NU2ICU V3 logoASSESSMENT – EVALUATION OF CLINICAL PERFORMANCE SCALE

Kathleen Nowak Bondy RN, PhD  suggested a five-point scale for the evaluation of nursing clinical performance in her publication “Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation” (Journal of Nursing Education. 1983;22(9):376-382, 1981).   Clinical practice is ranked across a hierarchy of increasing competency ranging from unskilled practitioner dependent on clinical supervision to independent, critical, proficient practitioner.  The scale whether used for personal reflection or peer feedback has the potential to:

  • support learners to identify their current capability and scope of practice
  • identify requirement for ongoing professional development

And so by using this criteria we can standardise our assessment of clinical performance;

Scale label No Standard of procedure Quality of performance Level of assistance required
Independent

 

5 ·       Safe

·       Accurate

·       Achieved intended outcome

·       Behaviour is appropriate to context

·       Proficient

·       Confident

·       Expedient

 

·       No supporting cues required

 

Supervised

 

4

·       Safe

·       Accurate

·       Achieved intended outcome

·       Behaviour is appropriate to context

·       Proficient

·       Confident

·       Reasonably expedient

 

·       Requires occasional supportive cues

 

Assisted

 

3 ·       Safe

·       Accurate

·       Achieved most objectives for intended outcome

·       Behavior generally appropriate to context

·       Proficient throughout most of performance when assisted

 

·       Required frequent verbal and occasional physical directives in addition to supportive cues

 

Marginal

 

2 ·       Safe only with guidance

·       Not completely accurate

·       Incomplete achievement of intended outcome

·       Unskilled

·       Inefficient

 

·       Required continuous verbal and frequent physical directive

cues

Dependent

 

1 ·       Unsafe

·       Unable to

demonstrate behaviour

·       Lack of insight into behaviour appropriate to context

·       Unskilled

·       Unable to demonstrate

behaviour / procedure

·       Required continuous verbal and continuous physical

directive cues

X

 

0         Not observed  

(Bondy, K 1983)

 

CUES

Directive Cues – refer to assistance/cues that give direction or correct the student’s performance / expression of knowledge, directive cues can be either verbal or physical

Supportive Cues – refer to cues that only reinforce or encourage a student’s performance / expression of knowledge, but do not change or direct the performance

Scale scores of 0 or 1 in any competency procedure standard would identify the nurse undertaking the activity as unsuitable to accurately perform patient assessment

 

More reading

GENERAL PHYSICAL ASSESSMENT

PRIMARY ASSESSMENT

SECONDARY ASSESSMENT

KNOWLEDGE ADJUNCTS

AUSCULTATION SKILLS

NORMAL VALUES

RRS / MET VALUES

ASSESSMENT PRACTICE TOOL