Portfolio assessment and evaluation : Implications and guidelines for clinical nursing education

With the advent of Outcomes-Based Education in South Africa, the quality of nursing education is debatable, es­ pecially with regard to the assessment and evaluation of clinical nursing education, which is complex and renders the validity and reliability of the methods used question­ able. This paper seeks to explore and describe the use of portfolio assessment and evaluation, its implications and guidelines for its effective use in nursing education. Firstly, the concepts of assessment, evaluation, portfolio and al­ ternative methods of evaluation are defined. Secondly, a comparison of the characteristics of the old (traditional) methods and the new alternative methods of evaluation is made. Thirdly, through deductive analysis, synthesis and inference, implications and guidelines for the effective use of portfolio assessment and evaluation are described. In view of the qualitative, descriptive and exploratory na­ ture of the study, a focus group interview with twenty stu­ dents following a post-basic degree at a university in Gau­ teng regarding their perceptions on the use of portfolio assessment and evaluation method in clinical nursing edu­ cation was used. A descriptive method of qualitative data analysis of open coding in accordance with Tesch’s proto­ col (in Creswell 1994:155) was used. Resultant implica­ tions and guidelines were conceptualised and described within the existing theoretical framework. Principles of trustworthiness were maintained as described by (Lincoln & Guba 1985:290-327). Ethical considerations were in accordance w ith D EN O SA ’s standards o f research (1998:7). Opsomming Met die koms van uitkomsgebaseerde-onderrig in SuidAfrika, is die kwaliteit van verpleegonderwys betwisbaar, veral ten opsigte van die waardering en evaluering van kliniese verpleegkunde, wat kompleks is en wat maak dat die geldigheid en betroubaardheid van die metodes wat gebruik word, aanvegbaar is. Hierdie artikel wil die gebruik van portefeuljewaardering en -evaluering ondersoek en beskryf, asook die im plikasies en riglyne daarvan vir doeltreffende gebruik in verpleegonderwys. Eerstens, word die konsepte van waardering, evaluering, portefeulje en altematiewe metodes van evaluering omskry we. Tweedens, word die kenmerke van die ou (tradisionele) metodes en die nuwe altematiewe metodes van evaluaering vergelyk. Derdens, deur deduktiewe analise, sintese en afleiding, word implikasies en riglyne vir die doeltreffende gebruik van portefeuljewaardering en -evaluering beskryf. Na aanleiding van die kw alitatiew e, beskrywende en ondersoekende aard van die studie, is ’n fokusgroeponderhoud m et tw in tig na-g raadse studente aan ‘n universiteit in Gauteng oor hul persepsies van die gebruik van die metode van portfeuljewaardering en -evaluering in kliniese verpleegonderwys, gebruik. ’n Beskrywende metode van kwalitatiewe data-analise van opekodering, volgens Tesch se protokol (in Creswell, 1994:155), is aan g ew en d . G ev o lg lik e im p lik a s ie s en rig ly n e is g ek o n sep tu a lisee r en b esk ry f b inne die b estaande raamwerk. Beginsels van betroubaarheid is gehandhaaf soos beskryf deur (Lincoln & Guba 1985:290-327). Etiese oorw egings was in ooreenstem m ing m et D EN O SA (1998:7) se navorsingstandaarde. Background and rationale South Africa has recently been experiencing a major edu­ cational paradigm shift from the traditional teacher to the learner-centered approach to learning that is outcomes based in nature. The outcomes-based curriculum requires the learner to evidence what he/she knows and can do, and to appreciate the acquired knowledge, skills and val­ ues. The South African Q ualifications A uthority Act SAQA (Act 58 of 1995) and the South African Nursing Council (SANC) are responsible for quality assurance in higher education institutions in the country, and the em­ phasis is placed on the quality of the product of learning programmes. Teachers are engaged in restructuring the educational pro­ grammes, and the assessment and evaluation reform debate continues. Teachers are expected to use research evidence, innovative teaching and evaluation methods that encourage collaborative education and the development of lifelong learn­ ing skills. Outcomes-based education raises a number of ques­ tions about the learners and the em ployer’s expectation of higher educational programmes. For the learner to be effi­ cient and fit well into the working world, the nature of learn­ ing and how that learning can be assessed must be revisited (Van der Horst & McDonald, 1997:169, 170). Comprehen­ 4 Curationis August 2002 sive competence of the learner should be evaluated through varied methods of assessment and evaluation such as portfo­ lio assessment (Wiggins, 2001:4). According to Johnson (2000:129), in these changing times, many learners and employers are beginning to view the higher education curriculum as being too prescriptive, outdated, ungrounded, content driven, delivered by inaccessible modes and inaccessible times, and assessed against irrelevant crite­ ria through inappropriate methods. Most of the traditional methods of assessment and evaluation make learners adopt a surface approach to learning. They are artificial and rigid, not capturing the actual changes in the learner’s knowledge and skills (Biggs, 1996:348 and Tynjala, 1998:210). Tradi­ tional tests lack the ability to measure higher-order thinking skills. While multiple choice items can be valid indicators or predictors of academic performance, they too often mislead learners and teachers about the type of work that should be mastered. However, the place of traditional tests still remains (Harden & Gleeson in Nicol & Freeth, 1998: 602), and needs to be supplemented by other alternative methods of assess­ ment and evaluation that are learner-centred. In accordance with the constructivistic approach to learning (Peters, 2000:167), learners are encouraged to engage in dialogic interaction where they have to justify their reason­ ing and arguments based on evidence. Interactive teaching strategies and related assessment and evaluation methods will facilitate the development of the learner’s critical and reflec­ tive thinking, a necessary skill to be learned by teacher train­ ers if educational standards are to be met. King and Kitchener (1997:3,78,194) advocate the use of authentic, ill-structured problems that will foster the use of higher-order thinking. which has the advancement of learning as its aim (Wolf & Siung-Runyan 1996:32,33). A portfolio is about the collec­ tion of evidence that learning has taken place (Snadden & Thomas 1998a: 192). Alternative methods of assessment and evaluation These methods are often referred to as authentic or perform­ ance assessment approaches that offer alternatives to the tra­ ditional methods. They focus on learner processes or perform­ ance where learners solve problems that have an equivalent in their real world involving the use of resources, consulta­ tion and the integration of knowledge and skills. They are concerned with the assessment of complex performance and higher-order skills in a real life context. Learners become active partners in the assessment enterprise whereby they re­ flect on how they can learn meaningfully (Nicol & Freeth, 1998:602; Van der Horst & McDonald, 1997:188). In the quest to differentiate the characteristics of the new al­ ternative methods of assessment and evaluation and the old (traditional) methods, Wiggins (2001:4-6) provides a com­ parison of the two methods. The resultant differences rein­ force and support the need for the method that will produce a learner who is balanced, reasonable, reflective and could make a useful contribution to society and the working world (Esteve, 2000:6 ). Definitions of concepts Assessment Assessment is a data-gathering process for measuring the learners’ knowledge, performance, values or attitudes to de­ termine the progress of the learner or to make a diagnosis of the learner’s learning problems. The measurement of the data gained from the assessment process helps with the process of evaluation (Van der Horst & McDonald 1997:170).

In view of the qualitative, descriptive and exploratory na ture of the study, a focus group interview with twenty stu dents following a post-basic degree at a university in G au teng regarding their perceptions on the use of portfolio assessment and evaluation method in clinical nursing edu cation was used.A descriptive method of qualitative data analysis of open coding in accordance with Tesch's proto col (in Creswell 1994:155) was used.Resultant implica tions and guidelines were conceptualised and described within the existing theoretical framework.Principles of trustworthiness were maintained as described by (Lincoln & Guba 1985:290-327).Ethical considerations were in a c c o rd a n c e w ith D E N O S A 's sta n d a rd s o f rese a rc h (1998:7).
Na aanleiding van die kw alitatiew e, beskryw ende en ondersoekende aard van die studie, is 'n fokusgroepo n d e rh o u d m et tw in tig n a-g ra ad se stu d en te aan 'n universiteit in Gauteng oor hul persepsies van die gebruik van die metode van portfeuljewaardering en -evaluering in kliniese verpleegonderwys, gebruik.'n Beskrywende metode van kwalitatiewe data-analise van opekodering, volgens Tesch se protokol (in C resw ell, 1994:155), is a a n g e w e n d .G e v o lg lik e im p lik a s ie s en rig ly n e is g e k o n s e p tu a lis e e r en b e sk ry f b in n e die b e sta a n d e raamwerk.Beginsels van betroubaarheid is gehandhaaf soos beskryf deur (Lincoln & Guba 1985:290-327).Etiese o o rw eg in g s w as in o o re en stem m in g m et D E N O SA (1998:7) se navorsingstandaarde.

