In a grounded theory study examining the process of precepting an unsafe student, it was found that preceptors assigned passing grades to students who in fact should not have passed. Although preceptors perceived their role as gatekeepers for the profession, by not assigning failing grades to students who should not have passed a course, essentially they were abdicating their responsibility. Indeed, the simple act of assuming responsibility for precepting a student implies professional as well as pedagogical accountability.
In academic writing on mentoring and preceptorship there is little consensus on the meaning or characteristics surrounding these terms. The writers of this paper contend that the correct usage of preceptorship and mentorship, which gives credence and respect to the very different concepts embedded in each, is a very important precursor to the evolution of these two concepts in nursing education, both academically and within practical application. Although language is continually changing, lack of clarity robs language of its richness and complexity and interferes with clear thinking about the issues. In professional terms, clarity demands that concepts, around which a body of knowledge is growing, be consistent in their meaning and characteristics. Such clarity between the related educational concepts of mentor(ship) and preceptor(ship) is lacking.
A study using a qualitative descriptive design was undertaken to explore the issue of "failure to fail" in a nursing program. Individual in-depth interviews were conducted with nursing university faculty members, preceptors, and faculty advisors (n=13). Content analysis was used to analyze the data. Results indicate that: (a) failing a student is a difficult process; (b) both academic and emotional support are required for students and preceptors and faculty advisors; (c) there are consequences for programs, faculty, and students when a student has failed a placement; (d) at times, personal, professional, and structural reasons exist for failing to fail a student; and (e) the reputation of the professional program can be diminished as a result of failing to fail a student. Recommendations for improving assessment, evaluation, and intervention with a failing student include documentation, communication, and support. These findings have implications for improving the quality of clinical experiences.
Clinical education is a cornerstone of undergraduate nursing education programs. Although protecting patient safety in clinical learning experiences is a standard of practice, no standard definition of the "unsafe" student exists. The purpose of this study was to describe the viewpoints of undergraduate student nurses and their clinical educators about unsafe clinical student practices. Using Q methodology, 57 students and 14 clinical educators sorted 39 unsafe student practice statements. These statements were generated from an integrated review of nursing and related literature and two undergraduate student focus groups. The use of centroid factor analysis with varimax rotation produced three dimensions of unsafe student practices. An unsafe student was characterized by his/her Compromised Professional Accountability, Incomplete Praxis, and Clinical Disengagement. A shared attribute among these three features was violated professional integrity. While students' affective, cognitive, and praxis competencies were priority elements in the conceptualization of unsafe student practice, this study also identified the salient role of educators as active participants in preparation of safe practitioners.
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