A Handbook for Teaching and Learning in Higher Education Enhancing academic and Practice

Nursing and midwifery
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The assessment of clinical reasoning also presents challenges. The dilemma is that this
skill is practice-orientated but based upon theoretical or empirical knowledge. The usual
assessment division of the theoretical and the practical is not helpful. Assessment
approaches that can probe the various facets of clinical reasoning are required. Practicebased
assessments conducted by mentoring clinical staff can be effective, as can the
simulated version of this, an objective structured clinical examination (OSCE) (see
Chapter 26).
Theory and underpinning knowledge
The theoretical perspectives and empirical knowledge underpinning practice for nursing
and midwifery are drawn from many disciplines, including the biological sciences,
psychology, sociology, ethics and philosophy, management, education and informatics.
These are synthesised or complemented by research and theoretical perspectives
originating directly from nursing and midwifery. To suit the wide-ranging subject matter
and learning outcomes, varied approaches to learning and teaching are necessary. There
is a place for the traditional lecture, for seminars, tutorials or supervision; for laboratory
work, practical skills classes, experiential learning, individual and group projects; for
simulation, self-directed learning, web-based learning, podcasts and portfolios; for
problem-solving and PBL/EBL. A range of approaches to facilitating learning should
strengthen the learning experience by capitalising on the strengths and minimising the
weaknesses of each approach (see Further reading).
Assessing students’ grasp of theory, recall of knowledge, and the synthesis and
application of these, is best achieved through a range of approaches. Recall can be tested
through unseen, written examinations or online tests via, for example, multiple choice
questions, annotation of diagrams, or short structured answers. Longer written responses
are required to demonstrate reflection, synthesis, application and creativity. Examinations
should be augmented with assignments completed over a period of weeks, for example:
essays, portfolios, learning journals, project reports and presentations. Assessment should
encourage students to apply theories and empirical knowledge to client care scenarios.
With each mode of assessment it is important to ensure that the process is, so far as is
possible, transparent, fair, ethical, valid, reliable and aligned with curricular intentions
(see Chapter 10). The face validity of an assessment is important for maintaining student
motivation.
Interrogating practice
What are the strengths and weaknesses of the approaches to learning,
teaching and assessment employed in your courses? Is each approach used
to best effect?