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Running head: DEVELOPING A CLINICAL RUBRIC 1

Scholarly Project Synthesis Paper: Developing a Clinical Rubric

Erin Kibbey

Ferris State University

DEVELOPING A CLINICAL RUBRIC 2

Abstract

The importance of assessing competency in the clinical setting is an essential job for the nurse

educator, although a universal way of doing so has not yet been agreed upon. While rubrics have

conventionally been used in academia, they are much less commonly used for evaluation of

performance in the hospital setting. The creation and implementation of a clinical rubric tool

could provide a uniform method for documenting and evaluating the progression of competency.

This paper describes a scholarly project created to gain experience in the nurse educator

competency of utilizing evidence-based assessment and evaluation techniques. The project

involved the development of a clinical rubric for use in the critical care internship program by

preceptors and educators at Munson Medical Center in Traverse City, Michigan. This paper

further describes the project goals and objectives, as well as details the experiences, analysis of

outcomes and adherence to standards, evaluation, and future recommendations for

implementation of a similar project.

Keywords: clinical rubric, clinical setting, competency, nurse educator


Scholarly Project Synthesis Paper: Developing a Clinical Rubric

As a future nurse educator, the ability to develop evidence-based assessment and

evaluation techniques is an important competency identified by the National League for Nursing

(NLN, 2012). Demonstrating skill in the design of tools for assessing clinical practice is also one

key to fulfillment of this competency (NLN, 2012). The following project focused on the

development of a rubric for evaluating competency of nurses within the clinical setting and was

created in order to help develop this NLN competency further.

Clinical evaluation is defined as a process that uses judgment about learners’

competencies in practice (Gaberson & Oermann, 2010). The importance of assessing and

verifying competency in the clinical setting cannot be underestimated. Yet, the best way to

achieve this requirement has not been widely agreed upon or established (Fahy et al., 2011).

According to the American Nurses Association (ANA, 2008), tools that capture objective and

subjective data about the learners’ knowledge base and performance and are appropriate to the

situation can be used to evaluate competence. Most often, evaluation about clinical performance

involves the direct observation of one’s performance and a subsequent judgment about

competence (Gaberson & Oermann, 2010). However, evaluation of competency in the clinical

setting can be subjective, influenced by values, and inconsistent amongst various evaluators

(Bonnel, 2012; Gaberson & Oermann, 2010). In addition, clinical evaluation is often assessed by

novice educators or preceptors that have received little preparation on how to determine the level

of one’s performance, how to provide constructive feedback, and have restricted time to devote

to providing feedback (Walsh, Seldomridge, & Badros, 2008; Isaacson & Stacy, 2009). A

framework for guiding observations and subsequent judgments should be based on outcomes or


competencies and known in advance in order to promote clear communication and expectations

(Bonnel, 2012; Gaberson & Oermann, 2010).

A clinical rubric is one tool that can be used to promote clear communication and

expectations about how competence is evaluated. Rubrics are defined as “scaled tools with

levels of achievement and clearly defined criteria placed in a grid. Rubrics establish clear rules

for evaluation and define the criteria for performance” (O’Donnell, Oakley, Haney, O’Neill, &

Taylor, 2011, p. 1163). The degree of performance in the clinical setting can be judged both

qualitatively and quantitatively through the convenient use of a rubric form (Bonnel, 2012).

Rubrics serve the purpose of specifying teaching and learning outcomes for both evaluator and

learner, thus reducing the subjectivity inherent in assessment (Frentsos, 2013; Isaacson & Stacy,

2009; O’Donnell et al., 2011). Therefore, the purpose of this scholarly project was to develop a

clinical rubric tool that could be used as a framework for evaluating clinical competence at a

hospital in northern Michigan, Munson Medical Center (MMC). The purpose of this paper is to

describe the project goals and objectives, personal and professional accountability for the project,

analysis and evaluation of the project, and recommendations for future implementation of a

similar project.

Project Description, Goals, and Objectives

Since there is no uniform tool used for assessment of clinical competence by preceptors

orienting nurses to the critical care internship program at MMC, all of the interns in the

internship program were being evaluated using different assessment practices, which had led to

difficulties in providing feedback between preceptors, interns, and the internship coordinator (P.

Hresko, personal communication, September 5, 2012). Thus, the purpose of this project was to

establish a uniform method for documenting and measuring clinical competency through the use


of rubrics. Therefore, the first goal of this project was to create rubrics that could be used for

measuring clinical competency of the critical care interns at MMC. The second goal of the

project was to implement the rubrics for use by preceptors working with the interns. Several

objectives were outlined in order to help meet these two goals. These objectives included:

obtaining references referring to the use of rubrics and their development, collaborating with a

team for input, determining competency standards, creating the rubric and an evaluation tool,

presenting rubrics to preceptors, trialing rubrics, and obtaining feedback.

Goal 1: Rubric Creation

The first objective for this project was to obtain literature and references about rubrics.

This objective was created as a first step to understanding the creation of rubrics and how they

may be best used in the specified setting. Activities designed to support this objective included a

search of various databases, compilation of a reference list, and a review of the literature.

The second objective identified for this project was to perform a needs assessment. This

coincides with Stevens and Levi’s (2005) first step to rubric creation, reflection. Reflection takes

into consideration what is desired from the learner, why the assessment is being created, what

type of rubric is needed, and other issues associated with the construction of a rubric (O’Donnell

et al., 2011). Because the involvement of key stakeholders in the creation of rubrics can provide

several benefits, according to O’Donnell et al. (2011), collaboration is important during this

stage. Feedback from the needs assessment as well as information gleaned from meeting with

staff educators was designed to be utilized for the next step. Since collaboration is so beneficial

to the creation of rubrics, the formation of a collaborative team for supplying input throughout

the creation process was the third objective. Some of the benefits of collaboration during this

time is the opportunity to discuss differences and clarify misunderstandings, take a sense of


ownership, and increase the chances of creating rubrics that everyone will accept (O’Donnell et

al., 2011).

The fourth objective related to the goal of developing rubrics was to determine the care

standards for the rubrics being created. This objective correlates with the second step in the

process of rubric development and involves defining the specific learning issues and level of

performance to be accomplished. According to Stevens and Levi (2005), team members should

decide whether the assessment is about knowledge content, skills, or both. Taxonomy guides

can be used during this time to clarify specific objectives and defining the level and type of

learning expected (O’Donnell et al., 2011). Scales defining the level of performance usually

include three to five levels such as “excellent”, “competent”, and “needs work” (Kirkpatrick &

DeWitt, 2012; O’Donnell et al., 2011). Reviewing the standards of practice and any other

application materials needed for the development of specified learning objectives are done at this

time.

