| Course | NUR 6053 Catalyst for Quality Improvement in Nursing Education |
|---|---|
| Module | Module 2 |
| Paper type | Validity and reliability analysis |
| Length | 1,190 words, about 4 pages plus title and reference pages |
| Format | APA 7 student paper |
| School | American College of Education |
| Program | Ed.S. in Nursing Education |
| Updated | September 2026 |
Free sample paper for NUR 6053 Module 2
Ninety-Seven Percent Satisfactory: Testing a Home-Grown Clinical Evaluation Tool Against Five Sources of Validity Evidence and a Twelve-Rater Video Study, and What to Do About the Results
Student Name
American College of Education
NUR6053: Catalyst for Quality Improvement in Nursing Education
Module 2 Assignment
Instructor Name
November 11, 2030
The Tool and the Question
Our clinical evaluation tool was written by program faculty in 2014. It has 20 items, such as "administers medications safely" and "communicates effectively with the health care team," each rated satisfactory, needs improvement or unsatisfactory at midterm and final. Last year, 97% of students were rated satisfactory on every item at the final evaluation, yet the same cohort's clinical instructors described about one student in six as unready for the next level, and the program's first-time licensure pass rate fell. A tool on which almost everyone succeeds while faculty doubt many students is either measuring something other than competence or measuring it badly. This paper asks which.
Validity as an Argument
Strictly, a tool is never valid or invalid in itself; what can be valid is an interpretation drawn from its scores. Messick (1995) argued that validity is a unified concept concerning the meaning of scores and the consequences of their use, and that all forms of validity evidence bear on construct validity. Building on this view for health professions education, Downing (2003) described validity as an argument supported by evidence from five sources: content, response process, internal structure, relationship to other variables and consequences. The question is therefore not whether our tool is valid, but whether the evidence supports interpreting a satisfactory rating as meaning that the student is competent to progress.
The Evidence, Source by Source
Content. The items were written by faculty from the program outcomes, which gives some content evidence, but they have not been reviewed against the current licensure test plan or the partners' expectations, and several important areas, such as recognizing deterioration, have no item. Response process. The three rating categories have no descriptions of what each looks like, so each instructor applies their own standard. Many of our clinical instructors are part-time staff nurses who received the tool without training. Internal structure. When I analyzed last year's final ratings, almost all items had no variance, since nearly every student was rated satisfactory, so internal consistency cannot even be estimated meaningfully. Relationship to other variables. Clinical ratings showed no relationship with scores on the program's standardized predictor examination or with simulation performance; a tool that measures competence should relate at least moderately to other measures of it. Consequences. A tool on which weak students pass gives them no warning and the program no data, and the program's own licensure results suggest that the consequence is real. On four of the five sources the evidence is weak or absent, and on the fifth it points the wrong way.
A Reliability Study
Reliability concerns the reproducibility of scores, and for ratings of clinical performance the main concern is whether different raters give the same rating to the same performance (Downing, 2004). Downing suggests that assessments used for high-stakes decisions need reliability of at least 0.90, moderate-stakes decisions at least 0.80 and lower-stakes decisions at least 0.70. Clinical evaluation determines progression, so it is at least moderate stakes.
To estimate our tool's reliability, I asked 12 clinical instructors, six from each campus, to rate three recorded simulated performances scripted at strong, borderline and weak levels, using our tool as they normally would. Agreement was high for the strong performance, with all 12 rating every item satisfactory. For the borderline performance, the proportion of raters giving the most common rating on each item ranged from 42% to 83%, with a median of 58%. For the weak performance, seven of 12 raters rated the student satisfactory on medication safety despite a scripted omission of an allergy check. Our tool does not produce consistent ratings in exactly the cases where the decision matters: the borderline student.
Why the Ratings Inflate
The reliability study explains part of the 97% figure, but not all of it, and a new instrument will not fix causes it does not address. Conversations with the twelve instructors after the study suggested three further causes. The first is reluctance to fail a student. Several instructors said that rating a student unsatisfactory triggers a formal process, a learning contract and possibly a failed course, and that they give the student the benefit of the doubt unless something unsafe happens in front of them. The second is limited observation. An instructor supervising eight students on a busy unit sees each student for a fraction of the shift and rates what they did not see as satisfactory by default. The third is the tool's three categories. With only satisfactory, needs improvement and unsatisfactory, a borderline student who is progressing but not yet at the expected level has no accurate rating, and instructors choose the kinder one.
Each cause needs its own response. The formative midterm introduced in Module 1 lowers the stakes of an early low rating, which should make instructors more willing to give one. Instructors will be asked to rate only what they observed and to mark competencies not observed, which reveals gaps in observation rather than hiding them. And the replacement instrument's descriptors distinguish levels more finely, so that a borderline performance can be rated as such.
Recommendation
The evidence supports replacing the tool rather than revising it. The Creighton Competency Evaluation Instrument was developed for the NCSBN National Simulation Study to evaluate both simulation and traditional clinical experiences in associate and baccalaureate programs; faculty in five programs rated its content validity between 3.78 and 3.89 on a four-point scale, and its internal consistency exceeded 0.90 when used to score three levels of simulated performance (Hayden et al., 2014). It has behavioral descriptors for each competency, covers assessment, communication, clinical judgment and patient safety, and can be used in both settings, which would let the program relate clinical and simulation ratings.
