evaluation methods in clinical teaching .pptx

EVALUATION IN CLINICALTEACHING
Mrs. NavyaVijayan
Lecturer
St.Thomas college of nursing,kattanam

A clinical teaching also known
as bedside teaching is a unique
learning strategy in nursing.
Clinical teaching is providing the
opportunity for acquisition and
demonstration of instructional
competence by beginning
professional educators.

DEFINE CLINICALTEACHING
ClinicalTeaching is a individualized or group
teaching to the nursing students in the clinical area
by the Nurses Educators , Staff Nurse and Clinical
Nurse Managers .

IMPORTANCE OF CLINICALTEACHING
 It can effectively help learners to improve clinical skills, judgement,
communication and professionalism .
 It can also integrate theoretical knowledge, practical and communication
competencies of learners

1.
• Identification the goal and
outcomes
2. • Assessing the learner
3. •Planning Clinical Activities
4. •Guiding student/learner
5
•Evaluating clinical
teaching
Process of clinical teaching

 Define evaluation
 Purpose of clinical evaluation
 Principles of clinical evaluation
 Participants in clinical evaluation
 Clinical evaluation process
 Methods of clinical evaluation
 Various types of evaluation tools and methods

MEANING OF EVALUATION
‘To evaluate’ means ‘to ascertain the value or amount
of appraisal carefully’
It is concerned with provision of learning experience,
increasing the capabilities to perform certain functions
Evaluation is a vital process in delivering a teaching
activity

Evaluation of clinical teaching involves collecting
evidence, from learners and evaluators , for the purpose
of improving the effectiveness of the teaching-learning
process.
A successful evaluation generates outcomes by the
learners that are valid, reliable and indicate directions
and action for development.
Evaluation is carried out from the perspective of the
learner, teacher, the patient and the institutional
administrators in the health care system

DEFINE EVALUATION
 The process of determining to what extent the educational
objectives are being realized.
--Ralph Tyler
 The process of judging or calculating the quality,
importance,amount or value of something
--Crow

IMPORTANCE
OF
EVALUATION
IN A CLINICAL
TEACHING
• Maintain and promote the academic quality of a
clinical teaching,
• It is a tool to measure systematically the standards
of teaching and overall benefits for the students in
line with their learning objectives.
• Evaluation effectively helps to train and teach
learners to become competent professionals for
future healthcare services.

OBJECTIVES OF CLINICALTEACHING EVALUATION
 Provide a reliable form for assessing the quality of
clinical teaching.
 Provide a method for providing feedback to faculty and
students.
 Provide a self-assessment tool for clinical teachers to
identify opportunities for faculty development.

PURPOSES OF EVALUATION
1. Essential for sound educational decision-making.
2.To attain educational goals and ascertain have been reached or
not.
3. For adequate Teaching-Learning situation.
4. It clarifies aims of education
5. Helps in improvement of curriculum.
6.Appraises the status and changes in pupil behavior.

PURPOSES OF EVALUATION
7. Familiarizes the Teacher with the nature of pupil learning, development
and progress.
8. It appraises the Teacher ‘s/Supervisor’s competence.
9. Serves as a method of improvement.
10. Encourage students learning by measuring their achievement and
informing their success.
11. Determine how far the objectives of teaching in particular subject are
being realized or to see whether the teacher’s method and the
experiences, which he organizes for children.

PHILOSOPHY OF EVALUATION
 Each learner should receive education that allows to develop
maximal potential
 Education should contribute to the society and also should
receive personal satisfaction in doing so.
 Fullest recognition of the individual requires recognition of
essential individuality along with some rational appraisal by self
and others.

 The evaluation process is complex in composition ,difficult to
make and filled with error, which can be reduced but never be
eliminated. Hence evaluation can never be considered as final.
 Composite assessment by a group of individuals is likely to be
in error than assessment made by a single person .
 Every form of apprasial will have critics, which is a spur to
change and improvement
 A conscientious group of individuals has to put efforts to
develop more reliable and valid appraisal methods of evaluation
and reduce errors.