The final objective was to completely develop the rubric and a tool for feedback. During

this stage of rubric development, items with similar expectations for performance are put

together and form the rubric dimensions (O’Donnell et al., 2011). The performance or task being

evaluated is broken down into components during this step (Kirkpatrick & DeWitt, 2012). The

fourth and final step to rubric creation is application, or the creation of the rubric grid. The last

activity designed to support this objective was to evaluate the rubrics.

Goal 2: Rubric Implementation

The second goal of this project was to implement the rubrics for use by the preceptors

working with the interns. The first objective to support this goal was to present the rubrics to

preceptors. This objective is important because it relates to the reliability and validity of the


rubrics. Validity refers to ensuring that the performance questioned is the performance being

measured by the rubric (O’Donnell et al., 2011). On the other hand, reliability is concerned with

consistency of ratings across multiple performances. According to O’Donnell et al. (2011), it is

best to give the raters the rubrics prior to implementation in order to increase accuracy. In

addition, opportunities for discussion with evaluators can lead to better consistency and possible

modifications to the rubrics.

The final objective of this project and the implementation stage was to obtain feedback.

Compiling feedback from team members, preceptors, educators, interns, and Ms. Hresko is one

activity that was planned for this time. Informal focus groups that include students and

evaluators can be useful for testing the interpretation of language used in a rubric (O’Donnell et

al., 2011). Rubrics can be used by facilitators to identify areas of student strengths and

weaknesses, assisting with both formative and summative assessment (O’Donnell et al., 2011).

Self-evaluation using a metarubric was another activity designed to support this objective.

Accountability

Professional nursing practice requires accountability for actions at all times (Ritchie &

Gilmore, 2013). In addition, personal attributes such as showing integrity, discretion, common

sense, and excellent communication skills are essential components of competent nursing

practice. In order to carry out this project, personal and professional accountability were

essential. From the start of this project, it was my responsibility to carry out the previously

described goals and objectives, including following through with the proposed project planning

guide and timeline of activities.


Personal

Throughout the implementation of the scholarly project, I demonstrated personal

accountability by adhering to deadlines, communicating with my preceptor and key project

stakeholders, displaying integrity, promoting collaboration, and demonstrating professionalism.

Specifically related to the project goals and objectives, I was accountable for carrying out all

completed aspects of this project, including the needs assessment survey (see Appendix A),

clinical rubric tool (see Appendix B), metarubric (see Appendix C), presentation of the project

for approval, and compilation of the project and presentation feedback (see Appendix D &

Appendix E). A letter confirming my accountability to presenting and obtaining feedback about

this project to hospital educators and clinical nurse specialists is included in Appendix F. In

addition, I was accountable for analyzing survey results, reflecting on my project, and reviewing

the literature. The bibliography, located at the end of this paper, is a list of research and

literature I personally reviewed in order to provide the foundation of knowledge necessary to

even begin this project.

Professional

According to the ANA (2010), nurses are “accountable for their professional actions to

themselves, their healthcare consumers, their peers, and ultimately to society” (p. 10). In

addition, nurses are expected to take part in activities, including leadership, related to their

professional role and appropriate to their education and situation. A nurse educator is defined by

its three roles of teacher, scholar, and collaborator (Southern Regional Education Board (SREB),

2002). All three of these roles were utilized in the implementation of this project, thus

demonstrating professional accountability related to the nurse educator role.


Teacher. The teacher function within the nurse educator role provides leadership in

curriculum, instruction and evaluation. Being a role model for suitable, desired behaviors of

professional practice, according to the SREB is also an essential component of the teacher role.

Through the course of this scholarly project, I was accountable for providing leadership in

evaluation methods through the development of a tool that could provide direction and promote

consistency in clinical evaluation of the critical care interns. In addition, I professionally

presented information related to clinical evaluation and the development of my rubric tool to

several hospital educators and resource nurse clinicians, further promoting leadership related to

clinical evaluation.

Scholar. A second role of the nurse educator is that of a scholar. This role is responsible

for the research of teaching, discovery, application and integration (SREB, 2002). Moreover,

designing, collaborating and using research to keep up with current knowledge in order to

integrate findings into the practice of the profession defines this component of the nurse educator

role. The creation of a needs assessment and integration of its results into the foundation of the

clinical rubric, as well as research on critical care competence, rubric development and clinical

evaluation methods were key activities I was accountable for related to this role.

The ability to integrate theoretical knowledge is also an important component of the

scholar role (SREB, 2002). Professional accountability to this component of the scholar role was

demonstrated through the utilization of cognitive learning theory into the design and framework

for the project. Cognitive learning theory focuses on students taking an active role in learning

(Candela, 2012). When taking an active role in learning students must be able to demonstrate

what they know (Bargainnier, 2003). Cognitive learning theory focuses on mental processes and

acquisition of knowledge and not just learning how to perform a task (Candela, 2012). This


central component of cognitive learning theory was the basis for this project and the reason for

not just utilizing a checklist to measure competency in the clinical setting, but using a rubric to

measure cognitive processes. According to Marcotte (2006), “well-designed rubrics help

instructors in all disciplines meaningfully assess the outcomes of the more complicated

assignments that are the basis of the problem-solving, inquiry-based, student-centered pedagogy

replacing the traditional lecture-based, teacher-centered approach in tertiary education” (para 3).

Thus, the use of rubrics for assessment and evaluation emphasizes the application and use of

knowledge, not just measurement of isolated, discrete knowledge (Bargainnier, 2003). This

emphasis is central to cognitive learning theory and its constructivist approach to knowledge

attainment.

Collaborator. Thirdly, as a collaborator a nurse educator should be able to work in

partnership with peers, students, administrators and other diverse constituencies in order to fully

express their role. As a skilled collaborator, nurse educators should be able to use their

knowledge and expertise associated with collaboration so they may endorse and improve best

practices within the teacher and scholar roles as well (SREB, 2002). Accountability to this

professional nurse educator role was demonstrated through collaborative efforts with my

preceptor, unit educators, and preceptors. I was responsible for obtaining a list of preceptors for

the needs assessment survey and had to first contact the educators of the various critical care

units and solicit their help. I also emailed and requested preceptors to complete the survey. In

addition, I utilized best practices in the development of the clinical rubric, including the use of

the American Association of Critical-Care Nurses (AACN) synergy model as a framework for

the rubric. Presentation and evaluation of the project based on feedback from hospital educators,


preceptors, and clinical nurse specialists was another essential responsibility I carried out in this

role.

Analysis of Outcomes and Adherence to Standards

As a future nurse educator, it is important to understand how the work one does has an

effect on patients, systems, the nursing profession, and the organization as a whole.

Additionally, adherence to legal, ethical, professional, and organization standards are an essential

component to any scholarly project. An analysis of the projects outcomes as well as challenges

related to adherence of legal, ethical, professional, and organization standards are included in the

following sections.

