Recording of presentation introducing narrative analysis, outlining what it is, why it can be a useful approach, how to do it and where to find out more. Presentation given at methods@manchester seminar at University of Manchester on 4 March 2010.

What is Narrative Analysis

In this paper, the state of research on the assessment of competencies in higher education is reviewed. Fundamental conceptual and methodological issues are clarified by showing that current controversies are built on misleading dichotomies. By systematically sketching conceptual controversies, competing competence definitions are unpacked (analytic/trait vs. holistic/real-world performance) and common- places are identified. Disagreements are also highlighted. Similarly, competing statistical approaches to assessing competencies, namely item- response theory (latent trait) versus generalizability theory (sampling error variance), are unpacked. The resulting framework moves beyond dichotomies and shows how the different approaches complement each other. Competence is viewed along a continuum from traits that underlie perception, interpretation, and decision-making skills, which in turn give rise to observed behavior in real-world situations. Statistical approaches are also viewed along a continuum from linear to nonlinear models that serve different purposes. Item response theory (IRT) models may be used for scaling item responses and modeling structural relations, and generalizability theory (GT) models pinpoint sources of measurement error variance, thereby enabling the design of reliable measurements. The proposed framework suggests multiple new research studies and may serve as a ''grand'' structural model.

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Beyond dichotomies: Competence viewed as a continuum

Clinical environment as a learning environment: student nurses' perceptions concerning clinical learning experiences.

Introduction: In recent years, the use of portfolios as learning and assessment tools has become more widespread across the range of health professions. Whilst a growing body of literature has acco...

The educational effects of portfolios on undergraduate student learning: A Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 11

Background. Self-assessment assists nurses to maintain and improve their practice by identifying their strengths and areas that may need to be further developed. Professional competence profiles encourage them to take an active part in the learning process of continuing education. Although competence recognition offers a way to motivate practising nurses to produce quality care, few measuring tools are available for this purpose.

Aim.  This paper describes the development and testing of the Nurse Competence Scale, an instrument with which the level of nurse competence can be assessed in different hospital work environments.

Methods.  The categories of the Nurse Competence Scale were derived from Benner's From Novice to Expert competency framework. A seven-step approach, including literature review and six expert groups, was used to identify and validate the indicators of nurse competence. After a pilot test, psychometric testing of the Nurse Competence Scale (content, construct and concurrent validity, and internal consistency) was undertaken with 498 nurses. The 73-item scale consists of seven categories, with responses on a visual analogy scale format. The frequency of using competencies was additionally tested with a four-point scale.

Results.  Self-assessed overall scores indicated a high level of competence across categories. The Nurse Competence Scale data were normally distributed. The higher the frequency of using competencies, the higher was the self-assessed level of competence. Age and length of work experience had a positive but not very strong correlation with level of competence. According to the item analysis, the categories of the Nurse Competence Scale showed good internal consistency.

Conclusion.  The results provide strong evidence of the reliability and validity of the Nurse Competence Scale.

Nurse competence scale: development and psychometric testing.

Background.  The literature review presented here was conducted as part of an English National Board for Nursing, Midwifery and Health Visiting funded project to evaluate the use of portfolios in the assessment of learning and competence. Initial consideration of the topic revealed the need to clarify the terminology and approaches used to assess competence using portfolios, and therefore the literature review was conducted to inform the study.

Aims.  To clarify definitions, theoretical bases and approaches to competence and the use of portfolios in the assessment of learning and competence in nursing education.

Methods.  A comprehensive literature review was conducted using the CINAHL and MEDLINE databases and the keywords competenc*, portfolios and nursing. Articles published in the period 1989–2001 in English were obtained and their reference lists scrutinized to identify additional references. Twenty articles were found using a combination of the keywords competenc* and portfolios, and 52 using the combination portfolios and nurse education. Articles were included in the review if they focused on the use of portfolios in nursing, and those concerned with professional or transitional portfolios were excluded. This article will analyse definitions of and approaches to competence and its measurement and to portfolios and their use as discussed in the articles identified.

Results.  Three approaches to competence were identified, each with its appropriate forms of assessment. With regard to portfolios, a number of definitions were again found, but there was a consensus that the theoretical basis of their use is theories of adult learning. A number of reasons for and advantages and disadvantages of their use were found, as well as varying ideas about what a portfolios should consist of and how it should be assessed.