Adoption will be paired with rater training, since no instrument is reliable without it. Every clinical instructor will complete a two-hour training session using the same three recorded performances from the reliability study. After a year, I will repeat the study with the new instrument and compare agreement, and I will examine whether final clinical ratings relate to predictor examination scores and simulation performance. If agreement on the borderline performance remains below 80%, training will be strengthened before the instrument is blamed.
Preparing for the Consequences
A more accurate tool will change results, and the program must be ready. If ratings become more discriminating, more students will be rated below expectations at midterm, and some will fail clinical courses who would have passed before. The program will need remediation capacity, including simulation time and faculty hours for learning contracts, and students will need to be told why the change is being made. The first semester's results will be reviewed carefully to confirm that lower ratings reflect real differences in competence rather than new inconsistency. Faculty who see failure rates rise may be tempted to return to the old habits, so the committee will present the reasons for the change and the reliability study's results at the start of each term.
References
Downing, S. M. (2003). Validity: On the meaningful interpretation of assessment data. Medical Education, 37(9), 830-837. https://doi.org/10.1046/j.1365-2923.2003.01594.x
Downing, S. M. (2004). Reliability: On the reproducibility of assessment data. Medical Education, 38(9), 1006-1012. https://doi.org/10.1111/j.1365-2929.2004.01932.x
Hayden, J., Keegan, M., Kardong-Edgren, S., & Smiley, R. A. (2014). Reliability and validity testing of the Creighton Competency Evaluation Instrument for use in the NCSBN National Simulation Study. Nursing Education Perspectives, 35(4), 244-252. https://doi.org/10.5480/13-1130.1
Messick, S. (1995). Validity of psychological assessment: Validation of inferences from persons' responses and performances as scientific inquiry into score meaning. American Psychologist, 50(9), 741-749. https://doi.org/10.1037/0003-066X.50.9.741
The NUR 6053 Module 2 assignment instructions
For NUR 6053 Module 2 the prompt typically names one assessment instrument, often a clinical evaluation tool, a skills checklist or a unit examination, and asks whether its scores can be trusted. You are expected to explain what validity and reliability mean in current measurement thinking, gather whatever evidence exists for the chosen tool, judge that evidence, and recommend what the program should do. Some sections want a small data exercise, such as an agreement check between raters or an item analysis, while others accept an analysis of published evidence alone. The usual length is five to seven pages in APA 7. Because a tool can be judged only against a stated purpose, say in the first paragraph what decision the scores are used for, since that sets how much reliability you need.
How this NUR 6053 Module 2 example is built
This sample starts with a paradox instead of a definition: nearly every student passes a tool that faculty no longer trust. The second section reframes validity as an argument about score interpretation, drawing on Messick and on Downing's five sources. The third walks through those sources one at a time and finds the evidence weak or missing on four of them. A reliability section then sets thresholds by stakes and reports what happened when twelve instructors rated the same three recorded simulations, with the borderline case splitting raters most. The paper does not stop at measurement: it asks why ratings inflate, names three human causes, and matches a response to each. It closes with the replacement instrument, a training plan and a section on the consequences of stricter ratings.
NUR 6053 Module 2 rubric: what full marks look like
Points on this rubric tend to follow the analysis rather than the definitions. A top rating on the concepts criterion needs validity described as a property of interpretations, which is why the paper spends a paragraph on Messick before touching the tool. The analysis criterion usually carries the most weight, and it rewards evidence organized by source with a verdict on each, plus reliability judged against a threshold the writer justifies. Recommendations score well when they follow from the findings and include a way to test the change, such as repeating the rater study after a year. Expect points for sources that are primary and current enough for the claim, and for honest limits. Formatting, headings and reference accuracy make up the final criterion in most versions.
NUR 6053 Module 2 help: mistakes that cost points
Many drafts for this module describe validity types from a textbook list, content, criterion, construct, without ever testing the program's own tool against them. Another common problem is calling a tool reliable because it has been used for years or because students rarely complain. A third is recommending a published instrument without checking whether its evidence came from a similar setting and level. Small numbers are fine if you report them honestly; the example's twelve raters are enough to show a problem, not to prove a coefficient. Avoid blaming instructors for inflated ratings without asking what the tool and the process make easy. If you want an analysis built on your own evaluation tool, with your data and your rubric, the desk can prepare a custom sample.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official American College of Education document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 6053 Module 2 questions, answered
What does NUR6053 Module 2 usually ask for?
NUR6053 Module 2 often asks you to analyze the validity and reliability of a clinical evaluation tool used in a nursing program and recommend improvements. Your classroom's instructions decide the tool.
What are the sources of validity evidence?
Content, response process, internal structure, relationship to other variables and consequences. Validity is an argument about what scores mean, built from evidence in each source.
How can I test a clinical evaluation tool's reliability?
Ask several raters to score the same recorded performances, including borderline ones, and measure how often they agree. Borderline performances show whether the tool works where decisions matter.
Where can I find a free NUR 6053 Module 2 sample paper?
You are reading one. This page holds the complete Module 2 paper on validity and reliability of a clinical evaluation tool, with a title page, seven sections, margin notes on each and four references, open to read without signing up.
What reliability is good enough for a clinical evaluation tool?
Downing suggests at least 0.90 for high-stakes decisions, 0.80 for moderate stakes and 0.70 for low stakes. Clinical evaluation decides progression, so the paper treats it as at least moderate stakes and checks agreement on a borderline performance.