Outcome One

The first outcome of this project was an analysis of the literature related to the use and

development of rubrics, clinical competency assessment and evaluation, adult learning theory,

cognitive learning theory, and the development of clinical competency. This outcome aligned

with the first objective of the project. A bibliography, included at the end of this paper, was

created in order to help achieve this outcome. One of the key literature findings was information

related to the best practices for clinical evaluation. It is emphasized in the literature that clinical

evaluation should include extensive formative and periodic summative evaluation, be timely and

continuous with suggestions for improvement, and based on preset outcomes, clinical objectives,

or competencies (Bonnel, 2008; Gaberson & Oermann, 2010). In addition, adequate preparation

for evaluators should include information about how to provide feedback and include tools, such

as rubrics, to promote consistency and fairness in evaluations. According to Isaacson and Stacy

(2009), clinical evaluation remains a challenge, but a strong case can be made for the utilization

of a rubric during the clinical evaluation process.


Another key literature finding was the support for the use of rubrics in a wide range of

academic subjects including economics, writing, speech, dentistry, and chiropractic medicine

(McGoldrick & Peterson, 2013; O’Donnell et al., 2011; Rezaei & Lovorn, 2010; Saxton,

Belanger, & Becker, 2012; Xiaohua & Canty, 2012). Furthermore, the literature supports rubrics

as an effective tool for clinical skill assessment and evaluation of student progression toward

competence (O’Donnell et al., 2011). Rubrics typically consist of three main parts including a

scale of the levels of performance, dimensions or criteria for evaluation, and a description of the

dimensions (O’Donnell et al., 2011). Rubrics are either holistic or analytical. According to

Kirkpatrick and DeWitt (2012), holistic rubrics are more globally scored and thus typically focus

on overall performance. Analytic rubrics, on the other hand, examine each significant

characteristic of performance. Depending on the type used, rubrics can provide summative or

formative evaluation of learning. Typically analytic rubrics are chosen for formative evaluation

and holistic rubrics are better suited for summative evaluation.

Finally, the literature also noted that although rubrics have been embraced throughout

academia, nursing staff development educators do not use rubrics consistently, instead they

typically use the nursing skills checklist (Frentsos, 2013). Despite the lack of consistent use of

rubrics in clinical nursing education, rubrics have many benefits. Research has shown that

rubrics support adult learning principles, provide competency documentation required by

regulatory agencies, can improve quality of care, allow more discrimination in judging

behaviors, and can expand knowledge through its use (Bonnel, 2012; Frentsos, 2013; Isaacson &

Stacy, 2009; Walsh et al., 2008). It has also been noted by Bonnel (2012), that rating scales offer

more detail about the quality of a performance compared to nursing skill checklists. In addition,

as previously mentioned, rubrics include more specific guidance for graders, thus promoting


reliability between graders. Rubrics provide timely and detailed feedback without superfluous

writing, an opportunity to self-assess, and promote clear communication for completion of skills

using best practice (Bonnel, 2012; O’Donnell et al., 2011; Walvoord & Anderson, 2010).

Outcome Two

The second outcome of this project was the creation and evaluation of a needs assessment

survey. This outcome aligned with the second objective of the project. A needs assessment is

“the process of collecting data to identify learning needs of employees” (Avillion, Brunt, &

Ferrell, 2007, p. 45). In addition, a needs assessment can identify specific needs, validate the

needs to key stakeholders, and document the identified needs into a format that can be

developed. Accordingly, needs assessment surveys should focus on obtaining the respondent’s

opinion, enable responses to be provided on a rating scale, multiple choice, fill-in-the-blank or

completion, or open-ended (Avillion, Brunt, & Ferrell, 2007). Thus, I ended up creating a 32

question survey utilizing a Likert five point scale (see Appendix A), the most widely used

scaling technique (Polit & Beck, 2012). The survey included demographic questions, a section

about feelings related to current assessment and evaluation strategies, and a section pertaining to

feelings toward the use of rubrics. Some advantages to using surveys include the ability to

obtain data in a short period of time, familiarity with the approach, honesty with anonymity, and

ease of tabulating results (Avillion, Brunt, & Ferrell, 2007).

Analysis of data from the survey was utilized to further understand evaluator attitudes.

The target population consisted of 55 critical care internship preceptors. I was able to achieve a

response rate of 67%-69%. Respondent demographics were representative from both day (55%)

and night (45%) shifts, all the critical care departments including 12.5% from the emergency

department, 37.5% from the cardiothoracic unit, 22.5% from the cardiovascular unit, and 27.5%


from the intensive care unit. The number of years the respondents had been precepting interns

ranged from less than one year (17.5%), 1-3 years (25%), 4-6 years (27.5%), and 7-10 years

(15%), to more than ten years (15%), respectively.

A confidence interval is the range of values that a population parameter is estimated at

being found within (Polit & Beck, 2012). The error of measurement is defined as “the deviation

between true scores and obtained scores of a measured characteristic” (Polit & Beck, 2012, p.

727). Using a 95% confidence interval the margin of error for the survey results was calculated

at 8.8% - 9.2%. Since the questions used an interval scale that ranged from 0 to 5 (so there were

5 equal intervals in the scale), a margin of error near 10% coincides with one full interval point

(20% of 5). Thus, if the survey was conducted 20 times, 19 out of 20 times (95%), it is expected

that the mean score will lie within +/-10% of the mean score found when the survey was initially

conducted.

Important findings gleaned from the survey included a response of 60% that disagreed or

strongly disagreed with survey item “I have a tool I consistently use to provide written

feedback.” Another important finding was that 68% of respondents agreed or strongly agreed

that evaluation of progression was inconsistent among preceptors. In addition, over 65% of

respondents felt that their unit did not have a tool that accurately communicated levels of

progress. On top of that, over 65% of respondents also believed that criteria for evaluating

progression of competence was unclear. With regard to items related to rubrics, there were also

several important findings. Half of participants were familiar with the use of rubrics. Over 50%

of respondents believed that rubrics would be beneficial for use in evaluating progression of

competence, only 5% disagreed, and 27% were unable to comment. Finally, nearly 60% of

surveyed preceptors were interested in using rubrics for evaluating progression of competence,


16% were not, and 16% were unable to comment. Since the needs assessment survey really did

show a desire by preceptors to have a tool that helped them communicate progression of

competency, this was the area I decided to focus the creation of one rubric on for the duration of

the project.

Outcome Three

The third outcome of this project was the synthesis of competency standards into the

developing rubric. The achievement of this outcome corresponded to objectives four and five.

In determining competency and evidence based practice standards for competency evaluation, I

examined how important organizations viewed competence. According to the ANA (2008),

competence is defined as the expected level of performance that integrates knowledge, skills,

abilities, and judgment. The ANA (2008), also notes that competence can be influenced by the

nature of the situation. The ANA’s (2008) Professional role competence (Position Statement)

was utilized as the main source of references for several other organizations’ competency

standards. Competency standards from the Institute of Medicine, the Quality and Safety

Education for Nurses, the National Council of State Board of Nursing, the Joint Commission and

the American Association of Critical-Care Nurses (AACN) were all reviewed. Through this

process, I was able to determine that the theoretical framework and domains of competence for

the critical care internship clinical competency rubric would be based on the AACN’s Synergy

Model.

