Rethinking Theoretical Assessment in Undergraduate Nursing Education: Evidence-Based Best Practice Guidelines

Vollständiger Abstract

Worum geht es in dieser Arbeit?

The quality of theoretical assessments in undergraduate nursing education is crucial to shaping students’ clinical reasoning, professional judgment, and overall readiness for professional practice. Despite growing emphasis on competency-based education, persistent challenges, including cognitive misalignment, inconsistent moderation practices, limited assessment literacy, and contextual constraints, continue to undermine the credibility and fairness of these assessments. Aim: To develop and validate evidence-based best-practice guidelines to strengthen the design of theoretical assessments in undergraduate nursing education. Methods: The study was conducted in two sequential phases. The first phase gathered, synthesised, and integrated evidence from a scoping review, moderation report analysis, qualitative interviews with nurse educators, and a student survey. This process generated 13 draft guidelines with 60 operational statements. A Delphi study was used in the second phase to establish expert consensus amongst 15 national and international nursing education experts on the guidelines and operational statements. Consensus was set at ≥80% agreement on clarity, relevance, and applicability. Results: All guidelines achieved consensus in the Delphi study. The validated guidelines emphasise the need for assessments based on cognitive taxonomy principles; constructive alignment to enhance theory-practice integration; adherence to core assessment principles; and institutional responsibility for educator development and quality assurance. Conclusion: The guidelines provide structured guidance to enhance the validity, fairness, and contextual responsiveness of theoretical assessment design. When implemented, they have the potential to strengthen quality assurance processes and advance equitable, competency-driven nursing education in South Africa.