The impact of clinical context on the practice assessor’s perception of the student nurse’s performance in placement: an exploratory narrative inquiry

The nature of nursing and the preparation and assessment of nursing students in the UK has changed radically in the last 40 years. Previous work has indicated that context impacts the assessment outcomes of students but has predominantly focussed on the learner perspective and made recommendations from this lens. This narrative study confirms the findings of previous authors, however it further develops current understanding by providing new insights into the perspective of the practice assessor, and the context in which they work and carry out their assessments of students. Influenced by the constructivist paradigm, this study adopted an exploratory narrative inquiry approach to explore the context of clinical practice and how this impacts the practice assessor’s judgement of the student nurse. Six practice assessors were interviewed on at least two occasions. Using a semi-structured method, the interviews were guided by an established four stage method of narrative interview. Conventional approaches for data analysis were rejected in favour of the process of emplotment and an interpretive approach was utilised. The narratives were explored using Bourdieu’s concepts of habitus, capital and field, the inquiry considered the clinical nursing history and clinical spaces of practice assessors, and how the habitus informs the judgements they make of student nurses’ performance in, and their ability to assimilate to those clinical spaces. It provides an insight into the structured systems of the practice assessors’ nursing field, and how they judge if students are successful in accumulating the capital necessary to function in those fields. The study reveals how the clinical context of the placement, and the experience of the assessor, consciously or unconsciously, impacts their judgement of the student. Despite proficiencies set by the NMC, there is evidence of tacit assessment criteria that are based on whether the proficiency ‘fitted’ the practice assessor’s concept of their clinical area, and the expectations of students at different levels of study. Additionally, students who possess certain embodied dispositions, pertinent to the specific clinical context, assimilate more easily to the environment and are successful as a consequence. Furthermore, the socio-political context of health care, and the impact that this may have upon the attitudes held by practice assessors and their team, are likely to influence the judgements made of the student. This study adds to the body of knowledge and raises particular questions for those engaged in the assessment of students and for those in higher education, and could ultimately lead to wider questions for the professional body that regulates nursing, the Nursing and Midwifery Council.

Grantor dc:publisher

Oxford Brookes University

Year dc:date

2023

Author dc:creator

• Maddison, Charlotte

Contributors dc:contributor

• Dalrymple, Roger
• Alexander, Patrick

Statement dc:rights

• All rights reserved

Language dc:language

en

DOI dc:identifier

https://doi.org/10.24384/4h84-8s18

OAI identifier oai:identifier

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