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Abstract Opsomming
With the advent of O utcomes-Based Education in South Met die koms van uitkomsgebaseerde-onderrig in Suid-
Africa, the quality o f nursing education is debatable, es Afrika, is die kwaliteit van verpleegonderwys betwisbaar,
pecially with regard to the assessm ent and evaluation of veral ten opsigte van die waardering en evaluering van
clinical nursing education, which is complex and renders kliniese verpleegkunde, wat kompleks is en wat maak dat
the validity and reliability of the methods used question die geldigheid en betroubaardheid van die metodes wat
able. This paper seeks to explore and describe the use of gebruik word, aanvegbaar is. Hierdie artikel wil die gebruik
portfolio assessm ent and evaluation, its implications and van portefeuljewaardering en -evaluering ondersoek en
guidelines for its effective use in nursing education. Firstly, beskryf, asook die im plikasies en riglyne daarvan vir
the concepts of assessment, evaluation, portfolio and al doeltreffende gebruik in verpleegonderwys. Eerstens, word
ternative methods of evaluation are defined. Secondly, a die konsepte van waardering, evaluering, portefeulje en
comparison o f the characteristics o f the old (traditional) altematiewe metodes van evaluering omskry we. Tweedens,
methods and the new alternative methods o f evaluation is word die kenmerke van die ou (tradisionele) metodes en
made. Thirdly, through deductive analysis, synthesis and die nuwe altem atiewe metodes van evaluaering vergelyk.
inference, implications and guidelines for the effective use Derdens, deur deduktiewe analise, sintese en afleiding,
o f portfolio assessment and evaluation are described. word implikasies en riglyne vir die doeltreffende gebruik
van portefeuljewaardering en -evaluering beskryf.
In view of the qualitative, descriptive and exploratory na
ture of the study, a focus group interview with twenty stu Na aanleiding van die kw alitatiew e, beskryw ende en
dents following a post-basic degree at a university in G au ondersoekende aard van die studie, is ’n fokusgroep-
teng regarding their perceptions on the use of portfolio o n d e rh o u d m et tw in tig n a-g ra ad se stu d en te aan ‘n
assessment and evaluation method in clinical nursing edu universiteit in Gauteng oor hul persepsies van die gebruik
cation was used. A descriptive method of qualitative data van die metode van portfeuljewaardering en -evaluering
analysis of open coding in accordance with Tesch’s proto in kliniese verpleegonderwys, gebruik. ’n Beskrywende
col (in Creswell 1994:155) was used. Resultant implica metode van kwalitatiewe data-analise van opekodering,
tions and guidelines were conceptualised and described volgens Tesch se protokol (in C resw ell, 1994:155), is
within the existing theoretical framework. Principles of 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
trustworthiness were maintained as described by (Lincoln 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
& Guba 1985:290-327). Ethical considerations were in raamwerk. Beginsels van betroubaarheid is gehandhaaf
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 soos beskryf deur (Lincoln & Guba 1985:290-327). Etiese
(1998:7). 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.
South Africa has recently been experiencing a m ajor edu Teachers are engaged in restructuring the educational pro
cational paradigm shift from the traditional teacher to the grammes, and the assessment and evaluation reform debate
learner-centered approach to learning that is outcom es continues. Teachers are expected to use research evidence,
based in nature. The outcom es-based curriculum requires innovative teaching and evaluation methods that encourage
the learner to evidence what he/she knows and can do, collaborative education and the development of lifelong learn
and to appreciate the acquired knowledge, skills and val ing skills. Outcomes-based education raises a num ber o f ques
ues. The South A frican Q ualifications A uthority Act tions about the learners and the em ployer’s expectation of
SAQA (Act 58 of 1995) and the South African Nursing higher educational programmes. For the learner to be effi
Council (SANC) are responsible for quality assurance in cient and fit well into the working world, the nature o f learn
higher education institutions in the country, and the em ing and how that learning can be assessed must be revisited
phasis is placed on the quality o f the product of learning (Van der Horst & M cDonald, 1997:169, 170). Com prehen
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sive competence o f the learner should be evaluated through which has the advancement of learning as its aim (W olf &
varied methods of assessm ent and evaluation such as portfo Siung-Runyan 1996:32,33). A portfolio is about the collec
lio assessment (Wiggins, 2001:4). tion o f evidence that learning has taken place (Snadden &
According to Johnson (2000:129), in these changing times, Thomas 1998a: 192).
