Failing securely: enabling mentors to fail underperforming student nurses in practical assessments

Hunt, Louise Anne (2014) Failing securely: enabling mentors to fail underperforming student nurses in practical assessments. Doctoral thesis, Birmingham City University.


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This study was undertaken in response to concerns that mentors who assessed practical competence were reluctant to fail student nurses in assessments which generated doubts about the fitness to practice of some registered nurses. This study set out to investigate mentor’s experiences of failing students in England and was undertaken in two phases.

In phase one comparative failure rates obtained from 27 universities indicated that, over a three year period, a very small proportion of students failed practical assessments; failure rates for theory outstripped practice by a ratio of 5:1. A quarter of the universities failed no students in practice. These findings appeared to support the initial concerns and raised a number of questions about practical assessment systems and practices.

In phase two, a grounded theory approach was used to explore the experiences of thirty one participants who had been involved in failing student nurses in practice and the factors which enabled them to do this. Findings revealed that a clash of priorities and cultures between universities and health care organisations generated significant obstacles to failing students. The practical assessment process itself functioned on the mentors’ goodwill, their informal social support network and local arrangements rather than on timely, formal, organisational systems. A number of effective interventions were identified which, when combined, supported a three stage process that enabled mentors to fail an underperforming student.

This study is the first to examine mentors’ perspectives of how and why they were enabled to fail student nurses in practical assessments in England, and resonates with those reported by other vocationally-based professions. The challenges faced by mentors that this study identifies contribute to national understanding of the processes and context which combine to facilitate robust assessment of the future nursing workforce, ensuring patient safety and public confidence in professions which provide essential care and services.

Item Type: Thesis (Doctoral)
November 2014Completed
Subjects: CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-01 - nursing (non-specific)
Divisions: Faculty of Health, Education and Life Sciences > School of Nursing and Midwifery
Doctoral Research College > Doctoral Theses Collection
Depositing User: Richard Birley
Date Deposited: 17 Jul 2017 14:28
Last Modified: 12 Jan 2022 11:26

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