Background and rationale
South Africa has recently been experiencing a m ajor edu cational paradigm shift from the traditional teacher to the learner-centered approach to learning that is outcom es based in nature.The outcom es-based curriculum requires the learner to evidence what he/she knows and can do, and to appreciate the acquired knowledge, skills and val ues.The South A frican Q ualifications A uthority Act SAQA (Act 58 of 1995) and the South African Nursing Council (SANC) are responsible for quality assurance in higher education institutions in the country, and the em phasis is placed on the quality o f the product of learning program m es.
Teachers are engaged in restructuring the educational pro grammes, and the assessment and evaluation reform debate continues.Teachers are expected to use research evidence, innovative teaching and evaluation methods that encourage collaborative education and the development of lifelong learn ing skills.Outcomes-based education raises a num ber o f ques tions about the learners and the em ployer's expectation of higher educational programmes.For the learner to be effi cient and fit well into the working world, the nature o f learn ing and how that learning can be assessed must be revisited (Van der Horst & M cDonald, 1997:169, 170).Com prehen sive competence o f the learner should be evaluated through varied methods of assessm ent and evaluation such as portfo lio assessment (Wiggins, 2001:4).According to Johnson (2000:129), in these changing times, many learners and employers are beginning to view the higher education curriculum as being too prescriptive, outdated, ungrounded, content driven, delivered by inaccessible modes and inaccessible times, and assessed against irrelevant crite ria through inappropriate methods.M ost of the traditional methods o f assessment and evaluation make learners adopt a surface approach to learning.They are artificial and rigid, not capturing the actual changes in the learner's knowledge and skills (Biggs, 1996:348 andTynjala, 1998:210).Tradi tional tests lack the ability to measure higher-order thinking skills.W hile multiple choice items can be valid indicators or predictors of academic performance, they too often mislead learners and teachers about the type of work that should be mastered.However, the place o f traditional tests still remains (Harden & Gleeson in Nicol & Freeth, 1998: 602), and needs to be supplemented by other alternative methods of assess ment and evaluation that are learner-centred.In accordance with the constructivistic approach to learning (Peters, 2000:167), learners are encouraged to engage in dialogic interaction where they have to justify their reason ing and arguments based on evidence.Interactive teaching strategies and related assessm ent and evaluation methods will facilitate the developm ent of the learner's critical and reflec tive thinking, a necessary skill to be learned by teacher train ers if educational standards are to be met.King and Kitchener (1997:3,78,194) advocate the use o f authentic, ill-structured problem s that will foster the use o f higher-order thinking.
which has the advancement of learning as its aim (W olf & Siung-Runyan 1996:32,33).A portfolio is about the collec tion o f evidence that learning has taken place (Snadden & Thomas 1998a: 192).

Alternative methods of assessment and evaluation
These methods are often referred to as authentic or perform ance assessment approaches that offer alternatives to the tra ditional methods.They focus on learner processes or perform ance where learners solve problems that have an equivalent in their real world involving the use of resources, consulta tion and the integration of knowledge and skills.They are concerned with the assessment o f complex performance and higher-order skills in a real life context.Learners become active partners in the assessment enterprise whereby they re flect on how they can learn meaningfully (Nicol & Freeth, 1998:602;Van der Horst & McDonald, 1997:188).
In the quest to differentiate the characteristics of the new al ternative methods of assessment and evaluation and the old (traditional) methods, W iggins (2001:4-6) provides a com parison of the two methods.The resultant differences rein force and support the need for the method that will produce a learner who is balanced, reasonable, reflective and could make a useful contribution to society and the working world (Esteve, 2000:6).

Definitions of concepts Assessment
A ssessm ent is a data-gathering process for m easuring the learners' knowledge, perform ance, values or attitudes to de termine the progress of the learner or to make a diagnosis of the learner's learning problems.The m easurem ent o f the data gained from the assessm ent process helps with the process of evaluation (Van der Horst & M cDonald 1997:170).

Evaluation
Evaluation is the process o f making a decision about the learn ing o f the learner, using information gained from formal and informal assessment.Evaluation enables a teacher to answer the question: "How good?" or "How w ellT' (Van der Horst & McDonald 1997:169).According to Scriven (1991:1,3), evalu ation is the process o f determ ining the merit, worth and value of things.Evaluation is treated as a key analytical process in all disciplined intellectual and practical endeavours.A ssess ment and evaluation are the backbone o f any educational dis cipline.