The AACN Synergy Model for Patient Care is based on five assumptions (AACN

Certification Corporation, 2002). These assumptions include:


Patients are biological, psychological, social, and spiritual entities who present at a

particular developmental stage. The whole patient (body, mind and spirit) must be

considered.

The patient, family and community all contribute to providing a context for the nurse-

patient relationship.

Patients can be described by a number of characteristics. All characteristics are

connected and contribute to each other. Characteristics cannot be looked at in

isolation.

Similarly, nurses can be described on a number of dimensions. The interrelated

dimensions paint a profile of the nurse.

A goal of nursing is to restore a patient to an optimal level of wellness as defined by

the patient. Death can be an acceptable outcome, in which the goal of nursing care is

to move a patient toward a peaceful death. (p. 9)

This model was designed to describe nursing practice and the development of nurse

competencies based on characteristics and needs of patients, as well as demands of the future

healthcare environment (Curley, 1998). Furthermore, the model describes eight competencies of

nursing practice including: clinical judgment, advocacy and moral agency, caring practices,

facilitation of learning, collaboration, systems thinking, diversity of responsiveness, and clinical

inquiry (AACN Certification Corporation, 2002). The various competencies are utilized based

on the patient’s needs; synergy results when a patient’s needs are aligned with a nurse’s

competencies.


Outcome Four

The fourth outcome of this project was the actual creation of the clinical rubric tool (see

Appendix B) and the selection and adaptation of a metarubric tool (see Appendix C) used for

evaluation of the created rubric. This outcome corresponded to the projects fifth objective.

There are four main steps to creating a rubric, according to Stevens and Levi (2005). The first

step involves reflection. The second step is listing and defining the specific learning objectives.

The third step consists of grouping similar components. The final step to rubric creation is

applying dimensions and descriptions.

The rubric created consists of nine dimensions including: clinical judgment, thinking in

action, advocacy and moral agency, caring practices, facilitation of learning, collaboration and

communication, systems thinking, response to diversity, and clinical inquiry. The rubric scale

correlates to Benner’s (2001) novice-to-expert model and uses the headings of: expert, proficient,

competent, advanced beginner, and novice. Experts, according to Benner, perform a wide

variety of functions and activities well, tend to use cues and labels that are not as obvious, take

pleasure in teaching others, and may be mentors for other competent or proficient nurses (Levi,

2001). The competent level was written to indicate the minimum standard level that the interns

should be at by the end of the internship program. Descriptions for each of the dimensions and

domains were also created utilizing Benner’s model. Research by Steffan and Goodin (2010),

noted that although Benner’s model has been described by few authors as a basis for a nurse

orientee evaluation tool, over 76% of their studies preceptors perceived the tools utilizing this

framework as easy to use and helpful for evaluation. In addition, Steffan and Goodin (2010)

referenced several articles utilizing Benner’s model during the evaluation process for orientation

as well as for self-assessment.


According to the literature, a rubric should be easy to use and interpret, valid and reliable,

and fair (Bargainnier, 2003; O’Donnell et al., 2011; Stevens & Levin, 2005). In order to make

effective revisions to rubrics that are meant to be flexible and adaptable tools, evaluation of the

rubrics is required (Stevens & Levi, 2005). A metarubric is a rubric used to evaluate rubrics

(Stevens & Levi, 2005). In addition, metarubrics can be applied for individual use in refining the

rubric details. The metrubric used for this project was adapted from Arter and McTighe (2001).

It consists of four main domains including: content coverage, clarity, practicality, and technical

quality.

Outcome Five

The final outcome of this project was the proposal of my rubric tool to MMC resource

nurse clinicians and clinical nurse specialists. The project was presented on March 27, 2014.

Request to be placed on the group’s agenda was approved in February. I was allotted

approximately 20 minutes to complete my presentation. Since lecture is considered useful in

clarifying complex, confusing, and new content, this was the main teaching strategy utilized to

deliver the content of my presentation. In addition, I utilized PowerPoint for an audiovisual

component and incorporated both passive and active teaching strategies. Although passive

learning and lecture has its advantages, it often lacks cognitive effort or the required use of

higher cognitive skills (Billings & Halstead, 2009). For this reason, I incorporated strategies

such as discussion and questioning that required the use of active learning methods. Active

learning is defined as using participation and exploration throughout all stages of the learning

process and has been shown to increase critical thinking skills and participation (Billings &

Halstead, 2009; Tedesco-Schneck, 2013). This process also allowed me to gather informal


feedback, which was one of my main goals for delivering the presentation of my project to this

group.

Legal Adherence

The use of reliable tools, such as rubrics, in evaluation of nursing competence helps to

ensure competence and a safe entry into nursing practice (Oermann, Saewert, Charasika, &

Yarbrough, 2009). Nurses have a duty to protect patients from an unreasonable risk of harm. By

developing this clinical project, I was able to create a tool that may be used to help prevent

unsafe nursing performance from being hidden due to a lack of adequate evaluation methods and

documentation practices. Rubrics can be utilized to indicate regulatory compliance, legal

reference, and improve quality of care (Frentsos, 2013). As such, the development of this project

adhered to the usage of the AACN’s core performance standards necessary to provide competent

critical care nursing. Competency standards from other important organizations were also

utilized in the development in this project. According to Gaberson and Oermann (2010), those

that make decisions about clinical competence should start with defining core performance

standards that include cognitive, sensory, affective, and psychomotor competencies. Thus, these

components were synthesized into the creation of the rubric created during this project.

Ethical

The ANA’s Code of Ethics for Nurses with Interpretive Statements (2001) is the guiding

document used to express the ethical obligations and duties of nurses, ethical standards, and the

nursing profession’s commitment to society. Since ethical practice is such an integral

component of nursing practice, I incorporated ethical principles directly into three of the nine

domains on the rubric created. The domain of advocacy and moral agency speaks to the ethical

principles of autonomy and fidelity. In addition, the ethical principle of beneficence is


incorporated into the domain of caring practices. Finally, the principle of justice relates to the

systems thinking domain and addresses the ability of the nurse to manage environmental and

system resources for patient, family, and staff across the healthcare system. The principle of

nonmaleficence is synthesized throughout the rubric and a key component to the purpose of

developing this project to begin with. The ANA (2001) also noted that nurses have many roles

and their interpretive statements can be applied to the nurse practicing as an educator as well as

many other roles. With this in mind, this project also adhered to ethical principles of respect for

the rights of those I interacted with to fulfill project outcomes, making a concerted effort with

others to attain the shared goal of improvement to questionable evaluation practices, and

implementation of written critical care nursing practice standards to be utilized for evaluation of

safe nursing practice. Finally, according to Shipman, Roa, Hooten, and Wang (2011), “rubrics

are touted as a fair, equitable, and consistent scoring guide measuring student achievement” (p.

