Unsatisfactory Performance and Student Reaction to Receiving Failing In Nursing Education

Nursing Education and Unsatisfactory Performance and Student Reaction to Receiving Failing

Unsatisfactory Performance by Students and Evaluation, Student Reactions to Receiving a Failing Grade, Excluding an Unsafe Student from Clinical Practice, Evaluation of the Evaluation Process in Nursing Education

Unsatisfactory Performance by Students and Evaluation in Nursing Education

Faculty often feel challenged in assigning failing grades, including emotional responses when students fail and anxiety as to whether their evaluations were correct. Poor man and Mastorovich’s (2014) study, relating to these concerns, found faculty worried about limited evaluation experience and the subjective nature of judgments about data.

In addition to ongoing faculty preparation, study implications included the need for faculty to help students better understand and prepare for evaluations; they also included the need for all team members to focus on caring and professional relationships.

Boley and Whitney (2003) note that when a student is given a failing grade, faculty must be aware of the standards to meet, grades must not be “arbitrary or capricious,” and faculty must be able to explain how grades are determined related to the program and course objectives.

When a fair judgment is made that a student’s performance is unsatisfactory or failing, strategies should be used to avert interpersonal or legal problems. The need to have clear program policies, a clear chain of command for communicating problems (prospectively) and team support was reiterated (Poorman & Mastorovich , 2014).

Once the decision has been made, communication with the student is essential. Documentation from formative evaluation conferences and student contracts can provide support for this decision. Published school policies and procedures should be followed, including documentation that decisions were made carefully and deliberately.

Support from the university or college is essential when performance is determined to be unsatisfactory, and the administration should be notified of impending problems early in the grading process. Final evaluations that result in unsatisfactory or failing performance require special tact and concern. Faculty need to share specific findings that resulted in a student not meeting the expected clinical objectives.

Student contracts that have not been fulfilled do not need to be identified. Students need time to process the information and should not feel rushed. Faculty need to listen attentively, with a strong show of concern and support, to the student’s perceptions. The student may need time to reflect and return for another conference after adjusting to the facts.

Student Reactions to Receiving a Failing Grade in Nursing Education

The student who has received a failing grade may react in a variety of ways. Caring faculty will recognize these behaviors and provide empathetic support. Students may respond with denial, providing their own perception of how a specified incident did or did not occur and offering excuses. Faculty need to steer the conversation to the student’s not meeting the clinical course objectives and provide support for the student’s emotional needs.

A student may attempt to bargain for a passing grade. Faculty need to stand firm and focus on the evaluation results. Faculty can be prepared to provide information about any program options that are available to students who fail a clinical course.

As the reality of the loss is recognized, the student may respond with despair, confusion, lack of motivation, indecision, and tears. Faculty should provide support, listen attentively, and generally convey caring behaviors; In some cases, faculty may also need to recommend professional counseling.

The student may come to terms with the outcome and begin to make plans. Assistance from the faculty in considering further options is often sought by the student. How well the student adapts to the final evaluation typically depends on how well he or she has been prepared for the results.

The student may respond with anger. The student may become demanding or accusing and may have the potential to become violent. In this case, faculty need to take steps to ensure their own safety and that of the student.

Faculty should not take the anger personally but provide guidance about feelings and focus on the anger as a part of loss. Thomas (2003) has recommended handling anger with a “professional deep breath.”

Additionally, an established grievance policy should be available. Both students and faculty share responsibility for knowing about and appropriately employing such a policy.

Excluding an Unsafe Student from Clinical Practice in Nursing Education

Faculty must immediately address student behaviors that are unsafe for patient care such as lack of preparation, violence, and substance abuse. Pierce (2001) notes the importance of a broad and thorough policy that allows for safe and appropriate actions to protect both the patient and the student. School policies and procedures need to be followed. Clear policies help prevent arbitrary or capricious responses to an incident.

O’Connor (2014) summarizes key points related to the student who is unsafe to care for patients, noting that safety of the patient is the first priority in removing a student, but that faculty have an obligation to ensure that all students are returned to an area of safety as well.

The student unprepared to care for an assigned clinical patient should be sent to the library or laboratory to prepare. Student orientation to clinical practice should include a review of relevant policies and clarification of professional student behaviors.

Evaluation of the Evaluation Process in Nursing Education

After the final student conference, the student and faculty need to evaluate the entire experience. The clinical site is evaluated on how well it met the learning, and practice needs of the students. Was the philosophy of the staff congruent with that of the faculty and students? Were the students given the opportunity to meet all objectives? Once these questions have been answered, the preparation phase for evaluation begins again.

A continuous quality improvement process for clinical evaluation should be considered, with attention given to structure (appropriate evaluation tools with appropriate clinical environment and patient care opportunities), process (appropriate plans for sampling and evaluating clinical behaviors and for sharing feedback and results of evaluation) , and outcome (satisfactory evaluative outcomes indicating safe, competent graduates).

Ongoing questioning of evaluation practices, including new approaches that further incorporate students’ perspectives is recommended (Rankin, Malinsky, Tate, & Elena, 2010).

Clinical evaluation is important to both patients’ safety and students’ skills and confidence. Especially in times of changing clinical contexts, best practices include multidimensional evaluation with diverse evaluation methods completed over time, seeking student growth and progress.

Advances in technology are promoting new opportunities for clinical performance evaluation. Clinical performance evaluation provides students with a means for critical reflection on their future nursing roles. An appropriate evaluation process sets the stage for productive assessment of student learning.

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