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
Alternative methods of
ria through inappropriate methods. M ost of the traditional assessment and evaluation
methods o f assessment and evaluation make learners adopt a
These methods are often referred to as authentic or perform
surface approach to learning. They are artificial and rigid,
ance assessment approaches that offer alternatives to the tra
not capturing the actual changes in the learner’s knowledge
ditional methods. They focus on learner processes or perform
and skills (Biggs, 1996:348 and Tynjala, 1998:210). Tradi
ance where learners solve problems that have an equivalent
tional tests lack the ability to measure higher-order thinking
in their real world involving the use of resources, consulta
skills. W hile multiple choice items can be valid indicators or
tion and the integration of knowledge and skills. They are
predictors of academic performance, they too often mislead
concerned with the assessment o f complex performance and
learners and teachers about the type of work that should be
higher-order skills in a real life context. Learners become
mastered. However, the place o f traditional tests still remains
active partners in the assessment enterprise whereby they re
(Harden & Gleeson in Nicol & Freeth, 1998: 602), and needs
flect on how they can learn meaningfully (Nicol & Freeth,
to be supplemented by other alternative methods of assess
1998:602; Van der Horst & McDonald, 1997:188).
ment and evaluation that are learner-centred.
In accordance with the constructivistic approach to learning
(Peters, 2000:167), learners are encouraged to engage in
In the quest to differentiate the characteristics of the new al
dialogic interaction where they have to justify their reason
ternative methods of assessment and evaluation and the old
ing and arguments based on evidence. Interactive teaching
(traditional) methods, W iggins (2001:4-6) provides a com
strategies and related assessm ent and evaluation methods will
parison of the two methods. The resultant differences rein
facilitate the developm ent of the learner’s critical and reflec
force and support the need for the method that will produce a
tive thinking, a necessary skill to be learned by teacher train
learner who is balanced, reasonable, reflective and could make
ers if educational standards are to be met. King and Kitchener
a useful contribution to society and the working world (Esteve,
(1997:3,78,194) advocate the use o f authentic, ill-structured
2000 :6 ).
problem s that will foster the use o f higher-order thinking.
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tive “item s” and hence provide the (one) right answer search design was qualitative, exploratory, descriptive and
for each item. contextual in nature.
• In alternative assessm ent tests, validity depends in part
on whether the test stimulates real world ‘test’ ability,
while validity on most multiple choice items is deter Population, sample and
mined merely by matching items to the curriculum
content (or through sophisticated correlation with other
sam pling, data collection and
test result. data analysis
• Alternative activities involve “ill-structured” chal O f the thirty-five students undertaking a post-basic degree at
lenges that prepare learners for the complex a university in Gauteng, who were required to compile port
ambiquities of the ‘gam e’ of adult and professional folios on a given topic as an assignment for the semester by
life. Their higher-order thinking and problem-solving using the guidelines described in the bigger study, twenty stu
skills are facilitated. They are open-minded, encour dents volunteered to take part in the study on completion of
age empathetic understanding, consider justice and the assignment to describe the implications of portfolios as
strive for independence and autonomous practice. Tra an evaluation method in clinical nursing education.
ditional tests are more like drills, assessing static and Two focus group interviews consisting of ten students each
too often arbitrarily discrete or simplistic elements of were conducted (Krueger, 1994: 6-10). The participants were
those activities. requested to call themselves by numbers for the sake o f main
taining anonymity. They were ensured of the confidentiality
Surely with the current revolution in higher education that of the data and they gave a written informed consent to take
demands quality assurance in education through a problem- part in the study. Two questions were asked as follows: What
based, constructivistic approach to learning, co-operative, are the implications o f portfolio assessment in clinical nurs
community-based and outcom es-based education, the tradi ing education? How could the use of the portfolio method of
tional methods of assessment and evaluation need to be revis assessment and evaluation be made effective? The interviewer
ited and supplemented where necessary with research-based was purposively selected, based on her expert interviewing
evidenced of alternative methods of evaluation. The use of skills and know ledge o f nursing education and qualitative
new technology, the pressure of accountability and accredita research. The researcher’s role was to ask probing questions
tion, and the provision o f the environm ent within the legal, in the quest to explore more in-depth information and to write
ethical and professional boundaries should provide guidance field notes in order to enrich the data collected (M iles &
in quality assurance in education. Huberman, 1994:241).