Portfolio
A portfolio is a selective collection of the learner's work and records of progress gathered across diverse contexts over time, fram ed by reflection and enriched through collaboration,

Comparison of the traditional and alternative methods of assessment and evaluation:
• Alternative assessment requires learners to be effec tive performers with comprehensively acquired knowl edge and skills (thoughts and feelings), while tradi tional tests reveal whether the learner can recognise and recall what was learned out of context.
• Alternative assessm ent presents the learner with a full array o f activities that mirror the priorities and chal lenges found in the best instructional activities.These are as follows: conducting research; writing, revising and discussing papers; providing and engaging in an analysis of events; collaborating with others on a de bate and discourse; and engaging in partnership with other stakeholders.Traditional tests are usually lim ited to pen and paper.Population, sample and sam pling, data collection and data analysis O f the thirty-five students undertaking a post-basic degree at a university in Gauteng, who were required to compile port folios on a given topic as an assignment for the semester by using the guidelines described in the bigger study, twenty stu dents volunteered to take part in the study on completion of the assignment to describe the implications of portfolios as an evaluation method in clinical nursing education.Two focus group interviews consisting of ten students each were conducted (Krueger, 1994: 6-10).The participants were requested to call themselves by numbers for the sake o f main taining anonymity.They were ensured of the confidentiality of the data and they gave a written informed consent to take part in the study.Two questions were asked as follows: What are the implications o f portfolio assessment in clinical nurs ing education?How could the use of the portfolio method of assessment and evaluation be made effective?The interviewer was purposively selected, based on her expert interviewing skills and know ledge o f nursing education and qualitative research.The researcher's role was to ask probing questions in the quest to explore more in-depth information and to write field notes in order to enrich the data collected (M iles & Huberman, 1994:241).
According to W olf & Siu-Runyan (1996:31), portfolios fit in well with the new views of learning and assessment.They are malleable enough to capture individual styles and varied con texts, and are robust enough to reflect broad and significant features of learning.They enable students and teachers to examine, discuss and reflect on their performance and perspec tives.The research questions to give guidance to the study are as follows: W hat are the implications o f portfolio assess ment in clinical nursing education?How could the use of the portfolio method of assessment and evaluation be made effec tive in clinical nursing education?
The objectives of the study are: • To explore and describe the im plications o f portfolio assessm ent and evaluation in clinical nursing educa tion.
• To describe guidelines for the effective use of portfolio assessm ent and evaluation in clinical nursing educa tion.

Research design and method
This study is a subsequent result of a bigger study in which a model to facilitate reflective thinking o f learners in clinical nursing education was developed with guidelines for its im plementation.The article serves to describe the implications and guidelines for the effective use of portfolio assessment and evaluation method in clinical nursing education.The re Data was analysed by means of the descriptive method of open coding by Tech (in Creswell 1994:155).The independent coder, who was purposively selected, was given a similar pro tocol to analyse the data.A consensus discussion meeting was held after six days to confirm the findings.Following the completion of the data analysis, a literature review was done to re-contextualise the data within the existing theoretical frameworks (M orse & Field, 1996:106).

Measures to ensure trustworthiness
Trustworthiness was m aintained by using strategies o f cred ibility, applicability, dependability and confirmability as de scribed by (Lincoln & Guba 1985:290-327).Credibility was achieved through prolonged engagement in clinical nursing education and by keeping reflexive field notes, and member checking was achieved by literature control using findings of similar studies done in portfolios as teaching and evaluation method to facilitate higher-order thinking skills.Dependability was ensured by a dense description of the data, an audit trail and the use o f the co-encoder.Transferability was achieved by participants volunteering to take part in the study, a dense description o f the method and literature review.Confirmability was ensured by audit trail and reflexivity (Lincoln & Guba, 1985:290-327).
In a portfolio, the work may have been selected by the learn ers them selves or the teacher, or through a mutual decision on the themes by both the learner and the teacher.Portfolio assessm ent could be used for com prehensive assessm ent as sembled consciously from a num ber o f tasks produced over a semester or a year (Gravett 1995:2 1).Portfolios could be used both as a way of constructing meaning and as an opportunity to teach the assessm ent of one's own work as evidenced by a citation made by a participant in LaBoskey (2000:591) "Port folio assessm ent helped me to make my philosophy of teach ing explicit and concrete.I became more reflective about my thought process and m ore confident about my opinions.A portfolio is a tangible expression o f my ideas, thoughts, feel ings, experiences and o f my journey as a student teacher.
Learning how to bring my inner thoughts in to a concrete process and product was a good model for the work we do as teachers" .
The relevant portfolios in clinical nursing education are those that merge assessm ent with learning, the kind o f learning that involves deep understanding, reflectivity and multiple dim ensions, including the moral and ethical dim ensions (LaBoskey 2000:593).The educational portfolios must allow for, prom ote and reveal individual meaning-m aking.They m ust allow the opportunity to interact about the content and meaning o f those portfolios with people who matter and who su p p o rt the re fle c tiv e p ro ce ss (W olf & S iu n g -R u n y an (1996:32,33);Gravett (1995:21);Boud (1995:147-149) and Van der Horst & M cDonald (1997:175).The value o f portfo lio assessment is best demonstrated where learners work col laboratively as a team, sharing ideas, thoughts and feelings to solve clinical problems related to a specific context, stated the participants.Through analysis, synthesis and inference from em pirical data, literature and theoretical frameworks, guidelines were described.
Guidelines for the effective use of portfolio assessment and evaluation • As with any assessment, learners should be clear on the rationale for compiling a portfolio, and exactly what is expected of the learners.

