Where is the grade coming from? Problems and challenges in evaluating the clinical performance of nursing students

Evaluating the clinical performance of nursing students effectively and fairly is a challenge which continues to confront nurse education and there is evidence of both faculty and student concerns. This paper reports part findings of a hermeneutic phenomenological study which explored the clinical learning experience of Malawian undergraduate student nurses. The study took place at a University Nursing College in Malawi, using a purposive sample of thirty student nurse participants. Conversational interviews were conducted to obtain participants’ accounts of their clinical learning experience and a framework developed by modifying Colaizzi’s procedural steps guided the phenomenological analysis. Several issues emerged from this study, but for this paper the assessment issues which the study revealed were discussed. It revealed concerns of unfairness and lack of objectivity during the evaluation of the clinical performance of nursing students. It also revealed that interpersonal relationships significantly influenced the evaluation process. Consequently, nursing students become preoccupied with building relationships with qualified nurses knowing the impact of such relationships on the clinical grade. The findings reveal that students employ various strategies in order to obtain good grades and this illustrates students’ overall preoccupation with “making the grade”. It is argued that the evaluation of the clinical performance of nursing students is a vital component of nursing education and it must be conducted in a manner that enables nurse educators to effectively determine the clinical proficiency of nursing students.