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Implications of portfolio assessment Learning how to bring my inner thoughts in to a concrete
process and product was a good model for the work we do as
and evaluation in clinical nursing teachers” .
education The relevant portfolios in clinical nursing education are those
that merge assessm ent with learning, the kind o f learning
Clinical nursing forms an integral part of the nursing profes
that involves deep understanding, reflectivity and multiple
sion. It is complex and challenging since the learner has to
dim ensions, including the moral and ethical dim ensions
integrate the theoretical com ponent m eaningfully into prac
(LaBoskey 2000:593). The educational portfolios must allow
tice. It is a hands-on learning activity where the life o f the
for, prom ote and reveal individual meaning-m aking. They
patient is involved. In clinical nursing education, assessm ent
m ust allow the opportunity to interact about the content and
and evaluation play a key role in the education and training
meaning o f those portfolios with people who matter and who
o f the learner. Learners have to make informed, rational de
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
cisions and solve both structured and ill-structured problems.
(1996:32,33); Gravett (1995:21); Boud (1995:147-149) and
The clinical judgem ents and decisions should be reliable,
Van der Horst & M cDonald (1997:175). The value o f portfo
valid, practical, free from bias and complete because it is the
lio assessment is best demonstrated where learners work col
life o f a patient that is at stake, stated the participants.
laboratively as a team, sharing ideas, thoughts and feelings
The learners have to consolidate the knowledge, skills and
to solve clinical problems related to a specific context, stated
attitudes acquired to make decisions that will benefit the pa
the participants. Through analysis, synthesis and inference
tients and bring satisfaction to them (Chabeli 2001:94). It is
from em pirical data, literature and theoretical frameworks,
therefore important that the teachers should make use o f a
guidelines were described.
wider range o f assessment and evaluation methods that will
facilitate higher-order thinking skills o f learners such as p o rt
fo lio assessment. The emphasis should be placed on the con
tinuous assessm ent o f the lea rn er’s competence. The teacher Guidelines for the effective use of
should constantly m onitor and provide support and guidance portfolio assessment and evaluation
to the learners during the preparation and compilation o f the
portfolio, stated the participants. Self-assessm ent, peer as • As with any assessment, learners should be clear on
sessment and teacher assessment in order to examine the prod the rationale for compiling a portfolio, and exactly what
uct and process that evidence the learners’ thinking process is expected of the learners.
and performance are mandatory in portfolio development (Van • The first task is for the learners to assess their previ
der Horst & M cDonald, 1997:175). 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
Like all other teachers, nurse teachers are accustom ed to the identified. Learners and teachers should provide evi
use o f traditional methods o f assessment and evaluation m eth dence of a learning contract drawn where learning
ods where evaluating the behaviour o f the learners is m eas outcomes, methods, evaluations, time frames and re
ured instead o f m easuring the com prehensive and holistic sources to be used in order to com pile a portfolio are
competence o f the learner. They still measure behaviours such outlined.
a s...d id the learner greet and introduce h erself to the p a • The learning outcomes should relate to the professional
tient? D id the learner check the d o cto r’s prescription, m ak com petencies but be transformed into learner-friendly
ing use o f the yes/no checklist? This m ethod is comfortable language so that the learners can see exactly what they
to use and to mark, but it does not demonstrate the learners’ have to achieve within the specified time frame. The
thinking process, stated the participants. Reflection on pre processing of the portfolio should occur over an ex
vious learning is expected from learners, otherwise a portfo tended period.
lio m ay b ecom e a little m ore than a scrap b o o k (B oud, • The portfolio should contain a diverse set of informa
1995:147-149; W olf & Siung-Runyan, 1996:31,33 and Van tion gathered across a variety o f learning context, con
der Horst & M cDonald, 1997:175). 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
In a portfolio, the work may have been selected by the learn way through the course, the learning outcomes should
ers them selves or the teacher, or through a mutual decision be broken down into a manageable series of themes,
on the themes by both the learner and the teacher. Portfolio which continually build upon each other.
assessm ent could be used for com prehensive assessm ent as
• The learners should build upon this fram ework by add
sembled consciously from a num ber o f tasks produced over a
ing their own material in the form of reading, plan
semester or a year (Gravett 1995:2 1). Portfolios could be used
ning collaborative projects, own research findings,
both as a way of constructing meaning and as an opportunity
artistic creations and reflective essays in which the most
to teach the assessm ent of one’s own work as evidenced by a
important ideas, skills and feelings they have experi
citation made by a participant in LaBoskey (2000:591) “Port
enced could be expressed. They should be able to evi
folio assessm ent helped me to make my philosophy of teach
dence their thinking progression throughout.