247), further demonstrating the adherence to ethical nursing practice in the development of this

project.

Nursing

The practice of nursing is taking place in a continually more complex environment, thus

it can be a challenge to provide feedback without essential tools, preceptor preparation, or

sufficient time (Walsh et al., 2008). In addition, “skills such as patient assessment and critical

thinking challenge students at the higher levels of learning described in Bloom’s taxonomy and,

therefore, require a more complex assessment tool to identify and quantify student achievement

of those skills” (O’Donnell et al., 2011, p. 1174). If an individual is consistently having

problems or doing well in the same area, a rubric can showcase these outcomes (Isaacson &

Stacy, 2009). Thus, a rubric could be helpful in creating goals for improving areas of nursing


practice that might otherwise go unnoticed or unwritten. The creation of a clinical rubric

designed to help with these challenges was one way this project adhered to nursing standards.

A second way this project adhered to nursing standards was through the incorporation of

the AACN’s Synergy Model and critical care competency standards into the rubric created. The

AACN’s model values the development of nurse competencies and states, “all these

competencies reflect a dynamic integration of knowledge, skills, experience, and attitudes

needed to meet patients’ needs and optimize patients’ outcomes” (Curley, 1998, p. 66). Patient

characteristics include: vulnerability, resiliency, stability, complexity, predictability, resource

availability, participation in care, and participation in decision making (AACN Certification

Corporation, 2002). According to Kenney (2013), nursing models and theories should be useful

in practice, logical and consistent with validated theories, and provide rationale and

consequences of nursing actions, leading to predictable patient outcomes. This is how the

Synergy Model could be viewed. The Synergy Model’s metaparadigms and its focus on optimal

patient outcomes are based on evidence-based nursing interventions. In addition, clinical

judgment is a core component of nursing practice in the Synergy Model, which is grounded in

the nursing process (Peterson & Bredow, 2013). Nursing interventions are planned based on the

integration of knowledge and critical thinking. The Synergy Model was developed to describe

nursing care in a high technology, multifaceted and often hectic environment (Peterson &

Bredow, 2013). These are all important considerations in the practice of critical care nursing.

Organizational

According to the Munson Medical Center strategic plan for nursing services 2013-2016

(MMC, 2013), one of the nursing strategic goals for the organization is that “nurses grow

professionally as preceptors, mentors, and leaders within the organization” (p. 8). One of the


tactics created to achieve this goal was to standardize preceptor education including evaluation.

Through the development of a clinical rubric that could be used by preceptors to evaluate interns

throughout the organization, this project works towards achieving MMC’s strategic plan.

Moreover, as evidenced by the needs assessment survey results, many preceptors felt they were

lacking a standard framework to utilize in the process. In addition, MMC’s care delivery model

is based on providing clinically competent, caring, and individualized care to patients and their

families (MMC, 2013). These standards were synthesized into the clinical rubric created. Thus,

this project adhered to MMC’s standards and actually worked towards achievement of

organizational goals.

Challenges

One of the main challenges to this project was the inability to fully carry out my second

goal of the project and implement the rubrics for use by preceptors. The inability to adhere to

this goal was both an issue with timing and organizational processes. In designing the proposal

for this project, I was unaware that a presentation for the project and evaluation of the project

would need to be done approximately one month before the end of the semester. The second half

of my project was not slated to start until the last month of the semester, corresponding to the

first few weeks of the interns being assigned to their home units. In addition, part way through

the semester, my preceptor required that I present the final draft of my rubric to the hospital

educator group for approval and feedback. She noted that this approval process was required

before trialing the rubric and moving to the implementation phase. Thus, I set-up and delivered

the presentation of my project to the educators on March 27, 2014. An action plan is in place for

the rubric to be presented to preceptors by the coordinator of the internship program and she will


begin trialing the rubric and making revisions as necessary. Unfortunately, this was the last step

of the project that was completed.

Evaluation

An evaluation tool (see Appendix D) was created and utilized as a means of evaluating

the goals of this project. The evaluation was completed by myself and my preceptor. Both of

these evaluations utilized a Likert five point scale. A Likert scale allows the evaluator the

opportunity to express an opinion on a particular issue through indicating the degree to which

they agree or disagree (Bourke & Ihrke, 2012). Overall, I feel this was a successful project. As

previously mentioned, the only main aspect of the project that was not able to be carried out was

a trial of the rubrics on the critical care units. My preceptor’s evaluation of the project was also

highly rated.

According to Saunders (2003), evaluation of instruction or the educational process can be

done formally or informally. Thus, the evaluation of the project and presentation was completed

using both of these methods. Informal examples included remarks from the group during the

presentation. Upon presentation of the rubric, one of the clinical nurse specialists noted that the

framework used for the rubric was a great choice. In addition, another comment from an

individual was that they felt the rubric could also be used for performance evaluation. Finally,

another educator stated that she felt the rubric could also be modified for use on medical-surgical

units.

Formal evaluation forms administered to students are often used by institutions at the end

of a course in order to solicit feedback on various criteria and are another way to receive

feedback (Saunders, 2003). Thus, before the presentation, I created a short evaluation form.

After the meeting, I collected the completed forms from the group and tabulated the results (see


Appendix E). Results from the presentation were overall very positive. Out of the 19

individuals that completed the presentation evaluation form, all strongly agreed that the

presentation content met stated objectives and that teaching aids or audiovisuals were used

effectively. In addition, everyone agreed or strongly agreed that the presentation information

was valuable to them; scientifically sound, fair, and balanced; and influential to his or her

practice. Additional comments provided were also positive in nature.

The metarubric was also given to the group. Due to a lack of time during the meeting,

the group was asked to review the rubric and metarubric and send the evaluated metarubric back

to my preceptor. This process allowed for anonymity and adequate time to review the rubric

created. A total of seven metarubrics were collected from MMC educators. Out of a total of 14

points awarded for the rubric, the average rating was 13.4 points. No section was given a “0”

rating. The most common section rated only half a point was the description related to clarity of

words not being specific or as accurate as they could be. This was given only half a point by 4

out of 7 evaluations. A couple of additional comments noted beyond that of the metarubric was

that the concept of systems thinking was not clear enough for one individual. In addition, two

individuals recommended that some of the wording in the novice category that had a negative

connotation could be modified to improve the rubric.

Recommendations

Based on the outcomes of this project and literature related to the development and

implementation of rubrics used for clinical evaluation, there are several recommendations that

should be considered for future projects of this nature. One recommendation I would make is to

form a group that is committed to creating the rubric(s) from start to finish. Frentsos (2013),

noted that department “champions” could be useful for fielding questions, concerns, or making


changes to the rubric. According to Isaacson and Stacy (2009), although rubrics can be tedious

to develop, the process itself is educational and can result in individuals that are more vested in

understanding expectations and aspects of evaluation.

