Evaluating the Effectiveness of the Symptom-Centered Competency Assessment Frameworks in Assessing Clinical Skill Progression in Nurse Practitioner Students

Background: The clinical evaluation of nurse practitioner (NP) students is often inconsistent and subjective, with traditional assessments failing to fully capture the key components of clinical reasoning and person-centered care. The Symptom-Centered Competency Assessment Frameworks (SCCAF) were developed to address this gap by offering a structured model to guide competency assessment across the learning domains. Purpose: The purpose of this pilot study was to evaluate the SCCAF as a structured model to track primary care NP students’ development of clinical reasoning and general competency during simulations. The study examined changes in performance over a semester and compared faculty video-based ratings with real-time peer (student) ratings to assess the framework’s utility and acceptability. Methods: Pre- and posttest comparisons were conducted with 75 primary care NP students, using performance scores based on SCCAF criteria developed by the researcher. Faculty completed ratings through video review, while peers (students) provided real-time evaluations during the simulations. These scores were compared across the beginning and end of the semester to assess changes in performance. Results: Scores significantly improved at the end of the semester ( P < .001). Peer evaluations were slightly higher than faculty ratings, and student satisfaction was high for the simulation experience. Conclusions: The SCCAF offers more than structure; it provides tangible evidence of competency for NP students as they prepare for complex clinical encounters.