A theory of fair treatment of health and social care students during fitness to practise proceedings: a constructivist grounded theory.
Aim: The aim of the study was to explore how higher education institutions (HEIs) in England operated their fitness to practise processes. Methodology: A qualitative approach within the constructivist paradigm underpinned the research that followed Charmaz grounded theory methodology. Methods: In phase one, an internet search of HEIs in England was undertaken to source the student fitness to practise procedures and process documents. Fifty-four HEIs were identified of which fourteen were selected for analysis. Coding was undertaken using the line-by-line approach advocated by Charmaz. Themes arising from the document analysis informed phase two; the semi-structured interviews. Staff within the fourteen universities whose documents were reviewed, were approached to take part in the second phase of the research. Fourteen individuals from four universities from the North, South and West of England agreed to participate in the semi-structured interviews. One participant withdrew prior to their interview. Thirteen participants were interviewed for the study. The staff were all academics and were from a variety of professional health and social care backgrounds. All participants had prior involvement with various aspects of the student fitness to practise processes. The interviews were digitally recorded and were transcribed verbatim. The transcripts were uploaded into NVivo and analysis of the transcripts was performed using line by line coding. An iterative approach towards the analysis was adopted until saturation was achieved. The study for this thesis was conducted at HEIs offering programmes validated by the Nursing and Midwifery Council, the Health and Care Professions Council and Social Work England. Findings: Fairness emerged as a core category and was adopted as the lens through which the student fitness to practise process was considered. A substantive process theory of “fairness and student fitness to practise processes” was created. Adding to the literature on fairness and fair procedures, the conceptual metaphor of the fairness yardstick was devised, which harmonised three components: policy, student voice and analysis. Three procedural stages of the fitness to practise process were identified: investigating, deliberating and resolving. The fairness yardstick was embedded throughout the process providing an ethical sense of positioning. Conclusion: A variety of approaches towards student fitness to practise processes were found to exist within HEIs in England. Fair treatment of students who were subject to fitness to practise processes was the underlying ethos of staff involved, however inconsistencies and contradictions were apparent. Fairness, in relation to student fitness to practise processes, has not been the focus of research previously. The development of a substantive, constructivist process theory of fairness and student fitness to practise processes, offers a unique and new addition to the minimal literature in this field.
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