Examining the effects of a rater training program on interrater reliability with the Lasater Clinical Judgment Rubric
Deborah A. Halliday, PhD, RN, Educator and Director of Simulation - Moravian University
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There is high demand for competent graduate nurses as they begin working in healthcare. However, the transition from classroom to professional practice can be difficult. Students and newly licensed entry-level practitioners must develop and possess suitable clinical judgments in order to demonstrate clinical competency in the delivery of safe patient care. Currently, there is a call for nursing education to provide increased rigor in performance evaluation of students’ clinical judgment prior to graduation.
The primary purpose of this study was to determine if rater training had an effect on interrater reliability among raters with the Lasater Clinical Judgment Rubric (LCJR) subscales in simulation compared to those who receive no training. The second purpose was to determine the effect of years of experience evaluating nursing students and level of nursing education on interrater reliability with the Lasater Clinical Judgment Rubric.
An experimental quantitative pre and post-test comparative study was conducted with a convenience sample of 34 nurse educators from across the U.S. The study consisted of rating recorded simulations on a weekly basis over six-weeks. Additionally, all participants viewed a recorded evaluation instrument orientation during week 2. The intervention group also attended two training sessions using Zoom® teleconferencing platform during week 3 and week 5. The evaluation instrument’s data were collected and examined using Kendall’s coefficient of concordance W, descriptive statistics and independent t tests to determine the level of agreement compared to an expert rater benchmark.
The training strategies developed for this study were minimally effective in improving interrater reliability. The study did not find statistically significant findings in experience evaluating students in clinical or simulation, or in the level of education. However, interrater reliability was higher in participants that had less than 5 years’ experience rating students in clinical environments, greater than 5 years’ experience rating students in simulation, and among the doctoral prepared participants. These findings provide additional evidence that supports Tanner’s Clinical Judgment Model and the LCJR. Future research is needed to further the application and enhancement of the research methods used in this study.
This study provided evidence of the importance of rater training. However, more research is needed on developing rater training programs that have a greater impact on improving interrater reliability. Implications for nursing science, nursing education, simulation, and nursing practice, along with recommendations for future research, are considered. These data will add to the body of evidence by providing valuable information for best practice in facilitating interrater reliability using the LCJR.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 29321479; ProQuest document ID: 2704037722. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
|Review Type||None: Degree-based Submission|
|Research Approach||Quantitative Research|
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