Simulation has become a common method for teaching students in nursing programs, and as part of that experience, students typically receive feedback on their performance. Feedback identifies areas of performance to be improved and is critical to the student's learning-this is formative evaluation. Simulation also can be used for summative evaluation of students' competencies, documenting that their performance meets predetermined standards. Summative evaluation often has high-stakes consequences; for example, students need to perform at a certain level to pass the course. Simulations for summative evaluation need to be valid (do they assess the intended competencies?) and reliable (would a rater come to the same conclusion at another time, and would different raters similarly judge the performance?). Nurse educators should not be using simulation for summative evaluations unless they can ensure both validity and reliability. The knowledge and competencies to be evaluated should be specified clearly as in any evaluation. These guide the scenario development and selection of an evaluation tool. Ask colleagues to critique the scenarios you have developed to validate they require use of the knowledge and skills to be evaluated and are consistent with the current practice of a nurse or interprofessional team. Your tool should have established validity and reliability. It may list specific performance behaviors to look for and check off or may be a rating scale with broader areas to be assessed, similar to the tools used for clinical evaluation. Regardless of format, the tool needs to be valid and reliable. For summative evaluation, you should use more than 1 rater, and they need to be prepared to accurately observe and judge the competence of the student. Errors can occur when rating performance in a simulation and in the clinical setting, and preparing nurse educators for observing and evaluating performance across settings can help prevent some of them. Summative simulation-based evaluations should not be used in a nursing program until the faculty are prepared to carry them out.

Marilyn H. Oermann, PhD, RN, ANEF, FAAN, Editor-in-Chief, Nurse Educator