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Blanchette P, Poitras ME, St-Onge C. Assessing trainee's performance using reported observations: Perceptions of nurse meta-assessors. NURSE EDUCATION TODAY 2023; 126:105836. [PMID: 37167832 DOI: 10.1016/j.nedt.2023.105836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/12/2023] [Accepted: 04/30/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Educational and health care organizations who prepare meta-assessors to fulfill their role in the assessment of trainees' performance based on reported observations have little literature to rely on. While the assessment of trainees' performance based on reported observations has been operationalized, we have yet to understand the elements that can affect its quality fully. Closing this gap in the literature will provide valuable insight that could inform the implementation and quality monitoring of the assessment of trainees' performance based on reported observations. OBJECTIVES The purpose of this study was to explore the elements to consider in the assessment of trainees' performance based on reported observations from the perspectives of meta-assessors. METHODS Design, Settings, Participants, data collection and analysis. The authors adopted Sandelowski's qualitative descriptive approach to interview nurse meta-assessors from two nursing programs. A semi-structured interview guide was used to document the elements to consider in the assessment of nursing trainees' performance based on reported observations, and a survey was used to collect sociodemographic data. The authors conducted a thematic analysis of the interview transcripts. RESULTS Thirteen meta-assessors participated in the study. Three core themes were identified: (1) meta-assessors' appropriation of their perceived assessment roles and activities, (2) team climate of information sharing, and (3) challenges associated with the assessment of trainees' performance based on reported observations. Each theme is comprised of several sub themes. CONCLUSIONS To optimize the quality of the assessment of the trainee's performance based on reported observations and ratings, HPE programs might consider how to clarify better the meta-assessor's roles and activities, as well as how interventions could be created to promote a climate of information sharing and to address the challenges identified. This work will guide educational and health care organizations for better preparation and support for meta-assessors and preceptors.
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Affiliation(s)
| | - Marie-Eve Poitras
- Department of Family Medicine and Emergency Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada.
| | - Christina St-Onge
- Department of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada
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Hauge KW, Bakken H, Brask OD, Gutteberg A, Malones BD, Ulvund I. Are Norwegian mentors failing to fail nursing students? Nurse Educ Pract 2019; 36:64-70. [PMID: 30875605 DOI: 10.1016/j.nepr.2019.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 11/30/2018] [Accepted: 03/01/2019] [Indexed: 11/17/2022]
Abstract
It is highly important that nursing students are well educated and become safe and competent practitioners. This article presents the findings from a quantitative study investigating if Norwegian mentors fail to fail nursing students not achieving the learning outcomes in clinical studies in the bachelor's programme in nursing, in addition to the factors influencing their decisions. A survey was conducted among nurse mentors in hospital- and home-based nursing care in two Norwegian municipalities, and 561 nurses answered the questionnaire. The findings indicate that mentors sometimes fail to fail nursing students in clinical studies. Important factors influencing this decision were that the students did not put the patient's life at risk and that the mentors gave the student the benefit of the doubt. The mentors in our study thought that failing to fail students was not related to personal challenges and burdens. They also felt a lack of support from the educational institution. The findings suggest some future directions for nurse education programmes. The training of mentors, especially in managing failing students, and better support from liaison lecturers from the educational institution are important. It is also suggested that nurse education programmes together with mentors discuss the distinction between unsafe practices and learning outcomes for clinical studies.
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Affiliation(s)
- Kari Westad Hauge
- Department of Nursing and Social Sciences, Høgskolen i Molde, Postboks 2110, 6402, Molde, Norway.
| | - Hege Bakken
- Department of Nursing and Social Sciences, Høgskolen i Molde, Postboks 2110, 6402, Molde, Norway.
| | - Ole David Brask
- Department of Nursing and Social Sciences, Høgskolen i Molde, Postboks 2110, 6402, Molde, Norway.
| | - Anne Gutteberg
- Department of Nursing and Social Sciences, Høgskolen i Molde, Postboks 2110, 6402, Molde, Norway.
| | - Bente Dale Malones
- Department of Nursing and Social Sciences, Høgskolen i Molde, Postboks 2110, 6402, Molde, Norway.
| | - Ingeborg Ulvund
- Department of Nursing and Social Sciences, Høgskolen i Molde, Postboks 2110, 6402, Molde, Norway.
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North H, Kennedy M, Wray J. Are mentors failing to fail underperforming student nurses? An integrative literature review. ACTA ACUST UNITED AC 2019; 28:250-255. [PMID: 30811229 DOI: 10.12968/bjon.2019.28.4.250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM: this review aimed to identify and review primary research to address the question: 'Is there evidence that mentors are failing to fail underperforming student nurses?' Design: this was an integrative literature review. METHODS: online databases (Medline, Scopus, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)) were searched using specified inclusion and exclusion criteria to focus the review. Critical appraisal was undertaken and key findings, outcomes and emergent concepts were identified from each study. These were then collated and synthesised into themes. RESULTS: five articles met the criteria and review aim. Three main themes were identified. These were the mentors' relationship with the university, documentation when failing a student, and psychological and emotional impacts. CONCLUSION: the phenomenon of failing to fail continues to concern the nursing profession but there is limited primary research evidence to inform contemporary discussions in the UK regarding the management of this in practice.
