Perceived Constraints to Effective Clinical Assessment of Nursing Students Competencies among Nursing Students and Educators in Southwest Nigeria

Main Article Content

Edith Chinonyelum Ike
Omotola Margaret Oseni
Detu Adesuwa Onwochei
Njideka Judith Esievo


Aim: This study investigated the perception of nursing students and educators on the constraints to effective clinical assessment of nursing students’ competencies and probed possible solutions to the identified constraints in Lagos, southwest Nigeria.

Methods: In this cross sectional study, 175 nursing students, and 49 nurse educators from five randomly selected nursing schools participated. The study adopted a triangulation approach of quantitative and qualitative method for data collection and analysis. A self-administered questionnaire was utilized to collect quantitative data from the nursing students and nurse educators and a response return rate of 163(93%) and 46(94%) were recorded respectively from both groups. Focus Group Discussion (FGD) was employed for qualitative data among 12 nursing students and 11 nurse educators in two nursing schools. Data was analyzed and relative importance index (RII) and its ranking (R) was utilized to establish the relative importance of the various constraints identified as responsible for effective clinical assessment of competencies.

Results: The result revealed as major constraints from the students; lack of confidence by the students in carrying out procedures in clinical setting and lack of materials and instruments for clinical practice with equal ranking (RII=0.78; R=1.5), similarly, the educators rated; Lack of confidence by the students in carrying out procedures in clinical setting (RII=0.74; R=1.0) as a key constraint. The Mann Whitney U test showed no statistical significant differences to the perception of the constraining factors and probable solutions by both groups (p>0.05)

FGD revealed; lack of clear objectives for each clinical posting, as both students and clinical assessors do not have clear idea of what competencies they are to acquire and assess as a major constraint.

Conclusion: The researchers recommend that clinical placement objectives should be set and communicated to the students, educators and assessors to direct nursing students’ clinical practice and evaluation and assessment formats developed in line with specific skills to be evaluated.

Clinical assessment, constraints, competencies, nursing students, nurse educators.

Article Details

How to Cite
Ike, E. C., Oseni, O. M., Onwochei, D. A., & Esievo, N. J. (2020). Perceived Constraints to Effective Clinical Assessment of Nursing Students Competencies among Nursing Students and Educators in Southwest Nigeria. Asian Journal of Medicine and Health, 18(9), 1-13.
Original Research Article


Sumari A, Eliaremisa N. Factors influencing clinical teaching of midwifery students in a selected clinical setting in Tanzania, Semantic Scholar; 2006.


Khomeiran T, Yekta Z, Kiger A, Ahmadi, F. Professional competence: Factors described by nurses as influencing their development. International Nursing Review. 2006;3(1):66–72.

Rafiee G, Moattari M, Nikbakht A, Kojuri J, Mousavinasab M. Problems and challenges of nursing students’ clinical evaluation: A qualitative study. Iranian Journal of Nursing and Midwifery Research. 2014;19(1):41–49.

Davies A, Rotimi A, Alexander I. Health workforce and governance: The crisis in Nigeria. Human Resources for Health. 2017;15(32).

Anarado A, Agu G, Nwonu E. Factors hindering clinical training of students in selected nursing educational institutions in Southeastern Nigeria. Nurse Education Today. 2016;40:140-145.

Vorne Industries: Theory of Construct Methodology; 2017.


Ugwu O, Haupt T. Key performance indicators and assessment methods for infrastructure sustainability - a South African construction industry perspective, Building and Environment. 2007;42:665-680.

Nahid J, Zahra M, Farkhondeh S, Camellia T. Majid. Challenges of Nursing Students in the Clinical Learning Environment in Iran school: A Qualitative Study. The Scientific World Journal; 2016.


Eta V, Atanga M. Atashili J. D’Cruz, G. Nurses and challenges faced as clinical educators: A survey of a group of nurses in Cameroon. The Pan African Medical Journal. 2011;8(28).

Esmaeilivand M, Ghafourifard M, Mohammadi M, Taghizadeh P, Chalechale K, Sharifi A. Barriers and Facilitators to Clinical Education from the Perspective of Junior and Senior Nursing Students. Global Journal of Health Science. 2017; 9(3).

Narjes R, Ali A, Amishahla K, Mohammad R, Reza M, Ali E. Academic training and clinical placement problems to achieve nursing competency. Journal of Advanced in Medical Education and Professionalism. 2017;3(1):15–20.

Ward E, Kwan J, Garlen K, Bassett E, Klein L. ‘To teach or not to teach?’ Factors that motivate and constrain Australian emergency medicine physicians to teach medical students; 2013


Hanifi N, Parvizy S, Joolaee S. The miracle of communication as a global issue in clinical learning motivation of nursing students. Procedia Social and Behavioral Sciences. 2012;47: 1775–1779.

Irby D. Effective clinical teaching and learning: Clinical teaching and the clinical teacher; 2007.


Kabir S. addressing the barriers to clinical education in emergency medicine. Australian Journal of Clinical Education. 2016;1(3).