Evaluation Models for Undergraduate Nursing Clinical Skills: A Scoping Review Protocol

Undergraduate nursing students are expected to perform a high-stakes clinical skills test, which ultimately determines their ability to engage in clinical practice. With intake number of students growing nationally, clinical instructors are modifying these skills tests to be shorter in duration as an attempt to meet scheduled class times, severely decreasing the assessments' accuracy and increasing student stress.

The objectives of this review are to examine best practices of evaluation structures or models for undergraduate nursing students participating in clinical skills-based assessments as part of their program curriculum to explore alternative, best-practice methods for evaluating key clinical skills. The goal is to use what is known in the literature to help inform the development of a new evidence-based clinical skills evaluation model that is adaptive to student population growth, enhances student learning and faculty teaching experiences, and ensures safe patient care.

This scoping review will consider studies involving nursing students enrolled in an undergraduate nursing degree program who undergo clinical skills testing as part of their degree fulfillment. Original articles published in English from January 1, 2015, to present day will be included. This review will follow the Joanna Briggs Institute methodology for scoping reviews, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The literature search will use the following databases: SCOPUS, CINAHL, Medline, PsycInfo, ProQuest Central, and ProQuest Dissertations and Theses to identify relevant sources. Moreover, nonempirical research, such as editorials, opinion papers, gray literature, and reviews, will be included. Data from professional nursing organizations, including the College of Nurses of Ontario (CNO), the Registered Nurses' Association of Ontario (RNAO), and the Canadian Association of Schools of Nursing (CASN), will be considered. Two independent reviewers will conduct a screening of article titles and abstracts, followed by full-text reviews. Together, they will determine which articles will proceed to the data extraction stage. If discrepancies arise, a consensus discussion will take place between the two reviewers with assistance from a third reviewer.

The project was funded in June 2025 (Figure 1). The scoping review is scheduled to begin in July 2025, with the literature search and study selection processes planned through Fall 2025. Results are expected to be submitted for publication in Winter 2026.

The results of this review will summarize the current breadth of knowledge on clinical skills testing and best-practice methods used for clinical skill evaluation among undergraduate nursing students. Any gaps in the literature will be identified as these can be used to guide future research within this area of nursing education.