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The problem of self-assessment in nurse education
The problem of self-assessment in nurse education
of student self-assessment this boils down to either a concern for the 'social function' of assessment as an 'instrument of social selection' (Bridges 1989), or for assessment as a means for facilitating personal development. After first identifying nurse education's two functions as professional selection and the facilitation of personal development, this article offers an outline of each function and illustrates the tensions generated between the two through a discussion of the problem of selfassessment in nurse education.
Michael Purdy Nurse education is expected to fulfil two functions: the facilitation of individual personal development and professional selection. The need to produce competent nurses compromises the facilitation of personal development. This is reflected in the minor role assigned to self-assessment in preregistration nurse education. The problematic nature of self-assessment in nurse education is illustrated through a discussion of three issues: self-assessment and power, selfassessment and stereotyping and selfassessment and context.
INTRODUCTION
Michael Purdy BA(Hons), Grad CertEd, RMN, RGN, Nursing Lecturer, Department of Community and Primary Care Nursing, The University of Sheffield,Schoolof Nursing and Midwifery, Ridgeway House, Lodge Moor Complex, Redmires Road, SheffieldSI0 4LH, UK (Requests for offprints to MP) Manuscript accepted 14 November 1995
Assessment is an integral part of any educational process and is concerned with what happens 'in terms of the learning process and in terms of any anticipated or unanticipated outcomes' (Murphy & Torrance 1990, p 12). It is directed at the individual learner and is 'an attempt to know that person' (Rowntree 1977, p 4). This desire to know the learner can be the reason for including self-assessment as part of the overall assessment strategy. In this way self-assessment may provide the subjective component which makes the teacher's objective observations of the student more accurate and complete. The needs of the teacher, however, may not be the principal reason for adopting self-assessment. Instead it may operate primarily for the benefit of the learner; for example, where student-centred learning methods are advocated (Green 1994). Which is the case will depend upon the aims o f the educational process. As McIntyre (1972) observed, 'The value of our assessment practices can ultimately be judged only in relation to our educational goals' (p 164). In the context of the debate on the role
Nurse Education Today (1997) 17, 135-139 © 1997PearsonProfessionalLtd
NURSE EDUCATION'S TWIN FUNCTIONS: PROFESSIONAL SELECTION AND PERSONAL DEVELOPMENT Nurse education finds itself required to satisfy both processes - to facilitate individual personal development and professional selection. Personal development refers to the personal p@ssional development of the nurse rather than implying any development or change o f personality. Professional selection, on the other hand, involves mandatory professional development; that is development relying on student nurses to demonstrate that they satisfy the nursing competencies required of a registered nurse. Personal development - including for example the development o f 'critical reflection' (Bradshaw 1989) - is now regarded as central to the role of the professional nurse. Pursuing the twin goals ofprofessional selection and personal development draws nurse education in opposing directions, the public need for a competent professional and the private need for individual growth. Nurse education is asked to meet the needs of both society and the individual learner. These needs may not be incompatible, but recognizing that competent professional practice requires the personal professional development of the practitioner does not remove the tensions and conflicts that exist between the two processes. That nurse education is unable to satisfy both processes is clear from the assessment strategies it employs, and specifically from the role it gives to self-assessment. Its 'dual' nature affects the role that self-assessment strategies are permitted to perform in nurse education. The limitations it places on self-assessment in favour o f criterion referencing illustrate nurse education's emphasis on professional selection at the expense of personal professional development. Is this emphasis and the role it offers to selfassessment justified?
