Transparency of assessment decision-making when students are not meeting required levels of proficiency in clinical practice

Utilising the invitational theory provides a framework for understanding assessors' experiences of failure to fail

AIM

The aim of this paper is to describe how the Invitational Theory were used to frame each of the phases of this sequential mixed methods study to provide valuable insights to the failure to fail phenomenon.

BACKGROUND

The assessment of student nurses in clinical courses in undergraduate programmes remains problematic, with some students passing clinical courses when they do not meet standards for practice - failure to fail. Failure to fail is the allocation of passing grades to students who do not meet standards for practice. An understanding of assessors' experiences is central to unravelling the complexities surrounding the phenomenon of failure to fail. Traditionally, such inquiry has been specific and narrow. The Invitational Theory is offered as a comprehensive approach to provide insights and understanding into the complex phenomenon of failure to fail.

DESIGN

The five domains of the Invitational Theory; people, processes, programmes, policies and places, were used to inform this sequential exploratory mixed methods study.

METHODOLOGY

Phase 1 consisted of an integrative literature review. Phase 2 involved interviews and focus groups with tertiary assessors involved in assessment of students in clinical courses. Phase 3 involved the development, testing and piloting of a survey with tertiary and industry assessors. Phase 4 consisted of a meta-integration of all phases of the study.

RESULTS

Key findings of the synthesis of these study phases demonstrated that the domains of the Invitational Theory enable a comprehensive and unique viewpoint of assessment during clinical practicum. All five domains of the Invitational Theory were evident throughout this study and provided unique insights into failure to fail. This research has identified the theoretical underpinnings of the Invitational Theory and its application can be of value in the area of nurse education and specifically assessments.

CONCLUSION

The Invitational Theory domains provides a comprehensive and unique viewpoint of assessment of nursing students and contributed to the emerging body of literature regarding failure to fail. How the theoretical framework facilitates the understanding of failure to fail is described in this paper.

Developing a consensus-based scoring rubric to enhance practice-based assessment of student nurses' clinical competence: A Delphi study

BACKGROUND

Concerns about reliability and validity of practice-based assessment of professional competencies are frequently reported in the literature. Difficulty in understanding competency statements or distinguishing different achievement levels has been found to be a major factor.

OBJECTIVES

To develop a consensus-based scoring rubric based on stakeholders' interpretations of level descriptors for student nurses' professional values competencies.

DESIGN

Two rounds of Classic e-Delphi.

SETTINGS

This study was conducted in a London based university using Bristol Online Survey website as a host.

PARTICIPANTS

100 stakeholders with vested interests in undergraduate pre-registration nurse education were purposefully invited to participate.

METHOD

Round one collected free-text interpretations of the United Kingdom Nursing and Midwifery Council professional values competency statements. Round two used a Likert scale questionnaire to measure the level of agreement to the level descriptor statements generated through round one. Responses were analysed through content analysis in round one and consensus measure in round two. A threshold of 70% agreement to determine consensus was set in advance.

RESULTS

In round one, 47 participants provided their interpretations of the competency statements. In round two, 51 participants completed the questionnaire. All 24 items achieved a strong consensus with 86%-100% of participants agreeing or strongly agreeing with the statements.

CONCLUSIONS

A Delphi study was successfully used to develop a consensus-based scoring rubric with clearly stated descriptors for professional values competency statements. This scoring rubric holds the potential to enhance practice-based assessment across all healthcare professional disciplines.