Developing a 'core of steel': the key attributes of effective practice assessors.

BACKGROUND: the Nursing and Midwifery Council has emphasised that its recently introduced standards for student supervision and assessment aim to 'ensure that no one gets onto the register who shouldn't be there'. A key element in achieving this is the new practice assessor role, implemented to bolster practical assessment processes. AIM: to identify the key personal characteristics of robust practice assessors who are prepared to fail underperforming students. METHOD: a national study, using a grounded theory approach. Thirty-one nurses were interviewed about their experiences of failing students in practice-based assessments. FINDINGS: robust practical assessors have a 'core of steel', characterised as having five key features: solidarity, tenacity, audacity, integrity and dependability. CONCLUSION: organisations should base their selection of practice assessors on how strongly they exhibit these five characteristics. Designating all current mentors as new practice assessors, when it is known that often they are reluctant to fail, could perpetuate failure to fail.

Manipulating mentors' assessment decisions: Do underperforming student nurses use coercive strategies to influence mentors' practical assessment decisions?

There is growing evidence of a culture of expectation among nursing students in Universities which leads to narcissistic behaviour. Evidence is growing that some student nurses are disrespectful and rude towards their university lecturers. There has been little investigation into whether they exhibit similar behaviour towards their mentors during practical placements, particularly when they, the students, are not meeting the required standards for practice. This paper focuses on adding to the evidence around a unique finding - that student nurses can use coercive and manipulative behaviour to elicit a successful outcome to their practice learning assessment (as noted in Hunt et al. (2016, p 82)). Four types of coercive student behaviour were identified and classified as: ingratiators, diverters, disparagers and aggressors, each of which engendered varying degrees of fear and guilt in mentors. The effects of each type of behaviour are discussed and considered in the light of psychological contracts. Mechanisms to maintain effective working relationships between student nurses and mentors and bolster the robustness of the practical assessment process under such circumstances are discussed.

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

BACKGROUND: This study was undertaken in response to concerns that mentors who assessed practical competence were reluctant to fail student nurses which generated doubts about the fitness to practise of some registered nurses. Limited evidence was available about the experiences of mentors who had failed underperforming students and what had helped them to do this. AIM: To investigate what enabled some mentors to fail underperforming students when it was recognised that many were hesitant to do so. METHOD: An ethically approved, grounded theory approach was used to explore thirty-one nurses' experiences of failing student nurses in practical assessments in England. Participants were recruited using theoretical sampling techniques. Semi-structured interviews were conducted. Analysis was undertaken using iterative, constant comparative techniques and reflexive processes. The theoretical framework which emerged had strong resonance with professionals. FINDINGS: Five categories emerged from the findings: (1) Braving the assessment vortex; (2) Identifying the 'gist' of underperformance; (3) Tempering Reproach; (4) Standing up to scrutiny; and (5) Drawing on an interpersonal network. These categories together revealed that mentors needed to feel secure to fail a student nurse in a practical assessment and that they used a three stage decision making process to ascertain if this was the case. Many of the components which helped mentors to feel secure were informal in nature and functioned on goodwill and local arrangements rather than on timely, formal, organisational systems. The mentor's partner/spouse and practice education facilitator or link lecturer were identified as the key people who provided essential emotional support during this challenging experience. CONCLUSION: This study contributes to understanding of the combined supportive elements required for robust practical assessment. It presents a new explanatory framework about how mentors formulate the decision to fail a student nurse and the supportive structures which are necessary for this to occur.

Assessment of student nurses in practice: a comparison of theoretical and practical assessment results in England.

This study was undertaken in response to concerns raised by Duffy (2003) that assessors of practice were reluctant to fail student nurses in assessments. This generated doubts about the fitness to practice of some registered nurses. An investigation was undertaken into whether quantitative evidence supported the view that pre-registration nurses rarely failed practical assessments. Comparative failure rates from theoretical and practical assessments were requested from all 52 universities in England that offered pre-registration nursing programmes. Responses were received from 27. Findings indicated that a very small proportion of students failed practical assessments; failure rates for theory outstripped practice by a ratio of 5:1. A quarter of universities failed no students in practice. Students were most likely to fail in year one and least likely in year three. This study supports the belief that assessors of practice are reluctant to fail student nurses. It raises a number of questions about the influence that the systems and practices of professional bodies and universities have on practical assessment. However it also indicates that some student nurses have failed practical assessments and that some universities do have systems in place to address this issue.

Integrating practice into theory in the new nursing curriculum.

This article examines the progress made by the University of Central England (UCE) over the last 18 months in implementing Health Service Circular 1999/219; the government document that contains guidance on the main points that had to be included in new pre-registration nursing curricula. Sixteen pilot sites were chosen to implement the new curriculum and UCE was one of these. The key focus of the curriculum being implemented is to draw practice and theory more closely together. Achievement of strong collaboration between practitioners and University staff is a necessary element of such a venture and the resultant empowerment of clinical assessors is highlighted. The article explores the methods employed to ensure that the practical assessment process mirrors the rigour of academic assessment and that there is equity of assessment across all four branches of nursing. A considered discussion of the use of modular assessment, focussed practical assessment documents and assessment of practical nursing skills provide insight into how practice and theory can be equally valued in a pre-registration nursing courses.