136
NurseEducation Today
Professional selection The selection of professionals is the social function of nurse education and involves the development of a product, the competent nurse. This need to ensure that nurses are professionally competent has led nurse education into adopting criterion referencing, in terms established by the United Kingdom Central Council ( U K C C 1989) under Rule 18A which specifies 'nursing competencies'. Assessment strategies have employed summative assessments of the student nurse's ability and involve selfassessment in a relatively minor role, often no more than as a 'check' to ensure that the students are realistically appraising their own clinical skills and performance in line with that observed and reported by qualified clinical staff. This function of nurse education to select professional nurses by ensuring that they are professionally competent operates on a traditional expert-novice relationship, in which the professionally competent (registered) nurse teacher or clinical nurse judges the student nurse's performance, knowledge and attitudes for 'signs' of professional competence. The emphasis on criterion referencing in relation to Rule 18A is understandable. Publicly scrutinized professional practice cannot be based solely on a system of self-referencing, including self-assessment. The point is well illustrated by 1Kowntree (1977): Individual progress is sometimes not enough. If we want a leg amputated, or need to be flown across the Atlantic, or desire a new pump fitted in the central heating system, we'd like to feel that the surgeon/pilot/plumber has reached a reasonable standard of competence. To know merely that he or she has improved greatly might not be sufficiently reassuring. In such cases we take it for granted that the practitioners have been licensed on the basis of a criterion-referenced assessment of their skills or knowledge. (p 17) Once Rule 18A has been satisfied and professional registration gained, the situation with respect to self-assessment is somewhat different. Rather than appearing as a peripheral activity, self-assessment assumes a role at the very heart of professional practice and development. In acting professionally, registered nurses are expected to be able to function as autonomous and self-directing independent practitioners, reflecting on their practice and determining their own individual needs for further personal and professional development. This principle of self-assessment is enshrined in the U K C C Scope of professional practice (1992) which states, in paragraph 9, that the registered nurse, midwife
or health visitor 'must honestly acknowledge any limits of personal knowledge and skill and take steps to remedy any relevant deficits in order effectively and appropriately to meet the needs of patients and clients'. While it seems correct to say that initial preregistration nurse education requires assessment based on criterion referencing, the reality of postregistration professional practice - requiring of the nurses abilities to think critically and reflectively about their practice, and to determine their own individual needs for personal and professional development - points to a need to develop the student nurse's ability to self-assess. AsJarvis (1983) comments: Self-assessment is an ... important skill to develop since many practitioners may rarely have their professional performance appraised overtly once they have finished their basic professional education. (p 103) Self-assessment is not something that will become instantly effective once the student becomes a registered nurse. It is, like any other skill, something which requires thought, practice and development. Learners need to be exposed to practices of self.assessment and critical reflection in their initial preparation for professional practice. Only by encouraging reflective thinking during initial training can these skills be developed by the professional (Boud et al 1985). Recognition of the need to develop skills and habits of self-assessment with student nurses has led to its inclusion in Project 2000 courses.
Personal development That nurse education has a role facilitating the student's individual professional development reinforces the need to include self- and peerassessment strategies, both of which are seen to facilitate the development of self-awareness (Burnard 1987) and promote individual professional accountability (Malkin 1994). This has been achieved by including work in curricula which is formatively rather than summatively assessed. Such work includes the production of individual or group projects, the writing of learning journals or diaries - which assists selfdisclosure and self-awareness (Bumard 1988, Landeen et al 1992) - and the compiling of individual portfolios. Clinical area assessment documents may also include provision for learners to self-assess, providing students with opportunities to express levels of achievement they feel they have already reached, and identify areas in which they require 'help, supervision and guidance' (Skelton 1989). The value of self.assessment strategies lies in their increasing self.awareness (Brown 1990) -
The problem of self-assessmentin nurse education
which enhances the delivery o f nursing care (1kawhnson 1990) - promoting reflection on the part of the individual learner and encouraging self-direction and self-determination. Heron (1981) suggests that this involves the development of a 'procedural' competence in the learner, necessary to the development of 'product' competence (for example, professionally competent nursing practice). Self-assessment is central to any process of individual personal development, and whilst such development is regarded as significant to the professional practice of the nurse it can be argued that nurse education should be facilitating it in its own right, insofar as it is advancing a genuine educational process. This is not to suggest that processes of personal development are easy to facilitate in a course of professional education. Indeed, the suspicion has been voiced that personal development initiatives may not sit well with technical and vocational education due to the latter's impositional character and the former's liberal and 'progressive' appearance (Bridges 1989). Opportunities for personal development may be used 'instrumentally' by student nurses to meet perceived professional demands rather than their own personal needs. Student nurses may assess themselves in a way which they have calculated will be expected by their nurse teachers. Cameron & Mitchell (1993) identify this practice in the context of the use of reflecrive journals in Canadian nurse education, and comment, 'It's easy to write the instructor's journal ... but the experience was phoney from the student's perspective' (p 290). Undoubtedly, the fact that up to 50% of the student's grade was made dependent on their journal keeping encouraged instrumental 'misuse' o f a device intended to facilitate personal development. But this is precisely the point. Where professional demands coexist with personal needs, and the former involve 'making the grade', there should be no surprise when students sacrifice formative opportunities for personal professional development in order to concentrate on 'what really counts' in a course of professional education, namely passing summative assignments and examinations.
