To improve the validity and reliability of theoretical assessments, nursing programmes should prioritise training in assessment design, strengthen alignment with learning outcomes, and implement moderation strategies to address inconsistencies.
Abstract
Introduction Theoretical assessment design is crucial in nursing education, ensuring students develop cognitive and problem-solving skills for clinical practice. However, misalignment with learning outcomes and inconsistent cognitive level distribution remain complex issues. Methods and findings This multimethod qualitative study explored theoretical assessment design in a South African nursing school through in-depth interviews with nurse educators and a document review of moderators’ reports. Stratified purposive sampling ensured diverse representation across National Qualifications Framework Levels 5–8. Data saturation was reached after nine interviews, analysed using Creswell and Creswell’s six-step thematic framework. The document review analysed 70 moderation reports (22 internal and 48 external) from 2015 to 2019, focusing on feedback related to final theoretical assessments. Content analysis, following Krippendorff’s framework, was used to identify themes and patterns. Findings revealed an overemphasis on lower-order cognitive skills (Bloom’s taxonomy), inconsistent question distribution, and misalignment with national qualification standards. Educators acknowledged these issues but cited time constraints, inadequate training, and institutional pressures as contributing factors. Moderation reports confirmed assessment inconsistencies, emphasising the need for better alignment with constructive alignment principles. Triangulation of data highlighted a gap between perceived best practices and actual assessment quality, suggesting assessments do not fully support higher-order cognitive skill development. Conclusion To improve the validity and reliability of theoretical assessments, nursing programmes should prioritise training in assessment design, strengthen alignment with learning outcomes, and implement moderation strategies to address inconsistencies. These findings contribute to the broader discourse on improving assessment practices in nursing education globally.
Embedding structural changes within assessment design, rather than relying on rule enforcement, will ensure nursing and midwifery graduates are prepared to thrive in an AI-enabled world.
Y. Salamonson, Pauletta Irwin, R. Kornhaber et al.· Journal of Clinical Nursing· 0 citations
BACKGROUND
The rapid integration of generative artificial intelligence (GenAI) into nursing education presents both opportunities and challenges, yet empirical evidence on students' critical engagement with AI-generated content within assessment contexts remains limited.
AIM
To examine undergraduate nursing students' reflections when comparing their own evidence-based summaries with AI-generated outputs in response to the same clinical research questions.
METHODS
A qualitative descriptive design was employed using retrospective analysis of 497 assessment submissions from an undergraduate nursing cohort at an Australian university. Students formulated a research question, synthesised peer-reviewed evidence, submitted the same question to an AI tool, and critically reflected on the comparison. Data were analysed using qualitative content analysis and thematic analysis.
RESULTS
Four themes were identified: 1. Credibility, quality of evidence and academic rigour. Students identified fabricated references, outdated information, and absence of peer-reviewed sourcing as key limitations. Additionally, students reflected on algorithmic limitations and the challenge of verifying AI outputs without prior topic knowledge; 2. Critical thinking, depth of analysis, and human intelligence. AI was perceived as unable to replicate contextual reasoning or multi-source synthesis; 3. Efficiency, accessibility, and practical utility. AI's speed and clarity were valued for brainstorming and initial scoping; and 4. Student identity, learning, and professional development were shaped by the view that engaging in manual, hands-on research was integral to forming a safe, evidence-informed nursing identity.
CONCLUSION
This study suggests that structured AI-comparison tasks offer the opportunity to develop AI and digital health literacy in nursing students. Students are neither naively accepting of AI nor reflexively dismissive but are actively working to understand its place within the ethical frameworks of nursing education. These findings contribute to AI integration in nursing education and offer practical guidance for educators seeking to support graduates to be AI-critical and well-equipped to leverage the efficiencies of these tools.
Background: Objective Structured Clinical Examination (OSCE) and Objective Structured Practical Examination (OSPE) are competency-based assessment methods used to evaluate clinical knowledge, psychomotor skills, communication, and professional competence in nursing education. Compared with traditional assessment methods, they offer greater objectivity, standardization, and reliability.
Objective: To explore undergraduate nursing students' perceptions and experiences regarding the use of OSCE and OSPE as clinical assessment methods in nursing education.
Methodology: A qualitative descriptive study was conducted among Bachelor of Science in Nursing students at Northwest Nursing College and NCS University System, Peshawar, Pakistan. Participants were recruited through purposive sampling based on prior OSCE and OSPE experience. Individual semi-structured interviews were conducted from March to April 2024 until data saturation was achieved. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed using Braun and Clarke’s six-phase thematic analysis. Trustworthiness was enhanced through reflexive journaling, researcher triangulation, member checking, peer debriefing, and an audit trail.
Results: Eight undergraduate nursing students participated. Six major themes emerged: promotion of learning, development of clinical confidence, perceived limitations, examination-related stressors, coping strategies, and perspectives on grading. Participants considered OSCE and OSPE effective for promoting active learning, improving psychomotor skills, and enhancing clinical confidence. However, they reported challenges related to examination organization, limited resources, scheduling delays, examiner behavior, perceived grading inequities, and psychological stress. Students managed these challenges through preparation, self-confidence, and prior clinical exposure.
Conclusion: Undergraduate nursing students generally perceived OSCE and OSPE as valuable educational and assessment strategies that facilitate competency development and clinical preparedness. Nevertheless, concerns regarding examination logistics, transparency of grading, and examination-related stress require institutional attention.
Keywords: Clinical Competence, Nursing Education, Objective Structured Clinical Examination, Objective Structured Practical Examination, Pakistan, Qualitative Research, Undergraduate Nursing Students.
Iqdar Ali, Zabih Ullah, Afaq Riaz et al.· Journal of Saidu Medical Col...· 0 citations
A unified educational framework that integrates these components is required to enable confident, adaptable, and practice-ready midwives, and to identify gaps in the existing literature to inform a coherent and future-ready educational framework.
As many newly graduated nurses lack proficiency in practical nursing skills, understanding their development during education and placements is important for delivering high-quality patient care. This study explored first-year nursing students’ reflections on practical skill performance during clinical placements, using Bjørk’s model of practical skill performance as a framework.
A qualitative content analysis was employed, analysing reflection notes from 22 first-year nursing students through deductive content analysis, guided by Bjørk’s model, with additional inductive content analysis to explore qualitative variation in the depth of reflection.
The results revealed that students demonstrated patient-centred care, preparation, and the integration of technical, relational, and contextual elements. Further, that students’ reflection notes varied in how descriptively and analytically they applied Bjørk’s model.
Variability in the depth of reflections using Bjørk’s model highlights the need for tailored educational strategies to promote reflective thinking when learning and performing practical skills.
M. Ravik, I. E. Dalsmo, M. T. Gonzalez et al.· BMC Medical Education· 0 citations
