Assessing the clinical skills of nurse practitioners

The purpose of this study was to develop methodologies to assess the competence of nurse practitioners in clinical decision-making and communication skills. The decision-making skills were evaluated for two conditions: acute respiratory infections in children and hypertension in adults. A questionnaire was sent to three groups of physicians; when all three groups agreed on a certain action or nonaction for a specified condition, a consensus criterion was established. The nurse practitioners were then judged by their responses to the consensus criteria, which were weighted by such factors as criticality or clinical relevance. Communication competence, which involves predictive empathy and the ability to accurately perceive and judge others, was evaluated for two different conditions: well infants' first year of life and ambulatory adults suffering chronic illness. Communication ability was measured by assessing practitioners' interpersonal effectiveness and empathy to patient- and family-oriented concerns. Questionnaires were completed by patients and nurses; responses indicated the degree of congruence. Both study approaches were deemed operationally feasible. Validity activities and feedback measures are recommended.