PSYCHOLOGY OF EVALUATION
 Student will be ready to have the evaluation of his/her abilities when he
understands and accepts the values and objectives involved
 Learner tends to carry on, those activities which have success associated
with their results, i.e., law of effect.
 Individuals learn better when they are 'constantly' appraised in a
meaningful manner as to how well they are doing.
 Motivation of the student is important.A person's top performance on a
test is directly related to his/her motivation
 Learning is most efficient when there is activity on the part of the
learner.

DOMAINS OF EVALUATION
 The establishment of formalized education programs in clinical teaching
created the need for formalized evaluation programs.
 More systematic and scientific procedures were required to evaluate
these programs
 Seels and Richey define the domain of evaluation as “the process of
determining the adequacy of instruction and learning”
 The domain of evaluation examines the instruction; making changes
where needed (formative evaluation) and determines the effectiveness of
the instruction and the impact upon learners (summative evaluation).

Domains of
evaluation
Summative evaluation
Formative evaluation
Criterion
referenced
measurement
Problem
analysis
Domains of evaluation

1.PROBLEM ANALYSIS
 “Problem analysis involves determining the nature and
parameters of the problem by using information-gathering and
decision-making strategies”
 Instructional designers must collect data using appropriate data
collection instruments to identify the problem and causes in
order to provide solutions to the problem.

2.CRITERION-REFERENCED MEASUREMENT
 “Criterion-referenced measurement involves techniques for
determining learner mastery of pre-specified content”
 The purpose of criterion-referenced measurement is to
determine if the student learned the intended information and
to determine if the goal of the materials has been reached.

3.FORMATIVE EVALUATION
 “Formative evaluation involves gathering information on adequacy and
using this information as a basis for further development”
 The purpose is to identify errors in the instructional materials, identify
issues affecting learning outcomes, diagnose learning problems of users,
and revise and improve the quality of materials and learning.
 Formative evaluation is conducted during the development or
improvement of a program or product.
 It may be implemented by an internal or external evaluator or by both

 Formative evaluation consists of three phases: one-to-one evaluation,
small-group evaluation, and field trial Each phase is described below.
 One-to-one evaluation- The instructional designer works directly with
individual learners to obtain data for revision of the materials.
 Small-group evaluation- The instructional designer will randomly select
eight to twenty learners who represent the target population to review
the effectiveness of teaching
 Field trial-The instructor will use a learning context that resembles the
intended setting to determine whether the instruction is administratively
possible to implement.

4.SUMMATIVE EVALUATION
 “Summative evaluation involves gathering information on
adequacy and using this information to make decisions
about effectiveness of teaching
 It is conducted after the implementation of the program
 The principle behind summative evaluation is to
determine whether to continue use of the current
teaching method

There are four levels of summative evaluation according to
Kirkpatrick: reaction, learning, transfer and results (Kirkpatrick,
1994).

KIRKPATRICK’S FOUR LEVELS OFTRAINING EVALUATION
 Is a key tool for evaluating the efficacy of training within
an organization.This model is globally recognized as one
of the most effective evaluations of training.
 The Kirkpatrick model consists of 4
levels: Reaction, learning, behavior, and results.
 It can be used to evaluate either formal or informal
learning and can be used with any style of training.

LEVEL 1: REACTION
 The first level is learner-focused.
 It measures if the learners have found the training to be relevant to their role, engaging,
and useful.
There are three parts to this:
 Satisfaction: Is the learner happy with what they have learned during their training?
 Engagement: How much did the learner get involved in and contribute to the
learning experience?
 Relevance: How much of this information will learners be able to apply on the job?
 Reaction is generally measured with a survey, completed after the training has been
delivered.This survey is often called a ‘smile sheet’ and it asks the learners to rate their
experience within the training and offer feedback.

Steps for implementing level 1: reaction
 Use an online questionnaire.
 Set aside time at the end of training for learners to fill out
the survey.
 Provide space for written answers, rather than multiple
choice.
 Pay attention to verbal responses given during training.