Although time did not allow for trialing this rubric as planned, research has shown, it is

best to give raters rubrics prior to implementation in order to increase accuracy (O’Donnell et al.,

2011). Thus, time should be spent with those that will be utilizing the rubrics prior to actual

trialing of the rubrics on the units. According to Walsh et al. (2008), a cover letter from faculty

describing the purpose of evaluation and instruction for using a clinical rubric are a must. In

addition, they recommend face-to-face workshops and brief, on-the-spot guidance during rounds

to help support preceptors as evaluators. Educational materials, including a PowerPoint should

be created. A chance to ask questions and role play are additional strategies that could be

utilized during this phase. Opportunities for discussion can lead to better consistency and

possible modifications to the rubrics (O’Donnell et al., 2011).

Reliability and validity are also important components and considerations in the creation

and implementation of rubrics (Frentsos, 2013). Thus, reliability through pilot testing with a set

of evaluators is another recommendation for a future project. One study that looked at

preceptors perceptions of a new evaluation tool for orientation, noted that more data through a

pilot study may have made preceptors feel more comfortable with the performance items on the

evaluation tool (Steffan & Goodin, 2010). Validity of a rubric can also be tested by rubric

developers by determining if the results accurately reflect the measurements obtained from

evaluation using the rubric (Frentsos, 2013). An article by Hallgren (2012), discussed the

importance of considering and computing reliability and validity when looking at observational

data. Suggestions of how to compute inter-rater reliability, depending on the number of people


measuring or assessing, were also provided in this article and would be helpful to improve future

projects focused on rubric development.

Conclusion

Measuring clinical competence is an important job for the nurse educator. Although

rubrics have been embraced throughout much of academia and provide many benefits, their use

in evaluating nursing competence in the clinical setting has not been consistent. This paper

described a project involving the development of a clinical rubric tool to be utilized by

preceptors evaluating nurses in the critical care internship program at MMC. Cognitive learning

theory served as a foundation for carrying out the proposed project. Finally the project goals and

objectives, personal and professional accountability of the project, analysis of project outcomes,

evaluation of the project, and recommendations for future implementation of a similar project

were also described.


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Appendix A


Needs Assessment Survey


Appendix B

Clinical Rubric

Clinical Competency Rubric for Critical Care Nursing Name: Evaluated By:

Directions: Circle or place a checkmark in the box that most accurately describes the individual being evaluated. There should be one checkmark or circle per row. Wk. # Expert Proficient Competent Advanced Beginner Novice

Clinical Judgment The outcome of critical thinking in

nursing practice necessary to provide safe, effective, quality, evidence-based patient care.

Expert Proficient Competent Advanced Beginner Novice

Has an intuitive grasp of patient and family picture. Utilizes past experiences

to anticipate changing picture.

Quickly sees the big clinical picture of the patient and family.

Sees the big clinical picture of the patient and family.

Sees pieces of the whole clinical picture of the patient

and family.

Does not see the clinical picture of the patient and family.

Quickly recognizes signs of patient deterioration. Evaluates multiple sources of data to make clinical

judgments. Formulates plan to avoid complications. Seeks collaboration and

consultation without hesitation. Eliminates extraneous details.

Recognizes signs of patient deterioration. Analyzes trends in

complex clinical data and compares with patient response. Promptly addresses and reports patient changes and provides

recommendations when appropriate.

Recognizes and prioritizes obvious changes in patient

condition. Collects and interprets complex patient data. Focuses

on key findings. Reports significant patient changes in a

timely manner.

Developing clinical assessment skills.

Distinguishes between normal and abnormal findings. Recognizes variations in patient

condition but requires assistance in prioritizing.

States expected norms in patient condition.

Requires guidance and support in order to

perform clinical assessment. Reports

data and is focused on a single intervention.

Thinking in Action Thinking linked with action in ongoing

situations.


Demonstrates mastery of all necessary nursing skills during ongoing clinical

situations.

Quickly performs advanced technical skills including the

titration of multiple drips, ACLS, and emergency management

during ongoing clinical situations.

Proficient in most nursing skills including the titration of 2-3

drips, could improve speed or accuracy in ongoing clinical

situations.

Hesitant and ineffective in performing nursing skills in ongoing clinical situations.

Unable to perform most nursing skills in ongoing clinical

situations.

Readily assumes responsibility. Consistently delegates. Displays

leadership and confidence in ongoing clinical situations. Often serves as a

primary preceptor.

Displays leadership and confidence in ongoing clinical

situations. Ability to delegate as needed. Ability to function as a

preceptor.

Usually displays leadership and confidence in ongoing clinical

situations. Occasionally delegates.

Sometimes displays leadership and confidence

in ongoing clinical situations.

Lacks leadership and confidence in ongoing

clinical situations.

Responds to rapidly changing and highly complex patient demands in

calm, confident manner.

Able to stay in control of difficult and complex situations. Flexible

with changes.

Able to control and keep calm in most situations. Usually flexible

with changes.

Becomes stressed and disorganized easily with

more complex situations.

Disorganized and inflexible in ongoing clinical situations.

Advocacy & Moral Agency Expert Proficient Competent Advanced Beginner Novice


Working on another's behalf and representing the concerns of the patient/family and nursing staff;

serving as a moral agent in identifying and helping to resolve

ethical and clinical concerns within and outside the clinical setting.

Keeps patient at center of care, knows the patient as a person, recognizes the unique ways that patients and families respond to change, and advocates for them in order to provide care that is

grounded in understanding, knowledge, and wisdom. Nursing practice is deeply

rooted in the ethical principles.

Advocates consistently and effectively on the behalf of the patient, family, and vulnerable populations in order to provide

patient-centered care. Demonstrated ability to empower

patients and their families.

Works on behalf of patient and family; advocates for vulnerable populations. Practices within an

ethical and legal framework. Recognizes autonomy of the

patient and family when coordinating care. Engages and supports co-workers in ethical decision making; decisions can

deviate from rules.

Works on behalf of patient. Demonstrates integrity,

honesty, and accountability. Maintains patient

confidentiality, privacy, respect, and dignity.

Illustrates examples of ethical and legal issues

encountered in the health care environment. Makes decisions based on rules.

Works on the behalf of the patient.

Differentiates between ethical and legal issues. Aware of

patients' rights. Makes decisions based on

rules

Caring Practices Nursing activities that create a compassionate, supportive and

therapeutic environment for patients and staff, with aim of

promoting comfort and healing and preventing unnecessary suffering.

Includes, but not limited to, vigilance, engagement and

responsiveness of caregivers, including family and healthcare

personnel.


Demonstrates deep understanding of how to create a compassionate and

therapeutic environment driven by the needs of the patient and family.

