Test‐skill interaction errors in the assessment of nurses' clinical proficiency

The accuracy of tests of clinical proficiency in nursing depends not only on the nature of the test instrument used, but also on the type of skill being assessed. A task analysis of the nursing assignment of caring for a patient receiving peritoneal dialysis reveals that it involves a diverse range of skills. Four types of practical examination commonly used in nursing—self-report, simulations, the ward-based examination and continuous assessment—are each relatively sensitive to some of these skills, and relatively insensitive to others. Different types of test are sensitive to different types of skill. Hence, no one test technique can be expected to sample adequately all aspects of performance in the nursing task investigated, and so the whole range of techniques should be used, successful performance in individual tests being interpreted as necessary but not sufficient evidence of mastery.