Perceived Constraints to Effective Clinical Assessment of Nursing Students Competencies among Nursing Students and Educators in Southwest Nigeria

Aim: This study investigated the perception of nursing students and educators on the constraints to effective clinical assessment of nursing students’ competencies and probed possible solutions to the identified constraints in Lagos, southwest Nigeria.

Methods: In this cross sectional study, 175 nursing students, and 49 nurse educators from five randomly selected nursing schools participated. The study adopted a triangulation approach of quantitative and qualitative method for data collection and analysis. A self-administered questionnaire was utilized to collect quantitative data from the nursing students and nurse educators and a response return rate of 163(93%) and 46(94%) were recorded respectively from both groups. Focus Group Discussion (FGD) was employed for qualitative data among 12 nursing students and 11 nurse educators in two nursing schools. Data was analyzed and relative importance index (RII) and its ranking (R) was utilized to establish the relative importance of the various constraints identified as responsible for effective clinical assessment of competencies.

Results: The result revealed as major constraints from the students; lack of confidence by the students in carrying out procedures in clinical setting and lack of materials and instruments for clinical practice with equal ranking (RII=0.78; R=1.5), similarly, the educators rated; Lack of confidence by the students in carrying out procedures in clinical setting (RII=0.74; R=1.0) as a key constraint. The Mann Whitney U test showed no statistical significant differences to the perception of the constraining factors and probable solutions by both groups (p>0.05)

FGD revealed; lack of clear objectives for each clinical posting, as both students and clinical assessors do not have clear idea of what competencies they are to acquire and assess as a major constraint.

Conclusion: The researchers recommend that clinical placement objectives should be set and communicated to the students, educators and assessors to direct nursing students’ clinical practice and evaluation and assessment formats developed in line with specific skills to be evaluated.