Performance Tests in Nursing Skills: High Stakes?!

[historyfan]

Hi everyone: In our nursing program, in the first semester, we require students to successfully pass several different nursing skills (BP, oral medication administration, parenteral medication administration, cardiac/respiratory/GI assessment and a sterile procedure, which could be catheterization, wound care or setting up an infusion). If students are not successful, they can return the following week for a repeat. However, according to our syllabus (and long standing tradition)...if the student is not successful on the second attempt, they are dismissed/have failed the class.

As you can imagine, these performance tests are extremely anxiety provoking. Several other instructors and I have suggested we change our model to something gentler or more forgiving...but we have met resistance from some of the diehards. I can't find any research supporting this type of high stakes testing...

My question is: what do you do? Do you have any other ideas...better ways...any suggestions that I can bring to my colleagues?

Thanks for any advice...it is appreciated.

[CraigB-RN, MSN, RN]

Do you do any remediation between assesments?

[historyfan]

Yes, we give students immediate feedback (verbal and written) explaining what they missed on the performance test. Then they have one week to practice in the nursing lab and refine their skill, after which time they come back for the second chance.

[meanmaryjean, DNP, RN]

What if you allowed the student to video themselves doing the procedure while narrating? Seems like it's the audience that is the major source of anxiety. Remove the audience and you remove some of the anxiety.

And a student who self-reports on a step they miss during debriefing (before feedback) should get an extra attempt. Just my 2 cents.

[historyfan]

I love this idea! I've thought of videotaping and I know other schools use this approach. Maybe that's the direction we need to go. Thank you!