Development and Preliminary Evaluation of a Fundamentals of Care Practice Process Rubric for Person‐Centred Clinical Reasoning in Nursing Education

AIM (S): To develop and preliminarily evaluate a case-based rubric for assessing undergraduate nursing students' person-centred clinical reasoning within the Fundamentals of Care Practice Process (FoC-PP). DESIGN: Methodological study of rubric development and preliminary validity and reliability evidence. METHODS: The study was conducted from January to October 2025 and comprised rubric development and preliminary evaluation of selected sources of validity and reliability evidence. Content validity was assessed by an expert panel of five participants using structured ratings. Face validity was explored through cognitive interviews with 12 nursing tutors and clinical placement mentors. Inter-rater reliability was evaluated through independent scoring of 83 undergraduate nursing students' performances during a structured clinical reasoning exercise based on a standardised case. Each performance received two independent tutor ratings. Reliability was analysed using a one-way random-effects model for anonymous paired tutor ratings. Measurement precision was examined using the standard error of measurement and minimal detectable change at the 95% confidence level. RESULTS: Item-level CVI values ranged from 0.80 to 1.00, with an S-CVI/UA of 0.87 and S-CVI/Ave of 0.97. Face validity findings supported clarity and usability, with minor wording refinements. Inter-rater reliability was high. ICC(1 1) was 0.970, 95% CI: 0.953 to 0.980 for a single rating, and ICC(1,2) was 0.985, 95% CI: 0.976 to 0.990 for the mean of two ratings. SEM and MDC95 were 0.61 and 1.68 points for a single rating, and 0.43 and 1.19 points for the mean of two ratings respectively. CONCLUSION: The rubric provides a theory-informed approach to assessing person-centred clinical reasoning within case-based FoC-PP assessment. Findings provide preliminary support for content validity, face validity, scoring consistency and measurement precision. Further research should examine construct validity, internal structure, responsiveness, performance across cases and raters, and applicability across educational and cultural contexts. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: By supporting the formative assessment of person-centred clinical reasoning within the FoC-PP, the rubric may strengthen alignment between education, supervision and clinical practice, contributing to the development of person-centred fundamental care. IMPACT: What problem did the study address?: Assessment approaches in nursing education often fail to capture integrated, person-centred clinical reasoning within fundamental care. What were the main findings?: A theory-informed rubric showed high content validity indices, supportive face validity findings, high scoring consistency across anonymous paired tutor ratings with measurement precision quantified using SEM and MDC95 under controlled assessment conditions. These findings support its cautious formative use in undergraduate nursing education. Where and on whom will the research have an impact?: The findings are relevant for nursing educators, clinical mentors, and educational institutions seeking to support person-centred care through structured assessment practices. REPORTING METHOD: This study adheres to the Guidelines for Reporting Reliability and Agreement Studies (GRRAS), with methodological considerations for reliability and measurement error informed by COSMIN guidance for performance-based outcome measurement instruments. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting.