Failing securely: The processes and support which underpin English nurse mentors' assessment decisions regarding under-performing students

摘要

Background: This studywas undertaken in response to concerns thatmentorswho assessed practical competenceudwere reluctant to fail student nurses which generated doubts about the fitness to practise of some registeredudnurses. Limited evidence was available about the experiences of mentors who had failed underperformingudstudents and what had helped them to do this.udAim: To investigate what enabled some mentors to fail underperforming students when it was recognised thatudmany were hesitant to do so.udMethod: An ethically approved, grounded theory approachwas used to explore thirty-one nurses' experiences ofudfailing student nurses in practical assessments in England. Participantswere recruited using theoretical samplingudtechniques. Semi-structured interviewswere conducted. Analysiswas undertaken using iterative, constant comparativeudtechniques and reflexive processes. The theoretical framework which emerged had strong resonanceudwith professionals.udFindings: Five categories emerged fromthe findings: (1) Braving the assessment vortex; (2) Identifying the ‘gist’udof underperformance; (3) Tempering Reproach; (4) Standing up to scrutiny; and (5) Drawing on an interpersonaludnetwork. These categories together revealed that mentors needed to feel secure to fail a student nurse in audpractical assessment and that they used a three stage decision making process to ascertain if this was the case.udMany of the components which helped mentors to feel secure were informal in nature and functioned on goodwilludand local arrangements rather than on timely, formal, organisational systems. The mentor's partner/spouseudand practice education facilitator or link lecturer were identified as the key people who provided essentialudemotional support during this challenging experience.udConclusion: This study contributes to understanding of the combined supportive elements required for robustudpractical assessment. It presents a new explanatory framework about how mentors formulate the decision toudfail a student nurse and the supportive structures which are necessary for this to occur.