Grading student clinical practice performance: the Australian perspective

Educators have long considered assigning a grade in the assessment of student clinical practice performance as too variable, too subjective, or educationally inappropriate. Consequently, most undergraduate nurse education programs have maintained non-graded pass/fail criteria assessment for evaluating and reporting student clinical performance. This paper argues that, while the varied clinical environments do make assessing students’ clinical performance difficult, the reliability and validity of assessment practices should be maintained no matter what the grading system. Furthermore, many assumptions about criterion-referenced assessment, and the associated preclusion of graded assessment, are seen to be baseless when dealing with competencies rather than with traditional behavioural objectives. By combining both criterion-referenced and norm-referenced assessment, graded assessment can clarify and impress on students the minimal competency requirements, while at the same time describing and rewarding meritorious practice. It is argued that to do so would provide a more appropriate way of communicating the assessment of theory application in praxis, a highly relevant issue in a practice-based discipline such as nursing. It is now appropriate to reconsider the debate of graded student clinical performance assessments, and to investigate both the practicalities and benefits of this approach.