ing explicit and concrete. I became more reflective about my
thought process and m ore confident about my opinions. A • Every week, the learners should analyse and reflect on
portfolio is a tangible expression o f my ideas, thoughts, feel a critical incident to the learners in terms o f their learn
ings, experiences and o f my journey as a student teacher. ing, the incident that provides the material for exam-
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ining the relationship between theory and practice. portfolio can become ‘an episode o f learning; without
The portfolio should serve the purpose of identifying reflection, the portfolio may b e ...a little more than a
the areas that the learners find m ost stressful, the ar scrapbook’ (Boud 1995:147-149; W olf & Siung-
eas where they received increased guidance and sup Runyan 1996:31,33 and Van der Horst & M cDonald
port, as well as the areas that provide an indication of 1997:175).
extra work on the theme. This is subsequently used at Portfolio assessment should be criterion referenced ac
the weekly portfolio workshops. By reviewing their cording to the learners’ guidelines for the portfolio.
progress on a regular basis, the learners gain the satis The portfolio marking criteria should be m utually de
faction of monitoring and controlling their own learn cided on by learners and teachers.
ing. The marking criteria should be sufficiently broad to
Formative assessm ent should take place first in a encom pass the individuality of each learner while en
monthly tutorial where learners are helped with their suring that a uniform standard is met. In developing a
self-assessment in relation to their professional devel scoring scheme and using it to evaluate the entire port
opm ent and the acquisition of competence. folio, a rubric as indicated in table 1 is advocated. A
There should be portfolio workshops during which rubric is a scaled set o f criteria that clearly define what
learners work in small groups with or without a facili the range of acceptable and unacceptable performances
tator, and interact with peers and other related m ulti o f the learner would look like. Rubric is a scoring guide
disciplinary team m em bers including the family and that determ ines the quality o f the answers to meet the
community members. desired performance (Van der Horst & M cDonald
By discussing their ideas, thoughts and feelings with 1997:197).
Table 1 : Scoring rubric for portfolio assessment (Van der Horst & M cDonald, 1 9 9 7 :1 9 7 )
Poor The learner did not do the task, did not complete the assignment, or shows
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
Outstanding All the criteria are met, and the product or assessment exceeds the assigned
others, the learners deepen their ability to reflect on Constructive, positive feedback should be provided continu
their own work from a variety of perspectives. Each ously to encourage deep-holistic learning that promotes growth
portfolio might also include reflections from others in clinical nursing education. The critical analysis o f the com
about the learners’ performance. With reflection, the piled portfolio and the development o f an action plan for fu
ture im provem ent is crucial.
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Both the learner and the teacher should be acquainted and K IN G , PM & K IT C H E N E R , KS 1997: Developing reflective
flexible with regard to the criteria used to determine the rubric. judgem ent. Understanding and Promoting Intellectual Growth
and Critical Thinking in Adolescents and Adults. San Fran
cisco: Jossey-Bass Publishers.
Conclusion
K R U E G E R , R A 1994: Focus Group: a practical guide for ap
Portfolio assessm ent and evaluation has proved to be valu
plied research. London: Sage Publications.
able in developing the learner’s competency and thinking skills
(Johnson 2000:130). There is a need for a new philosophy of
L a B O S K E Y , V K 2 0 0 0 : P o rtfo lio s H ere , P o rtfo lio s
assessm ent and evaluation in education that never loses sight
T h ere.. .Searching for the Essence o f ‘Educational Files’ PHI
o f the learner. To build such an assessment, we need to return
DELTA KAPPA.April 2000:591-595.
to the roots o f alternative, authentic assessments, since only a
hum ane and intellectually valid approach to assessm ent and
LIN C O L N , YS & GUBA, EG 1985: Naturalistic Inquiry. Lon
evaluation could help us ensure progress toward national ‘in
don: Sage Publications.
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,
M IL E S , M B & H U B ER M A N S, A M 1994: Qualitative data
simplistic m onitoring tests for reaching our intellectual stand
analysis. London: Sage Publications.
ards, the learner’s perform ance and teaching, and our thinking
and discussions about assessm ent will rem ain flaccid and un
M O R SE , JM & FIE L D , PA 1996: Nursing research. London:
inspired.
Chapman & Hall.
It is recom m ended that further research be undertaken to ad
dress the validity and reliability of portfolio assessment in nurs
N IC O L , M & F R E E T H , D 1998: Assessment of clinical skills:
ing education, to describe implications and guidelines for other
a new approach to an old problem. Nurse Education Today.
alternative m ethods o f assessm ent and evaluation that are
18:601-609.
learner-centred in a specific context in order to assist teachers
in the implem entation o f these methods.
P E T E R S , M 2000: Does constructivist epistemology have a
place in nursing education? Journal of Nursing Education. April
2000,39(4): 166-172.
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I
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