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Updated: Jun 30, 2026

Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 21, 2010
The effectiveness of an educational programme for nursing students on developing competence in the provision of
René van Leeuwen1, Lucas J Tiesinga, Berrie Middel
1Department of Nursing, Ede Christian University, Ede, The Netherlands. rrvleeuwen@che.nl
Aim:
To determine the effects of a course for nursing students on developing competence in spiritual care and the factors that might influence the effects.
Background:
Studies suggest that role preparation in nursing for spiritual care is poor. For the assessment of competence, few or no explicit competency framework or assessment tools seemed to be used.
Design:
Quasi-experimental crossover design (pre-post-test).
Method:
The subjects were students from Christian nursing schools in the Netherlands (n = 97). The intervention consisted of a course in spiritual care. Competencies were measured with an assessment tool, the Spiritual Care Competence Scale. Data were analysed by t-test procedures (paired-samples t-test). At T(1) vignettes were added to assess the quality of the students' own analyses. These data were analysed by a Mann-Whitney test. Regression analyses were performed on the influence of student characteristics on the subscales of the assessment tool.
Results:
Ninety-seven students participated in this study. Analysis showed statistically significant changes in scores on three subscales of the Spiritual Care Competence Scale between groups (T(1)) and over time for the whole cohort of students on all subscales (T(2)). Clinical placement showed as a negative predictor for three subscales of the Spiritual Care Competence Scale. Experience in spiritual care and a holistic vision of nursing both showed as positive predictors on certain competencies. A statistically significant difference was observed between groups in the student analysis of a vignette with explicit spiritual content.
Conclusions:
The outcomes raise questions about the content of education in spiritual care, the measurement of competencies and the factors that influence competency development.
Relevance To Clinical Practice:
The results provide nurse educators with insight into the effects of education in spiritual care on students' competencies and help them consider a systematic place for spiritual care within the nursing curriculum.
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