"Failure to Assign Failing Grades": Issues with Grading the Unsafe Student

Luhanga, Florence; Yonge, Olive; Myrick, Florence

doi:10.2202/1548-923x.1366

Cited by 92 publications

(150 citation statements)

References 24 publications

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“…[28] Preceptors themselves have stressed the need for clearer role expectations, guidance, and support; [17,29] however, preceptors have reported that they feel ill-prepared to assume the role. [13,30,31] Kowalski et al [15] suggest that a lack of preparation is a reason for burnout and dissatisfaction with nurses working as preceptors. There is consensus in the literature that preceptors need some type of preparation.…”

Section: Literature Reviewmentioning

confidence: 99%

“…[27] This sense of accountability and responsibility is viewed by preceptors as critical, especially if students are deemed unsafe or incompetent. [29][30][31] Preceptors report less satisfaction in the role when students are perceived as "difficult". [44] Research indicates that poorly performing students are often a significant source of stress, leading to feelings of self-doubt, fear, anxiety, anger, and frustration for preceptors.…”

Section: Literature Reviewmentioning

confidence: 99%

“…[44] Research indicates that poorly performing students are often a significant source of stress, leading to feelings of self-doubt, fear, anxiety, anger, and frustration for preceptors. [29][30][31] Support from colleagues may help to buffer this stress. Carlson, Pilhammar, and Wann-Hansson [21] found that nurse preceptors found collegial support from their co-workers to be invaluable in creating a positive learning experience for students.…”

Section: Literature Reviewmentioning

confidence: 99%

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Role functions of staff nurse preceptors for undergraduate pre-licensure nursing students

Hall

2016

JNEP

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Preceptorships are an indispensable part of undergraduate clinical education and are prevalent among schools of nursing. However, there is wide interpretation and implementation of preceptorships which leaves many facets of the preceptor role poorly understood. Research has suggested preceptors experience several benefits from serving; however, the role has also been described as one leading to overload, conflict, and burnout. There is a lack of studies exploring preceptor role functions from the perspective of those who serve in it. The purpose of this qualitative study was to explore staff nurse experiences as preceptors to undergraduate, pre-licensure nursing students with emphasis on the RN's perceptions of the role, specifically the preparation for, support in, and understanding of what the role entails. Focus groups were used to collect data. Transcripts were analyzed using conventional content analysis. Findings suggest that the primary role function is Protector, with Socializer and Teacher as secondary role functions. Preceptors in this study described a strong empathetic drive to protect students from negative experiences, to protect patients from harm, to protect their own professional identities, and to protect the nature of the nursing profession. Within each role function, there are specific behaviors in which the preceptor engages to varying degrees depending on the needs of the individual student. Findings have implications for continued development of the preceptor role.

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Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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Role functions of staff nurse preceptors for undergraduate pre-licensure nursing students

Hall

2016

JNEP

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“…[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.…”

Section: Faculty Advisor Role and Responsibilities In Preceptorshipmentioning

confidence: 99%

“…Identification and intervention are critical processes in working with and managing students who are unsafe or whose clinical performance is marginal or failing to meet the program objectives. [10][11][12] Many faculty advisors, however, may have difficulty in identifying students with unsafe practices and particularly in making appropriate decisions regarding unsafe performance. [11,13,14] Multiple interpretations of what constitutes 'unsafe practice' and the absence of guidelines for response reflect the complexity of the issue.…”

Section: Introductionmentioning

confidence: 99%

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

Luhanga

Koren

Yonge

et al. 2014

JNEP

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Objective: The purpose of this study was twofold: 1) to explore the psychosocial process involved when senior baccalaureate students were being evaluated as unsafe by their preceptors; and 2) to understand how faculty play a role in that process.Method: A grounded theory method was employed. Data were generated from six faculty via semi-structured interviews and analyzed using constant comparative analysis. Results:The process of 'Facilitating student success' emerged as the core variable. Intrinsic to this process were six major categories and their inherent subcategories: 1) recognizing red flags of unsafe practice; 2) strategies for managing students who display unsafe practice; 3) using evaluation strategies to foster success; 4) deciding to fail a student; 5) guiding and supporting the student and preceptor; and 6) guiding and supporting faculty. The six major categories represent the processes that faculty advisors used to facilitate student learning and success in the clinical setting. In this article, only findings related specifically to the last category 'Guiding and supporting faculty', and subcategories: 'role preparation', 'faculty advisor perceived roles', and 'guidance and support received from the educational program' will be discussed. The other categories have been reported elsewhere. Conclusion:The findings from this study can contribute to our understanding of: a) the process involved in working with final year nursing students who display unsafe clinical practice; b) identifying preparatory and support needs of faculty who oversee the preceptorship experience; and c) the value of the development and implementation of preceptorship support programs.

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“They were very very nice but just not very good”: The interplay between resident–supervisor relationships and assessment in the emergency setting

Laurin,

Castonguay,

Dory

et al. 2024

AEM Education and Training

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PurposeClinical supervisors hesitate to report learner weaknesses, a widely documented phenomenon referred to as “failure to fail.” They also struggle to discuss weaknesses with learners themselves. Their reluctance to report and discuss learner weaknesses threatens the validity of assessment‐of‐learning decisions and the effectiveness of assessment for learning. Personal and interpersonal factors have been found to act as barriers to reporting learners’ difficulties, but the precise role of the resident–supervisor relationship remains underexplored, specifically in the emergency setting. This study aims to better understand if and how factors related to the resident–supervisor relationship are involved in assessment of and for learning in the emergency setting.MethodsWe conducted a qualitative study, using semistructured interviews of 15 clinical supervisors in emergency medicine departments affiliated with our institution. Transcripts were independently coded by three members of the team using an iterative mixed deductive–inductive thematic analysis approach. The team then synthesized the coding and discussed analysis following guidelines for thematic analysis.ResultsParticipating emergency medicine supervisors valued resident–supervisor relationships built on collaboration and trust and believed that such relationships support learning. They described how these relationships influenced assessment of and for learning and how in turn assessment influenced the relationship. Almost all profiles of resident–supervisor relationships in our study could hinder the disclosing of resident weaknesses, through a variety of mechanisms. To protect residents and themselves from the discomfort of disclosing weaknesses and to avoid deteriorating the resident–supervisor relationship, many downplayed or even masked residents’ difficulties. Supervisors who described themselves as able to provide negative assessment of and for learning often adopted a more distant or professional stance.ConclusionsThis study contributes to a growing literature on failure to fail by confirming the critical impact that the resident–supervisor relationship has on the willingness and ability of emergency medicine supervisors to play their part as assessors.

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"Failure to Assign Failing Grades": Issues with Grading the Unsafe Student

Cited by 92 publications

References 24 publications

Role functions of staff nurse preceptors for undergraduate pre-licensure nursing students

Role functions of staff nurse preceptors for undergraduate pre-licensure nursing students

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

“They were very very nice but just not very good”: The interplay between resident–supervisor relationships and assessment in the emergency setting

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