Assessing Clinical Practice Evaluation for Nursing Students: A

Systematic Review on Validity, Reliability, Practicability, and

Objectivity Components

Muhamad Andika Sasmita Saputra

and Tukimin bin Sansuwito

Faculty of Nursing, Lincoln University, Petaling Jaya, Selangor Darul Ehsan, 47301, Malaysia

Keywords: Clinical Practice, Evaluation, Quality Components, Nursing Students.

Abstract: The evaluation of clinical practice serves as a critical foundation for assessing students' progress and

determining the success of nursing education programs with the use of components such as validity,

reliability, practicability, and objectivity is crucial to ensure the accuracy and reliability of evaluation results.

This Study aims to provide an overview of the existing research landscape, highlighting the components of

validity, reliability, practicability, and objectivity in the evaluation of clinical practice among nursing

students. This systematic review utilized electronic databases accessed via journal search engines: Google

Scholar, ProQuest, PUBMED, Springer, Hindawi, DOAJ, and Science Direct. The selected journals met the

criteria of being open-access publications released in the past five years (2018-2023). The results of the

journal search obtained 13 journals that were relevant to the keywords. Most researchers develop or create

evaluation instruments by paying attention to the validity component 13 (100%), while the reliability

component is 11 (85%), the practicability component is 9 (69%), and the objectivity component is 6 (46%).

A better understanding of preferences for the quality components of clinical practice evaluations use can

improve the evaluation's quality and ultimately improve the education quality, clinical practice, and nursing

student's skills.

1 INTRODUCTION

Every nursing educational institution that carries out

clinical practice should certainly have a clinical

practice evaluation assessment form. This is because

clinical practice evaluation is a critical basis for

assessing student progress and determining the

success of nursing education programs (Paler et al.,

2022). However, in the application or process of

creating the assessment form, many aspects need to

be addressed, especially those related to components

such as validity, reliability, practicability and

objectivity (Oermann & Gaberson, 2019). All of these

components are very important to ensure the accuracy

and reliability of evaluation results because they are

determining factors in whether a clinical practice

evaluation can be said to be of quality or not.

Nursing education plays a vital role in producing

competent and qualified health workers. One

https://orcid.org/0000-0003-0473-3052

https://orcid.org/0000-0001-7323-4308

important element in the nursing education

curriculum is clinical practice, where students can

hone their clinical skills through direct experience in

the field (Maharani et al., 2022; Orellano & Carcamo,

2021). Clinical practice evaluation is a crucial

assessment tool in assessing nursing students' abilities

and development during their training (Einarsen &

Giske, 2019). The accuracy and reliability of these

evaluations are fundamental to ensuring that students

are able to meet high nursing standards (Kahya &

Oral, 2018; Koldestam et al., 2021). Therefore,

attention to the quality of clinical practice evaluation

is very important. Reliable and high-quality

evaluation of clinical practice requires a careful

approach to the selection and application of

assessment instruments (Kahya & Oral, 2018). In

measuring the quality of the evaluation, four main

components have a crucial role, namely validity,

reliability, practicability and objectivity.

Saputra, M. A. S. and Sansuwito, T. B.

Assessing Clinical Practice Evaluation for Nursing Students: A Systematic Review on Validity, Reliability, Practicability, and Objectivity Components.

DOI: 10.5220/0013666300003873

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 1st International Conference on Medical Science and Health (ICOMESH 2023), pages 78-85

ISBN: 978-989-758-740-5

Validity measures the extent to which an

evaluation instrument is able to measure what it is

supposed to measure. In the context of clinical

practice evaluation, it is important to ensure that the

instruments used truly reflect the abilities and

competencies that are intended to be assessed in

nursing students (Orellano & Carcamo, 2021).

Reliability is a determining factor in measuring the

extent to which an instrument provides consistent and

reliable results (Said & Muslimah, 2021). In clinical

practice evaluation, instrument reliability is the basis

for making accurate and reliable decisions regarding

student progress. Practicability, which includes the

ease and usability of instruments in the field, is also a

key element in ensuring that evaluations can be

implemented efficiently without compromising the

quality of the results (Rohendi et al., 2020; Smith,

2019). Objectivity guarantees that the subjective

factors of the assessor do not influence the evaluation

results (Oermann & Gaberson, 2019). In the context

of clinical practice, this aspect is very important to

minimize potential biases that may arise during the

assessment process.

