This paper aims to describe a clinical evaluation tool for assessing nursing students’ competency with taking blood pressures. The proposed tool uses the method of observation to evaluate students’ performance while measuring blood pressure. According to Oermann and Gaberson (2019), despite its wide use, observation is questionable in terms of reliability and validity because of the observer’s bias related to the first impression. Therefore, it is decided that in this clinical evaluation tool, the observation of each student should be performed two times to get a more accurate performance evaluation. Observation will take place in classroom settings with the help of simulation, namely, standardized patients. A detailed classroom scenario will be discussed in the respective section.
The observation of students will be recorded in a checklist. Checklists are a common tool used for evaluating performance in standardized patient simulations (Oermann & Gaberson, 2019). The checklist will contain 11 items reflecting the steps that need to be performed while taking blood pressures. These items include (1) letting the patient relax for 5 minutes before measuring pressure; checking whether the patient has (2) uncrossed legs, (3) feet on the floor, and (4) arms supported; (5) choosing the right cuff size; (6) placing the cuff over the bare arm; (7) not speaking; (8) excluding the use of mobile phone or reading; (9) taking measurements in both arms; (10) identifying the arm with higher BP as more important; (11) choosing the arm with higher BP for future measurements (Rakotz et al., 2017). The observer will use the checklist to mark each step that the student performs correctly.
The Scenario of the Tool Being Put to Use
The suggested clinical evaluation tool is supposed to be used in classroom settings. The simulation should involve a standardized patient, that is, an actor who should be taught to follow the predetermined script and not talk to the student unless the student asks questions. According to the script, the standardized patient should be described to the student as a 50-year-old individual who has not seen a doctor for several years. Based on this information, the student should conclude that BP should be measured in both arms.
Students should enter the classroom individually and see a patient sitting on a stool with no support and having his or her legs crossed. According to the script, the patient should ask the student to begin the measurement right away and start using his or her phone while measuring BP. These elements are included in the standardized patient script to test the student’s ability to identify and correct patient behaviors that could distort BP readings. As for the BP measurement equipment, it is suggested that an automated BP device should be used. The use of automated BP devices is explained by recent US guidelines that prescribe utilizing automated appliances whenever possible to reduce the risk of human error and bias (Rakotz et al., 2017). Furthermore, a measuring tape and cuffs of different sizes should be present to evaluate whether the student can choose the right cuff size. A teacher should observe how the student measures the patient’s BP and mark items on the checklist each time the student performs the necessary step correctly.
Outcomes of the Tool’s Use
The use of the clinical evaluation tool for assessing competency with BP measurement will result in identifying the student’s ability to perform the procedure correctly. Since it has been proposed that two observations will be necessary, it is suggested that the first evaluation should be formative, and the second one should be summative. Formative evaluations aim at providing feedback to students to enhance their learning outcomes, while summative evaluations are conducted at the end of the course to assess the student’s competencies (Oermann & Gaberson, 2019). Thus, after the first observation, the teacher may discuss the student’s performance with the student and provide both verbal and visual feedback. This will ensure that the learning needs of each student will be met. After the second observation, the teacher will grade each student’s competency with taking BP to identify the student’s success in completing the course.
Oermann, M. H., & Gaberson, K. B. (2019). Evaluation and testing in nursing education (6th ed.). Springer Publishing Company.
Rakotz, M. K., Townsend, R. R., Yang, J., Alpert, B. S., Heneghan, K. A., Wynia, M., & Wozniak, G. D. (2017). Medical students and measuring blood pressure: Results from the American Medical Association Blood Pressure Check Challenge. Journal of Clinical Hypertension (Greenwich, Conn.), 19(6), 614–619. Web.