A case study of Clinical Nursing Facilitator performance judgement

This study investigated the process whereby clinical facilitators (CFs) make judgements about a nursing student's performance during clinical placement. Previous studies have reported that many CFs lack confidence in their ability to judge nursing students’ performance. This lack of confidence is problematic as poor-performing students can progress through the study program, resulting in graduates not ready to function as independent registered nurses. This thesis details an interpretive–constructivist case study that investigated the performance judgement of CFs within an Australian clinical placement environment. A clinical facilitator (CF) is defined for this study as an educator within a health care facility employed to supervise six or more students simultaneously. Semi-structured interviews were conducted in 2018 with 15 CFs who had at least six months of experience facilitating nursing students within the Australian health care context. The research question guiding this study was: How do clinical facilitators construct judgements about a student nurse's performance in clinical placement? Guided by the Braun and Clarke thematic data analysis, the researcher identified six thematic actions that are foundational to CFs' performance judgements, which are described using participants’ own words. The cognitive continuum theory was used to frame the study and interpret findings. The study findings first reveal that the judgement of CFs is inherently reflexive due to the recursive development of new knowledge that occurs through interactions between self and other key players. Second, this judgement is also idiosyncratic, resulting in a wide variation in the accuracy of performance judgements. Third, CFs recognising and responding constructively to their feelings of uncertainty is a vital and valid component of performance judgement that needs to be investigated further. This study has contributed to the body of knowledge about how clinical facilitators make performance judgements, which may assist in the future production of work-ready graduates.