Author: Bridget Henderson
Henderson, Bridget, 2025 Developing nursing students' evaluative judgement: exploring the pedagogical concept in nursing education, Flinders University, College of Nursing and Health Sciences
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Abstract
On graduation, Australian nursing students gain registration with the Nursing and Midwifery Board of Australia (NMBA) and enter a professional regulated workforce. It is incumbent on higher education providers to equip students with requisite skills, knowledge, and capabilities to prepare them for the transition from student to healthcare professional. An important capability is evaluative judgement where a person can make decisions about the quality of their and others’ work. This capability is important for Registered nurses who need to make decisions about the quality of their and others clinical practice and recognise when they need future education or training. Registered nurses who can reflect on their clinical practice and identify where their knowledge deficits are, demonstrate competencies of a self-regulated, lifelong learner.
How educators develop students’ evaluative judgement is mainly theoretical, with few studies exploring the practical application of the theory. Self/peer-assessment, peer feedback and feedback conversations have been suggested as approaches that have potential to develop students’ evaluative judgement. Using exemplars or rubrics to show students what quality work looks like has also been investigated as potential avenues. Exemplars or rubrics are potential means by which students can benchmark their understanding of the required standard, comparing their work and making judgements on it merit.
Developing students’ evaluative judgement supports the NMBA standards for practice through fostering reflexive practice. The concept of evaluative judgement is new to nursing education and no primary studies have been found that explore the practical application of the theoretical pedagogy in nursing curricula. To address this gap, the studies presented in this thesis aimed to explore the development of evaluative judgement in nursing education, both theoretical and practical components.
Program of research
The central research question guiding this program of research is: What are the possible strategies to develop students’ evaluative judgement in undergraduate and postgraduate nursing education? A constructivist framework underpinned the design of the research by supporting the idea that students’ evaluative judgment emerges through active participation, critical thinking, and the integration of prior knowledge with new experiences, all within authentic learning contexts. This program of research was undertaken in a series of four studies. Three of these studies are published in Quartile 1 peer-reviewed journals (Chapters Four to Six), with the final study (Chapter Seven) currently under review. The publications are included in the thesis as Word documents, consistent with Flinders University policy, inclusive of their respective reference lists. A reference list for the entire thesis is also included after Chapter Eight.
The first two studies in the thesis explored the practical application of developing evaluative judgement in postgraduate emergency nursing students. Study one is a peer reviewed publication that explored postgraduate nursing students’ perceptions of consensus marking with online oral vivas following a retrospective thematic analysis. This study explored a new approach to grading oral viva exams using consensus marking. The design of the consensus marking approach was underpinned by the theoretical concepts of developing evaluative judgement. The findings of this study confirmed that this approach facilitated reflection, self-evaluation, and feedback dialogue. Study two is a peer reviewed publication exploring and comparing two different assessment grading methods for postgraduate nursing students, consensus marking as a grading method for the development of evaluative judgement and traditional grading methods. A convergent mixed methods parallel research design was used to compare the two grading methods. The findings of this study identified that students’ anxiety levels were lower, and satisfaction levels were higher when students engaged in consensus marking versus traditional grading methods. The findings of these two studies suggested that online oral vivas using consensus marking is an assessment and grading method that provides opportunities for students to develop their evaluative judgement.
Embedding the concept of developing evaluative judgement in the undergraduate nursing program was more complex and required careful consideration. Undergraduate nursing student demographics, and exposure to the nursing profession is very different to postgraduate nursing students. In addition, the large student numbers in undergraduate nursing programs meant that while consensus marking was a successful assessment method in postgraduate students, it was not necessarily generalisable or practical for the undergraduate cohort. Therefore, studies three and four in the program of research shifted focus to exploring foundational concepts in developing evaluative judgement at the undergraduate nursing level.
Study Three produced a peer reviewed publication following a systematic scoping review of the literature. This foundational work explored the features that aligned with developing evaluative judgement in nursing clinical practice teaching and assessment methods. The identification of important aspects of developing evaluative judgement were examined in the literature. The findings highlight that the evaluative judgement features of discerning quality and feedback were well embedded in nursing clinical teaching and assessment methods. However, the judgement process and calibration were rarely included. The review also identified that 41% of clinical practice education feedback is verbal and it was not reported whether the self-evaluation was reviewed in the feedback process. This finding suggests that there is a missed opportunity to facilitate students’ understanding of what quality work looks like. The results of the systematic scoping review informed the fourth and final study, exploring feedback in undergraduate clinical practice.
Study four, explored feedback as a process to develop nursing students’ evaluative judgement in clinical practice education. This qualitative study applied the Co-creating Knowledge Translation framework (Co-KT) to explore student, academic, and clinical educator perspectives of feedback as a process to develop nursing students’ evaluative judgement in clinical practice education. This study highlighted that student, academic and clinical educator perceptions of good feedback practice was closely aligned to the concepts of developing evaluative judgement. When feedback practice was reported by participants as working well, the feedback process described had embraced aspects necessary to develop evaluative judgement. Feedback that facilitates the development of evaluative judgement has potential to improve the quality of nursing clinical education and develop students’ lifelong learning capabilities.
Significance
To the best of our knowledge, this is the first program of research that has explored possible strategies to embed the concepts of developing evaluative judgement in nursing curricula. The findings add to the understanding and practical application of the theoretical concepts of evaluative judgement in nursing education and provide a foundation from which further research and practice can explore this important capability.
Keywords: Evaluative judgement, nursing education
Subject: Nursing thesis
Thesis type: Doctor of Philosophy
Completed: 2025
School: College of Nursing and Health Sciences
Supervisor: Professor Lucy Lewis