Promotes an environment that is grounded in empathy. Establishes

trusting patient and family relations. Provides holistic, caring,

and safe nursing care that is individualized to the patient and

family’s needs.

Tailors care to individualized patient needs. Engages family in

care. Integrates caring into practice. Assists patients and

families in developing goals that are part of the individualized plan

of care.

Engages in caring practices. Visibly engages in caring.

Recognizes that not all care can be based on standards

and protocols.

Expresses the importance of caring.

Displays a caring attitude. Bases care on

standards and protocols.

Comments:

Facilitation of Learning Expert Proficient Competent Advanced Beginner Novice


Use of self to facilitate learning.

Easily and accurately recognizes and diagnoses own learning needs.

Demonstrates ability to realistically diagnose own learning needs.

Ability to assess own learning needs, including strengths and

weaknesses.

Needs assistance in identifying strengths and

weaknesses.

Under or overly critical of self.

Consistently develops SMART goals, plans, and activities to support

learning. Maintains a professional portfolio of evidence to validate

accomplishments.

Develops SMART goals, plans, and activities to support learning.

Collects evidence to validate accomplishments.

Ability to develop SMART goals, plans, and activities to support

learning.

Needs assistance in developing SMART goals,

plans, and activities to support learning.

Does not develop SMART goals, plans, or

activities to support learning.

Demonstrates commitment to ongoing improvement and lifelong learning. Has

achieved specialty certification.

Demonstrates initiative and involvement in opportunities for

improvement. Studying for or has achieved specialty certification.

Takes initiative in seeking out opportunities for improvement and resources as needed.

Demonstrates awareness of limitations and sometimes seeks appropriate resources

as needed.

Does not assume responsibility in seeking

new opportunities for learning or

improvement.

Collaboration & Communication

Working with others (e.g., patients, families, healthcare providers) in a

way that promotes/encourages each person's contributions toward

achieving optimal/realistic patient/family goals; involves intra-

and inter-disciplinary work with colleagues and community


Uses skilled communication to collaborate with the healthcare team in

order to provide quality patient-centered care. Fosters true

collaboration and effective team functioning. Directs and involves care

team members using clear and concise communication. Checks for

understanding.

Provides relevant, accurate, and complete information in a concise,

clear and timely manner to the healthcare team, patients, and

families. Maintains effective working relationships and open communication with patients,

families, and team members. Shift report is organized, concise and a

pertinent summary of patient's status.

Engages in collaboration to plan and implement care. Gives clear

directions to team. Could be more effective in establishing rapport. Communicates in a

professional manner. Shift report is organized.

Developing collaborative skills. Initiates collaborative

efforts. Shows some communication ability.

Communication with team members and/or patients

and families is only somewhat successful.

Describes the meaning of collaboration in health care. Has

difficulty communicating. Fails to

interact. Directions given to others may be unclear. Patients and

families are confused or unsure of explanations.

Systems Thinking Body of knowledge and tools that

allow the nurse to manage whatever environmental and

system resources exist for the patient/family and staff, within or

across healthcare and non-healthcare systems. Ex.

Documenting presence of pt.’s pain --> participation in medical

record reviews of unit's pain management documentation


Consistently recognizes, understands, and synthesizes the interactions and interdependencies of the components in a complex healthcare system that influence the care of an individual

patient. Demonstrates ability to apply skills associated with improving the

system of care.

Understands how various components of one's work system

are related to the whole. Takes responsibility in applying skills associated with improving the

system of care.

Ability to view how any one component of one's own work

system is related to other components and to the whole.

Illustrates examples of systems thinking.

Describes the meaning of systems thinking.

Response to Diversity Expert Proficient Competent Advanced Beginner Novice


The sensitivity to recognize, appreciate and incorporate

differences into the provision of care; differences may include, but

are not limited to, cultural differences, spiritual beliefs,

gender, race, ethnicity, lifestyle, socioeconomic status, age and

values

Holds all cultures in high esteem. Proactive in developing academic and

interpersonal skills that increases understanding of developing new

approaches based on culture. Shares knowledge obtained with fellow nurses. Consistently recognizes, appreciates, and incorporates differences into the

holistic plan of care.

Accepts and respects all cultures. Develops academic and

interpersonal skills that increases understanding and appreciation of

culturally diverse groups of patients. Ability to integrate holistic and culturally competent care with

patients and their families.

Accepts and respects other cultures. Includes patient's

cultural beliefs and values when addressing the holistic (physical, mental, spiritual, sociocultural, etc.) needs of the patient and

family. Increased awareness of inequities and barriers to health

care for minorities.

Illustrates examples of culturally competent care. Aware of racial and ethnic

disparities in health and the importance of sociocultural

factors on health beliefs and behaviors.

Lacks awareness of various cultures.

Provides inadequate care to patients and

their families due to the lack of awareness of cultural differences.

Clinical Inquiry Engagement in the ongoing process of questioning and evaluating practice; creating

practice changes through research utilization and experiential learning


Frequently seeks learning opportunities that reflect evidence based practice. Continually questions and evaluates

practice and uses best available research and evidence to guide nursing

practice. Engaged participant in opportunities that support clinical

inquiry.

Participates in opportunities to support clinical inquiry and

improvement of nursing practice and patient care. Reviews the

literature, questions, and evaluates current practice in order to improve

patient care.

Questions current practice, standards, and guidelines.

Seeks advice or resources to improve patient care.

Provides examples of research based practice.

Relates research to clinical practice. Recognizes the

need for further learning to improve patient care.

Explains the meaning of clinical inquiry to the

profession.

Comments:

Appendix C


Metarubric

Ready to use 1 point

Needs some revision. 5 point.

Not ready for use0 points

Total Points

Content Coverage

Content is selective and relevant, as well as complete.

The rubric is about ½ way there in content. Much of the content is relevant but some important things have been left out.

The rubric is incomplete. Important, relevant content has been left out of the rubric.

The rubric closely aligns with the standard or learning target it is supposed to assess, and the relationship is easy to identify in the wording of the scoring criteria.

The rubric shows some relationship to the standard or learning target being assessed, though the relationship could be more direct or easier to identify. The wording of the scoring criteria could be improved so that the rubric more closely reflects the standard or learning target being assessed.

The rubric does seem to align with the standard or learning target it is supposed to assess. It is very difficult to identify the relationship because the wording does not reflect the language in the standard or learning target being assessed.

The rubric includes the best thinking about what it means to perform well on the product or skill under consideration.

Although the rubric seems reasonable, parts of it do not represent the current or best thinking about what it means to perform well on the product or skill under consideration.

The rubric does not represent the current or best thinking about what it means to perform well on the product or skill under consideration.

.

This rubric helps the preceptor and the orientee organize their thinking about what it means to perform with quality. Rubric content helps the orientee understand the nature of a high quality performance.

Although the rubric covers much of what is important, it also contains features that are confusing or might lead to incorrect assumptions about the nature of a quality performance.

