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Gut feeling: A grounded theory study to identify clinical educators' reasoning processes in putting students on a learning contract

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  • Mohamed Toufic El Hussein
  • Olive Fast

Abstract

Aim To develop a substantive theoretical explanation that makes sense of the decision‐making process that clinical instructors use to place students on a learning contract. Background Clinical instructors are challenged with the task of objectively evaluating students using subjective tools such as anecdotal notes, diaries, unstructured observations and verbal feedback from other nurses. Clinical instructors' assessment decisions have a considerable impact on a variety of key stakeholders, not least of all students. Design Grounded theory method and its heuristic tools including the logic of constant comparison, continuous memoing and theoretical sampling to serve conceptualisation were used in the process of data collection and analysis. Methods Seventeen individual semi‐structured interviews with clinical instructors in one university in Western Canada were conducted between May 2016–May 2017. Data were analysed using open, axial and selective coding consistent with grounded theory methodology. The study was checked for the Standards for Reporting Qualitative Research (SRQR) criteria (See Appendix S1). Findings Three subcategories, “brewing trouble,” “unpacking thinking” and “benchmarking” led to the study's substantive theoretical explanation. “Gut feeling” demonstrates how clinical instructors reason in their decision‐making process to place a student on a learning contract. Conclusion Placing a student on a learning contract is impacted by personal, professional and institutional variables that together shift the process of evaluation towards subjectivity, thus influencing students' competency. A system‐level approach, focusing on positive change through implementing innovative assessment strategies, such as using a smart phone application, is needed to provide some degree of consistency and objectivity. Relevance to clinical practice Making visible the objective assessments currently being done by clinical instructors has the potential to change organisational standards, which in turn impact patient and clinical outcomes.

Suggested Citation

  • Mohamed Toufic El Hussein & Olive Fast, 2020. "Gut feeling: A grounded theory study to identify clinical educators' reasoning processes in putting students on a learning contract," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(1-2), pages 75-84, January.
  • Handle: RePEc:wly:jocnur:v:29:y:2020:i:1-2:p:75-84
    DOI: 10.1111/jocn.15058
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    References listed on IDEAS

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    1. Karen Missen & Lisa McKenna & Alison Beauchamp, 2016. "Registered nurses’ perceptions of new nursing graduates’ clinical competence: A systematic integrative review," Nursing & Health Sciences, John Wiley & Sons, vol. 18(2), pages 143-153, June.
    2. Elizabeth Halcomb & Moira Stephens & Julianne Bryce & Elizabeth Foley & Christine Ashley, 2016. "Nursing competency standards in primary health care: an integrative review," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(9-10), pages 1193-1205, May.
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