 Create questions that focus on the learner’s takeaways.
 Use information from previous surveys to inform the questions
that you ask.
 Let learners know at the beginning of the session that they will
be filling this out.This allows them to consider their answers
throughout and give more detailed responses.
 Reiterate the need for honesty in answers –learners need not
have to give polite responses rather than their true opinions!

LEVEL 2: LEARNING
 This level focuses on whether or not the learner has
acquired the knowledge, skills, attitude, confidence, and
commitment that the training program is focused on.
 These 5 aspects can be measured either formally or
informally.
 For accuracy in results, pre and post-learning assessments
should be used.

Steps for implementing level 2: learning
 Conduct assessments before and after for a more complete
idea of how much was learned.
 Questionnaires and surveys can be in a variety of formats,
from exams, to interviews, to assessments.
 In some cases, a control group can be helpful for comparing
results.

 The scoring process should be defined and clear and
must be determined in advance in order to reduce
inconsistencies.
 Make sure that the assessment strategies are in line with
the goals of the program.
 Don’t forget to include thoughts, observations, and
critiques from both instructors and learners – there is a
lot of valuable content there.

LEVEL 3: BEHAVIOR
 This step is crucial for understanding the true impact of the training.
 It measures behavioral changes after learning and shows if the learners are
taking what they learned in training and applying it as they do their job.
 The results of this assessment will demonstrate not only if the learner has
correctly understood the training, but it also will show if the training is
applicable in that specific workplace.
 This is because, often, when looking at behavior within the workplace, other
issues are uncovered. If a person does not change their behavior after
training, it does not necessarily mean that the training has failed.

Steps for implementing level 3: behavior
 The most effective time period for implementing this
level is 3 – 6 months after the training is completed.Any
evaluations done too soon will not provide reliable data.
 Use a mix of observations and interviews to assess
behavioral change.
 Be aware that opinion-based observations should be
minimized or avoided, so as not to bias the results.

LEVEL 4: RESULTS
This level focuses on whether or not the targeted
outcomes resulted from the training program,
alongside the support and accountability of
organizational members.

Steps for implementing level 4: results
 Before starting this process, know exactly what is going to be
measured throughout, and share that information with all
participants.
 If possible, use a control group.
 Don’t rush the final evaluation – it’s important that participants
are given enough time to effectively fold in the new skills.

5.CONFIRMATIVE EVALUATION
Confirmative evaluation is a continuous type of evaluation used to
determine the long-term organizational impact of the implementation
Confirmative evaluation is conducted by a team of unbiased evaluators.
The evaluators use tools such as interviews, surveys, performance
assessments, and knowledge tests to gather information
Confirmative evaluation should take place at least six months to a year
after initial implementation of teaching method

CHARACTERISTICS OF GOOD EVALUATION INSTRUMENT
 It should show how far the educational objectives have been achieved
 It has to measure the knowledge and overall personality development of the
individual learner
 It is a continuous process, therefore it should have formative, summative and terminal
evaluation
 Evaluation technique should be reliable and valid to identify how far changes have
taken place among the students in the teaching learning process.
 Validity:The accuracy with which a test measures whatever it is intended/supposed
to measure
 Reliability :The efficiency with which a test measures what it attempts to measure

 Objectivity:A test is objective when the scorer's personal judgment does not affect the
scoring. It eliminates fixed opinion or judgment of the person who scores it.
 Practicability (usability):The overall simplicity of use of a test for both test constructor
and for learner. Practicability depends upon various factors, such as ease
administrability, scoring, interpretation and economy
 Ease of interpretation:The raw scores of a test should easily converted into meaningful
derived scores.
 Economy: Economy refers to the cost well as the time required for administering and
scoring
 Comparability:A test possesses comparability if scores resulting from its use can be
interpreted in terms of a common base that has a natural or accepted

 Relevance:The degree to which the criteria established for selecting the item so that
they conform to the aims of the measuring instrument.
 Equilibrium/Equity:Achievement of the correct proportion among questions allotted
to each of the objectives and teaching content.
 Specificity:The items in a test should be specific to the objectives.
 Discrimination:The discriminating power of a test item refers to the degree to which
it discriminates between good and poor students in a given group or a variable.This
suggests that learners with superior ability should answer the item corrective more
often than learners who do not have such ability.
 Efficiency: It ensures the greater possible number of independent answers per unit of
time