There are many features of this rubric that might lead to inaccurate or incorrect conclusions about the nature of a quality performance.

Clarity

Words are specific and accurate. It is easy to understand just what is meant.

Words are not as specific or as accurate as they could be. As a result, there are places in the rubric where it is not easy to understand exactly what is meant. Some criteria need interpretation by the user.

Wording is are NOT specific or is inaccurate. It is not be easy to understand exactly what is meant. Too much of the wording is open to interpretation.

The rubric is so clear that different preceptors would give the same rating to the same performance. A single preceptor could use the rubric to provide consistent ratings for many orientees.

The rubric is not clear enough to ensure that different preceptors would give the same rating to the same performance. Consistent ratings for many orientees by the same preceptor are possible but not assured using this rubric.

The rubric is NOT clear. Different preceptors would have difficulty giving the same rating to a single performance. A single preceptor would find it difficult use the rubric to provide consistent ratings for many orientees.

The basis for assigning ratings is clear. Each rating is defined with clear indicators and descriptions.

The basis for assigning ratings could be made much clearer if each rating were defined with better indicators and descriptions.

The basis for assigning ratings is very poorly defined. In order to use the rubric, indicators and descriptions would have to be far more precise.

Practicality The rubric is manageable – there are not too many things to remember so both orientees and preceptors can use it.

The rubric provides useful information but it is NOT easy to use. There needs to be some tweaking to make the rubric more useful.

The rubric is NOT manageable. The rubric has not been designed in a way that is useful. Preceptors and orientees would find it very hard to use.

.


Rubric usefulness could extend beyond evaluation to include planning instruction, tracking orientee progress, and communicating with others.

Rubric usefulness could extended beyond evaluation, but it would take some re-working in order to use it for such purposes as planning instruction, tracking orientee progress, or communicating with others.

Rubric usefulness is very limited. It is weak for use as a clinical assessment tool and could NOT be extended beyond that purpose.

The rubric could be used by orientees themselves to improve on their own, plan their progress goals, or track their progress.

Some additional work needs to be done on the rubric so that orientees can use it themselves to improve on their own, plan their progress goals, or track their progress.

The rubric is not designed well enough for use by orientees.

Technical Quality

The rubric is well organized both within and across rating scales. Each column and row in the rubric has an appropriate title.

The rubric is well not very organized. Each column and row in the rubric has a title, but these are not always appropriate or easy to interpret.

The rubric is very poorly organized. Columns and rows do not have titles or titles are not appropriate.

The most important criteria are listed FIRST in the rubric. Those criteria at the top of the rubric are those that the standard or achievement target specifically focuses upon.

The most important criteria are NOT listed FIRST in the rubric, but are easy to find within the rubric. Criteria near the top of the rubric are those that the standard or achievement target specifically focuses upon.

The most important criteria are NOT listed FIRST in the rubric and are not easy to find within the rubric. Those criteria at the top of the rubric are NOT those that the standard or achievement target specifically focuses upon.

The rubric can be used to show the degree to which learning targets or standards have been mastered.

It could be easier to use the rubric for indicating the degree to which learning targets and standards have been mastered.

The rubric can NOT be used to show the degree to which learning targets or standards have been mastered.

The criteria lead to fair evaluations for all orientees, regardless of ethnicity, socioeconomic status, or any factors other than achievement.

There are some criteria that are questionable and may not lead to fair evaluations for all orientees. But, overall, there has been an effort to eliminate sources of bias.

It would be difficult to use the rubric for fair evaluations because multiple sources of bias could creep in. Fair evaluations for all orientees are NOT assured.

Total Possible Points for Rubric Design Assignment = 14 Total Points Earned for Rubric Design =

Adapted from Arter, J. & McTighe, J. (2001). Scoring rubrics in the classroom: Using performance criteria for assessing and improving student performance. Thousand Oaks, CA: Corwin Press, Inc.


Appendix D

Evaluation of Scholarly Project

Student name: Erin Kibbey________________________________________________________

Evaluated by: Erin Kibbey________________________________________________________

Goal/Objective Strongly Disagree

Disagree

Neutral Agree Strongly Agree

Comments

Demonstrates ability to use literature to design evidence-based rubrics for use in the clinical setting

X

Demonstrates ability to participate in interdisciplinary efforts to develop rubrics for use at MMC

X

Demonstrates ability to create rubrics for measuring competency of the critical care interns at MMC

X

Rubrics submitted on time according to proposed guide

X

Teaching strategies for rubric implementation are grounded in educational theory and evidence-based teaching practices

X

Uses information technologies skillfully to support the teaching-learning process

X

Communication X


with preceptor was appropriate and professionalDemonstrates ability to compile feedback on rubric implementation trial on units

X Unable to trial rubrics on units

Demonstrates ability to use assessment and evaluation data to enhance the teaching-learning process

X


Appendix E

Presentation Summary of Evaluations

Title of Presentation: Scholarly project: Developing a clinical rubric

Please complete the evaluation form below by circling the number that best fits your evaluation of the presentation.

Strongly Agree

Agree Disagree Strongly Disagree

Content was presented in an organized fashion 18 1Content was presented clearly and effectively 18Presenter was responsive to questions/comments 18 1Teaching aids/audiovisuals were used effectively 19Teaching style was effective 18 1Content met stated objectives 19Content of presentation was valuable to me 18 1Content was scientifically sound, fair, and balanced 17 2Presentation information will influence my practice 17 2

Comments:

Well done you are the expert. Looking forward to more to be done with your project here @ MMCI really want to evaluate this for broader use at MMCNice job!Occasionally “read” slides to the group. Overall wonderful presentation/valuable project.Awesome presentation!Nice job. Would suggest putting an “N” value on your tables we don’t have to add up the totals. Also colors on pie chart were a little hard to differentiate.Fantastic! Very useful for educators!Nicely done Erin – Thank you!You presented very eloquently! I am so impressed!Excellent job! Look forward to where this all heads. Could use this rubric right now in current orientation.Very well done – congratulations!! You will go far in this organization – leadership qualities very evident.Nice job. The powerpoint was great but the work that it reflected was even better.I am excited about this project. It will be helpful for ALL UNITS (preceptors & orientees) GREAT JOB!!Great job! This has been needed for a long time. Maybe the education could include some workshops on how to use the rubric?


Great work – This will be very valuable not only for orientees, but for all staff when evaluating competenceWhat a great project! This rubric is not only needed and applicable to the critical care interns but can be used across the organization. Please keep us updated as to the progress of your project.Excellent project + presentation. This area has always needed improvement on general med units.Erin, great job! This was a great idea for a scholarly project that is very useful in the work setting. Congratulations! What a great project! Your presentation was well-organized and you kept the learner very engaged. The slides weren’t overwhelming and had appropriate content! Awesome!


Appendix F

Presentation Confirmation Letter


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