Continuous clinical assessment: An interpretive description of the experience of mentors and students' preregistration nursing education

Abstract

Background: In many countries around the world, professional nursing training is provided after completing higher education. In Hong Kong, the syllabus of the accredited program for registered nurses must consist of theory and clinical practice components. While written assessment is used in the theoretical component, continuous clinical assessment (CCA) is deployed in clinical practice to assess the competence of students. Although nurse educators confirm CCA's importance, feedback on clinical assessment process is not uncommon. Study Aim, Objectives, and Significance: This study aimed to gain insights from the current practice and complexities inherent in CCA implementation to recommend practice implications and future research directions. The key study objectives are as follows: 1) to describe the outcomes of CCA implementation perceived by students and mentors; 2) to identify commonalities and differences between the concepts and actual practice of CCA for the factors that affect CCA implementation; and 3) to generate the themes that fill the gap existing in the body of literature about success in CCA practice and development for preregistration nursing education. Methods: The interpretive descriptive methodology (Thorne, 2016) was adopted to explore in depth the CCA experiences of the mentors and students. Data were transcribed and analyzed through the constant comparative analysis approach based on primary understanding of the text, analysis of the descriptive reflection, and interpretive reflection to unravel participants' CCA experiences. Results: Three final themes emerged: 1) "Relation" without Relationship, 2) Stand behind the Yellow Line, and 3) The Sound of Silence. These themes are important structural components in identifying the main theme, Shades of Gray, which contextualize and personify the subtleties of the CCA experiences of nursing students and mentors in preregistration nursing education. Conclusions: The study findings reveal the phenomenon of mentor practice diversity in CCA. The key to improving CCA is striking a balance in practice decision-making while upholding nurses' competence to ensure patient safety. Effective mentorship seems to provide guidance for achieving such a balance. The importance of developing complete and practical guidance for CCA implementation in preregistration nursing education is also suggested.