Conclusions.  A holistic approach to competence seems to be compatible with the use of portfolios to assess competence in nursing students, but the concept and its implementation is still evolving. A variety of assessment methods are needed for assessment and portfolios appear to have the potential to integrate these. Reflection is an essential component of a portfolio, as are the student–teacher relationship and explicit guidelines for constructing the portfolio. Issues of rigour in assessment of portfolios need to be addressed, but the assessor's professional judgement will inevitably enter into this assessment.

Portfolios and assessment of competence: a review of the literature.

Parker and Carlisle (Journal of Advanced Nursing 24, 771-778) argue that there is a scarcity of empirical research focusing on issues such as supernumerary status and mentorship in Project 2000 courses from the students' perspective. This paper presents the findings of a longitudinal cohort study using Grounded Theory to discover the effect(s) of mentorship on student nurses following the introduction of the 1992 programme of education leading to a Diploma of Higher Education in Nursing and registration with the United Kingdom Central Council (UKCC). The cohort consisted of 10 students from a large Scottish College of Nursing & Midwifery who were interviewed on five occasions during the three years of their course. Students also kept a diary to record their thoughts and experiences regarding mentorship during their practice placements. In addition, a further seven students volunteered to participate by diary only. Data were analysed with the aid of NUD.IST and subjected to the constant comparative method of analysis. Findings indicate that Diploma students quickly lose their idealistic view of their mentor and over time develop an insight into the qualities they perceive are required of an effective mentor. Students quickly become aware of the importance of choosing good role models and learning their own mentor's likes and dislikes as they realize this impinges on the outcome of their assessment. As students move into their Branch programme, a gradual distancing from their mentor is evident. This coincides with a development in their confidence, skills and a holistic perspective of care.

The qualities of an effective mentor from the student nurse’s perspective: findings from a longitudinal qualitative study

This paper presents a new theory of professional socialization in relation to diploma of higher education in nursing students (Project 2000). It was derived from a 3-year, grounded theory, longitudinal study exploring the effects of supernumerary status and mentorship on students undertaking practice placements. A purposive sample of 17 students was used. Ten students volunteered to be interviewed on five separate occasions throughout their course and to keep a diary to record their experiences of mentorship during their practice placements. Their diary acted as an aide memoir during their tape-recorded interviews. The other seven students participated by diary only and kept written accounts of their experiences of being supernumerary and having a mentor whilst on practice placements. Data were analysed with the aid of NUD.IST and subjected to the constant comparative method of analysis. Findings indicate that the mentor is the linchpin of the students' experience and that some students develop intuition much earlier than previous work has stated.

The professional socialization of diploma of higher education in nursing students (Project 2000): a longitudinal qualitative study.

Background A portfolio captures learning from experience, enables an assessor to measure student learning, acts as a tool for reflective thinking, illustrates critical analytical skills and evidence of self-directed learning and provides a collection of detailed evidence of a person's competence

Aims  This paper reports data on how assessors and nursing students match learning outcomes and/or competencies to their practice and then reconstruct those experiences into the format required by the portfolio documentation The data were gathered as part of a larger study to evaluate the use of portfolios in the assessment of learning and competence in England

Methods  This three phase stakeholder evaluation was designed to gain the views of those involved in designing, implementing and using portfolios in nurse education In phase 2, 122 students and 58 nurse teachers were interviewed about their perceptions of portfolio use, and a further 32 students and 26 assessors were interviewed after they had been observed taking part in an assessment process Thematic data analysis was used

Findings  Assessors and students underwent a complex process of deconstructing learning outcomes/competences to fit these to their practice These then had to be reconstructed through the written medium to fit the structure of the portfolio Confirmation that this met teachers’ expectations was essential to allay feelings of insecurity

Conclusions  To achieve maximum benefit from the portfolio as a learning tool to link theory and practice, there needs to be a clear fit between the model of portfolio and the professional practice that is to be assessed Outcomes and competences, as well as the type of evidence required to demonstrate their achievement, and integration of the whole experience should match the students’ stage of professional and academic development Over-complex approaches to practice assessment, particularly in the early stages of students’ careers, can detract from clinical learning in favour of learning how to complete the portfolio successfully

Morag Gray

Papers

Portfolios and assessment of competence: a review of the literature.

The qualities of an effective mentor from the student nurse’s perspective: findings from a longitudinal qualitative study

The professional socialization of diploma of higher education in nursing students (Project 2000): a longitudinal qualitative study.

Making portfolios work in practice

Evaluating portfolio assessment systems: what are the appropriate criteria?