Gerald J. Cason

A deterministic theory of clinical performance rating: promising early results.

The proposed theory provides a basis for both measuring and correcting rater stringency error in some grossly incomplete rating data matrices. The theoretical model fit (R = .92, .85, .82; joint p <.000001) ratings made byfaculty and resident physicians (n = 47, 31, and 29) of student clinical performance in each of three junior year medical student cohorts (n = 29, 30, and 35) better than alternative models. In these data the percentage of variation attributable to stringency and ability was about 35 and 40, respectively. Three-month test-retest reliability for rater stringencies was .16 < r < .29 (joint p < .04). Cross-validation supported the proposed model (r = .61) over the conventional alternative (r = .41; z = 2.62, p < .004). Both reliability and convergent validity of the ability construct were .20 greater for one corrected rating than for one observed (uncorrected) rating.

Maternal-infant clinical nurse specialist performance assessment: reliability and validity of an evaluation tool.

The Maternal-Infant Clinical Nurse Specialist Performance Evaluation Tool was used to evaluate the clinical performance of two classes of graduate students (n = 7, n = 4) enrolled in maternal-infant clinical practicians. When used by raters very familiar with the tool, i.e., those paruetpating in its development, it yielded valid [90] and reliable (.93) ratings of performance. When used by raters with limited familiarity with the tool, both validity and reliability declined but were still quite acceptable (.68 and .81, respectively) Better training for such raters should produce even more useful results. These results warrant continued cautious, monitored use of the tool in maternal-infant nursing The generic content of the tool offers the possibility of its generalization to other specialties.