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Affiliation(s)
- Hannah North
- Adult Nursing Programme, School of Health and Social Work, University of Hull, at the time of writing
| | | | - Jane Wray
- Director of Research, School of Health and Social Work, University of Hull
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Davenport R, Hewat S, Ferguson A, McAllister S, Lincoln M. Struggle and failure on clinical placement: a critical narrative review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:218-227. [PMID: 29159842 DOI: 10.1111/1460-6984.12356] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 10/03/2017] [Accepted: 10/09/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Clinical placements are crucial to the development of skills and competencies in speech-language pathology (SLP) education and, more generally, a requirement of all health professional training programmes. Literature from medical education provides a context for understanding how the environment can be vital to all students' learning. Given the increasing costs of education and demands on health services, students who struggle or fail on clinical placement place an additional burden on educators. Therefore, if more is known or understood about these students and their experience in relation to the clinical learning environment, appropriate strategies and support can be provided to reduce the burden. However, this literature does not specifically explore marginal or failing students and their experience. AIMS To review existing research that has explored failing and struggling health professional students undertaking clinical placements and, in particular, SLP students. METHODS & PROCEDURES A critical narrative review was undertaken. Three electronic databases, ProQuest, CINAHL and OVID (Medline 1948-), were searched for papers exploring marginal and failing students in clinical placement contexts across all health professions, published between 1988 and 2017. Data were extracted and examined to determine the breadth of the existing research, and publications were critically appraised and major research themes identified. MAIN CONTRIBUTION Sixty-nine papers were included in the review. The majority came from medicine and nursing in the United States and United Kingdom, with other allied health disciplines less well represented. The review identified key themes with the majority of papers focused on identification of at risk students and support and remediation. The review also highlighted the absence of literature relating to the student voice and in the allied health professions. CONCLUSIONS & IMPLICATIONS This review highlighted the limited research related to failing/struggling student learning in clinical contexts, and only a handful of papers have specifically addressed marginal or failing students in allied health professions. The complexity of interrelated factors in this field has been highlighted in this review. Further research needs to include the student's voice to develop greater understanding and insights of struggle and failure in clinical contexts.
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Affiliation(s)
- Rachel Davenport
- Speech pathology, Newcastle University, Newcastle, NSW, Australia
- Speech pathology, La Trobe University, Melbourne, VIC, Australia
| | - Sally Hewat
- Speech pathology, Newcastle University, Newcastle, NSW, Australia
| | - Alison Ferguson
- Deputy Dean, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Sue McAllister
- Associate Dean, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Michelle Lincoln
- Deputy Dean, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
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Fisher M, Bower H, Chenery-Morris S, Jackson J, Way S. A scoping study to explore the application and impact of grading practice in pre-registration midwifery programmes across the United Kingdom. Nurse Educ Pract 2017; 24:99-105. [DOI: 10.1016/j.nepr.2016.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 01/17/2016] [Accepted: 01/24/2016] [Indexed: 10/22/2022]
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Scanlan JM, Chernomas WM. Failing Clinical Practice & the Unsafe Student: A New Perspective. Int J Nurs Educ Scholarsh 2016; 13:/j/ijnes.2016.13.issue-1/ijnes-2016-0021/ijnes-2016-0021.xml. [PMID: 27744416 DOI: 10.1515/ijnes-2016-0021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/27/2016] [Indexed: 11/15/2022]
Abstract
Students who fail clinical courses is a long standing issue in nursing education. Although faculty intuitively "know" a student is in clinical difficulty, the research literature is limited to delineating and describing characteristics of these students. A retrospective analysis of students' files in which there was at least one clinical failure was conducted to identify clinical failure indicators. Files included students who were successful, required to withdraw, or voluntarily withdrew. This study integrates these characteristics in a manner not discussed in the literature. Two themes emerged that characterize student practices: (i) How students are in practice and (ii) Aspects of practice. A third theme surfaced as clinical teachers responded to these students by labelling the practice unsafe and increasing vigilance. A model was developed that shows the relationship between these characteristics and unsafe student practice.
