Failing to fail: clinicians' experience of assessing underperforming dental students.

INTRODUCTION: Anecdotal evidence within a UK dental school indicated that staff's grading did not always match their evaluation of students' clinical proficiency. The invalid assessment of underperforming students, which has considerable ramifications, has been reported internationally for students of nursing and medicine, but a database search revealed no accounts for dental education. AIM: To develop an understanding of clinicians' approaches to assessing underperforming dental students. METHODOLOGY: Seventeen clinical staff were interviewed (eleven females, six males). Interviews were recorded and transcribed verbatim. A grounded theory methodology was used, with simultaneous data collection and analysis. The main analytical technique was constant comparison. FINDINGS: Participants' shared basic problem was Assessing undergraduate students, expressed as how they evaluated and used the assessment system or perceived others to do so. The core category, which explains what clinical staff do to manage their difficulties with assessment, was identified as Failing to Fail and has three subcategories: Evaluating the Assessment System, Shielding the Student and Protecting Myself. CONCLUSION: This study has substantiated the complexity of failing to fail and confirmed that some causes are shared across healthcare professions, although insufficient staff discussion, the avoidance of confrontation and the impact of negative student attitude are not reported elsewhere or are minor findings. It is recommended that clinical staff receive additional training in assessment and that they are made more aware of their learning needs, their attitudes and beliefs. Increased discussion between staff about assessment and about students known to be in difficulty is essential.

Pay equity and nursing in Ontario: ten years later.

'Nurses have never been compensated in accordance with their central role in health care' (Schreiber 1994), reflecting the generalized and well-documented under-valuing of the work of women (Schreiber 1993). Pay equity legislation, passed in Ontario, Canada in 1987, designed to correct gender wage discrimination, created great optimism that the under-valuing of nurses' work might be ending. Nonetheless, this has not been the case, as the social, political, and economic climate has not kept pace with the speed and enormity of social change necessary to enact the intent of the legislation. Indeed, gains in nurses' wages have been directly offset by significant lay-offs. In this paper, we examine the issues surrounding the implementation of pay equity legislation in Ontario, Canada, along with analysis and implications of these issues, drawn from 10 years of experience. In addition, we highlight lessons that can be learned from the Ontario experience.