The integration and correct application of these

four components supports the creation of quality

clinical practice evaluations, which in turn can make

a positive contribution to the formation of a qualified

and competent nursing workforce (Gray & Grove,

2021; Hickey & Giardino, 2019). Although the

importance of these components is recognized,

challenges and complexities remain in their use,

particularly in the nursing context. Therefore, there is

a need for a systematic review to explore the extent to

which the use of these four components has been

integrated into the evaluation of nursing students'

clinical practice.

A careful search of the literature will open up

space for an in-depth understanding of current trends

and findings surrounding the use of validity,

reliability, practicability, and objectivity in the

context of nursing clinical practice evaluation

(Holmboe et al., 2020; Mohamadirizi et al., 2021). By

understanding the extent to which the use of these

components has occurred, we can gain better insight

into the effectiveness and challenges faced in

selecting, implementing, and improving clinical

practice evaluation instruments. A systematic

literature review also provides an opportunity to

identify best practices and innovative approaches in

measuring the quality of clinical practice evaluation,

which can serve as a basis for the development of

guidelines and policies at the nursing education level.

Through this systematic review, it is hoped that

we can answer the research question "How is the

utilization of clinical practice evaluation

components?" and "Which component is most widely

used among the validity, reliability, practicability,

and objectivity components?" In addition, this

systematic review is expected to provide a significant

contribution to our understanding of how the integrity

and quality of clinical practice evaluations of nursing

students can be improved through the wise

application of these evaluation components. As a

final result, this effort is directed at providing a

holistic view of the use of validity, reliability,

practicability and objectivity components in order to

improve the quality of clinical practice evaluations of

nursing students, bringing a positive contribution to

improving the quality of education and forming a

competent and responsive nursing workforce.

2 METHODS

This study is a systematic review study which aims to

provide a general overview of the existing research

landscape, highlighting the components of validity,

reliability, practicability and objectivity in evaluating

clinical practice among nursing students by

answering the research question, namely "How is the

utilization of clinical practice evaluation

components?" and "Which component is most widely

used among the validity, reliability, practicability,

and objectivity components?" The systematic review

process was carried out by taking sources from

several open electronic databases using journal search

engines, such as Google Scholar, ProQuest,

PUBMED, Springer, Hindawi, DOAJ, and Science

Direct. The journals selected are journals from the last

five years (2018-2023) so that the data obtained is the

most updated and is currently used. The keywords

used to obtain systematic review sources were made

specifically, namely "Quality Components of Clinical

Practice Evaluation among Nursing Students;

Validity, Reliability, Practicability, and Objectivity".

The purpose of using specific keywords is so that

researchers can immediately find journals that are

truly related to the topic being discussed so that they

are more effective and efficient. In the search process,

the words "OR/AND" are used to filter during the

search process so that the search results match the

keywords. Journal analysis was carried out using the

Preferred Reporting Items for Systematic Review and

Meta-Analysis (PRISMA) method and analysed

descriptively. The data extraction process is seen

from the database and content or subject matter.

Journal criteria are determined based on inclusion and

exclusion criteria (Table 1).

Assessing Clinical Practice Evaluation for Nursing Students: A Systematic Review on Validity, Reliability, Practicability, and Objectivity

Components

Table 1: Inclusion and exclusion criteria for assessing identified papers

Assessment

Level

Criteria Assessing identified papers criteria

1 Type Inclusion Open access

Exclusion Payable access

2 Year of

Publication

Inclusion 2018 until 2023

Exclusion Lon

er than 2018

3 Title and abstract

(Screening)

Inclusion

• At least one operational research, quality component of clinical

practice evaluation among nursing students with the name or general in

the article title, journal title, or keywords.

AND/OR

• At least one quality component (validity, reliability, practicability, and

objectivity) of clinical practice evaluation among nursing students in

the article title, journal title, keywords, or abstract.

AND/OR

• Discuss quality components (validity, reliability, practicability, and

objectivity) of clinical practice evaluation among nursing students in

the abstract or metho

Exclusion E1: Title or journal of publication did not relevance to operational research:

quality components (validity, reliability, practicability, and objectivity)

of clinical practice evaluation among nursing students.

E2: The abstract did not indicate the quality components (validity,

reliability, practicability, and objectivity) of clinical practice evaluation

among nursing students.

E3: The paper did not focus on the quality components (validity, reliability,

practicability, and objectivity) of clinical practice evaluation among

nursin

students.

4 Full Text

(Eligibility)

Inclusion

• Discuss the quality components (validity, reliability, practicability, and

objectivity) of clinical practice evaluation among nursing in the

abstract and body of paper.

• Discuss the quality components (validity, reliability, practicability, and

objectivity) of clinical practice evaluation among nursing in the

abstract and body of the

aper, quantitative research metho

Exclusion E4: All which do not meet the inclusion criteria.

