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A phenomenological study of clinical teachers’ experiences with borderline nursing students Boyer, Mary Margaret

Abstract

The challenge of working with borderline students is a reality of the clinical teacher's role which had not been researched. Based on the review of the literature, it was apparent that more knowledge was needed to understand the experience of evaluating borderline nursing students from clinical teachers' perspectives. In order to present a description of how clinical teachers perceived their experiences with these learners, the phenomenological method of qualitative research was used to explore the experiential meaning of evaluating borderline students from the perspectives of eight diploma program-based teachers. The data were collected through the use of two unstructured audio-taped interviews with each informant. The concepts of role, perception, and decision-making provided direction for the trigger questions used in the first interviews. Data collection and analysis were done simultaneously. The themes and concepts which emerged from the data were validated and clarified with the teachers during their second interviews. From data analysis, three overlapping concepts emerged: ambiguity, student's self-awareness, and laborious decisions. It was concluded that clinical teachers' experiences with borderline students involve evaluating individuals with an ambiguous performance within an ambiguous process. The ambiguity of borderline performance amplifies the ambiguity inherent in clinical evaluation and in the nurse educator's dual responsibility to students and to patients. Further, the experience of evaluating borderline students entails the time-consuming process of fostering borderline students' awareness of their performance problems. Students with insight accept their clinical standings and are less likely to appeal their clinical failures. It was concluded that dissonance and a variety of emotions, of which uncertainty is the most predominant, are associated with the decision-making process about borderline performance. Dissonance is reduced by using various forms of rationalization and peer support is essential for dealing with the feelings of uncertainty. Finally, it was concluded that clinical teachers use intuitive strategies during the laborious process of deciding a borderline student's final grade. These strategies include a sense of knowing, a sense of the student's whole performance, and a sense of whether or not the student can be trusted as a future co-worker and/or care-giver. The clinical teachers in this study did not value the use of intuition as a respectable element of evaluative decision-making. The research findings have implications for nurse educators, educational preparation for clinical teaching, and for nursing research specific to clinical evaluation.

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