 Time:The required time to answer items should be provided to avoid hurry, guessing,
taking risks or chances, etc.
 Length:The number of items in the test should depend upon the objectives and
content of the topic.
 Test usefulness: Grading or ranking of the student can be possible with items in the
test.
 Precise and clear: Items should be precise and clear so that students can answer well
and score marks.
 Comprehensiveness:The total content and objectives has to be kept in mind while
preparing items for the test.
 Adequacy:A measuring instrument should be adequate to measure the desired
outcome as well abide to the objectives .

 Balanced and fair.The test should include items, measuring both the
objectives and the content.
 Ease of administrability: Provision should be made for the preparation,
distribution and collection of test materials.
 Instruction should be simple, clear and concise. Practice exercises will be
illustrated, Illustrations should be clear cut and easily tied up with the
appropriate test items.
 Ease of scoring: Simple scoring is good.Algebraic AI calculations should
not be used to get the scores,

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Participants in clinical
teaching

PROCESS OF CLINICAL EVALUATION
Preparation Clinical activity
Final data
interpretation
and feed back

PHASE I: PREPARATION
 Determines objectives and competencies to be evaluated
 Identify evaluation methods and tools
 Choose clinical site
 Orient students to the evaluation plan
 Focus on objectivity in evaluation

 Orient student and staff to the student role
 Provide students with the clinical opportunities
 Ensure patient safety
 Observe and collect evaluation data

PHASE II: CLINICALACTIVITY
 Orient student and staff to the student role
 Provide students with the clinical opportunities
 Ensure patient safety
 Observe and collect evaluation data

 Provide student feedback to enhance learning
 Document findings and maintain privacy of records
 Contact with students regarding any deficiencies

PHASE III: FINAL DATA INTERPRETATION AND
PRESENTATION
 Interpret data in fair, consistent and reasonable manner
 Assign grade
 Provide summative evaluation conference (ensure privacy and respect
confidentiality)

ROLES OF AN EVALUATOR DURING THE EVALUATION
PROCESS
1. Preparation phase
 Choosing the clinical setting and patient assignment as a part of evaluation process
 Determining the standards and measurement tools
 Reasonable
 Consistent and applied equally
 Established and communicated before implementation.

II. CLINICALACTIVITY PHASE
 In both obtaining and analyzing clinical evaluation data, faculty need to
make professional judgement about the performance of the students.
Because of the subjective nature of evaluation, there may be concern that
evaluation is biased.

III. FINAL DATA INTERPRETATION AND PRESENTATION
a) Clinical Evaluation Conference
b) Student response
c) Working with students with questionable performance and supporting at risk students
d) Unsatisfactory performance
e) Student reactions
f) Dismissing an unsafe student from the clinical practice

1. Observational techniques:
 Checklists
 Rating scales
 Anecdotal Records
 Critical incidents

1. Observational techniques:
Checklists
Rating scales
Anecdotal Records
Critical incidents

THE ADVANTAGES OF OBSERVATION
 Provides a continuous check on progress of student.
 The errors and problems can be immediately directed and corrective action taken
quickly.
 Observation techniques are not so time consuming.
 Observational data provides teachers with valuable data which could not be obtained
in other way.

TIPS FOR MAKING VALID OBSERVATIONS
 Plan in advance what is to be observed.
 The observer must be aware of the sampling errors.
 Coordinate the observation with your teaching otherwise there is a danger that invalid
observations will result.
 Record and summarize the observations immediately after it has occurred. Make no
interpretation regarding the observation until later on to prevent interference in objectivity of
gathering observational data.

TYPES OF OBSERVATIONAL TOOLS
1. CHECKLIST
 A check list consists of steps activities or behaviour which the observer records when
an incident occurs.
 A check list enables the observer to note whether or not a trait or characteristic is
present. They can be used when components of competence specified. A two column
format is often used.