3 RESULT

The search was carried out on open electronic

databases, namely Google Scholar, ProQuest,

PUBMED, Springer, Hindawi, DOAJ, and Science

Direct, following the inclusion and exclusion criteria

and then analysed. The results of the journal search

that has been carried out are displayed in the

PRISMA flow chart as shown in Figure 1.

The flow chart (Figure 1) is the process and results

of the assessment from the journal being analysed.

This flow chart was created using the PRISMA flow

diagram generator application (Haddaway et al.,

2022). From the assessment results, it was found that

1,253 journals were processed and analysed further.

Several journals were eliminated because they were

duplicates and needed to match the topic, and also fell

into the exclusion criteria E1, E2, E3, and E4 (table

1). The final results of the assessment and analysis

left 13 journals eligible.

ICOMESH 2023 - INTERNATIONAL CONFERENCE ON MEDICAL SCIENCE AND HEALTH

Figure 1: Flowchart of the systematic review selection stage

Table 2: Result of systematic review assessment

No Author & year Instrument/tool

Qualit

of evaluation com

onent use

Validit

Reliabilit

Practicabilit

Objectivit

1 D’Aoust et al. (2022)

PRIME-NP Clinical

Com

etenc

 

- -

Román-Cereto et al.

(2022)

SCE (Self-Confidence

Educational) Clinical Practice



- - -

Park & Hwang

(2021)

Evidence Based Practice

(EBP)

  

Belintxon et al.

(

2021

)

CUSNUR (Cultural

Sensibilit

Scale for Nursin

  

5 Todd et al. (2023)

C-CEI (Creighton

Competency Evaluation

Instrument) 2.0

   

6 Zhang et al. (2021)

HPAN Scale (Humanistic

Practice Abilit

of Nursin

   

7 Wu et al. (2022)

Self-Efficacy Scale Clinical

Nursing



- - -

8 Faraji et al. (2019)

NCS (Nursing Competence

Scale)

   

9 Chen et al. (2023)

Mini-CEE (Mini Clinical

Evaluation Exercise

)

  

10 Wang et al. (2023)

CBL-SCT (Case Based

Learning with Situated

Combination Theory)

 

- -

Hashimoto et al.

(

2023

)

HCT (Holistic Critical

Thinkin

   

Assessing Clinical Practice Evaluation for Nursing Students: A Systematic Review on Validity, Reliability, Practicability, and Objectivity

Components

No Author & year Instrument/tool

Qualit

of evaluation com

onent use

Validit

Reliabilit

Practicabilit

Objectivit

12 Terefe et al. (2023)

CCI (Clinical Competency

Instrument

)

   

13 Knipe et al. (2020)

DP (Deliberate Practice) and

simulation scenarios

   

4 DISCUSSION

Based on Table 2, it is known that of the 13 journals

analysed, the majority of researchers developed or

created evaluation instruments by paying attention to

the validity component 13 (100%), while the

reliability component was 11 (85%), the

practicability component was 9 (69%), and the

objectivity component was 6 (46%). The use of

validity, reliability, practicability and objectivity

components is very important in creating an

instrument, especially in evaluating nursing clinical

practice. The validity component in clinical practice

evaluation assures that the evaluation instrument

created can indeed measure what it is supposed to

measure (Mohamadirizi et al., 2021; Renton et al.,

2019). Therefore, by understanding and utilizing the

concept of validity, nursing educational institutions

can assess the extent to which nursing students can

apply the knowledge and skills they already have in

the context of practice. Apart from validity, the use of

reliability components is also very important, and

educational institutions must ensure that the results of

clinical practice evaluations are reliable and

consistent (Fukada, 2018; Lorwald et al., 2018).

Stable results of evaluation instruments over time

provide a strong and unambiguous basis for making

decisions related to nursing student abilities.

Practicality is a crucial element in evaluating an

instrument because it includes the extent to which the

evaluation instrument is easy to implement. The use

of a clearly structured evaluation rubric, as well as

efficient evaluation implementation, can significantly

increase the practicality of the evaluation process

(Joel, 2018; Rao, 2019). In this way, practicality not

only minimizes the need for large resources but also

ensures that evaluation instruments can be seamlessly

integrated into daily routines. In this context,

practicality is not just about efficiency but also about

the ability to align evaluation with the dynamics and

needs that arise in daily activities (Joel, 2018; Rao,

2019). Thus, practical implementation of evaluation

can support the effectiveness of using these

instruments in improving performance and achieving

holistic evaluative goals.

