The critical incident technique in evaluating student nurse performance

LONG@) describes a study of ward sisters’ reactions to a specific form designed for reporting on student nurses’ clinical progress. Such forms are general in terms of the dimensions to be judged, e.g. ‘Maintains a very high standard when carrying out nursing procedures’ and ‘Works well as a member of a team’. The particular form examined asks for judgements on 28 items (including an overall grading), divided into five main headings: application to work, quality of work, attitude to patients, attitude to co-workers and professional behaviour. Long’s study concentrated on reactions to the structure of the form and factors influencing its completion, e.g. contact between sister and student, the perceived purpose of the report form and the time available to the sister for carrying out the reporting process. The question of sisters’ value systems, in terms of their perceptions of ‘effective nursing’, and how they might influence completion of such a form was examined in parallel with Long’s study and forms the basis of this report. The general literature on report forms (Guilford) t2) stresses, among other things, that a form should be completed by the person in the best position to observe relevant behaviours, that the items on a form should be understood by the rater and that the items should be seen by raters to be relevant to the overall concept of competence. There have been numerous and well documented studies of the involvement of raters in the design of reporting procedures, aiming to produce documents seen as relevant, meaningful and acceptable to their users. Among such studies in nursing are those of Bailey, t3) Goreham, t4) Smith and Kendall, t5) and Fivars and Gosnell.@) Similar approaches have been used to design systems for evaluating physicians; Brumback and Howell(‘) and Freeman and Byrne.(*) Each study has attempted to obtain descriptions of specific behaviours seen by raters (actual or potential) as indicating effective or ineffective behaviour in a relevant aspect of the job. The procedures for collecting these descriptions follow or adapt those described by FlanagancD) in his ‘Critical Incident Technique’. The assumption behind the technique is that raters will make inferences about a person’s general competence on the basis of the person’s performance in a number of specific situations. Flanagan