Advantages of Checklist
 They are adaptable to most subject matter areas.
 They are useful in evaluating those activities that involve a procedure
process and some aspects of personal social adjustment.
 They are useful for evaluating those procedures which can be divided
into separate actions.

 When properly prepared they constrain the observer to direct his
attention to clearly specified traits.
 They allow interindividual comparison to be made on a common set of
traits.
 It is a simple method of recording

Construction of Checklist
 Express each item in clear, simple language
 Avoid lifting verbatim from the text.
 Avoid negative statements
 Make sure each item is clearly yes or no.
 Review each item independently.

Disadvantage of checklist
 Quality of the observed trait or the degree to which the attribute is present
cannot be assessed.

2.ANECDOTAL RECORD
Definition: (by Randall)
“Anecdotal record is a record of some significant item of conduct, a record of
an episode in the life of student, a word picture of a student in action, a word
snapshot at the moment of the incident, ant narration of events which may be
significant about his personality.”

Characteristics ofAnecdotal records
 They should contain factual description of what happened.
 The interpretation and recommendation should be noted independently.
 Each anecdotal record should contain a single incident.
 The incident recorded should be that which is significant to the student’s
growth and development.

Merits ofAnecdotal records
 Help in clinical service practices
 Provide a factual record of our observation of a simple significant incident in
Student’s life.
 They stimulate teacher to use records contribute to them.
 They provide specific and exact description of personality and minimize
generalizations.

Demerits ofAnecdotal records
 They tend to less reliable than other observational tools as they are less formal.
 They are time consuming to write.
 Difficult to maintain objectivity.
 The observer tends to record only undesirable incidents.
 They present only verbal description of incident. They do not reveal causes.

3. CRITICAL INCIDENT TECHNIQUE
 It is a method of assessing the student’s analytic and problem solving competencies.
 Rivers and Gosnell defined Critical Incident as “one that makes a significant difference in
the outcome of an activity.”
 The critical incident technique is effective for formative evaluation; it enables the learner
and the teacher to assess the learner’s behaviours in relation to their impact an outcome of
an action.

4. RATING SCALE
 A rating scale is a method by which we systematize the expression of opinion
concerning a trait.
 A rating scale resembles a checklist but in this instead of merely indicating the
presence or absence of a trait or characteristic, it enables us to indicate the
degree to which the trait is present.

Advantages of Rating Scale
 It is a standard device for recording qualitative and quantitative judgements about
observed performance.
 They measure specified outcomes or objective which are significant.
 They evaluate procedures.
 They evaluate products
 They evaluate personal social development.

 They help teachers rate their students periodically.
 They can be used with large number of students.
 They are adaptive and flexible
 They are efficient and economical.

Disadvantages of rating Scale
 Since the scales are standardized items, it sometimes may not be consistent with the objectives.
 There is a lack of uniformity with which terms are interpreted by the evaluators.
 There are several common sources of errors in rating scales.
 Errors may be due to
 Ambiguity
 Personality of the rater: halo effect, personal bias, logic error; attitude of rater
 Opportunity for adequate observation.

Types of rating scales
 Numerical Rating Scale
 Graphic Rating Scale
 Ranking

2. Written communication methods
 Nurses notes
 Problem oriented records
 Nursing care studies
 Process recording

NURSES NOTES
According to Phaneauf quality of care provided to the patient is assessed by using
Quality of care provided to the patient is assessed by using the patient’s charts as a
source of information. The reason for this are;
 The chart is a service instrument essential for the safety of the patient.
 The chart is a service instrument essential for the safety of the patient.
Nurses Notes

 It serves as a major means of communication between the various
professionals involved in the care.
 It provides legal documentation of the care provided.
 Recording is one essential function of the nurse.
 The chart is readily available to the authorized nurses for purpose of
auditing.

Problem Oriented Records
 Problem oriented record is a systematic record of patient’s health
problem. According to Weeds it has four components as follows
 Database – all appropriate information about the patient for assessing his
condition.