Objectivity plays a central role in ensuring that the

results of clinical practice evaluations reflect fairness

and are free from bias. In an effort to achieve an

optimal level of objectivity, strategic steps need to be

implemented, one of which is using a standardized

evaluation rubric. This rubric provides a clear and

consistent framework for assessing various aspects of

clinical practice, thereby reducing room for

subjective interpretation (María & Moreno-mulet,

2021; Mukhoirotin et al., 2021). Apart from that,

intensive training for assessors is also an important

aspect of maintaining objectivity. By deeply

understanding evaluation parameters and recognizing

them consistently, appraisers can avoid personal

biases that could influence their judgments.

Therefore, the combined use of standardized

evaluation rubrics and careful ratter training are

critical steps in achieving the objectivity necessary to

ensure fairness and accuracy in the assessment of

clinical practice.

Understanding and effectively applying the

components of clinical practice evaluation is very

important for assessing and improving the skills and

knowledge of health practitioners. Utilizing clinical

practice evaluation components is not only a critical

step but also an essential effort in assessing and

improving the quality of education and

professionalism in the health sector (Majumder et al.,

2019). By realizing and optimizing validity,

reliability, practicality and objectivity, educational

institutions and health practitioners are able to ensure

that clinical practice evaluations provide an accurate

and relevant picture of the abilities and competencies

possessed by health practitioners (Melnyk & Fineout-

Overholt, 2019; Orellano & Carcamo, 2021; Ortiz et

al., 2018). These aspects create a solid foundation for

measuring individual achievement and development

in the clinical practice environment (Oermann &

Gaberson, 2019). In addition, integrating evaluation

results into a continuous improvement process is an

important key. This action provides a guarantee that

the resulting graduates or health practitioners are

ready to face the complex demands that exist in the

world of health, along with the progress and

developments that continue to characterize this field.

ICOMESH 2023 - INTERNATIONAL CONFERENCE ON MEDICAL SCIENCE AND HEALTH

The quality of clinical practice evaluation also

involves several elements that need to be considered,

such as meeting or exceeding expectations related to

people, products, processes and the environment

dynamic and can change at any time. Factors that

influence the quality of nursing clinical practice

include several key aspects. First, the role of humans

has a significant impact, both bad and good, on the

quality of products produced by educational

institutions. Therefore, training, health insurance,

motivation, career paths and other efforts need to be

considered to improve the quality of teaching staff

and students (Oermann & Gaberson, 2019; Smith,

2019). Second, effective management and good

coordination between parts of an educational

institution are important factors so that all processes

run smoothly without chaos (Oermann & Gaberson,

2019; Smith, 2019). Apart from that, the financial

aspect (money) is also a concern because sufficient

funds are needed to maintain or improve the quality

of educational products. Third, materials, including

student practice areas, must also receive attention

because clinical practice sites are a forum for

developing students' experience and skills in

providing services (Cunningham & Moore, 2020;

Gibson et al., 2020; Terry & Rue, 2021). Finally, the

use of machines and mechanization, as well as the

application of modern technology, also influences the

quality of the students produced. Better tools can

improve students' abilities, while the use of outdated

and incomplete equipment and evaluation methods

can harm the quality of education. Therefore, before

measuring the quality of clinical practice evaluation

among nursing students, it is important to pay special

attention to the elements and factors that have been

mentioned.

5 CONCLUSIONS

This systematic review provides an in-depth

understanding of the role and challenges in using the

components of validity, reliability, practicability, and

objectivity in evaluating nursing students' clinical

practice. There is a need to understand the importance

of the quality components of evaluation as a basis for

developing guidelines and policies to improve

clinical practice evaluation so that it becomes higher

quality, as well as providing insight for further

development in the field of nursing education. The

analysis in this study provides an overview of which

components are most widely used or prioritized in

various clinical practice evaluation contexts. The

findings in this systematic review may have

implications for the future development of evaluation

instruments, improving ratter training, and improving

the overall clinical evaluation process. A better

understanding of preferences for the use of quality

components of clinical practice evaluations can help

improve the quality of evaluations and ultimately

improve the quality of education, clinical practice,

and skills of nursing students.

AUTHOR CONTRIBUTION

All authors contributed to the systematic review, data

analysis, interpretation, drafting, and critical article

revision.

ACKNOWLEDGEMENT

Thank you to my supervisor and all those who have

supported the researcher in writing this systematic

review.

CONFLICT OF INTEREST

The author declares no conflict of interest.

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Assessing Clinical Practice Evaluation for Nursing Students: A Systematic Review on Validity, Reliability, Practicability, and Objectivity

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