Assessment Items

Assessment 1

Within clinical practice, nurses often use clinical assessment tools to aid health assessment. Clinical assessment tools are usually in the format of questionnaires which have been developed to assist in the assessment of a particular aspect of patient assessment that cannot be directly (objectively) assessed (such as the construct of pain, level of sedation, level of consciousness).
Such tools can be used for a variety of purposes but mostly to determine baseline characteristics, monitor improvement or deterioration in clinical status, and to influence clinical decision making and subsequent management of patients. Understanding the evidence-base that supports or refutes the use of these tools in particular patient cohorts is important for individual patient assessment. The research basis for many of the tools however, is often not known by clinicians and the tools may be used to quantify aspects of a patient’s clinical presentation without knowing how accurately the tool is in assessing a particular construct
(e.g. pain).
PART 1 (max 500 words)
Reliability describes to what degree an assessment tool will produce similar results under different circumstances, assuming the baseline characteristics remain the same. eg different operators, change over time etc. (Roberts et al 2006)
1. Define the following concepts and describe their general role in measuring the reliability of an assessment tool (see Roberts et al 2006; Gillespie &Chaboyer et al 2013. p.222-5)
a) Inter-rater reliability....
b) Test-retest reliability....
c) Internal Consistency (also known as homogeneity) and the use of Chronbach's alpha coefficient
d) What would a reliability score of 0.38 mean and how would this influence your confidence in the reliability of a tool?
 
Validity refers to the extent to which an assessment tool accurately reflects the concept it is claiming tomeasure (Roberts et al 2006).
Internal Validity is the extent to which you can claim your assessment result is absolutely caused by the phenomena you are measuring. The major areas of concern are internal and external validity. Internal validity can be threatened by several things, including change over time in the conditions/environment of your assessment; the effect of time on the people you are assessing; the learning curve of your participants in relation to the tool you are using; a change over time in the way an assessment tool is used by the researcher; and by selection bias - where certain people are more likely to be chosen to be assessed with the tool being tested.

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2. Define the following concepts (Including the headings and subheadings) and describe their use in measuring or describing the validity of an assessment tool
       a) content validity.... Gillespie &Chaboyer2013, p.227
       b) Construct Validity

(See Trochim 2006; Gillespie &Chaboyer2013, p.225-229

              i) convergent validity....
              ii) divergent (also known as discriminant validity)....

See Lund Research 2012, p2 Gillespie &Chaboyer2013, p.225-229

       b) criterion-related validity, also known as concrete validity.... (which includes the following    factors) (See Lund Research 2012, p1)
              i) concurrent validity....
              ii) predictive validity....
             
External Validity refers to the extent to which results of testing of an assessment tool are generalisable to other settings. External validity of an assessment tool can be measured by using risk ratios, sensitivity and /or specificity.
3. Define the following
       Risk ratio.... (see García-Fernández et a, 2014).
       Sensitivity.... (see el Masri 2015a)
       Specificity.... (see el Masri 2015b)
 
Readings Part 1 Assessment 1
El-Masri, M.M. Terminology 101: Screening tests and sensitivity. Canadian Nurse. October, 2015a.111(7): 14.
El-Masri, M.M. Screening tests and specificity Canadian Nurse,November 2015b; 111(8): 13
García-Fernández, .P.,Pancorbo-Hidalgo, P.L.,Agreda, J.J.S. Predictive Capacity of Risk Assessment Scales and Clinical Judgment for Pressure Ulcers;  A Meta-analysis. Journal of Wound, Ostomy and Continence Nursing.  2014;41(1):24-34
Gillespie, B. &Chaboyer, W. Assessing & Measuring Instruments. In Nursing & Midwifery Research: methods and appraisal for evidence-based practice. 4^thedn.  (Eds Z. Schneider, D. Whitehead et al.) Sydney: Mosby-Elsevier, p.218-236.
Lund Research.  Criterion Validity, 2012. http://dissertation.laerd.com/criterion-validity-concurrent-and-predictive-validity.php
Roberts, P.,Priest, H., Traynor, M. Reliability and validity in research. Nursing Standard. 2006; 20, 44, 41-45.
Shinn, J.B. The Importance of Sensitivity, Specificity, Validity, and Reliability in Clinical Practice. Audiology Today. April, 2014, 26(2),62
Trochim, W.M. Convergent & Discriminant Validity. Research Methods Knowledge Base,  2006. http://www.socialresearchmethods.net/kb/convdisc.php
 
 
 
 
Part 2
To complete this assessment, students need to:
1. Select one of the following clinical assessment tools:
·                Glasgow Coma Scale
·                Health of the Nation Outcome Scale {HoOS)
·                Paediatric FOUR score coma scale
·                Numerical Rating Scale(NRS) for Pain Assessment
·                Waterlow Pressure Ulcer Scale
 
(Students who wish to focus this assessment on a clinical assessment tool other than those listed above should discuss the suitability of this with the unit of study coordinator before commencing the assignment.  You should ensure there are at least three primary research articles on an alternative tool).
Briefly describe your own patient population. With reference to validation literature, discuss the elements of reliability and validity of your chosen assessment tool. Where possible, select studies specific to your own patient population.  Draw a conclusion about the usefulness of the assessment tool for your clinical practice. Your discussion should include a brief comparison of your chosen tool with alternative methods of assessment. Please refer to the marking criteria and resources on the eLearning site when preparing this assessment. For this work it is permissible to include older literature as the original validation study may be the most comprehensive.
 
 
Resources have been specifically developed to assist students in completing this assignment. This resource has information about reliability and validity and students are encouraged to explore the literature further to develop their discussion of these concepts. This material can be accessed through the Information for Practice Thinking link on the NURS5012 eLearning site.
 
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