A Study of factors affecting clinical performance grades of nursing students

This study involved an investigation of factors affecting clinical performance grades of first and second year nursing students in a two-year Diploma program. The purpose of the study was to increase knowledge of factors which may correlate with clinical performance of nursing students; related goals were to assist nurse educators in predicting student clinical performance and providing guidance accordingly. The study was planned to test the following hypotheses: 1 . Grades in Nursing, Biology, and Psychology courses during the first semester of the nursing program account for a significant proportion of the variance in clinical performance scores of students; 2. Complexity of the nursing situation accounts for an additional significant proportion of the variance in clinical performance scores of students. The study population consisted of 59 first and second year nursing students. The dependent variable was the average of the clinical performance scores of the students given by the clinical instructors (who wrote and scored the anecdotal records) and two nursing judges (who scored the written anecdotal records). The independent variables were the grades in first semester Nursing, Biology, and Psychology; and the complexity of the nursing situation. Data for the study were collected over a three-week period. This phase included: (a) writing of anecdotal records of students' clinical performance by their instructors, and subsequently scoring of these records by the clinical instructor and two nursing judges using the scoring instrument; (b) assessing the level of complexity of the students' clinical assignments by their clinical instructors, using the complexity of the nursing situation instrument; and (c) obtaining the students' first semester Nursing theory, Psychology, and Biology grades from their permanent records. The clinical instructors and the nursing judges were trained in the writing and scoring of anecdotal records, and in determining the complexity of the students' assignments by utilizing a 10 minute videotape prepared by the investigator depicting the performance of a nursing student in a simulated clinical situation. Analyses of the data were carried out in two phases. Phase one included product moment correlational analysis and general izabi I ity analysis to determine the reliability of the clinical scores. Phase two included stepwise multiple regression analysis to determine the predictors of clinical scores. The findings of the study showed that the inter-rater correlations among the clinical instructors and two nursing judges were moderately strong (.58 to .84). Likewise generalizability analysis showed that the clinical scores were reliable. The data on complexity of the nursing situation showed very little variability in each of the four semesters and were therefore deleted from the regression analysis. The regression analysis showed that in Semesters II and III 51 and 76 percent of the variance in clinical performance scores could be accounted for by the grades in first semester Nursing, Psychology, and Biology. However, in Semesters IV and V the amount of variance accounted for by the independent variables was not significant. Thus, hypothesis 1 is accepted in the case of Semester II and III students, and rejected in the case of Semester IV and V students.Applied Science, Faculty ofNursing, School ofGraduat