| Clinical practica, observations, and evaluations are critical aspects of the education that prepares nurse practitioners to provide competent, high quality care. In more than 30 years of U.S. nurse practitioner (NP) education, little has been written on these processes, and there has been no standardization of clinical competency evaluation. NP programs independently define clinical evaluation standards and forms, and NP faculty go into an examination room with a student and patient, close the door, watch the student-patient encounter, and "grade" the student's performance. It is unclear what experienced NP clinical faculty: (1) feel are the critical behaviors NP students must learn and demonstrate; and/or what they (2) actually attend to when making assessment observations. The "experts" are beginning to retire without sharing their practical knowledge, and new faculty find themselves uncertain about their assessment role.;This study described clinical evaluation in nurse practitioner education programs from the viewpoint of expert faculty who regularly do student clinical assessment. The researcher used a two-mailing national Delphi survey and focus groups to assist 81 expert faculty from 52 NP programs in 35 states to: (a) reflect upon their own experiences of doing student performance observations; and (b) articulate their expectations and practical wisdom about NP student clinical competency assessment.;Participant faculty described strategies used, and problems encountered in evaluating student performance. They defined: (1) clinical competencies they consider critical, and most consistently use, in their assessments of NP students; (2) the level of clinical performance they expect of advanced-level students; (3) clinical performance distinctions between "exceptional", "just passing", and "failing" NP students; and (4) factors that determine a student is "unsafe". They also discussed "ideal" clinical evaluation processes, and made suggestions for new faculty orientation to clinical assessment.;The researcher: (a) compared performance expectation data from expert faculty participants with national statements about NP role core competencies (NONPF, 1995; NCSBN, 1997); (b) described the level of proficiency expected of advanced-level NP students, in terms of Benner's (1996, 1984) developmental model of nursing expertise; and (c) developed a model of the clinical evaluation process in nurse practitioner education programs. |