ISSUES Self-assessment and power Self-assessment itself may be problematic in view o f the professional nature o f the educational process. To be credible such assessment must be accepted as relevant and accurate. Otherwise only lip service is being paid to self-
137
assessment as a significant component of an assessment strategy. So what of the student nurse who assesses their own clinical performance as adequate when it is viewed as unsatisfactory by clinical staff and/or nurse teachers? Which assessment is to be regarded as o f most significance in a course of professional education, the student's or the teacher's? It seems unlikely that the student's assessment will be accepted insofar as demands for professional competence are articulated by members o f the profession - registered nurses and nurse teachers - and not by those seeking entry into the profession. Resolution of such conflicts over assessment illustrate the unequal power relationship which characterizes teacher-student relations in courses of professional education, where the teachers stand as gatekeepers to the profession. If student self-assessment did not conflict with that of clinical and teaching staff, selfassessment strategies would be able to assume a significant role in the assessment of summative as well as formative components o f courses. Unfortunately, there is conflicting evidence concerning the 'realism' o f student self-assessment. Burke (1969), cited in 1Kowntree (1977), showed that in self-assessment of graded work students unrealistically overassess, but are far more realistic in their grading o f colleagues' work. Wondrak & Goble (1992), on the other hand, found students rating themselves lower than either their peers or their tutors. Such underestimation has been seen to reflect a cautious self-presentation strategy for maintaining high self-regard, rather than a feeling of incompetence (Eshel & Kurman 1991). Whichever the case, when conflicts do occur between students' and teachers' assessments the situation will resolve in the direction of the existing balance of power.
Self-assessment and stereotyping For all the talk of student-centred learning, nurse education pays lip service to self-assessment considered as a vehicle for personal development due to its overriding function to satisfy professional demands. The self-assessment that is employed checks the "realism' of the students' appraisal o f their clinical performance and professional, not their personal development. The linking of self-assessment with professional demands shows in the selective nature of the skills and qualities that nurse teachers anticipate will be present in a student's self-assessment. Only certain skills, performances, attitudes and opinions will be valued. These will come to define the range of 'acceptable' self-assessment. In effect, the whole person is
138
NurseEducation Today not expected to enter into the exercise. The whole person is not valued, only those aspects which are seen as indicators of an emerging professionally competent nurse. There is a very real danger that self-assessment will be conducted and judged in terms of a role, that this is not just any student selfassessing but a potential nurse. Consequently, self-assessment in nurse education can be expected to conform to a stereotype. To think that self-assessment could be conducted in any other way is perhaps naive. It is not the individualistic process that humanist ideology would have us believe. It is not grounded in the uniqueness of a particular human being. Rather, it is a social and cultural activity, and as such is caught up in purposes other than increasing the self-determination and autonomy of the individual. In conforming to social demand rather than individual need, self-assessment lends itself to becoming a means of social control.