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AFAP1 Is a Novel Downstream Mediator of TGF-β1 for CCN2 Induction in Osteoblasts. PLoS One 2015; 10:e0136712. [PMID: 26340021 PMCID: PMC4560384 DOI: 10.1371/journal.pone.0136712] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 08/07/2015] [Indexed: 02/06/2023] Open
Abstract
Background CCN2 acts as an anabolic growth factor to regulate osteoblast differentiation and function. CCN2 is induced by TGF-β1 and acts as a mediator of TGF-β1 induced matrix production in osteoblasts and Src is required for CCN2 induction by TGF-β1; however, the molecular mechanisms that control CCN2 induction in osteoblasts are poorly understood. AFAP1 binds activated forms of Src and can direct the activation of Src in certain cell types, however a role for AFAP1 downstream of TGF-β1 or in osteoblats is undefined. In this study, we investigated the role of AFAP1 for CCN2 induction by TGF-β1 in primary osteoblasts. Results We demonstrated that AFAP1 expression in osteoblasts occurs in a biphasic pattern with maximal expression levels occurring during osteoblast proliferation (~day 3), reduced expression during matrix production/maturation (~day 14–21), an a further increase in expression during mineralization (~day 21). AFAP1 expression is induced by TGF-β1 treatment in osteoblasts during days 7, 14 and 21. In osteoblasts, AFAP1 binds to Src and is required for Src activation by TGF-β1 and CCN2 promoter activity and protein induction by TGF-β1 treatment was impaired using AFAP1 siRNA, indicating the requirement of AFAP1 for CCN2 induction by TGF-β1. We also demonstrated that TGF-β1 induction of extracellular matrix protein collagen XIIa occurs in an AFAP1 dependent fashion. Conclusions This study demonstrates that AFAP1 is an essential downstream signaling component of TGF-β1 for Src activation, CCN2 induction and collagen XIIa in osteoblasts.
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An evaluation of nursing and midwifery sign off mentors, new mentors and nurse lecturers' understanding of the sign off mentor role. Nurse Educ Pract 2014; 14:43-8. [DOI: 10.1016/j.nepr.2013.04.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 03/27/2013] [Accepted: 04/30/2013] [Indexed: 11/18/2022]
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Pratt M, Martin L, Mohide A, Black M. A descriptive analysis of the impact of moral distress on the evaluation of unsatisfactory nursing students. Nurs Forum 2013; 48:231-9. [PMID: 24188434 DOI: 10.1111/nuf.12036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Nurse educators assume a difficult role when evaluating unsatisfactory students, including those at risk for failure in clinical and classroom settings. While the decisional dilemma inherent in evaluating unsatisfactory students has been well documented in literature, little is known about how moral distress impacts the nurse educators' decisions regarding whether to pass or to fail unsatisfactory students. PURPOSE This article aims to provide a descriptive analysis of the moral dilemmas and the potential impact of moral distress experienced by nurse educators when evaluating the performance of unsatisfactory students in clinical and classroom courses. METHODS Nathaniel's theory of moral reckoning guided the descriptive analysis of six studies to understand how nurse educators work through moral dilemmas, make decisions, and provide justification for their decisions when evaluating the performance of unsatisfactory students. FINDINGS Nathaniel's theory has been shown to be helpful in discussing the dilemma of evaluating unsatisfactory students, and it is a suitable framework for nurse educators in working through their dilemmas as a form of structured reflection. PRACTICE IMPLICATIONS The outcomes of this descriptive analysis highlight the need for educational administrators to provide support to undergraduate nurse educators experiencing moral distress in this type of situation.
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Affiliation(s)
- Maria Pratt
- School of Nursing, McMaster University, Hamilton, ON, Canada
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Hills C, Ryan S, Smith DR, Warren-Forward H. The impact of ‘Generation Y’ occupational therapy students on practice education. Aust Occup Ther J 2011; 59:156-63. [DOI: 10.1111/j.1440-1630.2011.00984.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Carlisle C, Calman L, Ibbotson T. Practice-based learning: the role of practice education facilitators in supporting mentors. NURSE EDUCATION TODAY 2009; 29:715-721. [PMID: 19345449 DOI: 10.1016/j.nedt.2009.02.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Revised: 02/26/2009] [Accepted: 02/27/2009] [Indexed: 05/27/2023]
Abstract
Central to the provision of high quality clinical placements for nursing and midwifery students are mentors who help engender a positive learning environment. In 2004 the Scottish Executive Health Department (now Scottish Government Health Directorates), NHS Scotland, NHS Education for Scotland, NHS Boards and Higher Education Institutions initiated and supported the establishment of the Practice Education Facilitator (PEF) role whose purpose is to ensure that the student experience, at both pre- and post-registration level, is of the highest quality, primarily through the support of mentors. A 3-year project evaluated the implementation and impact of the PEF role across Scotland. The study utilised both quantitative and qualitative data collection, with a sample comprising mentors, PEFs, students and other key stakeholders. This paper reports on selected findings from that study, specifically the perceived impact of the PEF in supporting mentors. Findings indicate that the PEF role has been accepted widely across Scotland and is seen as valuable to the development of quality clinical learning environments. PEFs provide support and guidance for mentors when dealing with 'failing' students, and encourage the identification of innovative learning opportunities. PEFs play an active part in student evaluation of their placements, but further work is needed in order that the feedback to clinical areas and mentors is timely.
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Affiliation(s)
- Caroline Carlisle
- School of Nursing, Midwifery and Social Work, Room 5.323 University Place, The University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom.
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Gopee N. Assessing student nurses' clinical skills: The ethical competence of mentors. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2008. [DOI: 10.12968/ijtr.2008.15.9.30827] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Neil Gopee
- Faculty of Health and Life Sciences, Coventry University, Priory Street, Coventry, CV1 5FB
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