Situation: This research article begins to build evidence for promoting safety among nursing students in the clinical environment by investigating passing/failing behaviors observed by faculty.
Background: Almost every clinical instructor was once baffled by at least one nursing student who simply did not have the knowledge or skill to have passed a previous nursing course. Today, newly licensed nurses are having their skills competency and knowledge questioned as they are stereotyped by an wide spread belief that new graduates aren't ready for practice. Educating and producing safe and competent nurses is becoming more and more challenging for nursing faculty as budgets shrink,
curriculum expands, and staffing shortages plague many nursing schools across the United States. To address this problem, faculty may have to start failing students not fit for the nursing profession. Among these demands and pressures, a widely accepted standard for failing students based on behavior has yet to be developed.
Abstract: "Achieving safe patient care underlies all of clinical nursing education. Nurse educators are professionally, legally, and ethically expected to anticipate safety risks for patients and prevent students from causing harm to patients in the clinical arena. When a student's behavior or behaviors pose a threat to patient safety, that student may be subject to a failing grade in the clinical nursing course. However, determining what student behaviors will result in failure in a clinical nursing course is challenging for even the most experienced nurse educators. Moving from a culture of blame to a culture of safety is also challenging. The authors developed a multiphase project to facilitate that move. Phase I, the focus of this article, began with a qualitative study. Focus groups of part-time and ranked faculty in baccalaureate nursing programs were conducted. The goal was to begin to identify faculty perspectives regarding nursing student behaviors that result in failure in a clinical course. One major theme (context and patterns) and five subthemes (safety, thinking, ethics, communication, and standards) with clarifiers emerged from this study. Plans for the next four phases of the multiphased project are presented."
Review: "It is the professional responsibility of nurse educators, as gate keepers, to determine which nursing students are able to think and function professionally in clinical courses and which are not."
Authors conducted a literature review using the following questions:
- Which student behaviors determine that a nursing student fails a clinical nursing course?
- How do nurse faculty determine that nursing student behavior is a threat to patient safety?
- What processes do faculty use to determine that a nursing student is not competent and thus is failing the clinical course?
- How do faculty learn to make decisions about competent and non-competent behaviors?
The review found common patterns showcased in over 40 articles. Some utilized teaching strategies to help facilitate student success. However, no common assessment and evaluation standards were discovered and the lack thereof was repeatedly discussed. Furthermore, inconsistencies in applying nursing practice standards within the academic realm have led to poorly defined expectations and guidelines. Ultimately, the authors determine that the literature review failed to provide “an evidence base for how nurse educators might distinguish between passing and failing student behavior in clinical course.
So much more can go into discussing the results and implications of this literature review. It is widely well known and experienced, that this problem continues to plague almost any nursing school around the country. Contributing factors, both internal and external to nursing education institutions, can assume portions of blame. However, this overlooking literature review and purpose of this article aims to contribute evidence for faculty to consider. Comments are welcome.
In this phase of the ongoing study, authors asked faculty from different universities to volunteer for participation in focus groups. Characteristics of the participants along with findings from the focus groups can be found in the article. The figure illustrates several findings from the study and serves as a preliminary guide for future study.
The authors conclude by reiterating the preliminary phase of the overall multiphase study. Identified limitations prevented authors from makings significant implicating suggestions. However, the pilot study generated usable findings and a survey for use in future study.
Nurseacademia will try to follow the authors’ progress during their multiphase study.
Article Reference
Tanicala, M. L., Scheffer, B. K., & Roberts, M. S. (2011). DEFINING PASS/FAIL Nursing Student Clinical Behaviors Phase I: Moving Toward a Culture of Safety.
Nursing Education Perspectives, 32(3), 155-161. doi:10.5480/1536-5026-32.3.155>
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