La neutralización de un enemigo por medio del estamento judicial

This next theme relates to passing and/or failing students. Children’s nurse SOMs shared their experiences of these decisions and the effect it had on them. The experiences shared by the SOMs suggests that the final assessment decision which determines if a student can enter the nursing register is the most difficult decision to make. The findings give insight into the SOM decision-making processes that have received limited attention in the existing mentor research literature. Steps to be taken during SOM assessment

135 processes and strategies necessary to support those processes have been identified as key factors that are required in order to strengthen decision-making.

The children’s nurse SOMs shared they undertook an appraisal of the student’s professional appearance, attitude, willingness and reported written feedback from

previous mentors, along with their own findings from the initial meeting with the student to make their initial judgement and decisions. In addition, they employed their children’s nursing expectations and observation of the student nurse performance as subsequent measures to support their assessment and to monitor the student’s progress. Children’s nurse SOMs made decisions based upon these initial judgement and through their observations of the student. A sense of ‘just knowing’ a student was meeting the right level was frequently articulated by SOMs as a way of confirming, or not, the student was ready to enter the professional register. This sometimes was a result of subtle indicators which may have alerted SOMs to a potential problem and often participants referred to early feelings that some things did not feel quite right, despite at times not being sure what this was when first meeting the student. The feelings usually came about because the student did not behave or preform as expected. These intuitive feelings are aligned with ‘gut feelings’ and ‘instincts’ and importance is often placed on these in nursing. The use of intuitive knowledge has been used and discussed often by nurses in the assessment of patients (Carper, 1978; Buckingham & Adams, 2000; Hams, 2000; Herbig, Bussing & Ewert, 2001; Carr, 2005). In summary these authors suggest that the use of intuition is based on nursing experience, and as SOMs are experienced it could be that they are referring to their own expected norms and standards of a registered children’s nurse. However, children’s nurse SOM do not rely on intuition alone. Children’s nurse SOMs were able to identify specific indicators for example: meeting learning outcomes set in the student’s practice assessment documentation, communication with children and families and meeting the range of SOM expectations as discussed previously (Theme 2 – expectations, p.132).

It was evident that children’s nurse SOMs used expert decision making in the assessment of student nurses (Benner, 1987, 2001), and that intuitive knowledge may be context bound to a particular field of experience, in this instance children’s nursing. Furthermore, the findings suggest children’s nurse SOMs used other sources of knowledge to make their assessments of students. In addition, specific nursing knowledge gained through

136 SOM preparation workshops, previous pre- registration nurse education and expected norms of professional practice was frequently relied upon tacit sources of knowledge. This was evident in the SOMs ability to articulate their expectations in terms of knowledge, skills and performance (SOM expectations) that a student was expected to exhibit when asked to consider how they determine their SOM assessment decisions. In support of Benner (1987), the children’s nurse SOMs participants themselves

exhibited anticipatory ability, which Benner reports is an expression of nursing expertise associated with expert practice and intuitive knowing. This occurred prior to and

following the children’s nurse SOMs opportunity to develop a mentee-mentor

relationship during the time of the sign off practice learning experience. Whilst nurses often use intuition in relation to the nurse-patient relationship, the findings from this research demonstrated that children’s nurse SOMs adapted this to influence their

assessment of students in practice learning settings. Whilst there is an acknowledgement that the NMC guidelines in relation to sign-off assessment responsibilities (NMC, 2008, 2010b) and the student nurse practice assessment documentation are also used, the findings suggest that children’s nurse SOMs possess tacit knowledge which was deeply embedded, instinctive and intuitive.

Children’s nurse SOMs share the belief that this should not be a decision made by a SOM alone but a joint decision making process between the SOM and a representative from the University (possibly the student’s personal teacher). This joint approach would allow for opportunities for shared assessment and responsibility and also provide an opportunity to fully discuss and consider the student’s journey and an opportunity to discuss concerns and/or positive feedback. A shared approach to assessment was previously recommended by Duffy (2003), yet whilst participants in this current study acknowledged formal arrangements for reporting concerns, many thought this aspect could be developed further. This approach would also strengthen assessment in practice and could be viewed as a form of moderation, something that is currently routinely used for theory assessment but not routinely used for the assessment of practice learning (Smith, 2012). Developing communication in order to share information about students were also identified as a way which would enable children’s nurse SOM feel more supported when making SOM assessment decisions in the student’s final practice learning experience.

137 In summary, the findings give insight into decision-making processes that have received limited attention in the existing mentor research literature. Steps to be taken during SOM assessment processes and strategies to necessary to support those processes have been identified as key factors that are required in order to strengthen decision-making. These matters require further attention from the NMC, educational providers and employers, who need to further consider this aspect of the SOM role. Lack of recognition for when SOMs are passing and/or failing students has significant implications given the impact this aspect of decision making can have on SOMs.