Clinical assessment and the benefit of the doubt: What is the doubt?

Abstract

Introduction: Clinical education and associated assessment is an important component of nurse education. A range of factors contribute to a culture that makes the assessment of clinical competence difficult. These factors are environmental, educational, cultural and linguistic diversity amongst students, student expectation, a diverse range of clinical education models. All of which contribute to the variable quality of the clinical education experience and the outcome of clinical assessment. 

Aim: The term ‘benefit of the doubt’ is frequently heard in relation to the  assessment process; and, despite the utilisation of a seemingly comprehensive competency framework to assess clinical learning for close to two decades, it seems that a concerning level of doubt persists. The aim of this paper is to examine the complex factors that impact on the quality of decisions around competence the decision by an assessor to assign a judgement of competent or not, and to explore the reasons that lead to doubt on the part of the assessor and to suggest some possible solutions.

Conclusion: It is suggested that what is needed going forward is a continued commitment on the part of government, the health sector, the tertiary education sector and the National Regulatory Authority to implement, value and extend the initiatives that are currently being developed to insure a viable and sustainable education and training culture for clinical supervisors in the future.