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ABSTRACT
This article describes an approach to the evaluation of students' clinical performance. Specifically, the paper describes: (a) the history of the evaluation of clinical performance in nursing education; (b) the development of the Clinical Evaluation Tool (CET), an instrument designed to measure the clinical performance of nursing students across settings; and (c) the relationships between basic baccalaureate nursing students' scores on the CET and the following variables: age, college credits earned prior to entry to the program, grade point average at entry, college aptitude, and moral reasoning.
Introduction
Indicators of achievement of students in baccalaureate nursing education programs traditionally have included: (a) completion/non-completion of the program, (b) passage or failure of the state licensure examination, and (c) grade point average (cumulative GPA or GPA in nursing courses only). Although these are useful indicators of overall achievement in nursing programs, they are, in a sense, only proxy measures for the essential desired outcome - highquality clinical practice by graduates of the program.
Historically, assessment of the clinical performance of students has been problematic for educators in the various disciplines involved in health care. The complexity of the clinical environment, the reality that students provide care for clients while learning, the difficulties inherent in the process of evaluation, and the lack of uniform standards of performance are possible explanations for the dearth of well-controlled studies and the paucity of evidence about the nature of clinical learning (Dinham & Stritter, 1986; Pugh, 1983). Furthermore, problems in clinical evaluation mirror the larger problems faced by nurse educators related to the difficulties in evaluating nursing education in general.
History of Evaluation of Clinical Performance
Evaluation is the process of rendering judgment to determine worth, merit, or quality of a particular product, service, or phenomenon. The better one is able to define the phenomenon, the better one can evaluate it. There is a "long and tortured history" (Wooley, 1977) of attempts to describe quality clinical performance. Evaluating students' clinical performance requires that what is valued be identified, that criteria and standards for performance be delineated, and that reliable and valid means for measuring attainment of standards be developed. The importance of this process is apparent when one considers that excellence in clinical performance has always been the hallmark of...