Self-assessment and context The social nature of self-assessment points to the fact that it takes place in specific context, in which features of the situation influence the student's assessment. So at one level the student nurse's self-assessment is influenced by his or her conception of what the expectations of nurse teachers, as representatives of the nursing profession, will be, regarding the self-assessments of student nurses. At another level the social nature of self-assessment is far more radical. This is the level of specific discrete contexts. For the student nurse such contexts may be different clinical areas, different shifts in the same clinical area and different stages in his or her training in different clinical areas. Each 'context' may give rise to different self-assessments. Some, such as 'earlier' compared to 'later', will be anticipated by nurse educationalists and welcomed as evidence of professional development. But the contextual nature of the student's performance, skills, attitudes and knowledge is not genuinely accepted. It is believed that measurement of performance and skill will yield a 'result' that can be generalized across clinical contexts, be they shifts, wards or different stages in the student's training. Faith in such 'generalizability' is, however, open to challenge. Rowntree (1977), for example, suggests that the assumption that assessment of performance gives a basis for predicting what the student will do in the future may be unjustified, (a) 'if much time elapsed between the two performances', or (b) 'to cover very different situations' (p 189). If generalizing both performance and assessment across contexts is problematic, then
assessment of student nurses' professional competence is also problematic. The professional understanding of competence pursued in nurse education ignores the contextual features of performance and assessment in favour of a list of competencies which it regards as generalizable across space and time.
CONCLUSION It may be extremely difficult for nurse education to shed its faith in a context-free notion of nursing competence given its function to accredit professional status. But what of its other function - to facilitate individual growth and personal professional development? Here the contextual nature of self-assessment may become a positive resource for the individual, enabling rather than disabling them. Recognition of the significance of context leads to appreciation of the fact that reflection is a social rather than an individual process, linked to - and taking place in - real historical contexts (Kemmis 1985). As context changes so self may change, and self-assessment with it. The possibility of differing, and perhaps conflicting, assessments of the same individual, some by self, others by peers and by supervisors, can be encouraged and embraced rather than averaged out. A 'truer' picture of tlie whole person may be the result.
REFERENCES
Bradshaw P L1989Markingtime - the state of nurse educationin the United Kingdom.In: BradshawP L (ed) Teachingand Assessingin ClinicalNursing Practice. PrenticeHall, London,p 1-I 1 Bridges D 1989 Pupil assessmentfrom the perspectiveof naturalisticresearch. In: SimonsH, ElliottJ (e&) RethinkingAppraisaland Assessment.Open UniversityPress, Milton Keynes,p 119-130 Brown S i990 Assessment:a changingpractice. In: Horton T (ed) AssessmentDebates. Hodder and Stoughton, London, p 5-11 Boud D et al 1985 Promotingreflectionin learning:a model. In: BoudD et al (eds)Reflection:Turning ExperienceInto Learning.KoganPage,London, p 18-40 Burke 1KJ 1969 Some preliminarydata on the use of selfevaluationand peer-ratingsin assigninguniversity course grades.Journal of EducationalResearch 62: 444-448 Burnard P 1987 Selfand peer assessment.SeniorNurse 6: 16-17 Bumard P 1988 The journal as an assessmentand evaluationtool in nurse education.Nurse Education Today 8:105-107 Cameron B L, MitchellA M 1993Reflectivepeer journals: devdopingauthenticnurses.Journal of AdvancedNursing 18:290-297 Eshel Y, KurmanJ 1991 Academicself-coucept,accuracy of perceived abilityand academicattainment.British Journal of EducationalPsychology61:187-196
The problem of self-assessment in nurse education Green AJ 1994 Issues in the application of self-assessment for the Diploma of'Higher Education/Registered Nurse Mental Health Course. Nurse Education Today- 14:292-298 HeronJ 1981 Assessment revisited. In: Boud D (ed) Developing Student Autonomy in Learning. Kogan Page, London, p 55-68 Jarvis P 1983 Professional Education. Croom Helm, London Kemmis S 1985 Action research and the politics of reflection. In: Boud D et al (eds) 1Keflection: Turning Experience Into Learning. Kogan Page, London, p 139-163 Landeen J e t al 1992 Journal keeping as an educational strategy in teaching psychiatric nursing. Journal of Advanced Nursing 17:347-355 McIntyre D 1972 Assessment and teaching. In: Kubinstein D, Coleman C (eds) Education For Democracy. Penguin, Harmondsworch, p 164-171 Malkin K]P 1994 A standard for professional development: the use of self and peer review; learning contracts and reflection in clinical practice. Journal of Nursing Management 2:143-148
