The reliability of measuring nursing clinical performance using a competency based assessment tool: a pilot study.

The clinical performance of the novice nurse has been identified as problematic in the areas of medication administration, time management, and comfort and safety. In order to assess new graduate nurses' clinical competence in these areas, a forty four (44) item assessment tool was developed which was drawn from the Australian Nursing Council Inc. (ANCI) (1991) competency statements. A correlation descriptive design was used to determine the inter-rater reliability between assessors using this competency based tool. A pilot study utilising a convenience sample of 30 new graduate nurses were each assessed by two observers for a mean period of 127.5 minutes. Kappa coefficients were calculated to determine the level of agreement between the two observers. Very little rating agreement was found for individual items, however, there was no significant difference in the total competency scores between the two observers. The competency assessment tool has face validity and is internally consistent. However, inter-rater reliability for individual competency items was found to be poor.