appropriate for all assessment but "Time to Task" warrants further study.

Author Details

Mary Ann Shinnick, PhD, ACNP, CCNS, CHSE; Mary A. Woo, PhD

Sigma Membership

Non-member

Lead Author Affiliation

International Nursing Association for Clinical Simulation and Learning (INACSL)

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Simulation, Nurse Competency Assessment, Time Based Assessments

Conference Name

INACSL Conference

Conference Host

International Nursing Association for Clinical Simulation and Learning

Conference Location

Washington, D.C., USA

Conference Year

2017

Rights Holder

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All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Validation of "time to task" performance assessment method in simulation

Washington, D.C., USA

Background. Current methods to assess clinical performance are known to be often invalid and unreliable1. Therefore, we pilot tested an objective assessment of clinical competence, "Time to Task" (ability to perform specific activities within 5 minutes) and compared it to two other assessments, the Lasater Clinical Judgement Rubric (Lasater) and the common "pass/fail" assessment (subjective measure of whether the subject would "pass" or "fail").

Methods. Using a prospective, "Known Groups" (expert vs. novice nurses) design, Expert nurses (ICU nurses) and Novice nurses (senior prelicensure nursing students) participated individually in a simulation. Academic and clinical experts reviewed each video and scored each performance on two assessments while the third assessment, "Time to Task", (key task elements to be completed in 5 minutes) was calculated from each video by the researcher. Statistical analysis consisted of T-Tests and Chi-square.

Results. Fourteen evaluators reviewed the videos. For "Time to Task". There was strong statistical significance between the novice and expert groups (p < 0.01) and sensitivity (0.80) and specificity (0.85) were good. The Lasater (p < 0.01) only had sensitivity (0.72) and specificity (0.40) while "pass/fail", sensitivity was high (0.90) but specificity was low (0.47) indicating an ability to identify "Expert" nurses but not "Novice" nurses.

Conclusion. "Time to Task" performed best as a measure of competency in simulation. While there have been similar objective measures in healthcare, they have not been adopted for assessment of clinical performance 2,3. One instrument is not appropriate for all assessment but "Time to Task" warrants further study.