Problem list – listing the conditions, systems or
circumstances identified from the database, which have
implication for the patient’s health.
Initial plans – diagnostic and therapeutic orders for each
problem listed.
Progress notes

Nursing Care studies
Schweer defines a nursing care study as “a problem solving activity
whereby the student undertakes the comprehensive assessment of a
particular patient’s problems leading to planning, implementing, and
evaluation of nursing care measures.”

The student’s written description of actions implicit in meeting patient
needs enables the evaluator to determine ability in cognitive and affective
domains and also the ability to establish meaningful relationships among
the steps of the process.

Process Recording
 Schweer defines process recording as “the verbatim serial reproduction
of the verbal and nonverbal communication between two individuals for
the purpose of assessing interaction on a continuum leading towards
mutual understanding and interpersonal relationships.”

 There are four main components
 Client communication(Subjective data)
 Nurse communication(objective data)
 Nurse’s interpretation of patient communication.(nursing diagnosis)
 Implication of communication for nursing action.(Intervention)

3. Oral communication methods
Nursing patient care conference
Team conference

Nursing Patient Care conference
They are problem solving group discussions about some facet of
clinical practice.
In this the student represents a patient situation to the peer group for
critical analysis of the plan or action or implications.

The peers evaluate the action, raise relevant questions and propose
alternatives as appropriate.
In some instances the presentation may be preceded by nursing
rounds in which the participants have the opportunity to observe the
patients whose nursing care will be discussed.

Nursing Team Conference
The team conference is a small group activity that serves as an
effective medium for evaluating clinical practice. It involves managerial
decision making.
Managerial decision making as defined by Feinstein are “decisions for
therapeutic interventions or to prevent or alter disease.”

 The most common team activity is problem solving in which through
group process, plans for patient care are developed.
 The learner is evaluated in terms of his her participation in the group in
reporting observations, making relationships among data, making
proposals for action, evaluating actions as they are reported

Standardized patient examination:
 According to Borbasi and Koop standardised patient examination referred
to as objective structured clinical examination (OSCEs) can be
described as “pretend patients” in an artificial environment designed to
stimulate actual clinical condition.

 Standardised patients can provide feedback to students and ensure
competence before students begin practice in real world.
 Multiple evaluators can observe and test students in the performance of
numerous skills during brief examination periods.

OTHER METHODS ALSO USED
IN EVALUATION OF CLINICAL
TEACHING

SURVEY
 A survey is a method of gathering information from students and
instructors regarding satisfaction in clinical teaching using a set of
questions.
 Gathers quantitative data on attitudes, beliefs, opinions, and behaviors
of students learning experience as well as teaching .
 They tend to be relatively cost-effective to administer and allow to
systematically collect both quantitative data (using closed-ended
questions) and qualitative data (using open-ended questions) from the
learners .

QUESTIONNAIRE
 A questionnaire is a specific set of written questions
which aims to extract specific information from the
chosen respondents.
 The questions and answers are structured in order to
gather information not only about attitudes, preferences
but also regarding knowledge and skill acquired by the
students

INTERVIEW
 Interviews conducted for clinical teaching evaluation
are typically qualitative but may also include some
quantitative questions
 Includes interviewing with the instructor, learners ,health
care personnel ,family and concerned ones

FOCUS GROUPS
 Gather information from group of students having same
clinical experience
 Get more in-depth information on perceptions, insights,
attitudes, experiences, or beliefs.
 Gets qualitative information than quantitative

TEACHER AND EVALUATION
Evaluate student understanding of clinical scenario
Assess whether students are able to bring theory and
practice
Make adjustments to the teaching and learning process

STUDENT AND EVALUATION
Engaging with learning goals
Providing feedback to peers, receiving feedback
from teachers and peers

CONCLUSION
 Educators /clinical instructors can identify strengths and
weaknesses in the clinical teaching education system and
develop strategies to enhance student learning.
 Evaluation is also important in ensuring accountability in the
training process and promoting innovation.

evaluation methods in clinical teaching .pptx

evaluation methods in clinical teaching .pptx

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