139
Murphy R, Torrance H 1990 The need for change. In: Horton T (ed) Assessment Debates. Hodder and Stoughton, London, p 12-18 Rawlinson J W 1990 Self awareness: conceptual influences, contribution to nursing, and approaches to attainment. Nurse Education Today 10: 111-117 I~owntree D 1977 Assessing Students: How Shall We Know Them? Kogan Page, London Skelton G M 1989 Assessment and profiling of clinical performance. In: Bradshaw P L (ed) Teaching and Assessing in Clinical Nursing Practice. Prentice Hall, London, p 160-174 United Kingdom Central Council for Nursing, Midwifery and Health Visiting 1989 Statutory Instrument No 1456, 1989 Rule 18A. UKCC, London United Kingdom Central Council for Nursing, Midwifery and Health Visiting 1992 The Scope of Professional Practice. UKCC, London Wondrak R, GobleJ 1992 An investigation into self, peer and tutor assessment of student psychiatric nurses' written work assignments. Nurse Education Today 12:61-64
of student self-assessment this boils down to either a concern for the 'social function' of assessment as an 'instrument of social selection' (Bridges 1989), or for assessment as a means for facilitating personal development. After first identifying nurse education's two functions as professional selection and the facilitation of personal development, this article offers an outline of each function and illustrates the tensions generated between the two through a discussion of the problem of selfassessment in nurse education.
Michael Purdy Nurse education is expected to fulfil two functions: the facilitation of individual personal development and professional selection. The need to produce competent nurses compromises the facilitation of personal development. This is reflected in the minor role assigned to self-assessment in preregistration nurse education. The problematic nature of self-assessment in nurse education is illustrated through a discussion of three issues: self-assessment and power, selfassessment and stereotyping and selfassessment and context.
INTRODUCTION
Michael Purdy BA(Hons), Grad CertEd, RMN, RGN, Nursing Lecturer, Department of Community and Primary Care Nursing, The University of Sheffield,Schoolof Nursing and Midwifery, Ridgeway House, Lodge Moor Complex, Redmires Road, SheffieldSI0 4LH, UK (Requests for offprints to MP) Manuscript accepted 14 November 1995
Assessment is an integral part of any educational process and is concerned with what happens 'in terms of the learning process and in terms of any anticipated or unanticipated outcomes' (Murphy & Torrance 1990, p 12). It is directed at the individual learner and is 'an attempt to know that person' (Rowntree 1977, p 4). This desire to know the learner can be the reason for including self-assessment as part of the overall assessment strategy. In this way self-assessment may provide the subjective component which makes the teacher's objective observations of the student more accurate and complete. The needs of the teacher, however, may not be the principal reason for adopting self-assessment. Instead it may operate primarily for the benefit of the learner; for example, where student-centred learning methods are advocated (Green 1994). Which is the case will depend upon the aims o f the educational process. As McIntyre (1972) observed, 'The value of our assessment practices can ultimately be judged only in relation to our educational goals' (p 164). In the context of the debate on the role
Nurse Education Today (1997) 17, 135-139 © 1997PearsonProfessionalLtd
NURSE EDUCATION'S TWIN FUNCTIONS: PROFESSIONAL SELECTION AND PERSONAL DEVELOPMENT Nurse education finds itself required to satisfy both processes - to facilitate individual personal development and professional selection. Personal development refers to the personal p@ssional development of the nurse rather than implying any development or change o f personality. Professional selection, on the other hand, involves mandatory professional development; that is development relying on student nurses to demonstrate that they satisfy the nursing competencies required of a registered nurse. Personal development - including for example the development o f 'critical reflection' (Bradshaw 1989) - is now regarded as central to the role of the professional nurse. Pursuing the twin goals ofprofessional selection and personal development draws nurse education in opposing directions, the public need for a competent professional and the private need for individual growth. Nurse education is asked to meet the needs of both society and the individual learner. These needs may