Quint Leveled Clinical Competency Tool (QLCCT)

As part of the Evaluating Healthcare Simulation tools, the Quint Leveled Clinical Competency Tool (QLCCT)began when Quint observed a weakness in the Lasater Clinical Judgment Rubric (LCJR). A group of researchers (Quint et al., 2017), collaborated to the Quint tool to address the negative language in the LCJR, especially for novice learners, and the length of the tool for measuring clinical judgment. The rubric measures clinical competence in simulation or the clinical environment.

Download the Quint Leveled Clinical Competency Tool

Permission to Use FREELY: General use is already permitted by posting the statement: I understand that I have been granted permission by the creators of the requested evaluation instrument to use it for academic, clinical and/or research purposes. I agree that I will use the evaluation instrument only for its intended use, and will not alter it in any way. I will share findings as well as publication references with the instrument creator(s). I am allowed to place the evaluation instrument into electronic format for data collection. If official ‘Permission to Use’ letter is required, please contact the primary author. Include the purpose of the official request (research, grant), the intended use of the tool and with what population.

Why the Quint Leveled Clinical Competency Tool (QLCCT) was Developed: The Quint Leveled Clinical Competency Tool (QLCCT) resulted from one educator wanting to improve upon what she saw as a weakness in the Lasater Clinical Judgment Rubric (LCJR). Shelly Quint found that her clinical faculty were reluctant to score students accurately using the very popular LCJR because of the negative verbiage used in the tool, especially for novice performance. The length of the LCJR was also critiqued however, clinical judgment is a complex concept. Breaking it down into a one-page check box form would deny the skill required to demonstrate clinical judgment in a complex patient care event

How the QLCCT was Developed: The resulting tool, the QLCCT was developed specifically for use with nursing students. In 2007, a serendipitous meeting of two authors led to a funded grant for a multisite study in Washington state, and expert instrument development consultation. However, simulation was still so new in the state that few schools could participate in the validation and testing of the tool. Work continued periodically through another two rounds of testing, with two consulting instrument experts working with a statistician.

Reliability and Validity of the QLCTT: Reliability coefficients between student academic level and student scores (0.87) and internal consistency by coefficient alpha (0.83). Please see Prion et al. (2017) for a full history of the development of the tool and psychometric testing to date.

Using the QLCCT: There are 10 major concepts in the tool. Each concept has between 1-4 behavioral description lines, each one is rated 1 (novice nurse) to 4 (graduate nurse). The lowest score on the QLCCT would be a 10, the highest (usually only achieved by a graduating RN) would be 40. After observing a student in the simulation or clinical setting, the instructor marks each behavioral description line with an X. It is not unusual for a student to perform each behavior at a different level within the concept. The final score for a concept will be the lowest scored item. This prevents grade inflation and allows both the instructor and the students to see where improvement and progression are needed.

Download the Quint Leveled Clinical Competency Tool

References:

• Prion, S. K., Gilbert, G. E., Adamson, K. A., Kardong-Edgren, S., & Quint, S. (2017, March). Development and testing of the Quint Leveled Clinical Competency Tool. Clinical Simulation in Nursing, 13(3), 106-115. http://dx.doi.org/10.1016/j.ecns.2016.10.008.
• Shinnick, M. A., & Woo, M. (2020, September). Comparison of simulation assessments: Can they identify novice/student nurses? Clinical Simulation in Nursing, 46, 40-49. https://doi.org/10.1016/ j.ecns.2020.04.002.
• Webpage suggested citation: Prion, S., Gilbert, G. E., Adamson, K. A., Kardong-Edgren, S., & Quint, S. (2017). Quint Leveled Clinical Competency Tool. https://www.healthysimulation.com/tools/evaluating-healthcare-simulation/quint-leveled-clinical-competency-tool-qlcct/
• If you need an official ‘Permission to Use’ letter, or have questions about this tool, please contact Dr. Suzie Kardong-Edgren.

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