The Effect of Evaluator Training on Inter- and Intrarater Reliability in High-Stakes Assessment in Simulation.

AIM: The aim of this study was to evaluate the effectiveness of a training intervention in achieving inter- and intrarater reliability among faculty raters conducting high-stakes assessment of clinical performance in simulation. BACKGROUND: High-stakes assessment of simulation performance is being adopted in nursing education. However, limited research exists to guide best practices in training raters, which is essential to ensure fair and defensible assessment. METHOD: A nationwide sample of 75 prelicensure RN program faculty participated in an experimental, randomized, controlled study. RESULTS: Participants completing a training intervention achieved higher inter- and intrarater reliability than control group participants when using a checklist evaluation tool. Mixed results were achieved by participants when completing a global competency assessment. CONCLUSION: The training intervention was effective in helping participants to achieve a shared mental model for use of a checklist, but more time may be necessary to achieve consistent global competence decisions.

Enhancing Clinical Reasoning Through Simulation Debriefing: A Multisite Study.

AIM: The aim of this research was to replicate Dreifuerst's 2012 findings of enhanced clinical reasoning scores using a structured debriefing: Debriefing for Meaningful Learning (DML). BACKGROUND: The direct effect of debriefing on clinical reasoning is not well studied. The nursing education literature supports debriefing as a reflective dialogue necessary to enhance clinical reasoning. METHOD: A quasi-experimental, pretest-posttest, repeated measure research design was used to evaluate nursing students' clinical reasoning using the Health Sciences Reasoning Test (HSRT). RESULTS: The change in HSRT mean scores was determined to be significant for the intervention group at the .05 level and insignificant for the control group. The change in HSRT mean scores between the intervention and control groups was determined to be significant at the .10 level. CONCLUSION: Nursing students who had the DML debriefing scored significantly higher in their clinical reasoning than nursing students who had usual and customary debriefing.

Nursing student caring behaviors during blood pressure measurement.

The purpose of this multisite, nonexperimental study was to examine, using a repeated measures design, the effects of a teaching intervention designed to promote caring behaviors as students learn the psychomotor skill of blood pressure measurement. Watson's theory of human caring and a combination of cognitive and connectionist learning theories were used as the organizing construct. Baccalaureate nursing student participants were videotaped and evaluated at two points in time while performing the psychomotor skill of blood pressure measurement on a role-player. Role-players rated the students' caring behaviors using the Role Player Survey of Caring Behaviors During Blood Pressure Measurement instrument. Between these data collection points, students learned about caring behaviors through analysis of a videotaped role-play and required readings. An evaluator randomly selected 10 student videotapes from each of the 6 baccalaureate nursing program study sites and noted the presence or absence of caring behaviors on the Caring Behaviors During Blood Pressure Measurement instrument. Pretest and posttest scores on both subjective and objective research instruments were compared using descriptive statistics and repeated measures analysis of variance (ANOVA). Students demonstrated a significant improvement in objective and subjective caring behaviors between the two performance examinations. The findings support further investigation of teaching interventions to promote the development of caring behaviors during nursing psychomotor skill development.