Exploring the Issue of Failure to Fail in a Nursing Program

Abstract

A study using a qualitative descriptive design was undertaken to explore the issue of "failure to fail" in a nursing program. Individual in-depth interviews were conducted with nursing university faculty members, preceptors, and faculty advisors (n=13). Content analysis was used to analyze the data. Results indicate that: (a) failing a student is a difficult process; (b) both academic and emotional support are required for students and preceptors and faculty advisors; (c) there are consequences for programs, faculty, and students when a student has failed a placement; (d) at times, personal, professional, and structural reasons exist for failing to fail a student; and (e) the reputation of the professional program can be diminished as a result of failing to fail a student. Recommendations for improving assessment, evaluation, and intervention with a failing student include documentation, communication, and support. These findings have implications for improving the quality of clinical experiences.

The role of faculty advisors in preceptorship: From a faculty point of view

“…[9] The issue of reluctance to fail unsafe or incompetent students has been documented by a number of scholars in nursing. [10,12,20] For example, faculty advisors who lack knowledge, experience or confidence in the evaluation role are reluctant to fail unsafe or marginal students. [9,12,14,20] In addition, few schools of nursing have written policies or guidelines for faculty advisors to follow when dealing with unsafe students.…”

“…[10,12,20] For example, faculty advisors who lack knowledge, experience or confidence in the evaluation role are reluctant to fail unsafe or marginal students. [9,12,14,20] In addition, few schools of nursing have written policies or guidelines for faculty advisors to follow when dealing with unsafe students. [13,14,21] Walsh and Seldomridge [21] examined the relationship between 10 pairs of didactic and clinical courses at one university from 1997 to 2002 and found a marked disparity between didactic and clinical grades, with clinical grades being much higher.…”

A concept analysis of “Reluctance to fail”

“…[1,2] This makes it challenging to determine if a student has actually met the minimum standards to pass the course. [1,3] A concept analysis was completed to identify barriers that result in a reluctance to fail a student in a clinical course.…”

“…[3,4] Outcomes associated with the reluctance to fail include decreased patient safety, distrust of the nursing profession by society, and transition of unsafe students to professional practice. [3] Nursing faculty, responsible for assigning grades at the conclusion of clinical, capstone, or preceptorship experiences, are the gatekeepers for this scenario. [3] Typically, clinical grades are determined by the clinical faculty, the preceptor, and the student using a skills performance matrix and a clinical evaluation tool.…”

“…[3] Nursing faculty, responsible for assigning grades at the conclusion of clinical, capstone, or preceptorship experiences, are the gatekeepers for this scenario. [3] Typically, clinical grades are determined by the clinical faculty, the preceptor, and the student using a skills performance matrix and a clinical evaluation tool. [1] These evaluation tools fail to specifically describe performance behaviors indicative of successful completion of a clinical course.…”