not be incompatible, but recognizing that competent professional practice requires the personal professional development of the practitioner does not remove the tensions and conflicts that exist between the two processes. That nurse education is unable to satisfy both processes is clear from the assessment strategies it employs, and specifically from the role it gives to self-assessment. Its 'dual' nature affects the role that self-assessment strategies are permitted to perform in nurse education. The limitations it places on self-assessment in favour o f criterion referencing illustrate nurse education's emphasis on professional selection at the expense of personal professional development. Is this emphasis and the role it offers to selfassessment justified?
136
NurseEducation Today
Professional selection The selection of professionals is the social function of nurse education and involves the development of a product, the competent nurse. This need to ensure that nurses are professionally competent has led nurse education into adopting criterion referencing, in terms established by the United Kingdom Central Council ( U K C C 1989) under Rule 18A which specifies 'nursing competencies'. Assessment strategies have employed summative assessments of the student nurse's ability and involve selfassessment in a relatively minor role, often no more than as a 'check' to ensure that the students are realistically appraising their own clinical skills and performance in line with that observed and reported by qualified clinical staff. This function of nurse education to select professional nurses by ensuring that they are professionally competent operates on a traditional expert-novice relationship, in which the professionally competent (registered) nurse teacher or clinical nurse judges the student nurse's performance, knowledge and attitudes for 'signs' of professional competence. The emphasis on criterion referencing in relation to Rule 18A is understandable. Publicly scrutinized professional practice cannot be based solely on a system of self-referencing, including self-assessment. The point is well illustrated by 1Kowntree (1977): Individual progress is sometimes not enough. If we want a leg amputated, or need to be flown across the Atlantic, or desire a new pump fitted in the central heating system, we'd like to feel that the surgeon/pilot/plumber has reached a reasonable standard of competence. To know merely that he or she has improved greatly might not be sufficiently reassuring. In such cases we take it for granted that the practitioners have been licensed on the basis of a criterion-referenced assessment of their skills or knowledge. (p 17) Once Rule 18A has been satisfied and professional registration gained, the situation with respect to self-assessment is somewhat different. Rather than appearing as a peripheral activity, self-assessment assumes a role at the very heart of professional practice and development. In acting professionally, registered nurses are expected to be able to function as autonomous and self-directing independent practitioners, reflecting on their practice and determining their own individual needs for further personal and professional development. This principle of self-assessment is enshrined in the U K C C Scope of professional practice (1992) which states, in paragraph 9, that the registered nurse, midwife
or health visitor 'must honestly acknowledge any limits of personal knowledge and skill and take steps to remedy any relevant deficits in order effectively and appropriately to meet the needs of patients and clients'. While it seems correct to say that initial preregistration nurse education requires assessment based on criterion referencing, the reality of postregistration professional practice - requiring of the nurses abilities to think critically and reflectively about their practice, and to determine their own individual needs for personal and professional development - points to a need to develop the student nurse's ability to self-assess. AsJarvis (1983) comments: Self-assessment is an ... important skill to develop since many practitioners may rarely have their professional performance appraised overtly once they have finished their basic professional education. (p 103) Self-assessment is not something that will become instantly effective once the student becomes a registered nurse. It is, like any other skill, something which requires thought, practice and development. Learners need to be exposed to practices of self.assessment and critical reflection in their initial preparation for professional practice. Only by encouraging reflective thinking during initial training can these skills be developed by the professional (Boud et al 1985). Recognition of the need to develop skills and habits of self-assessment with student nurses has led to its inclusion in Project 2000 courses.