•
The first task is for the learners to assess their previ ous learning and accomplishments relating to the theme.This enables the learners to assess their own levels of knowledge and plan to remedy any deficits identified.Learners and teachers should provide evi dence of a learning contract drawn where learning outcomes, methods, evaluations, time frames and re sources to be used in order to com pile a portfolio are outlined.

•
The learning outcomes should relate to the professional com petencies but be transformed into learner-friendly language so that the learners can see exactly what they have to achieve within the specified time frame.The processing of the portfolio should occur over an ex tended period.

•
The portfolio should contain a diverse set of informa tion gathered across a variety o f learning context, con tent areas, and forms o f communication.Otherwise, the full range of the learners' talents and interest may not be revealed.In order for the learners to negotiate a way through the course, the learning outcomes should be broken down into a manageable series of themes, which continually build upon each other.

•
The learners should build upon this fram ework by add ing their own material in the form of reading, plan ning collaborative projects, own research findings, artistic creations and reflective essays in which the most important ideas, skills and feelings they have experi enced could be expressed.They should be able to evi dence their thinking progression throughout.
• Every week, the learners should analyse and reflect on a critical incident to the learners in terms o f their learn ing, the incident that provides the material for exam-7 Curationis August 2002 ining the relationship between theory and practice.
The portfolio should serve the purpose of identifying the areas that the learners find m ost stressful, the ar eas where they received increased guidance and sup port, as well as the areas that provide an indication of extra work on the theme.This is subsequently used at the weekly portfolio workshops.By reviewing their progress on a regular basis, the learners gain the satis faction of monitoring and controlling their own learn ing.
Formative assessm ent should take place first in a monthly tutorial where learners are helped with their self-assessment in relation to their professional devel opm ent and the acquisition of competence.
There should be portfolio workshops during which learners work in small groups with or without a facili tator, and interact with peers and other related m ulti disciplinary team m em bers including the family and community members.
Portfolio assessment should be criterion referenced ac cording to the learners' guidelines for the portfolio.
The portfolio marking criteria should be m utually de cided on by learners and teachers.
The marking criteria should be sufficiently broad to encom pass the individuality of each learner while en suring that a uniform standard is met.In developing a scoring scheme and using it to evaluate the entire port folio, a rubric as indicated in  1997:197).

Poor
The learner did not do the task, did not complete the assignment, or shows no comprehension o f the activity.

Inadequate
The product or assessment does not satisfy a significant number o f criteria, does not accomplish what was asked, contains errors, or is o f poor quality.

Fair
The product or assessment meets some criteria and does not contain gross errors or crucial omissions.

Good
The product or assessment meets the criteria completely or substantially.

Outstanding
All the criteria are met, and the product or assessment exceeds the assigned task and contains additional, unexpected or outstanding features.Both the learner and the teacher should be acquainted and flexible with regard to the criteria used to determine the rubric.

Conclusion
Portfolio assessm ent and evaluation has proved to be valu able in developing the learner's competency and thinking skills (Johnson 2000:130).There is a need for a new philosophy of assessm ent and evaluation in education that never loses sight o f the learner.To build such an assessment, we need to return to the roots o f alternative, authentic assessments, since only a hum ane and intellectually valid approach to assessm ent and evaluation could help us ensure progress toward national 'in tellectual fitness' o f the learner, states W iggins (1989:712).W iggins states that for as long as we hold on to the traditional, simplistic m onitoring tests for reaching our intellectual stand ards, the learner's perform ance and teaching, and our thinking and discussions about assessm ent will rem ain flaccid and un inspired.
It is recom m ended that further research be undertaken to ad dress the validity and reliability of portfolio assessment in nurs ing education, to describe implications and guidelines for other alternative m ethods o f assessm ent and evaluation that are learner-centred in a specific context in order to assist teachers in the implem entation o f these methods.

References
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table 1 is advocated.A rubric is a scaled set o f criteria that clearly define what the range of acceptable and unacceptable performances o f the learner would look like.Rubric is a scoring guide that determ ines the quality o f the answers to meet the desired performance (Van der Horst & M cDonald