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Validation of time to task performance assessment method in simulation: A comparative design study.

Mary Ann Shinnick1, Mary A Woo1

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Summary
This summary is machine-generated.

An objective nursing assessment, Time to Task, effectively differentiated expert from novice nurses, showing good sensitivity and specificity. Subjective measures like the Lasater Clinical Judgement Rubric and pass/fail assessments were less effective.

Keywords:
Clinical competencyEvaluationEye trackingHigh stakes evaluationLasaterNursing educationSimulation-based assessmentTime to task

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Area of Science:

  • Nursing Education
  • Healthcare Simulation
  • Clinical Competency Assessment

Background:

  • Assessing nursing clinical competence is crucial for patient safety, yet objective measures are lacking.
  • Existing subjective assessments may not accurately differentiate skill levels.
  • This study investigated the efficacy of an objective assessment, Time to Task, against subjective methods.

Purpose of the Study:

  • To evaluate the objective Time to Task assessment for measuring nursing clinical competence.
  • To compare the Time to Task measure with the Lasater Clinical Judgement Rubric (LCJR) and a pass/fail assessment.
  • To determine the sensitivity and specificity of each assessment method in distinguishing expert from novice nurses.

Main Methods:

  • A prospective comparative design using expert and novice nurses in a simulated decompensated heart failure scenario.
  • Objective Time to Task assessment measured performance within 5-minute thresholds for critical nursing actions.
  • Subjective assessments included the LCJR and a pass/fail evaluation, scored by blinded nursing instructors from recorded simulations.

Main Results:

  • The Time to Task measure showed significant differences between expert and novice nurses (p < 0.01) with good sensitivity (0.80) and specificity (0.85).
  • The LCJR also showed significant differences (p < 0.01) but had lower specificity (0.40) compared to Time to Task.
  • The subjective pass/fail assessment demonstrated high sensitivity (0.90) but low specificity (0.47).

Conclusions:

  • Subjective nursing competence assessments often struggle to achieve adequate specificity.
  • The objective Time to Task measure demonstrates strong potential for accurately differentiating nursing skill levels.
  • While multiple assessment tools are recommended, the Time to Task method warrants further investigation for its utility in evaluating nurse competency.