Personal development That nurse education has a role facilitating the student's individual professional development reinforces the need to include self- and peerassessment strategies, both of which are seen to facilitate the development of self-awareness (Burnard 1987) and promote individual professional accountability (Malkin 1994). This has been achieved by including work in curricula which is formatively rather than summatively assessed. Such work includes the production of individual or group projects, the writing of learning journals or diaries - which assists selfdisclosure and self-awareness (Bumard 1988, Landeen et al 1992) - and the compiling of individual portfolios. Clinical area assessment documents may also include provision for learners to self-assess, providing students with opportunities to express levels of achievement they feel they have already reached, and identify areas in which they require 'help, supervision and guidance' (Skelton 1989). The value of self.assessment strategies lies in their increasing self.awareness (Brown 1990) -
The problem of self-assessmentin nurse education
which enhances the delivery o f nursing care (1kawhnson 1990) - promoting reflection on the part of the individual learner and encouraging self-direction and self-determination. Heron (1981) suggests that this involves the development of a 'procedural' competence in the learner, necessary to the development of 'product' competence (for example, professionally competent nursing practice). Self-assessment is central to any process of individual personal development, and whilst such development is regarded as significant to the professional practice of the nurse it can be argued that nurse education should be facilitating it in its own right, insofar as it is advancing a genuine educational process. This is not to suggest that processes of personal development are easy to facilitate in a course of professional education. Indeed, the suspicion has been voiced that personal development initiatives may not sit well with technical and vocational education due to the latter's impositional character and the former's liberal and 'progressive' appearance (Bridges 1989). Opportunities for personal development may be used 'instrumentally' by student nurses to meet perceived professional demands rather than their own personal needs. Student nurses may assess themselves in a way which they have calculated will be expected by their nurse teachers. Cameron & Mitchell (1993) identify this practice in the context of the use of reflecrive journals in Canadian nurse education, and comment, 'It's easy to write the instructor's journal ... but the experience was phoney from the student's perspective' (p 290). Undoubtedly, the fact that up to 50% of the student's grade was made dependent on their journal keeping encouraged instrumental 'misuse' o f a device intended to facilitate personal development. But this is precisely the point. Where professional demands coexist with personal needs, and the former involve 'making the grade', there should be no surprise when students sacrifice formative opportunities for personal professional development in order to concentrate on 'what really counts' in a course of professional education, namely passing summative assignments and examinations.
ISSUES Self-assessment and power Self-assessment itself may be problematic in view o f the professional nature o f the educational process. To be credible such assessment must be accepted as relevant and accurate. Otherwise only lip service is being paid to self-
137
assessment as a significant component of an assessment strategy. So what of the student nurse who assesses their own clinical performance as adequate when it is viewed as unsatisfactory by clinical staff and/or nurse teachers? Which assessment is to be regarded as o f most significance in a course of professional education, the student's or the teacher's? It seems unlikely that the student's assessment will be accepted insofar as demands for professional competence are articulated by members o f the profession - registered nurses and nurse teachers - and not by those seeking entry into the profession. Resolution of such conflicts over assessment illustrate the unequal power relationship which characterizes teacher-student relations in courses of professional education, where the teachers stand as gatekeepers to the profession. If student self-assessment did not conflict with that of clinical and teaching staff, selfassessment strategies would be able to assume a significant role in the assessment of summative as well as formative components o f courses. Unfortunately, there is conflicting evidence concerning the 'realism' o f student self-assessment. Burke (1969), cited in 1Kowntree (1977), showed that in self-assessment of graded work students unrealistically overassess, but are far more realistic in their grading o f colleagues' work. Wondrak & Goble (1992), on the other hand, found students rating themselves lower than either their peers or their tutors. Such underestimation has been seen to reflect a cautious self-presentation strategy for maintaining high self-regard, rather than a feeling of incompetence (Eshel & Kurman 1991). Whichever the case, when conflicts do occur between students' and teachers' assessments the situation will resolve in the direction of the existing balance of power.
Self-assessment and stereotyping For all the talk of student-centred learning, nurse education pays lip service to self-assessment considered as a vehicle for personal development due to its overriding function to satisfy professional demands. The self-assessment that is employed checks the "realism' of the students' appraisal o f their clinical performance and professional, not their personal development. The linking of self-assessment with professional demands shows in the selective nature of the skills and qualities that nurse teachers anticipate will be present in a student's self-assessment. Only certain skills, performances, attitudes and opinions will be valued. These will come to define the range of 'acceptable' self-assessment. In effect, the whole person is
138
NurseEducation Today not expected to enter into the exercise. The whole person is not valued, only those aspects which are seen as indicators of an emerging professionally competent nurse. There is a very real danger that self-assessment will be conducted and judged in terms of a role, that this is not just any student selfassessing but a potential nurse. Consequently, self-assessment in nurse education can be expected to conform to a stereotype. To think that self-assessment could be conducted in any other way is perhaps naive. It is not the individualistic process that humanist ideology would have us believe. It is not grounded in the uniqueness of a particular human being. Rather, it is a social and cultural activity, and as such is caught up in purposes other than increasing the self-determination and autonomy of the individual. In conforming to social demand rather than individual need, self-assessment lends itself to becoming a means of social control.
Self-assessment and context The social nature of self-assessment points to the fact that it takes place in specific context, in which features of the situation influence the student's assessment. So at one level the student nurse's self-assessment is influenced by his or her conception of what the expectations of nurse teachers, as representatives of the nursing profession, will be, regarding the self-assessments of student nurses. At another level the social nature of self-assessment is far more radical. This is the level of specific discrete contexts. For the student nurse such contexts may be different clinical areas, different shifts in the same clinical area and different stages in his or her training in different clinical areas. Each 'context' may give rise to different self-assessments. Some, such as 'earlier' compared to 'later', will be anticipated by nurse educationalists and welcomed as evidence of professional development. But the contextual nature of the student's performance, skills, attitudes and knowledge is not genuinely accepted. It is believed that measurement of performance and skill will yield a 'result' that can be generalized across clinical contexts, be they shifts, wards or different stages in the student's training. Faith in such 'generalizability' is, however, open to challenge. Rowntree (1977), for example, suggests that the assumption that assessment of performance gives a basis for predicting what the student will do in the future may be unjustified, (a) 'if much time elapsed between the two performances', or (b) 'to cover very different situations' (p 189). If generalizing both performance and assessment across contexts is problematic, then
assessment of student nurses' professional competence is also problematic. The professional understanding of competence pursued in nurse education ignores the contextual features of performance and assessment in favour of a list of competencies which it regards as generalizable across space and time.
CONCLUSION It may be extremely difficult for nurse education to shed its faith in a context-free notion of nursing competence given its function to accredit professional status. But what of its other function - to facilitate individual growth and personal professional development? Here the contextual nature of self-assessment may become a positive resource for the individual, enabling rather than disabling them. Recognition of the significance of context leads to appreciation of the fact that reflection is a social rather than an individual process, linked to - and taking place in - real historical contexts (Kemmis 1985). As context changes so self may change, and self-assessment with it. The possibility of differing, and perhaps conflicting, assessments of the same individual, some by self, others by peers and by supervisors, can be encouraged and embraced rather than averaged out. A 'truer' picture of tlie whole person may be the result.
REFERENCES
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